TitleThe generalization of verbal speech across multiple settings for children with selective mutism
NameOrtega, Melissa L. (author), Oades-Sese, Geraldine V. (chair), LaRue, Robert H. (internal member), Kurtz, Steven M.S. (outside member), Rutgers University, Graduate School of Applied and Professional Psychology,
DescriptionSelective Mutism (SM) is a childhood psychological disorder characterized by a failure to speak in certain contexts for at least one month, despite speaking in other social contexts. Children diagnosed with SM usually speak without difficulty to family, but experience difficulties during social situations where they are expected to speak outside of the home (e.g., school, community). The purpose of this pilot study was to examine the effects of individualized treatment on the generalization of speech for children with selective mutism. Participants included four children with selective mutism receiving treatment guided by the Totally Anxiety-Free Communication treatment manual (T.A.L.K.; Gallagher, 2002), a child-focused, exposure-based, behavioral therapy approach. Initial treatment sessions were conducted in a university-based clinic. After each child demonstrated consistent speech output,
treatment transported to the child’s school. Participants received between 18 to 22 treatment sessions, depending on when treatment was started during the academic school year. A multiple-baseline design was used to track spontaneous and prompted speech at school across three conditions. These three conditions were as follows: (a) child with teacher alone, (b) child with teacher and peers (≤ 3), and (c) child during
lunch/snack. Changes in speech occurrence were assessed using direct observations and behavioral rating scales. Each child was observed weekly at the child’s school by trained observers during the three conditions. Teachers completed the School Speech
Questionnaire (SSQ; Bergman, 2002) and parents completed the Selective Mutism Questionnaire (SMQ; Bergman, 2001) weekly. Results indicated all participants demonstrated increased speech at school. Two participants achieved verbal speech generalization. Findings from the observational data indicated an increase in spontaneous and prompted speech at school compared to baseline. Teachers and
parents also reported an increase in the frequency of speech at school, home, and public settings. The results of this study support the use of an intensive individualized treatment, such as the T.A.L.K manual, across multiple settings to increase speech for
children with SM. Clinical challenges are discussed, including limitations of extended baseline designs, time constraints posed by conducting treatment during the academic year, and the need to train educators in techniques and skills for promoting speech at
school for children with SM.
NoteIncludes bibliographical references
Noteby Melissa L. Ortega
CollectionGraduate School of Applied and Professional Psychology Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.