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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
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European Journal of Physical and Rehabilitation Medicine 2017 October;53(5):643-50

DOI: 10.23736/S1973-9087.16.04037-5

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Pediatric selective mutism therapy: a randomized controlled trial

Maria ESPOSITO 1, Francesca GIMIGLIANO 2 , Maria R. BARILLARI 2, Francesco PRECENZANO 1, Maria RUBERTO 3, Joseph SEPE 4, Umberto BARILLARI 2, Raffaele GIMIGLIANO 3, Roberto MILITERNI 1, Giovanni MESSINA 5, Marco CAROTENUTO 1

1 Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy; 2 Division of Phoniatrics and Audiology, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy; 3 Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy; 4 University of Maryland, University College, Maryland, MD, USA; 5 Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy


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BACKGROUND: Selective mutism (SM) is a rare disease in children coded by DSM-5 as an anxiety disorder. Despite the disabling nature of the disease, there is still no specific treatment.
AIM: The aims of this study were to verify the efficacy of six-month standard psychomotor treatment and the positive changes in lifestyle, in a population of children affected by SM.
DESIGN: Randomized controlled trial registered in the European Clinical Trials Registry (EuDract 2015-001161-36).
SETTING: University third level Centre (Child and Adolescent Neuropsychiatry Clinic).
POPULATION: Study population was composed by 67 children in group A (psychomotricity treatment) (35 M, mean age 7.84±1.15) and 71 children in group B (behavioral and educational counseling) (37 M, mean age 7.75±1.36).
METHODS: Psychomotor treatment was administered by trained child therapists in residential settings three times per week. Each child was treated for the whole period by the same therapist and all the therapists shared the same protocol. The standard psychomotor session length is of 45 minutes. At T0 and after 6 months (T1) of treatments, patients underwent a behavioral and SM severity assessment. To verify the effects of the psychomotor management, the Child Behavior Checklist questionnaire (CBCL) and Selective Mutism Questionnaire (SMQ) were administered to the parents.
RESULTS: After 6 months of psychomotor treatment SM children showed a significant reduction among CBCL scores such as in social relations, anxious/depressed, social problems and total problems (P<0.001), Withdrawn (P=0.007) and Internalizing problems (P=0.020). Regarding SM severity according to SMQ assessment, children of group A showed a reduction of SM symptoms in all situations (school, P=0.003; family, P=0.018; and social, P=0.030 situations) and in SMQ total score (P<0.001).
CONCLUSIONS: Our preliminary results suggest the positive effect of the psychomotor treatment in rehabilitative program for children affected by selective mutism, even if further studies are needed.
CLINICAL REHABILITATION IMPACT: The present study identifies in psychomotricity a safe and efficacy therapy for pediatric selective mutism.


KEY WORDS: Psychomotor disorders - Pediatrics - Mutism - Rehabilitation

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Publication History

Issue published online: October 31, 2017
Article first published online: November 16, 2016
Manuscript accepted: November 8, 2016
Manuscript revised: September 1, 2016
Manuscript received: August 8, 2015

Per citare questo articolo

Esposito M, Gimigliano F, Barillari MR, Precenzano F, Ruberto M, Sepe J, et al. Pediatric selective mutism therapy: a randomized controlled trial. Eur J Phys Rehabil Med 2017;53:643-50. DOI: 10.23736/S1973-9087.16.04037-5

Corresponding author e-mail

francescagimigliano@gmail.com