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"Mutism."
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Fall back down when I die : a novel
\"An orphaned Montana ranch hand takes in the mute seven-year-old son of an incarcerated cousin and learns to love him as old grievances involving land and family come back to haunt them.\" -- (Source of summary not specified)
Book
Finding Your Voice
Selective mutism is a childhood anxiety disorder characterised by a child's inability to speak and communicate effectively in select social settings, such as school. These children are able to speak and communicate in settings where they are comfortable, secure, and relaxed. Most children with selective mutism also have social phobia or social anxiety: they fear social interactions where there is an expectation to speak and communicate. Finding Your Voice highlights the different challenges a child with selective mutism might face, and provides effective, research-based behavioural intervention plans. Tips for engaging and motivating children are provided, focusing on a gradual, step-wise approach to increased speech, as well as fun and engaging activities that can be used at each step of treatment. Authurs: Dr Daniel Fung, Dr Claire Kwan, Wong Zi Jun, Dr Kirthana Vasudevan.
eBook
Treatment for children with selective mutism : an integrative behavioral approach
\"Selective Mutism (SM) is an impairing behavioral condition in which a child fails to speak in certain social situations despite speaking regularly and normally in other situations. SM presents a significant mental and public health problem due to impact on the social, emotional, and academic functioning of young children at a critical point in their development. SM is closely related to childhood social phobia, but it cannot be treated in the same way because of the young age of the children affected, their lack of speech in the treatment setting, and the need for significant school involvement in treatment. Treatment for Children with Selective Mutism outlines the sequence and essential elements to guide clinicians through a comprehensive, integrated program for young children who display symptoms of SM. This approach utilizes behavioral interventions targeting gradual increases in speaking across settings in which the child initially has difficulty. The integrated nature of the therapy refers to the goal of incorporating input from the clinician with that from the parents and teacher, as well as others impacted by the lack of speech. Exposure exercises are based on behavioral techniques such as stimulus fading, shaping, and systematic desensitization that also allow for a less intense or gradual exposure to the speaking situation. These techniques are combined and used flexibly with a behavioral reward system for participation in treatment. The approach was developed by Dr. R. Lindsey Bergman as part of the UCLA Childhood OCD, Anxiety, and Tic Disorders Program. The treatment protocol consists of 20 sessions, 60 minutes each, delivered over the course of 24 weeks. Treatment for Children with Selective Mutism is an invaluable guide for mental health professionals who deliver CBT-based treatment to children and want to help those with SM\"-- Provided by publisher.
Book
Anxiety in Children with Selective Mutism: A Meta-analysis
This study evaluates the current conceptualization of selective mutism (SM) as an anxiety disorder in the DSM-5 using a meta-analytic approach. In the absence of any systematic assessment of anxiety in the field of SM, we pooled prevalence data of comorbid anxiety disorders in a random-effects meta-analysis. On the basis of 22 eligible studies (N = 837), we found that 80% of the children with SM were diagnosed with an additional anxiety disorder, notably social phobia (69%). However, considerable heterogeneity was present, which remained unexplained by a priori specified moderators. The finding that SM is often diagnosed in combination with anxiety disorders, indicates that these disorders are not discrete, separable categories. Moreover, this finding does not help to elucidate the relation between SM and anxiety as an etiological mechanism or symptomatic feature. Broadening our research strategies regarding the assessment of anxiety is paramount to clarify the role of anxiety in SM, and allow for proper classification.
Journal Article
Children Who are Anxious in Silence: A Review on Selective Mutism, the New Anxiety Disorder in DSM-5
Selective mutism (SM) is a relatively rare childhood disorder characterized by a consistent failure to speak in specific settings (e.g., school, social situations) despite speaking normally in other settings (e.g., at home). The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists SM among the anxiety disorders. This makes sense as the current review of the literature confirms that anxiety is a prominent symptom in many children suffering from this condition. Further, research on the etiology and treatment of SM also corroborates the conceptualization of SM as an anxiety disorder. At the same time, critical points can be raised regarding the classification of SM as an anxiety disorder. We explore a number of such issues in this review. Recommendations for dealing with this diagnostic conundrum are made for psychologists, psychiatrists, and other mental health workers who face children with SM in clinical practice, and directions for future research are highlighted.
Journal Article
Lotería : a novel
Using a deck of Lotería cards as her muse, eleven-year-old Luz Castillo, a ward of the state who has retreated into silence, finds each shuffle sparking a random memory that, pieced together, brings into focus the events that led to her present situation.
Book
Cerebellar mutism syndrome in children with brain tumours of the posterior fossa
Background
Central nervous system tumours constitute 25% of all childhood cancers; more than half are located in the posterior fossa and surgery is usually part of therapy. One of the most disabling late effects of posterior fossa tumour surgery is the cerebellar mutism syndrome (CMS) which has been reported in up to 39% of the patients but the exact incidence is uncertain since milder cases may be unrecognized. Recovery is usually incomplete. Reported risk factors are tumour type, midline location and brainstem involvement, but the exact aetiology, surgical and other risk factors, the clinical course and strategies for prevention and treatment are yet to be determined.
Methods
This observational, prospective, multicentre study will include 500 children with posterior fossa tumours. It opened late 2014 with participation from 20 Nordic and Baltic centres. From 2016, five British centres and four Dutch centres will join with a total annual accrual of 130 patients. Three other major European centres are invited to join from 2016/17. Follow-up will run for 12 months after inclusion of the last patient. All patients are treated according to local practice. Clinical data are collected through standardized online registration at pre-determined time points pre- and postoperatively. Neurological status and speech functions are examined pre-operatively and postoperatively at 1–4 weeks, 2 and 12 months. Pre- and postoperative speech samples are recorded and analysed. Imaging will be reviewed centrally. Pathology is classified according to the 2007 WHO system. Germline DNA will be collected from all patients for associations between CMS characteristics and host genome variants including pathway profiles.
Discussion
Through prospective and detailed collection of information on 1) differences in incidence and clinical course of CMS for different patient and tumour characteristics, 2) standardized surgical data and their association with CMS, 3) diversities and results of other therapeutic interventions, and 4) the role of host genome variants, we aim to achieve a better understanding of risk factors for and the clinical course of CMS - with the ultimate goal of defining strategies for prevention and treatment of this severely disabling condition.
Trial registration
Clinicaltrials.gov
:
NCT02300766
, date of registration: November 21, 2014.
Journal Article
Thornhill
\"Parallel plotlines set in different times, one told in text and one in art, inform each other as a young girl unravels the mystery of a ghost next door\"-- Provided by publisher.
Book
Development and application of a diagnostic and severity scale to grade post-operative pediatric cerebellar mutism syndrome
The post-operative pediatric cerebellar mutism syndrome (CMS) affects about one-third of children and adolescents following surgical removal of a posterior fossa tumor (PFT). According to the Posterior Fossa Society consensus working definition, CMS is characterized by delayed-onset mutism/reduced speech and emotional lability after cerebellar or 4th ventricle tumor surgery in children, and is frequently accompanied by additional features such as hypotonia and oropharyngeal dysfunction/dysphagia. The main objective of this work was to develop a diagnostic scale to grade CMS duration and severity. Thirty consecutively referred subjects, aged 1–17 years (median 8 years, IQR 3–10), were evaluated with the proposed Post-Operative Pediatric CMS Survey after surgical resection of a PFT and, in case of CMS, for 30 days after the onset (
T
0
) or until symptom remission. At day 30 (
T
1
), CMS was classified into mild, moderate, or severe according to the proposed scale. CMS occurred in 13 patients (43%, 95% C.I.: 25.5–62.6%), with mild severity in 4 cases (31%), moderate in 4 (31%), and severe in 5 (38%). At
T
1
, longer symptom persistence was associated with greater severity (
p
= 0.01). Greater severity at
T
0
predicted greater severity at
T
1
(
p
= 0.0001). Children with a midline tumor location and those aged under 5 years at diagnosis were at higher risk of CMS (
p
= 0.025 and
p
= 0.008, respectively). In conclusion, the proposed scale is a simple and applicable tool for estimating the severity of CMS at its onset, monitoring its course over time, and providing an early prognostic stratification to guide treatment decisions.
What is Known:
• Post-operative pediatric Cerebellar Mutism Syndrome (CMS) is a complex phenomenon with a wide
spectrum of symptoms that may manifest in children undergoing the resection of a posterior fossa tumor
(PFT) and that can result into long-term impairment.
What is New:
• This study developed and pilot-tested an easily applicable diagnostic and severity scale to grade the
duration and the severity of symptoms of the CMS.
• The proposed scale was found to be a sensitive instrument to identify even mild CMS presentations.
• By scoring not only the duration but also the severity of symptoms the scale allows a more accurate
prognostic stratification for an optimal planning of clinical and rehabilitative interventions.
Journal Article