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Meta-analysis of behavioral treatments for selective mutism: findings from selective mutism questionnaire (SMQ) and school speech questionnaire (SSQ)
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Meta-analysis of behavioral treatments for selective mutism: findings from selective mutism questionnaire (SMQ) and school speech questionnaire (SSQ)
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Journal Article
Meta-analysis of behavioral treatments for selective mutism: findings from selective mutism questionnaire (SMQ) and school speech questionnaire (SSQ)
2025
Overview
Background
This meta-analysis aims to assess the efficacy of behavioral therapy for selective mutism (SM) using the Selective Mutism Questionnaire (SMQ) and School Speech Questionnaire (SSQ).
Methods
We analyzed 12 articles involving 472 participants and comprising three randomized controlled trials and nine before-after or multiple baseline study designs.
Results
Our findings indicate a significant improvement in symptoms of SM, as indicated by the SMQ total, the SMQ subsections scores (school, home, and public), and the SSQ. The mean SMQ total score improved by 0.51 [95% confidence interval of 0.32–0.70] with a large effect size (Hedges’ adjusted g = 1.00 [0.62–1.39]). This effect did not differ significantly based on the study design. Based on the treatment strategy, web-based treatment demonstrated less improvement (0.12 [− 0.11–0.36]) compared with face-to-face treatment (0.59 [0.39–0.80]).
Conclusions
This meta-analysis revealed that SM treatment significantly improved their speaking behavior measured by the SMQ and SSQ, though potential subgroups that influence the treatment efficacy remain. SMQ has also shown validity and responsiveness as an outcome tool for behavioral therapy for SM. Further clinical practices with randomized controlled trials are recommended to clarify the potential differences of treatment or target populations.
Key points
Estimating the effect size of selective mutism (SM) treatment is essential to provide evidence-based intervention for children with SM.
The Selective Mutism Questionnaire (SMQ) and School Speech Questionnaire (SSQ) are commonly used to assess children with SM.
We conducted a meta-analysis to assess the efficacy of behavioral SM treatment using the SMQ and SSQ, analyzing 12 articles with 472 participants.
SM treatment significantly improved the weighted mean difference scores on both the SMQ and SSQ, with face-to-face treatment being more effective than web-based treatment.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
