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A comparative study on the correlation between (i) mathematics quotient and nonverbal intelligence quotient, and (ii) mathematics quotient and draw-a-person intelligence quotient in primary 3 children with selective mutism.
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The authors extended and, in some respects, updated a clinical assessment study that first appeared in
American Psychologist some 18 yrs ago. Using survey responses provided by 412 assessment-active clinical psychologists, it was found that (1) an identifiable, highly select core of assessment procedures is most often used by most clinical psychologists across most work settings; (2) psychological assessment as it is practiced now appears in many respects to be very similar to psychological assessment as it was practiced by psychologists 30 or more years ago; and (3) although much ado has been made about the decline of and academics' negative opinions about projective techniques, from the standpoint of practice, all that truly appears to be much ado about nothing. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Examined the phenomenological characteristics of selective mutism (SM) in the following areas: (1) mute and variant talking patterns occurring prior to the identification of SM and/or that occur as conditions within SM, (2) events that precipitate SM, (3) biological vulnerabilities of SM in terms of anxiety and temperament, (4) characteristics associated with SM, (5) other problems experienced with SM, and (6) school and social competencies. Surveys were conducted with or for 153 people (aged 2–72 yrs) who had experience with SM. Results support the existence of variant talking behaviors (talking with less frequency, volume, and spontaneity than usual), in addition to mutism, prior to the identification of SM and as part of the SM syndrome. Setting (home, school, community) affected the rate of occurrence for mute and variant talking behaviors. Evidence supported a link between SM and social anxiety or phobia. Support was found for the idea that persons with SM have have characteristics similar to behaviorally inhibited or slow-to-warm children, suggesting a potential link between temperament and SM. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Compared psychological test usage in 5 settings surveyed in 1982 by the 1st 3 authors (see record
1985-05592-001) to establish a more useful basis for subsequent comparisons than that which is available in their composite. The 1982 questionnaire containing the 30 most frequently used tests in the 1969 survey (the 1st author et al, 1971) was sent to groups of psychologists in 5 settings: psychiatric hospitals, community mental health centers and community clinics, centers for the developmentally disabled and mentally retarded, counseling centers, and Veteran's Administration medical centers. Data on the frequency of use of each of the 30 psychological tests for the 5-sample composite and for each of the 5 samples are presented. (7 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Draw A Person: Screening Procedure for Emotional Disturbance (DAP: SPED) scores were compared for 54 normal students and 54 students with conduct and oppositional defiant disorders who attended a psychiatric day treatment facility. Both samples were age 7-17 years. The samples were also matched by sex, race (White/Non-White), and geographic region. The DAP: SPED mean T score earned by the 54 subjects in the clinical sample (M = 56.63, SD = 10.27) was significantly higher (t = 4.05, p <.001) than that of the 54 normal subjects (M = 49.37, SD = 8.68), indicating that the clinical group produced more signs associated with emotional disturbance than did the normal group. Further analysis indicated that use of the DAP: SPED increased diagnostic accuracy by 25.8%. These results suggest that this new approach to scoring the man, woman, and self drawings may be more useful than previous human figure drawing techniques.
The age-stage relationship between young children's human figure drawings and Piaget's levels of cognitive development was investigated using 45 young children ages 4 through 6 years Analyses indicated a distinct monotonic trend between cognitive stage and drawing level; as cognitive ability increased so did drawing level. This suggests that children's human figure drawings can be a simple tool for the quick assessment of cognitive levels in young children.
An extended series of 100 children with elective mutism (EM) was clinically analyzed.
The total sample included two subgroups of clinically referred children at different locations and a subgroup of nonreferred children with EM. The study was based on comprehensive item sheets and, in the nonreferred sample only, the Child Behavior Checklist.
EM is a rare disorder in the referred child psychiatric samples. It typically starts at preschool age, is more common in girls, and is seen in all social strata. A background of migration and early developmental risk factors is also quite common. Premorbid speech and language disorders play a role in one third of the clientele, and three quarters of children with EM had behavioral abnormalities during infancy and preschool age. School and unfamiliar people create the social context in which children with EM most frequently do not speak. Shyness and internalizing behavior problems are the most common personality features in EM, and comorbid diagnoses are quite frequent.
This large series of affected children has identified the most typical features of EM and thereby extends the limited knowledge of this rare disorder of childhood.
Sixty Croatian children who had experienced directly the recent war in Croatia drew a man, followed on a separate page by either (i) a Croatian soldier, (ii) an enemy soldier or (ii) a second drawing of a man. Half of the sample had lost their father due to the war. There were no significant effects of Trauma group (with/ without father) or Topic of drawing on the drawings' size or their placement relative to the child's self-portrait drawing. The paper discusses the many mechanisms of influence of emotion on drawing but argues that these are idiosyncratic and unpredictable. The use of drawings in clinical assessments of adults and children has had a long tradition. Indeed, diagnostic drawing tests still rank in the top ten of all tests used by clinicians (Lubin, Larsen, Matarazzo & Sever, 1985; Watkins, Campbell, Nieberding & Hallmark, 1995). Furthermore, there are numerous case studies using drawings as a therapeutic tool (e.g., see Dalley, 1984; Winner, 1982). Both forms of practice indicate that it is commonly considered by those working with disturbed clients that drawings can provide a useful insight into the client's problems. Although there is little dispute that even line drawings can be expressive using aesthetic criteria (Arnheim, 1949; Gardner, 1974; Werner & Kaplan, 1963), the evidence for drawings conveying an emotional maladjustment in the drawer is far less convincing. Theoretical links between drawings and the drawer's maladjustment can be broadly categorized under three traditions (see Cox, 1992; Thomas & Silk, 1990; Thomas & Jolley, in press). First, Machover (1949) claimed that drawings can be used as a personality assessment. She devised the "Draw-a-Person" test in which the client is asked to draw a person and then make a second drawing of a person of the opposite gender to that depicted in the first drawing. Interpretations of the drawings are then made by the clinician using psychoanalytic theory. In extensive reviews of the literature, Swenson (1968) and Roback (1968) argue that the Draw-a-Person Test has weak reliability and validity, and that particular aspects of a drawing cannot be related to particular types of maladjusted personality (see also Falk, 1981). This is likely to be due to the tradition's reliance on the body-image assumption. That is, a drawing of an unidentified person conveys the artist's self-concept and possibly their physical image.
A general formula (α) of which a special case is the Kuder-Richardson coefficient of equivalence is shown to be the mean of
all split-half coefficients resulting from different splittings of a test. α is therefore an estimate of the correlation between
two random samples of items from a universe of items like those in the test. α is found to be an appropriate index of equivalence
and, except for very short tests, of the first-factor concentration in the test. Tests divisible into distinct subtests should
be so divided before using the formula. The index
[`(r)]ij\bar r_{ij}
, derived from α, is shown to be an index of inter-item homogeneity. Comparison is made to the Guttman and Loevinger approaches.
Parallel split coefficients are shown to be unnecessary for tests of common types. In designing tests, maximum interpretability
of scores is obtained by increasing the first-factor concentration in any separately-scored subtest and avoiding substantial
group-factor clusters within a subtest. Scalability is not a requisite.
Elective (or selective) mutism is a rare psychiatric disorder. Diagnostic criteria in both ICD-101 and DSM-IV2 include: ( a ) consistent failure to speak in specific social situations in which there is an expectation for speaking (for example, at school) despite speaking in other situations (for example, at home); ( b ) the disturbance interferes with educational or occupational achievement or with social communication; ( c ) it is not better accounted for by a communication disorder or by a lack of knowledge of the spoken language required in the social situation; ( d ) it has a duration of at least 1 month.3
It typically starts at preschool age, is more common in girls, and is seen in all social strata with shyness, withdrawal, sensitivity or resistance, and internalising behaviour problems as the most common personality features.
We followed up a 7.5 year old girl who was the third child from non-consanguineous parents. She was born normally at 37 weeks of an uneventful pregnancy, with a birth weight of 3,5 kg, length 47 cm, and head circumference 34.5 cm. The American pediatric gross assessment record was 9 at 5 minutes. Family history was non-contributory. There was neither family history of psychiatric illness nor of language abnormalities.
Developmental milestones were normal; she acquired head control at the 3rd month of life, sat at 7 months, and walked at 13 months. On the other hand, she …
Typescript. Thesis (M.A.)--Maryville University of Saint Louis, 1998. "Submitted in partial fulfillment of the requirements for the Master of Arts in Educational Processes, May, 1998." Includes bibliographical references (leaves 41-42).
To assess whether the Human Figure Drawing Test provides an assessment of nonverbal cognitive maturity, correlations for 31 youngsters who ranged in age from 6-0 to 10-10 on the Human Figure Drawing Test and the Verbal, Performance, and Full Scale IQs of the Wechsler Intelligence Scale for Children--Revised (WISC--R) were examined. Significant correlations were observed for each of the scales, but the value of .69 for drawings and WISC--R Performance IQs was significant, suggesting the assessment that these tests are largely nonverbal. Implications for the role of language were posited.
The aggregate score technique is a new method to assess problem-solving in an actual encounter with a simulated patient. The technique focuses on diagnosis, investigations and management, and results in the derivation of a score for each area based on the comparison of items listed by a student to those of a criterion group. The paper describes a series of studies which were designed to establish the reliability and concurrent validity of the method.
Twenty -four elective mute children were studied–this proved to be a rare condition, affecting slightly more girls than boys. They were compared with 84 speech-retarded controles and 102 normal control children. The main findings in the case of the elective mute children were as follows.
1. Evidence of immaturity of development, particularly of speech, and an excess pf speech abnormalities.
2. A higher rate of behaviour problems, and high levels of enuresis and soiling.
3. In the majority of cases, an insidious development of excessive shyness from the earliest years of life.
4. Performance LQ. covering most ranges of ability, but with a significant excess in the lower ranges.
5. A high rate of Psychiatric disturbance in the families of elective mute children.
6. And, finally, on follow-up, elective mutism proved to be a rather intractable condition.
In this study of 68 children displaying elective mutism, four types of mutism are distinguished: (a) symbiotic mutism, characterized by a symbiotic relationship with a caretaker and a submissive but manipulative relationship with others; (b) speech phobic mutism, characterized by fear of hearing one's own voice and use of ritualistic behaviors; (c) reactive mutism, characterized by withdrawal and depression which apparently resulted from trauma; and (d) passive-aggressive mutism, characterized by hostile use of silence as a weapon. The prevalence of physical and sexual child abuse in all four groups was high. The classification of elective mutism into subgroups is clinically relevant for a better understanding of the etiology and for devising appropriate intervention.
To ascertain characteristics of children with selective mutism.
Subjects with selective mutism were evaluated by means of parent and teacher rating scales and structured diagnostic interviews.
Thirty children were evaluated. Mutism severity varied markedly in different environmental settings. Ninety-seven percent of the subjects were diagnosed with social phobia or avoidant disorder of childhood or adolescence or both and 30% with simple phobia. No other psychiatric disorders were common. Parent and teacher rating scales showed high levels of anxiety symptoms, especially social anxiety, and low levels of all other psychiatric symptoms. Anxiety and social anxiety severity correlated with mutism severity. First-degree family history of social phobia and of selective mutism, obtained by family history method, was present in 70% and 37% of families, respectively. There was no evidence of a causal relationship between psychologically or physically traumatic experiences and development of selective mutism.
Selective mutism may be a symptom of social anxiety, rather than a distinct diagnostic syndrome. Further study of the characteristics of children with selective mutism and their families is warranted.
To clarify the diagnostic significance of selective mutism (elective mutism in DSM-III-R).
Fifty children with selective mutism were evaluated systematically by means of semistructured clinical interviews and rating scales to obtain detailed diagnostic information.
All 50 children met DSM-III-R criteria for social phobia or avoidant disorder and 24 (48%) had additional anxiety disorders. Clinical measures of anxiety and behavioral symptoms supported the presence of anxiety disorders as a characteristic of selectivity mute children. Only one case each of oppositional defiant disorder and attention-deficit hyperactivity disorder was found.
Persistent selective mutism typically presents in the context of anxiety disorders.
This study assessed the prevalence of selective mutism among second graders in elementary school, and examined related issues such as the situations in which the children refuse to speak, their performance level at school, and some temperamental/behavioural characteristics of these children.
A definition of selective mutism (according to the DSM-IIIR) was sent to all second grade teachers in the study area, asking them if there were any children with these symptoms in their class. If a positive answer, the teacher was asked to fill in a questionnaire concerning the child.
The prevalence rate for selective mutism was found to be 2%, with girls outnumbering boys. Selective mutism had been in progress more than a year in most cases. Most often, the children refused to speak to the teacher (58%), and one-fifth spoke to nobody at school. One-third of the mute children were performing at a lower level than average. Fewer of these children were reluctant to speak to the teacher than were mute children with an average or higher than average performance level. The children were characterized as shy, withdrawn and serious, with only some being hyperactive or aggressive. About one third of the children had had contact with health services.
To assess the comorbidity of developmental disorder/delay in children with selective mutism (SM) and to assess other comorbid symptoms such as anxiety, enuresis, and encopresis.
Subjects with SM and their matched controls were evaluated by a comprehensive assessment of the child and by means of a parental structured diagnostic interview with focus on developmental history. Diagnoses were made according to DSM-IV.
A total of 54 children with SM and 108 control children were evaluated. Of the children with SM, 68.5% met the criteria for a diagnosis reflecting developmental disorder/delay compared with 13.0% in the control group. The criteria for any anxiety diagnosis were met by 74.1% in the SM group and for an elimination disorder by 31.5% versus 7.4% and 9.3%, respectively, in the control group. In the SM group, 46.3% of the children met the criteria for both an anxiety diagnosis and a diagnosis reflecting developmental disorder/delay versus 0.9% in the controls.
SM is associated with developmental disorder/delay nearly as frequently as with anxiety disorders. The mutism may conceal developmental problems in children with SM. Children with SM often meet diagnostic criteria for both a developmental and an anxiety disorder.
Emotional and behavioural problems and competencies in a nation-wide sample of referred selective mute children (SM) and matched non-referred controls, aged 4-16 years, were assessed by the Child Behaviour Checklist, (CBCL), Teacher Report Form (TRF) and Youth Self Report (YSR) (1). Main issues addressed were the co-variation of internalising and externalising problems reported across informants, whether there exists a pure externalising group of children with SM, and the nature of the internalising and externalising problems. The results show that the children with SM differed substantially from their peers in internalising problems as reported by the parents and the teachers. In contrast, the results on the YSR indicated an under-reporting of internalising problems. Externalising problems in SM were reported in a low to moderate degree by the parents only. No child with SM and pure externalising symptoms was found. The children with SM differed mostly from their peers on the withdrawn scale. On the item level, both the internalising and the externalising symptoms that best differentiated the children with SM from the controls support the notion of SM as an expression of social anxiety.
Forty five patients (23 boys and 22 girls) with elective mutism (8.7 ± 3.6 years old), who were referred to a university department and a child guidance clinic within a 15-year-period, were followed up on average 12 years later. For 41 of them, sufficient information could be obtained at follow-up, and 31 patients could be investigated personally.
At follow-up, an interview and a standardized psychopathological examination were carried out as well as two standardized biographic inventories. The main results were: 1) a high load of individual and family psychopathology was characteristic of the patients. The disorder started already at age 3 to 4 and referral age was 8 years on average. 2) In 16 out of 41 patients (39 %), a complete remission could be observed. All other patients still revealed some communication problems. 3) The formerly mute patients described themselves as less independent, less motivated with regard to school achievement, less self-confident and less mature and healthy in comparison to a normal reference group. 4) A poor outcome could be best predicted by the variable “mutism within the core family” at the time of referral.
To examine the prevalence of selective mutism (SM) in a public school sample and compare the functioning and symptoms of children with SM to age- and gender-matched unaffected children.
Kindergarten, first, and second grade teachers in a large district were asked to identify pupils who met DSM-IV criteria for SM and to complete ratings of speaking behavior, social anxiety, other internalizing and externalizing symptoms, and overall functioning for these and comparison youngsters. Teachers completed the same ratings on the SM children 6 months later.
A participation rate of 94% (125 of 133 teachers) was obtained, and the prevalence of SM was .71% (16/2,256). Measures were completed for 12 (75%) of 16 identified children. Compared with peers, children with SM were more symptomatic on measures of frequency of speech, social anxiety, and other internalizing symptoms. As a group, children with SM had improved 6 months later but remained impaired and symptomatic when compared with the comparison group.
SM may not be as rare as previously thought. The functioning of children with SM is impaired, and although there is some improvement over time, notable impairment remains, suggesting that intervention is preferable to waiting for SM to remit spontaneously.
Our own, and several other cases of “elective mutism,” a relatively rare disorder, are described. The children thus afflicted are “sensitives,” often constitutionally predisposed, and come from an insecure milieu. The disorder has to be differentiated from other disorders in which partial mutism may occur. Elective mutism can be understood as a fixation at an early infantile level, on which an apprehended danger situation is met by a refusal to speak.
This study addressed four questions which parents of children with selective mutism (SM) frequently ask: (1) Is SM associated with anxiety or oppositional behavior? (2) Is SM associated with parenting and family dysfunction? (3) Will my child fail at school? and (4) Will my child make friends or be teased and bullied? In comparison to a sample of 52 community controls, 52 children with SM were more anxious, obsessive, and prone to somatic complaints. In contrast, children with SM were less oppositional and evidenced fewer attentional difficulties at school. We found no group differences in family structure, economic resources, family functioning, maternal mood difficulties, recreational activities, or social networks. While parents reported no differences in parenting strategies, children with SM were described as less cooperative in disciplinary situations. The academic (e.g., reading and math) and classroom cooperative skills of children with SM did not differ from controls. Parents and teachers reported that children with SM had significant deficits in social skills. Though teachers and parents rated children with SM as less socially assertive, neither teachers nor parents reported that children with SM were victimized more frequently by peers.
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