Please select the eligibility criteria that correspond to the clinical trial below.
Title: How to Help When Silence is Not Golden A RCT Study of Selective Mutism
Brief Summary: Selective mutism (SM) describes inhibited and withdrawn children who are persistently mute in central situations despite ability to talk. SM may cause great suffering and create problems, both socially and related to learning. SM is associated with social anxiety, neurodevelopmental delay and bilingualism. The prevalence is about .7-8 ‰. Adequate assessment and treatment of SM is seldom provided in the mental health services. SM is considered hard to treat, and randomised treatment studies are lacking. This study will examine the effect of a manual based treatment for SM. The treatment consists of home- and kindergarten /school based interventions including behaviour techniques and psychoeducation. Defocused communication is a general treatment principle. Comorbidity, including neurodevelopmental delay /disorder, and predictors of outcome, will be examined. A pilot study was conducted to ensure the feasibility of the planned effectiveness study. Seven children, aged 3-5 years were included. Six has started treatment, and all talked in the kinder garden within the first 3 months. The present study will have a randomised controlled design with 1. Manual based intervention for 6 months compared to 2. Waiting list controls (3 months), and then manual based intervention. The sample: Children aged 3-9 years consecutively referred to the school psychology- or the mental health services in Oslo and Eastern Norway. Expected N = 24 based on the pilot study, is a sufficient sample size to answer our primary research question. The treatment will be given by a therapist from the research group or by a local clinician under supervision. The study can add essential knowledge on treatment of SM and make effective treatment available to clinicians in the community.


Options:
A: Inclusion Criteria:

1. Diagnosis. DSM-IV primary diagnosis (most severe) of social anxiety disorder (as determined by the ADIS-PC)
2. Age and Sex. Boys and Girls, 14 through 19 years
3. Grade. 9th, 10th, 11th, or 12th
4. English speaking. Adolescent

Exclusion Criteria:

1. Current diagnosis of substance use or conduct disorder
2. Concurrent mental disorder of greater severity than social anxiety disorder
3. Current psychotic symptoms
4. Current suicidal ideation
5. Pervasive developmental disorder, or a significant medical disorder (e.g., substantially impairs functioning, school attendance, or the ability to engage in treatment)
6. Current psychological or pharmacological treatment
B: Inclusion Criteria:

* Children from Eastern \& Southern Norway will be included if they fulfill the diagnostic criteria for SM

Exclusion Criteria:

* Children with SM and mental retardation with IQ below 50.
* Children with SM and psychosis or pervasive developmental disorders with the exception of Asperger syndrome and PDD Nos (DSM-IV)
* Children with SM who receive an active treatment for SM in the CAMHS
* Children with SM who are medicated for social anxiety.
* Children with SM where the parents do not understand Norwegian.
C: Inclusion Criteria:

Children:

* meet criteria for a primary DSM5 anxiety disorder of generalized anxiety disorder (GAD), social phobia (SOP), and separation anxiety disorder (SAD) using the DSM-5 version of the Anxiety Disorders Interview Schedule -Child and Parent Versions (ADIS-C/P)
* mean score of 4 or greater on the ADIS-C/P Clinician Rating Scale of Severity (CSR)
* ceasing all other psychosocial treatment upon consultation with the clinic staff and the service provider
* not using any psychotropic medication other than a stable dose of stimulant medication treatment for comorbid ADHD or a stable dose of Selective Serotonin Reuptake Inhibitor (SSRI)
* children who are on a stable dose of stimulant medication or SSRI (i.e., a minimum of six weeks at the same dose) will be included so as not to limit generalizability.

Exclusion Criteria:

Children:

* primary diagnosis of any Axis I DSM-IV disorder other than GAD, SOP, Phobias and SAD
* any of the following disorders (e.g., primary, secondary, tertiary) - Pervasive Developmental Disorders, Mental Retardation, Organic Mental Disorders, Bipolar Disorder, Schizophrenia and Other Psychotic Disorders
* drug or alcohol abuse/dependence will also be exclusionary
* tic disorders will not be exclusionary unless they require psychotropic medication to stabilize
* Significant active suicidal ideation or a past suicide attempt in the last 6 months. Adolescents with a history of non-lethal self-harm behaviors (e.g., cutting) will be allowed to enroll if they meet other criteria
* have an intellectual disability as reported by guardian
* be a victim of past or present undisclosed abuse requiring investigation or ongoing supervision by the Department of Social Services
* not have been cohabiting with mother for at least one year prior to admittance. Parent:
* any of the following disorders (e.g., primary, secondary, tertiary) - Pervasive Developmental Disorders, Mental Retardation, Selective Mutism, Organic Mental Disorders, Bipolar Disorder, Schizophrenia and Other Psychotic Disorders. Drug or alcohol abuse/dependence will also be exclusionary
* not have been cohabiting with child for at least one year prior to admittance
* report the presence of any active suicidal ideation or a past suicide attempt in the last 6 months.
D: Inclusion Criteria:

* Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for separation anxiety disorder, social phobia, or generalized anxiety disorder

Exclusion Criteria:

* Major neurological disorder or medical illness that would interfere with participation in the study

Answer: B