assessment for selective mutism79

Assessment and Intervention ofSelective Mutism in Children

ASSESSMENTS FOR SELECTIVE MUTISM

Behavioral Checklists

Personality Inventoryfor Children

• Reference: Wirt, R. D., Lachar, D., Klinedinst, J. E., Seat, P. D., & Broen, W. E. (1977). Multidimensional evaluation of

childpersonality: A manualfor the Personality Inventoryfor Children. Los Angeles: Western Psychological Services.

• A 275 item measure of hyperactivity, conduct problems, social skills, and several other problems in youth ranging in age

from 5-19 years old. Can be completed by parent or an individual who knows the child well and takes approximately 40

minutes to administer.

• For more information: http://portal.wpspublish.com/portal/page?_pageid=53,112601& dad=portal& schema=PORTAL

Child Behavior Checklist (CBCL), Parent and Teacher's Report Form

• Reference: Achenbach, T. M. (1991) Integrative Guide to the 1991 CBCL/4-18, YSR, and TRF Profiles. Burlington, VT:

University of Vermont, Department of Psychology

• A 118 item test that measures child behavior problems. There are also 20 social competency items to determine the child's

social participation. There are separate child, parent, and teacher forms.

• For more information: http://www.aseba.org/

0 1 2

0 1 2

0

0

0

0

0

0

2

2

2

2

2

2

9 Cantp£l#t# mind off.gsr&in thoughts,.Ofos&ssions Wescnbe):^;./^^ ;;

10. '&mti ststtr, listless, or t^peractive •";

II Clings to adiiits^r toq^tiepencEent-

12. GSjnpfains ofitiApiinfess

^3. ^^^^^^^p^erns to be in a fog

15. Cruel to animals

16. Cruelty, bullying, or meanness to others

I (describe)

,fl 1 ;2 4;j/;lmpulsive or acts without thinking

0 12 42. Would rather be alone than with others

0 12 43 Lying or cheating

0 12 44. Bites fingernails

0 12 45. Nervous, highstrung, or tense

0 1 2 48 Nervous movements or twitching

(describe):

Conners' Rating Scale-Revised

• Reference: Conners, K.C., Sitarenios, J., Parker, J.D.A., & Epstein, J. N. (1998). The revised Conner's Parent Rating Scale :

factor structure, reliability, and criterion validity - CPRS-R. Journal ofAbnormal Child Psyhcology, 26, 257-268.

• Parent, teacher, and self-report measures that assess ADHD and related behavior problems such as conduct problems,

cognitive problems, family problems, emotional, anger control, and anxiety. The measure takes approximately 20 minutes to

complete and addresses behaviors in youth 3 to 17 years of age. There is also a short form available.

• For more information: Harcourt Assessment, Inc.

http://harcourtassessment.com/haiweb/cultures/en-us/productdetail.htm?pid=::Conners 3

Family Functioning

Parenting Stress Index

• Reference: Abidin, R. R. (1997). Parenting Stress Index: A measure ofthe parent-child system. In Zalaquett, C.P. & Wood,

R. (Eds), Evaluating stress: A book of resources (pp. 277-291). Scarecrow Press, Inc: Lanham, MD.

• A 101 item questionnaire that assists in the identification of dysfunctional parent-child systems. The questionnaire is filled

out by the parent and takes approximately 20 to 30 minutes to administer. This measure can be administered to parents of

children 3 months to 10 years of age. A 36-item short form is also available. An adjusted form for adolescents has also been

designed for children ranging in age from 11 to 19 years of age (Stress Index for Parents ofAdolescents - SIPA)

• For more information: Psychological Assessment Resources http://www3.parinc.com/products/product.aspx?Productid=PSI

Child Measures

Revised Children }s Manifest Anxiety Scale

• Reference: Reynolds, C.R. and Richmond, B.O. (1979). Factor Structure and Construct Validity of "What I Think and Feel":

The Revised Children's Manifest Anxiety Scale", Journal ofPersonality Assessment, 43, 281-283.

Do NOT Copy or Reproduce Any Test Measures Without Author Permission


Presented at the 1 lth Annual SSWAA National Conference

• A 37-item measure of anxiety which includes physiological anxiety, worry-oversensitivity, social concerns-concentration,

total anxiety, and a lie subscale. It takes approximately 10 to 15 minutes to administer and can be administered to children 6

to 19 years of age. For children over 9 years of age, the measure can be administered in a group setting as well.

• For more information: Western Psychological Services

http://portal.wpspublish.com/portal/page?_pageid=53,69357&_dad=portal&_schema=PORTAL

Read each question carefully. Put a circle around the word YES if you think it is true about you. Put a circle

around the word NO if you think it is not true about you

1. I have trouble making up my mind. Yes / No

2. I get nervous when things do not go the right way for me. Yes / No

_3. Others seem to do things easier than I can. Yes / No

Multidimensional Anxiety Scalefor Children

• Reference: March, J.S., Parker, J.D., Sullivan, k., Stallings, P., & Conners, C.K. (1997). The Multidimensional Anxiety

Scale for Children (MASC): factor structure, reliability, and validity. Journal ofthe American Academy ofChild and

Adolescent Psychiatry, 36, 554-565.

• A 39-item measure of anxiety which include physical symptoms, somatic symptoms, tense symptoms, social anxiety,

humiliation/fears, performance fears, harm-avoidance, perfectionism, anxious coping, separation/panic, anxiety disorders

index, total anxiety index, and an inconsistency index. It can be administered in approximately 15 minutes to youth 8 to 19

years of age.


http://harcourtassessment.com/haiweb/cultures/en-us/productdetail.htm?pid==015-8036-905

Social Anxiety Scalefor Children-Revised

• Reference: La Greca, A. M. (1999). Manualfor the Social Anxiety Scalesfor Children and Adolescents. Author: Miami, FL.

• A 22-item measure of social anxiety which includes fear of negative evaluation from peers, social avoidance and distress

around new peers or in new situations, and generalized social avoidance and distress. There is a child (SASC-R; 7 to 13

years) and an adolescent (SAS-A; middle school and high school age) version.

• For more information: Dr. Annette La Greca http://www.psy.miami.edu/faculty/alagrecay#social_anxiety

Social Phobia andAnxiety Inventoryfor Children

• Reference: Beidel, D. C, Turner, S. M., and Moms, T. L. (1995). A new inventory to assess social phobia in children: The

Social Phobia and Anxiety Inventory for children. PsychologicalAssessmentJ, 73-79.

• The scale assesses childhood social phobia in youth ages 8-14 years old. It contains 26 items assessing physical complaints,

and cognitive and behavioral symptoms of social phobia. It takes approximately 20-30 minutes to administer.

• For more information: Multi-Health Systems

https://www.mhs.com/ecom/(n0p2bo3dhpz0a555c3nxurnaVproduct.aspx?RptGrpID::::::SPC

Children fs Depression Inventory

• Reference: Michael, Kurt D. Reliability of children's self-reported internalizing symptoms over short- to medium-length time

intervals. Journal ofthe American Academy ofChild and Adolescent Psychiatry, 37, 205-212.

• A 27-item of depressive symptomatology in children including depressed mood, hedonic capacity, vegetative functions self-

evaluation, and interpersonal behaviors in youth age 6 to 17 years old. It also assesses depressive symptoms in relation to

school functioning and peer/child interaction. It takes approximately 5-10 minutes to administer. A short-form is also

available.

• For more information: Harcourt Assessment, Inc. http://www.pearsonassessments.com/tests/cdi.htm

Item 1

□

□

□

I

I

I

am

am

am

sad

sad

sad

once in a while.

many times.

all the time.




Standardized Tests of Achievement and Cognitive Abilities

• Wechsler Intelligence Scale for Children

• Wechsler Preschool and Primary Scale of Intelligence

• Wide Range Assessment ofMemory and Learning

• Wide Range Achievement Test-3

• Peabody Individual Achievement Test-Revised

Nonverbal tests:

S Performance Scale of the Wechsler scales

S Raven's Colored Progressive Matrices

S Test ofNonverbal Intelligence

S Kaufman Assessment Battery

Speech and Language Assessment

Lindamood Auditory Conceptualization Test (LACT)

• A measure of ability to perceive and conceptualize speech sounds using a visual medium. It can be administered to youth age

5 to 18 years of age. It takes approximately 25 minute to administer.

• For more information: Harcourt Assessment, Inc. http://ags.pearsonassessments.com/group.asp?nGroupInfoID=a 11395

Peabody Picture Vocabulary Test-Revised

• A measure of receptive vocabulary and verbal ability using a visual medium. Verbal or noverbal responses can be given by

test taker. It can be administered to individuals 2 to 90+ years of age. It takes approximately 15 minutes to administer.

• For more information: Harcourt Assessment, Inc. http://ags.pearsonassessments.com/group.asp?nGroupInfoID=a30700

Clinical Evaluation ofLanguage Fundamentals-4

• A measure of language performance in youth age 5 to 21 years of age. It takes approximately 30-60 minutes to administer.


http://harcourtassessment.com/HAIWEB/Cultiires/en-us/ProductdetaiI.htm7Pid-015--8037-200

Children's Communication Checklist (Parent Version)

• A 70-item measure of communication problems as well as an identification tool for a communicative profile characteristic of

autism. It can be administered to youth 4 to 16 years of age. It takes approximately 10 minutes to administer.


http://1iarcourtassessment.com/haiweb/cultures/en-us/productdetail.htm?pid:::=015-8440-48X

Complex Receptive Ability:

S Token Test for Children

S Test of Auditory Comprehension of Language-Revised

S Test of Language Development. The Utah Test of Language Development

S Preschool Language Scale-3

Structured Interviews

Anxiety Disorders Interview Schedulefor DSM-IV-TR (ADIS)

• For more information: Oxford University Press

http://www.oup.com/us/catalog/general/subject/Psychology/PractitionerClientGuides/7vi ew^usa&ci:r:9780195186758

Functional Diagnostic Profile

• See attached for sample items.




CHILD DAILY RATINGS OF BEHAVIORS

DIRECTIONS: Record the numbers of words you spoke, whispered or mouthed today in the following

situations. Rate how loud your speech was on a 0-10 scale where 0= no one could hear you and 10 = everyone

could hear you. Use any number from 0 to 10.

0 1 2

no one

SCHOOL

# words

PHONE

# words

PUBLIC

# words

3

spoke

spoke

spoke

4 5 6

some

# words whispered

# words whispered

# words whispered

7 8

# words

# words

# words

9

mouthed

mouthed

mouthed

10

everyone

Audibility

Audibility

Audibility

DIRECTIONS: Record the people that you spoke, whispered or mouthed to today in the following situations,

by answering yes or no. Yes indicates that you communicated with the person and no means you did not.

Please circle YES or NO.

SCHOOL

Mouthed

Whispered

Spoke

PHONE

Whispered family member YES NO friend YES NO teacher YES NO

Which family member (s)

teacher YES NO classmate YES NO



other person YES NO

other person YES NO

other person YES NO

Spoke

PUBLIC

Mouthed

Whispered

Spoke

family member YES NO friend YES NO teacher YES NO

Which family member (s)

family YES NO friend YES NO teacher YES NO other person YES NO



Do NOT Copy or Reproduce Any Test Measures WithoutAuthor Permission

UCLA- NPI Childhood OCD, Anxiety, and Tourette's Disorder Program

Integrated Behavioral Treatment for Selective Mutism

SMQ, Pagei of 3

ID:

Selective Mutism Questionnaire

(intake evaluation version)

Please consider your child's behavior and activities of the past month and rate how true each of the

statements is for your child.

ATSCHOOL

1. When appropriate, my child talks to most peers at school.

2. When appropriate, my child talks to selected peers

(his/her friends) at school.

3. When called on by his/her teacher, my child answers.

4. When appropriate, my child asks his/her teacher questions.

5. When appropriate, my child speaks to most teachers

or staff at school.

6. When appropriate, my child is willing to speak in groups

or in front of the class.

7. When appropriate, my child participates non-verbally

in class (i.e., points, gestures, writes notes).

8. How much does not talking interfere with school

for your child?

WITHFAMILY

9. While at home, my child speaks comfortably

with the other family members who live there.

10. When appropriate, my child talks to family members

living at home when other people are present.

11.When my child does not talk at home, he/she

communicates non-verbally.

12. When my child does not talk at home, he/she

asks others to talk for him/her.

Always Often Seldom Never







Not at all Slightly Moderately Extremely





Initials Date Week IE



SMQ, Page 2 of 3

ID:

13. When we are away from home, my child talks to

family members who are with him/her.

14. When appropriate, my child talks to family members

that don't live with him/her (e.g. grandparent, cousin).

15. When appropriate, my child talks on the phone

to his/her parents and siblings.

16. How much does not talking interfere with family

relationships?





INSOCIAL SITUATIONS (OUTSIDE OFSCHOOL)

17. When appropriate, my child speaks with his/her

friends when outside of school.

18. When appropriate, my child speaks with other

children whom he/she doesn't know.

19. When appropriate, my child speaks with family friends

(adults) whom he/she knows well.

20. When appropriate, my child speaks with family friends

(adults) whom he/she doesn't know.

21. My child speaks to at least one baby-sitter.

Check here if you do not use a baby-sitter.

22. When appropriate, my child speaks with his/her

doctor and/or dentist.

23. When appropriate, my child speaks to store clerks

and/or waiters.

24. When appropriate, my child speaks on the phone with

non-family members.

25. When appropriate, my child talks when in clubs, teams

or organized activities outside of school.

26. When appropriate, my child participates non-verbally in

clubs, teams or organized activities outside of school.

27. When my child does not talk in social situations,

he/she communicates non-verbally.

28. When my child does not talk in social situations,

he/she asks someone to talk for him/her.

Initials Date













Week IE



SMQ, Page 3 of 3

ID:

29. How much does not talking interfere in social

situations for your child? Not at all Slightly Moderately Extremely

OTHER

30. My child is comfortable in familiar situations

(i.e.does not freeze, or become distressed or withdrawn).

31. My child is comfortable in unfamiliar situations.

32. When my child is in a situation and does not talk,

he/she will whisper.

33. When my child is reluctant but willing to

speak, he/she speaks in an odd voice.

34. Overall, how much does not talking

interfere with daily living for your child?

35. Overall, how much does not talking

bother your child?

36. Overall, how much does your child's

not talking bother you?








Initials Date Week IE


School Speech Questionnaire

(intake evaluation version)

Name of Teacher Who Completed This Questionnaire:.

When responding to the following items, please consider the behavior of your student,

and activities of the past month and rate how often each statement is true.

1. When appropriate, this student talks to most peers at school.


2. When appropriate, this student talks to selected peers (his/her friends) at school.


3. When called on by his/her teacher, this student answers.


4. When appropriate, this student asks you (the teacher) questions.


5. When appropriate, this student speaks to most teachers or staff at school.


6. This student is willing to speak in groups or in front of the class.


7. When appropriate, this student participates non-verbally

in class (i.e., points, gestures, writes notes). Always Often Seldom Never

8. How much does not talking interfere with school

for this student? Not at all Slighdy Moderately Extremely

School Speech Questionnaire-T page 1

Journal of School Psychology

Table 1

Example Items From the Functional Diagnostic Protocol

Conditions Under Which

Selective Mutism Occurs

(Check Applicable Items)

Functional Hypotheses

(Check Applicable

Hypothesis)

Interventions

(Check Intervention

to Be Used)

Is SM likely to or always oc

cur:

— a. during periods of

minimal social atten

tion or activity stim

ulation (e.g., general

lack of sensory or so

cial stimulation, un

occupied in structure

program for ex

tended periods, un

availability of pre

ferred activities)?

Describe:

— b. following specific re

quests/directives or

corrective feedback by

family, teachers, peers.

Describe:

- Periods of high stimula

tion; decrease anxiety as

sociated with speech.

-The child is in a state of

deprivation, boredom, or

loneliness. The SM be

haviors are strengthened

and/or maintained by the

social or sensory-related

feedback from these be

haviors.

- The child has alternative

prosocial skills to obtain

valued attention or sen

sory stimulation, but the

inappropriate behavior is

more effective and effi

cient.

- The child does not have

alternative prosocial skills

of obtaining the valued so

cial and sensory stimula

tion.

- Specific requests/direc

tives/feedback are aver-

sive. The SM behaviors

are negatively reinforced

by delay or removal of

these aversive requests/di

rectives/feedback.

- Identify the specific social

and sensory consequences

of the SM and minimize

or remove these.

- Provide these or other so

cial and sensory feedback

at similar frequencies and

of similar quality for alter

native prosocial behaviors

currently in the person's

repertoire.

- Increase the reinforce

ment value, immediacy,

frequency and consistency

of reinforcement of alter

native prosocial behavior.

- Teach alternative proso

cial skills of obtaining and

maintaining valuable sen

sory and social stimula

tion.

- Remove the requests/di

rectives/feedback and do

not repeat these in the fu

ture.

-If repeated, attempt to get

the person in a positive

mood state and then pres

ent the requests/directives

in a calm, pleasant

Source. Cole C. L. & Gardner W. I. (1993). Psychotherapy with developmental^ delayed

children. InT. R. KratochwiU & R. J. Morris(Eds.), Handbook ofpsychotherapy with children andadolescents (pp. 426-471). Copyright © 1993 by Allyn and Bacon. Adapted with permission.

provided with a TEI-SF to evaluate the treatment that was shown to be most

effective during the in-clinic session, and they were asked to mail this form

back to the examiner. In approximately 3 months, following the out-of-clinic

replication session, the parents were mailed another form for evaluating the

analogue assessment procedures, called the Parent Evaluation of Analogue

Assessment Procedures. This format provided a means for parents to express

their perception of the usefulness and difficulty of participating in this assess-

assessment for selective mutism79

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