Selective Mutism Research Papers - Academia.edu (original) (raw)
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Selective Mutism is an anxiety disorder in which affected people speak fluently in some situations but remain silent in others” (SMIRA, 2011) Little qualitative SM research (other than single case studies) Role of the family widely... more
Selective Mutism is an anxiety disorder in which affected people speak fluently in some situations but remain silent in others” (SMIRA, 2011)
Little qualitative SM research (other than single case studies)
Role of the family widely emphasised in early literature (see Popper & Steingard, 1994; Spasaro et al., 1999; Black & Uhde, 1995).
No previous SM study looks at the ‘lived experience’ of parents.
Interpretative Phenomenological Analysis (IPA) aims to understand the “lived experience” of individuals (Smith, 2008).
Bu çalışmada, Mutizm (konuş(a)mama) üzerine yapılan çalışmalar ve bilimsel literatürde yayınlanan makaleler incelenerek derlenmiş ve raporlanmıştır. Temel olarak mutizm tanımı ve mutizmin çeşitlerinden, semptomlarından ve tedavi... more
Bu çalışmada, Mutizm (konuş(a)mama) üzerine yapılan çalışmalar ve bilimsel literatürde yayınlanan makaleler incelenerek derlenmiş ve raporlanmıştır. Temel olarak mutizm tanımı ve mutizmin çeşitlerinden, semptomlarından ve tedavi yöntemlerinden bahsedildikten sonra yaygın görülen iki mutizm tipi üzerine olgu çalışmaları örnek olarak sunulmuştur. Derleme bir makale olması nedeni ile Google Scholar, SCOPUS, Medline ve Web of Science gibi veritabanlarından “Selective Mutism, “Elective Mutism”, “Neurogenic Mutism”, “Posttraumatic Mutism”, “Psychogenic Mutism”, “Seçici Mutizm”ve “Seçmeli Mutizm” gibi anahtar kelimeler girilerek yapılan arama neticesinde bulunan makalelerden konu ile ilgili kapsamlı ve etkin makaleler seçilmiş, okunup anlaşılarak özetlenmiştir. Araştırma makalesi olmaması nedeni ile herhangi bir örneklem, Kişisel Bilgi Formu, Travmatik Stres Belirti Ölçeği ve Çok Boyutlu Algılanan Sosyal Destek Ölçeği gibi veri katılımcı üzerinde veri toplama araçları kullanılmamıştır. Erken dönemde tedavi edilmemesi durumunda yaşamın ilerleyen evrelerindeki sosyal ve akademik yaşama olumsuz etkilerinin olacağı bu hastalığın üzerinde yeterince araştırmanın yapılmamış olması çalışma sonucunda ulaşılan en önemli bulgulardan biridir. Teşhis ve tedavi yöntemleri açısından değerlendirildiğinde cevaplanması gereken araştırma problemlerinin olduğu saptanmıştır.
Selective Mutism is a disabling anxiety condition characterised by the inability to speak in different social situations. Therefore, the difficulties children experience in verbal communication can easily be overlooked and misunderstood.... more
Selective Mutism is a disabling anxiety condition characterised by the inability to speak in different social situations. Therefore, the difficulties children experience in verbal communication can easily be overlooked and misunderstood. This research aimed to explore parents’ perspectives on provision in mainstream schools for children identified and diagnosed with Selective Mutism under the new Special Educational Needs and Disability Code of Practice 2015. Fifty-two participants completed an online survey which used qualitative and quantitative approaches. Participants shared personal experiences and commented on schools’ provision. From the thematic data analysis, inadequacy of provision was of huge concern. Negative experiences were reported. The research’s strength was parents’ willingness to work in partnership and improve parental involvement in interventions. Proposals for Selective Mutism to be recognised as a disability with long-term effects in schools and life outcomes were recorded.
Essay on collections of human monsters in Italian Renaissance Courts: dwarves, giants, hirsutes, blind, mutes, goiters, brawnies, castrates, twins, albinos, loonies, obeses, hunchbacked, lames, and many others - male and female - 1450-1650
Selective mutism (SM) is a rare childhood and interesting case is associated with a wide range of psychiatric disorders. Historically seen as more of an oddity than a distinct diagnostic entity, in this case undoubtedly was largely... more
Selective mutism (SM) is a rare childhood and interesting case is associated with a wide range of psychiatric disorders. Historically seen as more of an oddity than a distinct diagnostic entity, in this case undoubtedly was largely oppositional behavior established early on case studies of their connection with the SM. Recently, a number of controlled studies have advanced our understanding of SM. This study answers the SM current evidence supports the idea that a state of anxiety about SM highlighting summaries. This paper describes the how mutism has relation with the classical condition theory.
INVISIBLE OTHERNESS AT THE UNIVERSITY. ANALYSIS OF THE PHENOMENON OF SELECTIVE MUTISM IN ADULTS STUDYING AT THE UNIVERSITY SUMMARY This article is an attempt to discuss the topic of selective mutism in adults. For his needs, a pilot study... more
INVISIBLE OTHERNESS AT THE UNIVERSITY. ANALYSIS OF THE
PHENOMENON OF SELECTIVE MUTISM IN ADULTS STUDYING
AT THE UNIVERSITY
SUMMARY
This article is an attempt to discuss the topic of selective mutism in adults. For his needs, a pilot
study was conducted among adults who have studied with selective mutism (MW). The aim of the
analyzes was to characterize the problems that a student of MW can face and to present suggestions
for solutions to these di_culties. The way to achieve these goals was to analyze the results of the
questionnaire survey.
KEYWORDS
selective mutism, anxiety, study, students, ACT, support system
Your article is protected by copyright and all rights are held exclusively by California Association of School Psychologists. This eoffprint is for personal use only and shall not be self-archived in electronic repositories. If you wish... more
Your article is protected by copyright and all rights are held exclusively by California Association of School Psychologists. This eoffprint is for personal use only and shall not be self-archived in electronic repositories. If you wish to self-archive your article, please use the accepted manuscript version for posting on your own website. You may further deposit the accepted manuscript version in any repository, provided it is only made publicly available 12 months after official publication or later and provided acknowledgement is given to the original source of publication and a link is inserted to the published article on Springer's website. The link must be accompanied by the following text: "The final publication is available at link.springer.com".
problems scales. Mothers of children with SM scored higher on the SCL-90-R obsessive–compulsive subscale and Global Severity Index than mothers of children with GAD, while fathers of children with SM scored higher on the SCL-90-R Phobic... more
problems scales. Mothers of children with SM scored higher on the SCL-90-R obsessive–compulsive subscale and Global Severity Index than mothers of children with GAD, while fathers of children with SM scored higher on the SCL-90-R Phobic Anxiety subscale and on the Global Severity Index than fathers of children with GAD. Parents of children with SM displayed a greater presence of stressful life events than parents of children with GAD. Data appeared to confirm that SM and GAD share a common anxious core, though some differences in the children's psychological profiles and the parents' history and personality emerged. Future research should focus on the role of external factors, such as parent– child relationship, in the development of SM. Keywords Selective mutism · Generalized anxiety disorder · Children's psychological profile · Parent's psychological profile
La qualità della relazione che riusciamo a stabilire con gli altri è sempre frutto della nostra capacità di interpretare il comportamento altrui come il più vicino possibile alla intenzionalità dell’altro o al suo stato d’animo del... more
La qualità della relazione che riusciamo a stabilire con gli altri è sempre frutto della nostra capacità di interpretare il comportamento altrui come il più vicino possibile alla intenzionalità dell’altro o al suo stato d’animo del momento. Sulla falsariga di queste riflessioni è facile comprendere come anche l’intervento sul bambino m.s. non può prescindere da un cambiamento di prospettive rispetto a quando ci si attende dall’alunno che non parla.
Selective mutism (SM) is classified in DSM-5 as an anxiety disorder. The aim of the study was to investigate the psychological features of children with SM and their parental psychological profiles, compared to generalized anxiety... more
Selective mutism (SM) is classified in DSM-5 as an anxiety disorder. The aim of the study was to investigate the psychological features of children with SM and their parental psychological profiles, compared to generalized anxiety disorder (GAD) children and their parents. The parents of 26 preschool children with SM and 32 with children with GAD filled out the child behavior check list for 1½-5 years (CBCL1½-5) and the symptom checklist-90-revised (SCL-90-R). Information about the children and their parents' histories was collected through clinical interviews. Children with SM scored higher than children with GAD on the CBCL1½-5 withdrawn scale and lower on the attention problems, aggressive behavior, and externalizing problems scales. Mothers of children with SM scored higher on the SCL-90-R obsessive-compulsive subscale and Global Severity Index than mothers of children with GAD, while fathers of children with SM scored higher on the SCL-90-R Phobic Anxiety subscale and on th...
This book purposefully connects practice to research, and vice versa, through the use of deeply personal stories in the form of autoethnographic memoirs. In this collection, twenty contributors share selected tales of teaching students... more
This book purposefully connects practice to research, and vice versa, through the use of deeply personal stories in the form of autoethnographic memoirs. In this collection, twenty contributors share selected tales of teaching students with dis/abilities in K-12 settings across the USA, including tentative triumphs, frustrating failures, and a deep desire to understand the dynamics of teaching and learning. The authors also share an early awareness of significant dissonance between academic knowledge taught to them in teacher education programs and their own experiential knowledge in schools. Coming to question established practices within the field of special education in relation to the children they taught, each author grew increasingly critical of deficit-models of disability that emphasized commonplace practices of physical and social exclusion, dysfunction and disorders, repetitive remediation and punitive punishments. The authors describe how their interactions with children and youth, parents, and administrators, in the context of their classrooms and schools, influenced a shift away from the limiting discourse of special education and toward becoming critical special educators and/or engaging with disability studies as a way to reclaim, reframe, and reimagine disability as a natural part of human diversity. Furthermore, the authors document how these early experiences in the everydayness of schooling helped ground them as teachers and later, teacher educators, who galvanized their research trajectories around studying issues of access and equality throughout educational structures and systems, while developing new theoretical models within Disability Studies in Education, aimed to impact practices and policies.
Uniwersytet im. Adama Mickiewicza w Poznaniu Dziecko z mutyzmem wybiórczym-charakterystyka zjawiska oraz sposoby przeciwdzia³ania trudnooeciom Artyku³ porusza kwestie zwi¹zane z problematyk¹ mutyzmu wybiórczego. Mutyzm wybiórczy jako... more
Uniwersytet im. Adama Mickiewicza w Poznaniu Dziecko z mutyzmem wybiórczym-charakterystyka zjawiska oraz sposoby przeciwdzia³ania trudnooeciom Artyku³ porusza kwestie zwi¹zane z problematyk¹ mutyzmu wybiórczego. Mutyzm wybiórczy jako zaburzenie o pod³o¿u lêkowym mo¿e byae przyczyn¹ wielu trudnooeci, dlatego istotne jest wdro¿enie wczesnych oddzia³ywañ terapeutycznych. Rozpatruj¹c mutyzm wybiórczy jako Ÿród³o specjalnych potrzeb edukacyjnych, pojawia siê wiêcej informacji, które pozwalaj¹ lepiej zrozumieae specyfikê tego zjawiska oraz wyzwañ stawianych przed pedagogami i terapeutami. Wczeoenie rozpoczêta terapia pozwoli zapobiec póŸniejszym trudnooeciom takim jak wycofanie z ¿ycia spo³ecznego, czêste ponoszenie pora¿ek, fobia szkolna czy nawet depresja. S³owa klucze: mutyzm wybiórczy, lêk, sliding in A child with selective mutism-characteristics of the phenomenon and ways to counteract the difficulties The article discusses issues related to the problem of selective mutism. Selective Mutism as an anxiety disorder may be the cause of many difficulties, so it is important to implement early therapeutic interactions. When considering selective mutism as a source of special educational needs, more information appears that allows you to better understand the specificity of this phenomenon and the challenges faced by educators and therapists. Early therapy will help prevent later difficulties such as withdrawal from social life, frequent failures, school phobia or even depression. Wprowadzenie Dziecko z mutyzmem wybiórczym po raz pierwszy opisa³ Adolf Kussmaul w 1877 r. Nazwy aphasia voluntaria u¿y³ on do scharakteryzowania przypadków dzieci, które mog³y komunikowaae siê werbalnie, poniewa¿ opanowa³y tê umiejêt-nooeae (nie posiada³y ¿adnych zaburzeñ rozwojowych czy organicznych), jednak nie mówi³y w ró¿nych miejscach. Nastêpnie w 1934 r. szwajcarski psychiatra Mor-tiz Tramer wprowadzi³ okreoelenie selective mutism, aby nazwaae dzieci, które milcz¹
Selective mutism (SM) is a developmental disorder characterized by a child’s inability to speak in certain contexts and/or in the presence of unfamiliar interlocutors. This work proposes a critical discussion of the most recent studies on... more
Selective mutism (SM) is a developmental disorder characterized by a child’s inability to speak in certain contexts and/or in the presence of unfamiliar interlocutors. This work proposes a critical discussion of the most recent studies on SM, with respect to clinical and diagnostic features, as well as the etiology and treatment of this disorder. At present, all research work supports the hypothesis that SM is a complex anxiety disorder with multifactorial etiology (interaction among biological and environmental causes). The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) places SM mutism among “Anxiety Disorders”, and no longer among “Other Childhood, Infant and Adolescent Disorders” (as in DSM-IV). Other important aspects relate to cognitive biases and emotional states at the base of SM, which partly explain the disorder’s persistence and represent an important objective of intervention work. No data in th...
ABSTRACT This article applies sociocultural theorizing as a tool to analyze children’s collaborative cooking practices through the key sociocultural concepts of social interaction and collaboration within a school cooking club. The... more
ABSTRACT
This article applies sociocultural theorizing as a tool to analyze children’s collaborative cooking practices through the key sociocultural concepts of social interaction and collaboration within a school cooking club. The “everyday” activity of cooking is examined using field notes gathered through participant observations, diary entries, and semistructured inter- views with child and adult participants. The fieldwork sample included 18 participants age 9 to 11 years and two adult participants. The sociocultural nature of the children’s learning during cooking practices was tracked over a 14-week period. Observed incidences of situated learning, legitimate peripheral participation, and guided participation were tracked throughout the fieldwork period. The analysis identifies the processes through which participants are able to contribute to and distribute shared knowledge. Through tracking the collaborative learning processes and the contrasting pedagogical practices, the research identified the learning trajectory of the “newbies” via legitimate peripheral participation (as observers and silent contributors), and explored how, through fractionally increasing participa- tion, the newbies become main members (masters) of this community of practice. The findings confirm children’s collaborative cooking practices as a lens through which social interaction and collaboration can be examined, while also highlighting the complexity of opposing pedagogical practices.
In this paper, following a literature review, a family containing a child who had been electively mute for four years is described. A concurrent programme of individual and family therapy and the systemic hypothesis which guided these... more
In this paper, following a literature review, a family containing a child who had been electively mute for four years is described. A concurrent programme of individual and family therapy and the systemic hypothesis which guided these interventions is then presented in detail. Behavioural and psychometric data are presented to illustrate the dramatic improvement which the identified patient showed over the course of treatment. Finally, the probable mechanisms underpinning the child's improvement, and how these differed from our initial expectations, are discussed.
Il problema dei bambini con Mutismo Selettivo non sta nel linguaggio: non hanno bisogno della logopedia perché dentro di loro il linguaggio ce l'hanno. In più, i partecipanti al laboratorio sono figli di migranti e vivono quotidianamente... more
Il problema dei bambini con Mutismo Selettivo non sta nel linguaggio: non hanno bisogno della logopedia perché dentro di loro il linguaggio ce l'hanno. In più, i partecipanti al laboratorio sono figli di migranti e vivono quotidianamente la scissione tra la cultura dei genitori e quella del luogo in cui vivono. Occorre dare a questi bambini la possibilità di mischiarsi e di tirar fuori per riflettere sulla loro identità e per mettere insieme i pezzi della loro storia senza la paura di perdersi.
Σο παιδί με εκλεκηική αλαλία : προηάζεις για ηην ανηιμεηώπιζη ηοσ ζηο τώρο ηοσ ζτολείοσ ΕΛΕΝΗ ΝΙΚΟΛΑΟΤ 1 Περίληυη Η παξνύζα εξγαζία δηαπξαγκαηεύεηαη έλα από ηα πξνβιήκαηα ζπκπεξηθνξάο θαη ζπλαηζζήκαηνο ησλ παηδηώλ, ηελ εθιεθηηθή αιαιία.... more
Σο παιδί με εκλεκηική αλαλία : προηάζεις για ηην ανηιμεηώπιζη ηοσ ζηο τώρο ηοσ ζτολείοσ ΕΛΕΝΗ ΝΙΚΟΛΑΟΤ 1 Περίληυη Η παξνύζα εξγαζία δηαπξαγκαηεύεηαη έλα από ηα πξνβιήκαηα ζπκπεξηθνξάο θαη ζπλαηζζήκαηνο ησλ παηδηώλ, ηελ εθιεθηηθή αιαιία. Αξρηθά παξνπζηάδνληαη ε ελλνηνινγηθή νξηνζέηεζε ηεο εθιεθηηθήο αιαιίαο, ηα ραξαθηεξηζηηθά ησλ παηδηώλ ηεο εθιεθηηθήο αιαιίαο θαη νη αηηηνινγηθνί παξάγνληεο απηήο ηεο δηαηαξαρήο. Αθνινπζνύλ νη ζπκβνπιεπηηθέο παξεκβάζεηο πνπ έρνπλ θαηαγξαθεί ζηε βηβιηνγξαθία κε έκθαζε ζηηο ηερληθέο ηνπ ζπκπεξηθνξηζκνύ. Τέινο, πξνηείλεηαη όηη ε ζπλεξγαζία κεηαμύ ησλ επαγγεικαηηώλ πγείαο, ησλ εθπαηδεπηηθώλ θαη ησλ γνλέσλ κπνξεί λα ζπκβάιεη ζηελ αληηκεηώπηζε ησλ πξνβιεκάησλ πξνζαξκνγήο πνπ αληηκεησπίδνπλ. Τν εθπαηδεπηηθό καο ζύζηεκα είλαη ζεκαληηθό λα ζέζεη σο πξνηεξαηόηεηα ηελ ςπρνθνηλσληθή αλάπηπμε ησλ παηδηώλ απηώλ. Abstract The present article discusses selective mutism, which is one of children's behaviour and emotional problems. Firstly, selective mutism is defined and its characteristics as well as its origins are presented. Secondly, counseling interventions are presented, focusing on behaviourism methods. Finally, it is suggested that the collaboration between teachers, parents, and mental health professionals can enhance the school adjustment of children with selective mutism. Psychosocial development of childern should be an important priority of our educational system. 1. Ειζαγφγή Η έγθαηξε αληηκεηώπηζε ησλ πξνβιεκάησλ ζπκπεξηθνξάο θαη ζπλαηζζήκαηνο ησλ παηδηώλ ζπλδέεηαη κε ηελ πξνζαξκνγή ησλ παηδηώλ ζην ζρνιείν (Σηνγηαλλίδνπ & Μπίκπνπ-Νάθνπ, 2006). Σηα πξνβιήκαηα ζπκπεξηθνξάο θαη ζπλαηζζήκαηνο ησλ παηδηώλ ζπγθαηαιέγεηαη ε εθιεθηηθή αιαιία. Τα πξνβιήκαηα απηά ηα νπνία θαηαηάζζνληαη ζηα εζσηεξηθεπκέλα πξνβιήκαηα ζπρλά δελ επηζεκαίλνληαη από ηνπο εθπαηδεπηηθνύο θαη απηό δπζρεξαίλεη ηελ αληηκεηώπηζε ηνπο (Μόηηε-Σηεθαλίδε & Τζηάληεο, 2000). Τν παξόλ άξζξν επηθεληξώλεηαη ζηελ εθιεθηηθή αιαιία θαη έρεη σο ζηόρν ηελ θαηαγξαθή ησλ ηξόπσλ αληηκεηώπηζεο ησλ ζπκπησκάησλ ηεο ζην ρώξν ηνπ ζρνιείνπ κε απώηεξν ζθνπό ηε ζπκβνιή ησλ εθπαηδεπηηθώλ ζηελ αληηκεηώπηζε ηνπο. 2. Εννοιολογική οριοθέηηζη Η εθιεθηηθή αιαιία απνηειεί κηα ζπάληα δηαηαξαρή ε νπνία ραξαθηεξίδεηαη από ηε ζπλερή απνηπρία λα κηιήζεη θαλείο ζε κηα ή δηάθνξεο θνηλσληθέο θαηαζηάζεηο, ζηηο νπνίεο ην παηδί αλακέλεηαη λα κηιήζεη. Τν παηδί δελ έρεη νξγαληθή αληθαλόηεηα λα κηιήζεη ηε γιώζζα ή δελ ραξαθηεξίδεηαη από έιιεηςε γλώζεο ηεο νκηινύκελεο γιώζζαο. Η άξλεζε λα κηιήζεη παξαηεξείηαη ζηαζεξά ζε όιεο ηηο θαηαζηάζεηο θαη ζπλήζσο ην παηδί κε εθιεθηηθή αιαιία κηιάεη ζε νξηζκέλνπο αλζξώπνπο ή ζε νξηζκέλεο θαηαζηάζεηο (APA, 1994). Σπλήζσο ην παηδί αξλείηαη λα κηιήζεη ζε ρώξνπο εθηόο ηνπ ζπηηηνύ ηνπ, γηα παξάδεηγκα ζην ζρνιείν ν θαηεμνρήλ ρώξνο ζηνλ νπνίν εθδειώλεηαη αξρηθά ε εθιεθηηθή αιαιία. Τν παηδί αιιειεπηδξά θπζηνινγηθά κε ηνπο γνλείο ή ηα αδέιθηα ηνπ (Viana, Beidel, & Rabian, 2009). Τν πνζνζηό ηεο εθιεθηηθήο αιαιίαο είλαη πεξίπνπ 1% (Lindsey, Piacentini, & McCracken, 2002). Ξεθηλά ζπλήζσο ζηελ πξνζρνιηθή ειηθία, είλαη πεξηζζόηεξε ζπρλή ζηα θνξίηζηα θαη παξαηεξείηαη ζε όια ηα θνηλσληθά ζηξώκαηα (Steinhausen, & Juzi, 1996).
Background: Selective Mutism is described as the inability to verbally express oneself in anxiety provoking social situations and may result in awkward social interactions in school-aged children. In this case-report we present the... more
Background: Selective Mutism is described as the inability to verbally express oneself in anxiety provoking social situations and may result in awkward social interactions in school-aged children. In this case-report we present the baseline electrophysiological neuroimaging results and after treatment with Sertraline for 6-weeks.
Abstract Cognitive Behavioral Therapy (CBT) is generally considered the recommended approach for Selective Mutism (SM). Prospective follow-up studies of treated SM and predictors of outcome are scarce. We have developed a CBT home and... more
Abstract
Cognitive Behavioral Therapy (CBT) is generally considered the recommended approach for Selective Mutism (SM). Prospective follow-up studies of treated SM and predictors of outcome are scarce. We have developed a CBT home and school-based intervention for children with SM previously found to increase speech in a pilot efficacy study and in a randomized controlled treatment study (RCT). In the present report we provide outcome data one year after having completed the 6-month course of CBT for 24 children with SM, aged 3-9 years (mean age 6.5 years, 16 girls). Primary outcome measures were the teacher-rated School Speech Questionnaire (SSQ) and diagnostic status. At follow-up, no significant decline was found on the SSQ scores. Age and severity of SM had a significant effect upon outcome, as measured by the SSQ. Eight children still fulfilled diagnostic criteria for SM, 4 were in remission, and 12 children were without diagnosis. Younger children improved more, as 78% of the children aged 3-5 years did not have SM, compared with 33% of children aged 6-9 years. Treatment gain was upheld at follow-up. Greater improvement in the younger children highlights the importance of an early intervention.
Selective mutism (SM) is a developmental disorder characterized by a child’s inability to speak in certain contexts and/or in the presence of unfamiliar interlocutors. This work proposes a critical discussion of the most recent studies on... more
Selective mutism (SM) is a developmental disorder characterized by a child’s inability to speak in certain contexts and/or in the presence of unfamiliar interlocutors. This work proposes a critical discussion of the most recent studies on SM, with respect to clinical and diagnostic features, as well as the etiology and treatment of this disorder. At present, all research work supports the hypothesis that SM is a complex anxiety disorder with multifactorial etiology (interaction among biological and environmental causes). The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) places SM mutism among “Anxiety Disorders”, and no longer among “Other Childhood, Infant and Adolescent Disorders” (as in DSM-IV). Other important aspects relate to cognitive biases and emotional states at the base of SM, which partly explain the disorder’s persistence and represent an important objective of intervention work. No data in th...