The efficacy of home-based virtual reality exposure therapy as an add-on to behavioral therapy for children with selective mutism: Protocol for a single-case experimental design

IF 1.5 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Contemporary Clinical Trials Communications Pub Date : 2026-04-01 Epub Date: 2026-01-16 DOI:10.1016/j.conctc.2026.101602

Wendy van Vlerken , Jeroen S. Legerstee , Robert G. Belleman , Samantha Bouwmeester , Lynn F. Meester , Annelot Roorda , Ramón J.L. Lindauer , Elisabeth M.W.J. Utens , Luuk Stapersma

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引用次数: 0

Abstract

Background

Selective Mutism (SM) is a rare childhood anxiety disorder characterized by an inability to speak in specific social situations, despite speaking freely in others. School is typically the environment where the disorder manifests itself most clearly. Children with SM often have difficulty generalizing speaking across different social situations. Parents and teachers often struggle to practice speaking with the child outside of therapy due to practical reasons and time constraints. Virtual Reality Exposure Therapy (VRET) at home has potential to enhance the treatment of SM by providing an alternative and engaging method for delivering exercises that support behavioral treatment.

Methods

This paper describes the development of the VRET application Speaking at School-VR and the methodology of the single case experimental design (SCED) to evaluate the feasibility and preliminary effects of the behavioral treatment at school, complemented with VRET at home, for children with SM, aged 4–13. A secondary aim is to evaluate the feasibility and adherence of home-based VRET based on qualitative information to capture participants’ experiences. A total of 15 children with SM and their families will be enrolled in the study to examine the potential effectiveness of the combined treatment. The treatment consists of 10 behavioral steps, each accompanied by complementary VRET exercises.

Conclusion

This is the first study to examine the feasibility and the potential effectiveness of home-delivered VRET as an adjunct to behavioral treatment for children with SM. The addition of VRET to behavioral treatment has the potential to enhance the generalization and transfer of skills across different situations in a facilitative and engaging way.

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基于家庭的虚拟现实暴露疗法作为选择性缄默症儿童行为治疗的附加疗法的效果：单例实验设计方案。

背景：选择性缄默症（SM）是一种罕见的儿童焦虑症，其特征是在特定的社交场合无法说话，尽管在其他场合可以自由说话。学校是这种障碍最明显地表现出来的典型环境。患有SM的儿童通常很难在不同的社交场合中概括说话。由于实际原因和时间限制，父母和老师经常在治疗之外与孩子练习说话。家庭虚拟现实暴露疗法（VRET）有可能通过提供一种替代的、有吸引力的方法来提供支持行为治疗的练习，从而加强对SM的治疗。方法：本文介绍了VRET应用程序“在学校说话”（Speaking at school - vr）的开发和单例实验设计（SCED）的方法，以评估4-13岁SM儿童在学校进行行为治疗并辅以在家进行VRET治疗的可行性和初步效果。第二个目的是基于定性信息来评估基于家庭的VRET的可行性和依从性，以捕捉参与者的经验。总共有15名患有SM的儿童及其家庭将被纳入这项研究，以检验联合治疗的潜在有效性。治疗包括10个行为步骤，每个步骤都伴随着补充的VRET练习。结论：本研究首次探讨了家庭提供的VRET作为SM儿童行为治疗辅助手段的可行性和潜在有效性。在行为治疗中加入VRET有可能以促进和参与的方式增强技能在不同情况下的泛化和转移。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Contemporary Clinical Trials Communications Pharmacology, Toxicology and Pharmaceutics-Pharmacology

CiteScore

2.70

自引率

6.70%

发文量

146

审稿时长

20 weeks

期刊介绍： Contemporary Clinical Trials Communications is an international peer reviewed open access journal that publishes articles pertaining to all aspects of clinical trials, including, but not limited to, design, conduct, analysis, regulation and ethics. Manuscripts submitted should appeal to a readership drawn from a wide range of disciplines including medicine, life science, pharmaceutical science, biostatistics, epidemiology, computer science, management science, behavioral science, and bioethics. Contemporary Clinical Trials Communications is unique in that it is outside the confines of disease specifications, and it strives to increase the transparency of medical research and reduce publication bias by publishing scientifically valid original research findings irrespective of their perceived importance, significance or impact. Both randomized and non-randomized trials are within the scope of the Journal. Some common topics include trial design rationale and methods, operational methodologies and challenges, and positive and negative trial results. In addition to original research, the Journal also welcomes other types of communications including, but are not limited to, methodology reviews, perspectives and discussions. Through timely dissemination of advances in clinical trials, the goal of Contemporary Clinical Trials Communications is to serve as a platform to enhance the communication and collaboration within the global clinical trials community that ultimately advances this field of research for the benefit of patients.