Selective mutism

This section needs additional citations for verification. Children and adults with selective mutism are fully capable of speech and understanding language but forgo speaking in certain situations, though speech is expected of them. The behaviour selective mutism be perceived as shyness or rudeness by others.

A child with selective mutism may be completely silent at school for years but speak quite freely or even excessively at home. The disturbance interferes with educational or occupational achievement or with social communication. The failure to speak is not due to a lack of knowledge of, or comfort with, the spoken language required in the social situation. Selective mutism is strongly associated with other anxiety disorders, particularly social anxiety disorder.

Particularly in young children, SM can sometimes be confused with an autism spectrum disorder, especially if the child acts particularly withdrawn around his or her diagnostician, which can lead to incorrect treatment. The former name elective mutism indicates a widespread misconception among psychologists that selective mute people choose to be silent in certain situations, while the truth is that they often wish to speak but have difficulty doing so. To reflect the involuntary nature of this disorder, the name was changed to selective mutism in 1994. The incidence of selective mutism is not certain. Due to the poor understanding of this condition by the general public, many cases are likely undiagnosed.

Based on the number of reported cases, the figure is commonly estimated to be 1 in 1000, 0. Besides lack of speech, other common behaviors and characteristics displayed by selectively mute people, according to Dr. The exact causes that affect each child may be different and yet unknown. Selective mutism occurs in all ethnic groups. The majority of reported cases are of white and multiethnic children. However this could be due to under-diagnosis and under-reporting in other ethnic groups. Most children with selective mutism are hypothesized to have an inherited predisposition to anxiety.

They often have inhibited temperaments, which is hypothesized to be the result of over-excitability of the area of the brain called the amygdala. SM have speech or language disorders that add stress to situations in which the child is expected to speak. Despite the change of name from “elective” to “selective”, a common misconception remains that a selectively mute child is defiant or stubborn. In fact, children with SM have a lower rate of oppositional behavior than their peers in a school setting. Contrary to popular belief, people with selective mutism do not necessarily improve with age.

Effective treatment is necessary for a child to develop properly. Without treatment, selective mutism can contribute to chronic depression, further anxiety, and other social and emotional problems. Consequently, treatment at an early age is important. If not addressed, selective mutism tends to be self-reinforcing.

Others may eventually expect an afflicted child to not speak and therefore stop attempting to initiate verbal contact. Alternatively, they may pressure the child to talk, increasing their anxiety levels in situations where speech is expected. Due to these problems, a change of environment may be a viable consideration. The exact treatment depends on the person’s age, any comorbid mental illnesses, and a number of other factors. For instance, stimulus fading is typically used with younger children because older children and teenagers recognize the situation as an attempt to make them speak, and older people with this condition and people with depression are more likely to need medication. Like other disabilities, adequate accommodations are needed for the afflicted to succeed at school, work, and in the home.

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