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Selective Mutism

Alternate Names

  • elective mutism

Definition

Selective mutism is a condition in which a person who is usually fluent in speech won't speak in specific situations. Selective mutism primarily affects children.

What is going on in the body?

The majority of people who exhibit selective mutism appear to have some type of anxiety disorder. A person who has this condition usually has a full understanding of language in most situations. In other cases, though, they appear as if they have a total lack of language where one would expect oral speech, such as in school. This condition may extend over a period of time, at least 1 to 2 months and longer. This occurs in the absence of any specific medical problem that may prevent speech.

Risks

What are the causes and risks of the condition?

The cause of selective mutism is not clear. Possible causes include:
  • immigrant family background
  • significant early childhood trauma
  • injury that affects the mouth
  • anxiety
  • possible history of speech disorders early in childhood or delayed onset of speech

Prevention

What can be done to prevent the condition?

There is no specific way to prevent selective mutism at this time. Reducing childhood emotional trauma or stress may reduce this and other mental disorders.

Diagnosed

How is the condition diagnosed?

Diagnosis of selective mutism is usually by history, physical examination, and ruling out other causes.
Tests may include cranial CT scans, x-rays, dental exams, or examination by specialists. A neurologist or an ear, nose, and throat specialist may rule out other causes of lack of speech. A speech therapist, psychologist, and psychiatrist can assess communication skills and mental state.

Long Term Effects

What are the long-term effects of the condition?

Most episodes of selective mutism may only last 2 to 3 months and cause short-term educational or occupational disabilities. Long-term effects may include other behaviors or problems that can have a long-term impact on education and employment.

Other Risks

What are the risks to others?

Selective mutism is not contagious and cannot be spread to others.

Treatments

What are the treatments for the condition?

Treatment for selective mutism may include cognitive-behavioral therapy. In behavioral treatment or therapy a person can work through situations that may cause selective mutism. Family therapy may also help the family resolve issues that may contribute to selective mutism. Therapy also offers support for those experiencing selective mutism. Medications for anxiety or social phobias may be given.

Side Effects

What are the side effects of the treatments?

Some medications may cause drowsiness, sleep disorders, irritability, and stomach upset.

After Treatment

What happens after treatment for the condition?

Normal oral speech generally returns in a short time. The person may require further psychological or psychiatric care for any other conditions that are present.

Monitor

How is the condition monitored?

Progress in speech therapy and cognitive-behavioral therapy will assist in monitoring selective mutism. Oral speech progress in a variety of settings will also help in monitoring selective mutism. Any new or worsening symptoms should be reported to the healthcare professional.

Sources

Selective Mutism Group [hyperLink url="http://www.seletivemutism.org" linkTitle="www.seletivemutism.org"]www.seletivemutism.org[/hyperLink]

The Anxiety Network International [hyperLink url="http://www.anxietynetwork.com/spsm.html" linkTitle="www.anxietynetwork.com/spsm.html"]www.anxietynetwork.com/spsm.html[/hyperLink]

Selective Mutism Foundation [hyperLink url="http://personal.mia.bellsouth.net/mia/g/a/garden/garden/home.htm" linkTitle="personal.mia.bellsouth.net/mia/g/a/garden/garden/home.htm"]personal.mia.bellsouth.net/mia/g/a/garden/garden/home.htm[/hyperLink]

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