Selective Mutism Disorder
Selective mutism disorder is characterized by the inability to speak during certain situations, under certain conditions or to certain people. People with this disorder are otherwise capable of normal speech, and situations which encourage symptoms vary and are based upon the individual. For example, some children will speak freely at home, but not at all to their peers or teachers. Others may not be able to speak during group activities, or may develop the inability to speak to parents and other family members.
Symptoms of Selective Mutism Disorder
Due to the nature of selective mutism disorder, it may often be confused with any number of other syndromes or mental afflictions. This particular disorder is rare, as compared to autism or Asperger syndrome, but displays some of the same signs. The following situations may point to this condition:
- Consistently failing to speak during particular social situations, while freely and normally speaking to other people at other times
- Interference with learning, communication or achievement is directly related to lack of speech
- Symptoms present themselves for at least one month without variation, and not according to a new or potentially uncomfortable surroundings
- Failure to speak is not directly related to a learning disability, speech impediment or lack of ability to formulate words
- No other mental disorders or communication disorders are present, such as stuttering or multiple personality disorder. Note: a speech impediment may accompany selective mutism disorder, but these may first need to be ruled out as the cause of symptoms
Causes of Selective Mutism Disorder
The exact cause of selective mutism disorder is unknown, but research suggests that children affected by this condition are susceptible to high amounts of anxiety, possibly with an inherited predisposition. Certain brain functions may come into play, causing over-excitability or inhibitions which lead to the inability to speak. If a threat is perceived, the fight-or-flight response may be activated, causing certain children to shut down verbally. Any learning disabilities or speech impediments will likely add to the anxiety which leads to symptoms. As with many other mental disorders, selective mutism disorder is usually not caused by a significant trauma, such as abuse or terror, though these situations could lead to the worsening of symptoms. Often, children who are experiencing symptoms will be mistakenly labeled as defiant or stubborn, but more careful examination will reveal that most are more obedient and agreeable than other children, only with the inability to speak.
Diagnosis of Selective Mutism Disorder
Selective mutism disorder may be difficult to diagnose, considering both the fact that other disorders can produce lack of speech, and also certain uncomfortable situations may cause a child to lose the inability to talk. Coming to a diagnosis of selective mutism disorder generally begins with the ruling out of all these other conditions that may lead to the symptom in question. If no other conditions are present, the child is experiencing symptoms during situations which could be considered comfortable, and symptoms are interfering with acceleration, learning or social activities, a diagnosis may then be made. It may be helpful to present video evidence of the sufferer in normal situations, so as to provide a professional or physician with conclusive differentiation of behavior.
Treatment Options for Selective Mutism Disorder
Due to the fact that selective mutism disorder is believed to be caused by underlying problems with anxiety, there are a number of treatment options to consider. Making the most effective choices may depend upon the individual situation and some trial and error. The following are some options for treatment of this disorder:
- Traditional medication for treating anxiety such as anti-depressants or anti-anxiety medication
- Behavior modification therapy, such as praising children for speech and withholding rewards during times of silence
- Stimulus fading acts to encourage speech by first whispering, then speaking softly, etc., or encouraging communication with only one person at a time