Selective mutism is one of the speech disorders with a psychotic cause. This manifests itself in the inability to speak in certain situations or with certain people. Although this problem is most common in children, adult patients are no exception. In addition to learning disabilities, mental stress or trauma is also to blame.
Selective mutism is a neurotic and psychotic speech disorder. Experts also understand this as a disorder of social adaptation or social relations. Although this disease manifests itself in speech, it is not a speech therapist's problem, but a psychological problem that manifests itself in the inability to speak in specific situations or with certain people.
This is definitely not an organic dysfunction. The patient understands the spoken language very well and can speak normally under certain conditions. Selective mutism often occurs in anxiety disorders.
Children are usually considered to be disabled, whereas girls may be affected somewhat more often. But the difference is not very significant. The disorder most often occurs in kindergarten or elementary school, especially when the environment changes. A very typical example: a child does not talk to teachers, but communicates without problems with parents or friends at home. Non-verbal communication in these children is usually completely preserved, some of them even whisper or at least respond with one word.
And why is the disorder called selective mutism? The word "selective" can be translated as "selective", which means that difficulties arise only in certain (selected) situations, with specific people or in certain places. Then mutism refers to a psychogenically caused loss of the ability to communicate verbally. Simply put, this means that a person is silent, although he can speak.
Causes of mutism
Selective mutism usually affects children whose nervous system maturity does not correspond to their biological age. However, it can also occur in unstable children and in people with ADHD symptoms. Of course, the development of the disease is also influenced by family and interpersonal relationships and upbringing - usually incorrectly chosen punishments, disagreements between parents, forced participation in any activity and too strict measures. But the occurrence of difficulties is definitely not related to the child's intelligence!
Mutism can also be caused by psychological stress or experiencing a certain trauma. It is important to understand that a slight injury is often enough to cause a strong body reaction that blocks speech functions. However, it is very difficult to find the exact cause of the problems, as it is often a combination of several factors.
The risk of developing the disorder increases in children who:
Shy
Frightening
Quiet
Sensitive
Closed
More disturbing
Symptoms of mutism
As mentioned above, mutism is a violation of communication skills, that is, loss of articulate speech. It usually first appears when entering kindergarten, but later age is no exception, for example, entering school, puberty, but also growing up. Mutism can also be accompanied in some people by an inability to come to terms with the collective, usually in motor, emotional and social terms. Thus, silence can also be associated with isolation from others.
As a rule, patients tend to resist social contacts, are more sensitive and often withdrawn. The development of the disease may be sudden, but there is also a slower gradual decrease in speech.
How to approach the patient?
Communicating with children with such disabilities requires a special approach. In particular, the following rules should be followed:
A child should not be forced to speak, even non-verbally.
The child should be praised even for the little things
We never put a child in the spotlight
We don't exaggerate this in response to communication successes.
We are trying new mechanisms of behavior towards the child and new ways of communication
When working with young patients, it should be borne in mind that they usually do not stand up to a strict approach, and also suffer from self-doubt, so teachers and parents should give children courage and encourage them. In this case, reading and coagulation of the patient may worsen the course of the disorder.
Even a speech therapist definitely should not insist on the child, but at first should try to communicate with him at least non-verbally. The circle of people the child talks to also needs to be expanded very slowly. The cooperation of a psychologist, parents and teachers of a young patient is also important. Other students should also be aware of the child's disability.
When it comes to teaching these children, teachers should also consider the problem and try to compensate for the lack of oral communication with other forms of communication, such as:
Gestures
By painting
By writing
Diagnosis of the disease
The diagnosis of the disease is usually made if the problem lasts more than one month. However, experts differ significantly in this regard. For example, some argue that in order to diagnose a disorder, the problem must last at least two years.
Selective mutism is then determined with the help of more participants. As a rule, a pediatrician, psychologist, psychiatrist, psychotherapist, phoniatrist and speech therapist may be involved. The child's parents and teachers play an important role.
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