Mutism in children is a reversible absence of speech (from “mutus” - silence), the causes of which are varied (stress, trauma, disease). In any children's group you can meet a “strange” child who is withdrawn, silent, almost “mute”. At home, the child behaves confidently, communicates well, feels quite comfortable, and is attached to his loved ones. But as soon as you find yourself in a different environment, your behavior changes radically.
The baby refuses to enter into any relationship with the interlocutor, avoids conversations, touches, and does not want to play with other children. This pathology of behavior is called “mutism,” which means “temporary muteness.”
Selective mutism is often diagnosed in children who stubbornly refuse to talk to strangers. The child is able to hear, understand and analyze other people’s speech, but cannot overcome his own psychological barrier and participate in the conversation.
Selective (also known as selective) or psychogenic mutism is an anxiety disorder. Children feel good and speak normally in conditions that are comfortable for them (home, family, friends).
If you have to change your usual environment, children stop speaking and lose communication skills. The child simply cannot utter a word (fear of speaking), and not just doesn’t want to.
Selective mutism can persist into adulthood, manifesting itself in the form of various social phobias.
Selective mutism occurs in families with an uncomfortable psychological climate. A number of experts consider this type of mutism to be a manifestation of a neurotic disorder.
In children, in addition to sudden muteness, symptoms of depressive tendencies, vulnerability, timidity, and impressionability are expressed. The disease is especially severe in adolescence. It tends to be passed down through the family.
Selective mutism in children occurs when the following character traits are present:
Hysterical mutism is characterized by the presence of acute paresis of verbal manifestations. The child retains the ability to communicate through gestures, facial expressions, and writing (articulation function).
Sometimes the baby makes mooing or other inarticulate sounds. But he cannot even speak in a whisper. Often hysterical mutism in children is combined with other neurotic diseases (enuresis).
Surdomutism (or temporary loss of hearing) may appear after stress or trauma in a child, but there is no damage to the central nervous system.
Akinetic mutism occurs when there are changes in brain tissue (trauma, tumor). Symptoms indicate the presence of systemic inhibition of the child’s mental activity. All requests are fulfilled with a long delay; the child has no speech or motor activity.
Apallic syndrome is similar to akinetic syndrome, but has more severe manifestations and consequences. The apallic type of mutism is called “waking coma” and rarely ends with complete recovery.
All types of mutism are characterized by symptoms:
Drug therapy is not the mainstay for mutism. It is not recommended to prescribe tranquilizers to children unless absolutely necessary. If drugs are still used, they should be discontinued gradually, preventing the development of addiction in the child.
Modern medicine is developing the use of new techniques (selective serotonin inhibitors), treatment of which minimizes side effects.
Treatment of mutism is carried out by specialists: psychologist, psychiatrist, psychotherapist, speech therapist. For children, mutism is treated using a “multimodal approach”, family, behavioral and individual therapy.
Selective mutism is treated by specialists taking into account the cause of the disease. Lesions of the central nervous system in akinetic mutism are difficult to treat, and the prognosis is not always optimistic.
Treatment by a psychologist for selective mutism is based on behavioral methods by establishing communication with peers and strangers.
Often the problem of the disease starts at school, so it is important for the school psychologist to use the help of the child’s teachers and classmates. The child is taught basic behavior and the ability to speak in large groups of people (class, group of friends).
The prognosis for any type of mutism depends on many factors: the duration of the disease, deformation of the child’s personality, and his personal qualities.
If mutism occurs when a child enters school, the disease is usually transient and goes away after 6-12 months. This condition often goes away in middle school. However, sometimes there are behavioral abnormalities in a child many years (5-10) after the disease.
It is important to start treatment of any type of mutism on time, because lost time can do a disservice and lead to complications when the disease becomes persistent and is fraught with many deviations in adulthood (social phobias, obsessive-compulsive disorder, mental disorders).
Speech mutism is the most severe psychomotor deviation observed in neurology and psychiatry. It is characterized by a complete loss of vocalization and articulation, that is, the occurrence of complete silence. At the same time, understanding the speech of other people and phonemic hearing are not impaired.
The disease is rare in childhood and is often confused with schizophrenia, mental retardation and other disorders. Often, mutism in a child is attributed to his banal laziness and stubbornness before learning to speak.
The causes of childhood mutism are directly related to mental disorders in the child, misunderstanding or overprotection on the part of parents, a kind of protest that gives rise to an inferiority complex.
All types of pathology are classified as endogenous-psychotic, psychogenic and psychopathic. Types of mutism vary according to the course of the disease and its occurrence.
This type of disorder preserves the patient’s ability to perceive information and speak. Characterized by a persistent refusal to speak in certain situations.
May be associated with psychological factors, depression, affective disorders; selective mutism in children - with loneliness or, on the contrary, overprotection on the part of parents. In some cases, selective mutism is a consequence of emotional or physical trauma.
Characterized by systemic inhibition of speech and motor activity. The patient is awake, there are no signs of fatigue or drowsiness.
However, requests are fulfilled with great delay, and there is a lack of expressive speech and motor activity.
In medical practice, this syndrome is called “waking coma.” Typically, the condition lasts from several weeks to several months, and upon recovery from it, the patient experiences amnesia of impressions that existed throughout the manifestation of the disorder.
It often manifests itself in childhood and is characterized by a persistent refusal to speak with strangers or in their presence. All functions of the speech apparatus are preserved.
The patient is capable of analyzing what is said, normally hears and understands other people’s speech, but cannot cope with his own barrier to continuing the conversation.
It is similar in characteristics to selective mutism, but can persist in adults, especially if adequate treatment measures were not taken in childhood. Selective mutism is directly related to social phobia in children and adults.
Such people retain the ability to understand speech and speak, but cannot speak themselves under certain circumstances.
Characterized by acute paresis of verbal function. Has certain similarities with the sudden onset of the transient phase of motor aphasia. The patient retains motivation for dialogue, but his verbal ability loses its properties.
The patient has the ability to write, gesture, and communicate using active facial expressions; he can even make inarticulate mooing sounds with intonation coloring, open his mouth slightly and move his lips. Conversation in a whisper becomes impossible, despite the preservation of articulatory functions.
Severe headaches can be caused by toxic encephalopathy of the brain. The widespread use of toxic chemical substances brings this disease to the forefront, especially for workers who are employed in the chemical industries.
Mutism syndromes arise due to local damage to the dominant parts of the brain by traumatic, tumor and inflammatory processes. The patient lies motionless, his pupils retain motor activity, vision fixation is not impaired.
At the same time, the patient has no contact with others and does not have the opportunity to talk to them. The response to painful and sound stimuli is temporary activation of physical activity.
Differs from akinetic in severity. In general, doctors classify this case as a vegetative state and equate it to a coma. The patient completely lacks any reflexes and reactions, or signs of vital activity.
Only the sleep and wake patterns are preserved. Most often, this process is irreversible.
It is characterized by the almost complete elimination of the patient’s mental activity and surrounding perception. The patient lies motionless in bed, his motor and speech functions are grossly impaired and are almost completely absent.
Urinary and fecal incontinence may occur. All symptoms appear while awake. The cyclicity of sleep is preserved. The patient readily accepts food from a spoon and may show signs of anxiety, restlessness, and dissatisfaction.
The provoking factors of mutism are different and diverse.
The disorder can be caused either by nervous shocks and hysterical neuroses, or by the presence of a tumor in certain areas of the brain.
It can also be triggered by simple fatigue and severe fear.
The most common causes of the disease are the following factors:
The clinical picture of the disorder may vary according to the type of disorder and its severity. There are no particular differences in the symptoms of the development of pathology in adults or children.
However, the age of the patient and the provoking factors that contributed to the development of mutism are also important.
For all patients, there are some common signs of the disorder:
Differential diagnosis of mutism is carried out comprehensively and in several stages, until the true causes of the disorder and its type are established in each individual case.
Additional consultation with a psychiatrist and speech therapist may be required.
Differential diagnosis of mutism and aphasia:
Effective treatment of mutism involves the use of medications and mandatory psychological assistance. In some cases, complex therapy is selected.
Depending on the type of deviation and the factors that provoke it, the prognosis can be either favorable or signal the irreversibility of the disorder. Thus, timely correction of selective mutism and affective disorders allows adults and children to return to a full life.
The outcome of post-stroke and post-traumatic therapy depends on numerous aspects, and only a specialist can make an adequate prognosis in each individual case.
If the disorder is ignored and its manifestations are not given due concern, mutism can cause irreparable harm to the patient’s social adaptation and his work activity.
To prevent the development of the disorder, it is enough to adhere to generally accepted standards for maintaining a healthy lifestyle.
It is very important to surround the sick person with care and care; it is necessary to protect him from shocks and stress.
Patients who have suffered a stroke, tumor resection or transient ischemic attack are required to receive maintenance therapy.
Preventing the disease involves following the following rules:
It is important to understand that with mutism it is necessary to carry out an adequate diagnosis in a timely manner and begin treatment immediately. If the disorder is associated with past illnesses, special supportive therapy and long-term work with specialists are needed.
If the provoking factor is a mental disorder, it is necessary to take measures for specific adaptation work. By leading a healthy lifestyle and monitoring their health, any person can avoid diseases and disorders that they entail.
At home, the child behaves confidently, communicates well, feels quite comfortable, and is attached to his loved ones. But as soon as you find yourself in a different environment, your behavior changes radically.
The baby refuses to enter into any relationship with the interlocutor, avoids conversations, touches, and does not want to play with other children. This pathology of behavior is called “mutism,” which means “temporary muteness.”
Selective mutism is often diagnosed in children who stubbornly refuse to talk to strangers. The child is able to hear, understand and analyze other people’s speech, but cannot overcome his own psychological barrier and participate in the conversation.
Selective (also known as selective) or psychogenic mutism is an anxiety disorder. Children feel good and speak normally in conditions that are comfortable for them (home, family, friends).
If you have to change your usual environment, children stop speaking and lose communication skills. The child simply cannot utter a word (fear of speaking), and not just doesn’t want to.
Selective mutism can persist into adulthood, manifesting itself in the form of various social phobias.
This behavior often occurs in children with a labile nervous system, character traits such as isolation, resistance, and causeless anxiety. Anxious children need support from adults in situations that are extreme for them.
Selective mutism occurs in families with an uncomfortable psychological climate. A number of experts consider this type of mutism to be a manifestation of a neurotic disorder.
In children, in addition to sudden muteness, symptoms of depressive tendencies, vulnerability, timidity, and impressionability are expressed. The disease is especially severe in adolescence. It tends to be passed down through the family.
Selective mutism in children occurs when the following character traits are present:
In adulthood, if untreated, such patients may experience changes in behavior in the form of:
Hysterical mutism is characterized by the presence of acute paresis of verbal manifestations. The child retains the ability to communicate through gestures, facial expressions, and writing (articulation function).
Sometimes the baby makes mooing or other inarticulate sounds. But he cannot even speak in a whisper. Often hysterical mutism in children is combined with other neurotic diseases (encopresis, enuresis).
Surdomutism (or temporary loss of hearing) may appear after stress or trauma in a child, but there is no damage to the central nervous system.
Akinetic mutism occurs when there are changes in brain tissue (trauma, tumor). Symptoms indicate the presence of systemic inhibition of the child’s mental activity. All requests are fulfilled with a long delay; the child has no speech or motor activity.
Apallic syndrome is similar to akinetic syndrome, but has more severe manifestations and consequences. The apallic type of mutism is called “waking coma” and rarely ends with complete recovery.
All types of mutism are characterized by symptoms:
Drug therapy is not the mainstay for mutism. It is not recommended to prescribe tranquilizers to children unless absolutely necessary. If drugs are still used, they should be discontinued gradually, preventing the development of addiction in the child.
Modern medicine is developing the use of new techniques (selective serotonin inhibitors), treatment of which minimizes side effects.
Treatment of mutism is carried out by specialists: psychologist, psychiatrist, psychotherapist, speech therapist. For children, mutism is treated using a “multimodal approach”, family, behavioral and individual therapy.
Selective mutism is treated by specialists taking into account the cause of the disease. Lesions of the central nervous system in akinetic mutism are difficult to treat, and the prognosis is not always optimistic.
Treatment by a psychologist for selective mutism is based on behavioral methods by establishing communication with peers and strangers.
Often the problem of the disease starts at school, so it is important for the school psychologist to use the help of the child’s teachers and classmates. The child is taught basic behavior and the ability to speak in large groups of people (class, group of friends).
The prognosis for any type of mutism depends on many factors: the duration of the disease, deformation of the child’s personality, and his personal qualities.
If mutism occurs when a child enters school, the disease is usually transient and goes away after 6-12 months. This condition often goes away in middle school. However, sometimes there are behavioral abnormalities in a child many years (5-10) after the disease.
It is important to start treatment of any type of mutism on time, because lost time can do a disservice and lead to complications when the disease becomes persistent and is fraught with many deviations in adulthood (social phobias, neuroses, obsessive states, mental disorders).
Mutism is a disease that manifests itself in the complete absence of speech, provided that the speech apparatus is completely intact. This process should not be considered irreversible, since speech restoration is quite possible with proper treatment, which is prescribed only by a doctor.
The following possible causes for the development of this disease are identified:
Rarely, but still occurring, a disease of unknown etiology.
There are such forms of this disease in children:
The most unfavorable prognosis is for the apallic form of mutism in a baby - in such cases, even if treatment is started in a timely manner, complete recovery is extremely rare.
It should be noted that with this disease the general clinical picture will be supplemented by specific signs of the form of the disease itself. General symptoms include the following:
Selective mutism in children is accompanied by the following symptoms:
Akinetic mutism can be accompanied by the following symptoms:
With selective mutism, the general clinical picture can be supplemented by the following symptoms:
It should be noted that in adult life, selective mutism can develop into various mental illnesses and social phobia.
The phobic form of this disease is characterized by periodicity of symptoms - the clinical picture appears only under severe stress, psychological trauma or moral violence against the child.
The appalic form does not have specific clinical manifestations; the symptoms fully correspond to the general list. However, with this form of the disease, complete recovery is extremely rare. In medicine, there is an unofficial name for this form of the disease - “waking coma”.
If you have the clinical picture described above, you should seek medical help as soon as possible. In this case, you may need to consult a neurologist, psychotherapist, or speech therapist.
The diagnostic program may include the following activities:
As for standard laboratory examination methods, they are prescribed only when necessary.
Basic treatment will depend on the underlying factor. If the etiology of mutism is a pathological process in the brain, then surgery may be required:
After the operation, rehabilitation is required both in the medical institution itself and in a specialized sanatorium, where the correction of speech function and social adaptation of the patient is carried out.
Taking medications is kept to a minimum. In some cases, the doctor may prescribe sedatives and tranquilizers. Nootropic drugs may be prescribed to improve brain function.
A special place in the treatment of this disease is occupied by psychotherapy with a multimodal approach - complex treatment is carried out with elements of family, individual and behavioral therapy.
It should be understood that the effectiveness of treatment for such a disease in a child will depend not only on the therapy prescribed by doctors, but also on the psycho-emotional situation in the family. The baby should be protected from stress, moral trauma and nervous strain.
In addition to the specific individual course of treatment, the following general recommendations should be taken into account:
Treatment for this disease can last several months or several years.
The prognosis will depend on the form and stage of development of the disease. As for complications, the following social disorders may develop against the background of mutism:
Unfortunately, there are no targeted methods of prevention. However, the risk of developing such a disease in a child can be minimized if the following is applied in practice:
At the first symptoms, you should consult a doctor, and not ignore the problem or try to fix it yourself.
If you think that you have Mutism and the symptoms characteristic of this disease, then doctors can help you: a neurologist, a psychotherapist, a speech therapist.
We also suggest using our online disease diagnostic service, which selects probable diseases based on the entered symptoms.
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Selective mutism is a pathology in which children develop muteness at certain moments and in cases of the presence of certain specific individuals, with complete preservation of the speech apparatus. These children retain the ability to understand speech and are able to speak in other conditions. The most common manifestation of selective mutism is the refusal of children to speak during adaptation to school and kindergarten. Most cases are associated with emotional disorders.
The disease usually develops in preschoolers and children of primary school age. In rare cases, selective mutism affects adults. When developing in children, mutism does not have a sexual preference, whereas in adulthood it has a preference for women.
In cases of normal development of a schoolchild, selective mutism, associated with adaptation to school, goes away on its own by the age of 10. This is explained by the fact that the patient realizes the need for verbal communication in society. The student understands that his peers and teachers will not indulge him, as his parents do, and if he does not overcome himself, he will receive the stigma of “inferior.” However, there are cases when the help of a specialist is necessary to correct the pathology. Therefore, if you suspect that a child has selective mutism, you should not expect the disorder to go away on its own.
The development of mutism is based on organic and mental disorders. The most common causes of mutism are:
Selective mutism can be caused by brain disorders. So, as a result of aphasia, patient a experiences disturbances in speech skills, understanding and word formation. Such children are practically silent. During the first three years, a sick baby is able to use only two or three words; vocabulary replenishment is either completely absent or occurs.
Mutism can be provoked by strong emotional shocks: fear, serious conflict, severe resentment. Children who have experienced psychological trauma suffer from selective mutism. In this case, muteness is not associated with organic disorders. Such mutism is quite rare, and when the patient begins to speak, the speech is completely normal.
Often this type of pathology is diagnosed in children with severe sensitivity, a high level of sensitivity, and physical weakness. In some cases, muteness is a certain form of protest, which is an expression of silent aggression.
The main symptom of this pathology is the refusal of speech communication in certain situations that are exciting for the patient, or in the company of certain people, while under normal circumstances speech skills are completely preserved. The presence of the disorder is indicated by persistence of the condition for more than one month.
Children with selective mutism are usually children with a high level of intelligence, who, according to psychologists, are not mature enough to communicate with people. At the same time, while they are aware of the need to maintain verbal contact with all the people around them, their character is capable of undergoing some significant distortions.
Inside the little mutist, claims towards others and dissatisfaction with oneself accumulate, which can be expressed in the form of demonstrative antics. Such children usually try to join the company of hooligans and poor students. They feel satisfaction from defiant behavior, sometimes it seems that they are literally fascinated by vices. If the behavior of such children is corrected in time, then such unpleasant moments can be avoided.
In the absence of specialized help, an adult mutist may experience serious difficulties in his personal life. This pathology literally chains the patient to his mother.
The mother constantly tries to help, taking care of the child in all situations, which leaves an imprint on relationships with the opposite sex in the future.
Children manipulate their peculiarity, using their parents as the only link connecting them with society. Parents are also influenced by this pathology of their children: they protect this emotional contact, every word has a special meaning for them. A certain symbiosis arises that distorts the personal development of children.
Boys grow up to be dependent, immature and at the same time overly domineering. In childhood, such children turn into family “tyrants”. Girls see their mother as a potential rival, which can lead to early marriage or promiscuity. This behavior is a kind of revenge for the feeling of lack of freedom, although the child himself did not let his mother go. In this regard, you should not wait until these deviations develop, but begin timely treatment, which will restore normal speech and prevent personal problems from developing.
Treatment of selective mutism depends on the type of pathology and can be carried out by psychiatrists, psychologists, speech therapists, and psychotherapists. Each of these specialists has their own methods of treating pathology. Treatment in any case involves taking into account the cause of the disease.
With drug therapy used by psychotherapists and psychiatrists, in special cases tranquilizers, selective serotonin reuptake inhibitors or sedative neuroleptics are prescribed. Drug therapy is not the mainstay.
Typically, treatment for selective mutism begins with a “multimodal approach,” which involves the use of a wide repertoire of techniques and techniques. The most effective in this case is a combination of family, individual and behavioral therapy.
Treatment by a psychologist is based on behavioral techniques. During classes, children practice their speech skills, and successful attempts are reinforced with rewards. Treatment involves participation in the correction of pathology by teachers, parents, and classmates. Classes begin with the child getting used to his own voice.
For this purpose, their speech is recorded and listened to, paying attention to how beautiful the child’s voice sounds. Gradually, he develops a need for pronunciation and communication. Then new interlocutors are introduced into the “company”. At first, these may be people whom the patient trusts, and then the group expands to include strangers. Usually they are the child's peers. Treatment involves working with one’s own anxiety, which is common to all people.
From what deep basements did you pull out the information that this is a “form of hysterical neurosis” I have no idea. Show in full... Since the adoption of ICD-10 (1994, for a second), this has been classified as an anxiety disorder and is often accompanied by quite serious social phobia. No, your child, of course, should be diagnosed by a specialist. Competent specialist. Of which there are, unfortunately, not many in Russia. But real selective mutism is not hysteria, and it is not an attempt at manipulation.
With strangers, alone, in a taxi, in a store, at school - it’s hard for me to talk. Show in full... When they ask me a question, when they demand an answer, when there is a lot of attention, it is very difficult for me to speak.
Coming to the store, when I try to say something, the sellers think that I forgot what I wanted... And they mock me.
That's why I'm silent.
At school they think I'm faking it. Because I talk to my classmates during breaks. No one in the family understands either.
Last year I went to two psychologists, one referred me to a psychiatrist, and the psychiatrist referred me to a psychotherapist.
And he prescribed pills.
But I didn’t go to see him again...
I can’t speak when I’m worried, a kind of stupor appears.. My body seems to go numb, it’s very difficult to pronounce any letter with my lips.
If you need to ask something. I'm writing. I write on my phone, on a piece of paper, anywhere.
I just get lost, cover my face, don’t look into your eyes and just remain silent.
I'm tired of this! But I am unable to fight this, and I don’t know what will happen next in life.
Sometimes children with normal physical and mental development cannot speak, although physical defects and organic lesions are not detected in them. Neurologists diagnose such children with “infantile mutism.” This disease-syndrome has not been sufficiently studied and is a rare phenomenon, common among young children and adolescents.
Mutism in children is often mistaken for schizophrenia or mental retardation, or this condition is assessed as stubbornness. In this case, inadequate psychological, pedagogical and therapeutic approaches are chosen for treatment. Often the fact of a violation of speech contact is regarded in various social situations as a temporary phenomenon that can be resolved on its own. However, persistent or chronic selective mutism, if treated incorrectly or not, can lead to maladaptation, both school and social, including in adulthood. To prescribe complete treatment, it is important to establish an accurate diagnosis in a timely manner.
There are: selective mutism, selective mutism in children and partial, voluntary mutism, situationally determined and characterological, speech phobia, muteness with preserved hearing.
When diagnosing mutism, the reasons can be different psychological and are considered individually. Mutism often manifests itself as a kind of silent protest directed against everyone and the entire world. This is how the child expresses silent aggression due to the inability to express himself, tell everyone about himself and express his desires orally. Such children sometimes simply do not have the space to express their aggression and other strong emotions adequately. Parents, teachers and nannies do not allow children to verbally demonstrate this aggression. Therefore, not having suitable words for expression, the child simply withdraws into himself and protests silently.
Misunderstanding by adults and lack of attention are significant reasons for mutism, since the child cannot correctly use his speech to tell his interlocutor about his worldview and problems. Realizing that adults or peers cannot understand him, the child stops trying to talk about himself. He chooses a position of waiting and changing the situation with the hope that he will be understood. In this case, the situation worsens and leads to the child’s immersion in his own inner world called childhood mutism.
It is difficult for parents to understand that mutism is developing in children; symptoms may appear:
Selective mutism in children comes in several variants and depends on the etiological factor:
The mechanisms of elective mutism can be mixed and have different classifications: constant, situational, elective and total with transient or continual duration.
Selective mutism is diagnosed in the absence of speech contact in educational institutions in general, or only in the classroom. The child may not talk to everyone or only to certain teachers or children. In such cases, knowledge is tested only in writing. Instead of verbal contact, children use pantomime and facial expressions, or may freeze in front of certain people, “lower” their eyes and head, pull it into their shoulders, and prevent physical contact. Mutism often affects only relatives.
Compared with early childhood autism, in which there is no verbal contact with others, selective mutism is characterized by a violation of verbal communication after normal verbal communication. His character will be selective, associated with a certain person, room or situation. With selective mutism, there will be no symptoms typical of autism: stereotypy with games and ridiculous overvalued hobbies, total behavioral disorders against the background of pretentious fears, facial expressions and motor skills, taking into account deep introversion and disharmonious mental development.
Akinetic mutism manifests itself as disturbances in speech and motor functions. The child will not talk or answer questions or interact with others while fully conscious. This is called a "waking coma." At the same time, he will lie motionless with his eyes open, directed at one point, but his gaze will be fixed on objects that move. With sharp stimuli (painful, light or sound), a motor response will occur. This type of mutism occurs when the oral parts of the brain stem and the limbic-reticular system in the activating parts are damaged. The cause is traumatic brain injury and tumor, inflammatory or vascular processes.
Total mutism is diagnosed when the child is completely silent in any environment, with all the people around him. The cause is schizophrenia and organic diseases of the brain of the head. It often manifests itself in catatonic syndrome and develops in the form of a reactive state in connection with an affective-shock reaction and hysterical states.
Selective symbiotic mutism is distinguished with the presence of a symbiotic relationship between a child and a certain person, and with the child’s subordinate-manipulative relationships with other participants in the social environment.
With speech phobic selective mutism, the child is afraid to hear his own voice, which is characterized by ritual behavior. With reactive selective mutism, the child becomes self-absorbed due to reactive depression. When muteness is used as a psychological weapon, selective passive-aggressive mutism develops.
Differential in-depth diagnostics are performed by speech therapists, pediatricians, neurologists and psychologists, psychotherapists, ophthalmologists, otolaryngologists and neuropsychologists, audiologists and neurosurgeons. They carry out and examine: craniography, ECG, radiography (scopy) of the chest organs, MRI, EEG, EchoEG, REG.
If a child is diagnosed with mutism, treatment is prescribed on an outpatient basis, except for cases requiring laboratory and instrumental studies and observation in a psychiatric hospital. Here, specific differences between ongoing organic or endogenous disease and selective mutism are identified. Children with deep school maladaptation are also distinguished. They are provided with gentle training in a semi-inpatient psychiatric hospital.
Treatment of mutism is carried out by a psychologist or psychotherapist using fairy tales and games, sand and hypnosuggestive therapy to correct the neurosis that caused the pathology, and correct the situation in the family and school. Behavioral techniques are used in groups. Incentives are provided for the child when he enters into a conversation. Teachers and classmates are involved in treatment after consultation with educational psychologists.
For articulation disorders, speech therapy is used to reduce the child's embarrassment and teach him to communicate freely with others.
Family therapy and social skills training are included in a complex that teaches how to overcome problems of social relationships. In the presence of selective mutism and social phobia, SSRIs (selective serotonin reuptake inhibitors) are used for treatment.
Drugs and dosages are prescribed individually to each patient.
Treatment is performed in order to relieve depressive and neurotic disorders, improve interpersonal contacts, and eliminate general developmental disorders: schizophrenia with specific speech development disorders, selective transient mutism associated with anxiety disorder due to fear of separation of young children from their parents.
Selective mutism is a pathology in which, for various reasons, the child refuses to speak. If it is diagnosed in a timely manner, there is a high chance of a complete recovery for the patient. The disease is considered neurological.
Selective mutism is a peculiar disease, which is characterized by proficiency in oral and written speech and normal mental development. The child does not focus on himself. In addition, the speech centers located in the brain are functionally intact.
The treatment process is not fast, but under no circumstances should you rush.
Selective mutism in children has a positive prognosis in most cases. However, there is one caveat: everything will be fine if the symptoms of the disorder disappear within a year after their onset.
Otherwise, silence may become a habit and become part of personality development. That is, this disease can remain with the child even after he grows up. That's all the features of this disease. Be healthy!
