Elective Mutism Selective Mutism

Overview, Causes, & Risk Factors

Selective mutism is a condition in which a person who is usuallyfluent 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 exhibitselective mutism appear to have some type of acute situational anxiety\ \generalized anxiety disorder\ \ panic disorder \ \ post-traumatic stress disorder \ \phobias\ \ obsessive compulsive disorders \ anxiety disorder. A person who has this condition usually hasa fullunderstanding of language in most situations. In other cases, though, theyappear as if they have a total lack of language where one would expect oralspeech, such as in school. This condition may extend over a period of time, atleast 1 to 2 months and longer. This occurs in the absence of any specificmedical problem that may prevent speech.

What are the causes and risks of the condition?

The cause ofselective 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
  • Symptoms & Signs

    What are the signs and symptoms of the condition?

    Symptoms of selective mutism include:

  • refusing to talk in one or more social situations, including school
  • a speech disturbance that interferes with achievement in work or schoolwhen the condition lasts at least 1 month or more
  • Selective mutism does NOT appear to be related to:

  • lack of familiarity with the spoken language
  • degree of comfort with speaking in social situation
  • communication disorders, such as stuttering or aphasia
  • pervasive developmental delay, schizophrenia, obsessive-compulsive disorder, or other psychotic disorder or attention deficit disorder
  • Diagnosis & Tests

    How is the condition diagnosed?

    Diagnosis of selectivemutism is usually by physical examination. Tests 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 and a psychologist can assess communication skills and mentalstate.

    Prevention & Expectations

    What can be done to prevent the condition?

    There is nospecific way to prevent selective mutism at this time. Reducing childhoodemotional trauma or stress mayreduce this and other mental disorders.

    What are the long-term effects of the condition?

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

    What are the risks to others?

    Selective mutism is notcontagious and cannot be spread to others.

    Treatment & Monitoring

    What are the treatments for the condition?

    Treatment for selective mutismmay include anxiety \ \ depression \ \eating disorders such as anorexia nervosa and bulimia \ \ alcohol and drug abuse problems\ cognitive-behavioraltherapy. In behavioral treatment or therapy a person can work throughsituations that may cause selective mutism. Family therapy may also help thefamily resolve issues that may contribute to selective mutism. Therapy alsooffers support for those experiencing selective mutism. Medications foranxiety or social phobias may be given.

    What are the side effects of the treatments?

    Somemedications may cause drowsiness,sleep disorders, irritability, and stomach upset.

    What happens after treatment for the condition?

    Normal oral speechgenerally returns in a short time. The person may require furtherpsychological or psychiatric care for any other conditions that are present.

    How is the condition monitored?

    Progress in speech therapy and anxiety \ \ depression \ \eating disorders such as anorexia nervosa and bulimia \ \ alcohol and drug abuse problems\ 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 provider.

    Article type: xmedgeneral