Selective Mutism

Selective Mutism - Selective Mutism in Children A...

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Selective Mutism in Children: A Psychogenic Voice Disorder Emily Buchanan April 1, 2003
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Definition in the Diagnostic and Statistical Manual of Mental Disorders The persistent refusal to talk in one or more social situations, including school Consistent failure to speak in specific social situations in which there is an expectation for speaking (e.g., school), despite speaking in other situations The disturbance interferes with educational or occupational achievement or with social communications The duration of the disturbance is at least 1 month (not limited to the first month of school) Failure to speak is not limited to lack of knowledge or comfort with social language required (e.g., bilingual or immigrant children) (American Psychiatric Association, 1994)
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Symptoms: Excessive shyness Fear of social embarrassment Social isolation Withdrawal Impulsive traits Negativism Clinging behavior Temper tantrums Controlling or oppositional behaviors
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Theories of causation Immigrant family background Significant early childhood trauma Injury that affects the mouth Possible family secrets Anxiety is most commonly an underlying feature!
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Problems of Selective Mutism Provides limited opportunity for social interaction and growth Delays the development of appropriate oral reading and work attack skills Hinders the involvement in normal school activities
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Prevalence Estimated to occur in less than .8 per 1,000 of the population Slightly more common in females than males Onset is usually before 5 years Many times disturbances may not come into attention until entry into school One or both parents of a selectively mute child have a history of anxiety symptoms, including shyness, social anxiety, or panic attacks Suggests the child’s anxiety is a familial trend! (Giddan et. Al, 1997)
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History Previously called elective mutism, renamed in 1987 Covers broad spectrum from psychoanalytic schools of Europe in 1800s to contemporary behavioral interventions In early German literature, selectively mute children were removed from the home and place in residential treatment centers A Norway study by Wergeland (1979) described selectively mute children who were removed from their homes from 8 months to 3 years Found that untreated children were better at follow-up than the children who had been removed from their homes (Giddan et. Al, 1997)
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Selective Mutism - Selective Mutism in Children A...

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