Selective mutism
From Freepedia
| Selective mutism | ||
|---|---|---|
| ICD-10 code: | F94.0 | |
| ICD-9 code: | 309.83 | |
Selective mutism is a condition in which what is often anxiety or excessive shyness causes a person, who has the ability to do so, to refuse to speak in certain situations.
In the DSM-IV selective mutism is described as a rare psychological disorder in children. Children with the disorder are fully capable of speech and understanding language, but fail to speak in certain social situations when it is expected of them. They function normally in other areas of behaviour and learning, though appear severely withdrawn and might be unwilling to participate in group activities. As an example, a child may be completely silent at school but speak freely at home. Sometimes the behaviour is triggered by the presence of strangers.
The disorder is not regarded as a communication disorder, in that most children communicate through facial expressions, gestures, etc. In some cases, selective mutism is a symptom of a pervasive developmental disorder or a psychotic disorder.
In diagnosis, it can be easily confused with autistic spectrum disorder, especially if the child acts particularly withdrawn around his or her psychologist. Unfortunately, this can lead to incorrect treatment.
Contrary to popular belief, people suffering from selective mutism do not necessarily naturally improve with age, and consequently, aggressive treatment at an early age is suggestive. The effectiveness of current treatment methods, generally involving therapy and gentle and supportive introductions to social situations. There is some evidence indicating that antidepressants such as Prozac may be effective in treating children with selective mutism.
The former name elective mutism indicates a widespread misconception even among psychologists that selective mute people choose to be silent in certain situations, while the truth is that they are forced by their extreme anxiety to remain silent; despite their will to speak they just cannot make any voice. To reflect the involuntary nature of this disorder, its name has been changed to selective mutism in 1994. However, misconceptions still prevail; for instance, the ABC News erroneously attributed the cause of selective mutism to trauma and described it as wilful in a report dated May 26, 2005.
The incidence of selective mutism is not certain. Owing to the poor understanding of the general public on this condition, many cases are undiagnosed. Based on the number of reported cases, the figure is commonly estimated to be 1 in 1000. However, in a 2002 study in The Journal of the American Academy of Child and Adolescent Psychiatry, the figure has increased to 7 in 1000.
