Elective Mutism: Definition, Signs and Treatment

Elective mutism is a pathology in which, for various reasons, the child refuses to speak. If it is diagnosed in a timely manner, then there are high chances for a complete recovery of the patient. The disease is considered to be neurological.

What is the disease?

Elective mutism is a peculiar disease characterized by oral and written speech, normal mental development. The child does not fixate on himself. In addition, speech centers located in the brain are functionally intact.

A sick child simply does not want to communicate with anyone, ignores any questions addressed to him. However, if you do not pay due attention to pathology, then it can go into a chronic form. In this case, the process of socialization of children in society is further violated.

Most often, this psychological abnormality is diagnosed at the age of 3 to 9 years. In this case, such a kind of dumbness is not always shown, it all depends on the situation. Elective mutism affects very sensitive and vulnerable children.

Diagnosis of this pathology should be differential. Otherwise, a severe mental illness can be attributed to the child and a completely wrong treatment can be prescribed.

Features of the disease

Selective mutism has some nuances:

1. More often, pathology is diagnosed in girls.
2. The risk group includes those children who have a family history and have adults with speech development problems.
3. There is a disease in most cases in those families where the situation is unsuccessful.
4. Practically all sick children have cerebral pathology.
5. Violations of facial expressions, motor skills and behavior are absent.
6. In most cases, the child is diagnosed with selective mutism. That is, the patient's behavior depends on a particular situation.

These features distinguish mutism in children from other mental disorders.

Causes of the disease

There are various factors that can cause such a pathological condition:

• Inability to communicate with others, to find a common language with them.
• The lack of ability in the child orally to formulate one's desire.
• The baby does not have a space for expressing negative feelings, so he just stops talking.
• Problems with articulation.
• Unfavorable situation in the family.
• Defeat of the brain.
• Severe depression.
• The initial stage of schizophrenia or autism.
• Hysterical neurosis.
• Strong emotional excitement as a result of fright, loss of a loved one.
• Lack of attention from the parents, misunderstanding in the family.
• Some mental disorders: increased anxiety, tics of different etiologies.
• Speech disorder or lag in intellectual development.
• Banal stubbornness.

These causes can cause other pathologies. However, it is necessary to determine the elective mutism as precisely as possible so that the treatment is effective.

Symptomatology of pathology

In addition to the fact that the child is silent, there are other signs of the presented disease:

1. Incomplete disappearance of vocalization, that is, a small patient can communicate with a narrow circle of people, for example, only by parents.
2. Frequent depression, increased anxiety.
3. Fears that can turn into phobias.
4. Enuresis.
5. Possible disorders of speech development.
6. Some problems with intelligence.
7. Difficulties with the process of adaptation in society.
8. Violation of volitional activity of the personality, manifested in the fact that the child categorically refuses to talk with those people who are not part of his trusted persons.
9. Shyness.
10. Sleep and appetite disturbance.

Elective mutism in adults, as well as adolescents, is much more complicated. The clinical picture in this case is more diverse.

Varieties of mutism

Classify mutism can be on different grounds:

1. By intensity of manifestation:

• Short-term (situational).
• Constant (elective).
• Total.

2. By duration of character:

• Transit.
• Continuous.

3. Depending on the impact of a trauma:

• Hysterical. It is provoked by a strong mental shock, as a result of which speech is simply taken away. This form is found in adults and can last up to several weeks.
• Logophobic. Such a mutism is more inherent in schoolchildren. It arises from insurmountable fear of hearing your own speech. In adults, this type of pathology is practically not found.
• Mixed.

In pre-school, as well as younger school age, pathocharacteric mutism manifests itself. The main reason for this condition is a change in the child's habitual situation. It is typical for those children who have a very strong attachment to home, timidity.

There is one more classification of pathology:

• Elective mutism, the correction of which in most cases is successful. It consists in the fact that speech is absent only in certain situations.
• Akinetic. In this case, in addition to speech disorders, the patient also has motor disorders.
• Apalistic. This is the most complex form of the disease, which is expressed in the total absence of reaction to external stimuli.

Diagnostic Features

In order to accurately determine the presented pathological condition, it is necessary to contact a psychologist, a clinical psychotherapist, a neurologist and a speech therapist. These specialists not only will see signs of elective mutism, but they will also be able to cure the child. But here it should be borne in mind that if a child has not started speaking before three years, then this state can be normal, since the formation of mental processes in different children is not the same.

In addition to psychological tests, specialists can assign the following procedures to the child:

1. Electrocardiogram.
2. Electroencephalography.
3. MRI.
4. Radiography of the chest.

How is the pathology treated?

It should be noted that the treatment of elective mutism with the help of medications is extremely rare. Most often the patient is prescribed drugs that contribute to the synthesis of serotonin. The doctor can prescribe such drugs: antipsychotics, nootropics, antidepressants.

In general, the method of behavioral psychotherapy is used to determine the exact causes of the development of a pathological condition. This method of treatment involves the adaptation of a sick child in a group of interlocutors of the same age. And it is gradually increasing. At first, only two are interlocutors. If the child tries and has a positive tendency, then it should be encouraged and encouraged in every possible way.

In addition, elective mutism in children is treated with family and speech therapy. That is, parents play an important role in the treatment. They should encourage any verbal contact of their child. In addition, the baby is important to feel the attention of the parents, their emotional support.

Much depends on the environment of the small patient. If such dumbness manifests itself in the kindergarten or school, then in these institutions the teachers and peers of the child must act according to a pre-determined scheme of therapy.

It should be noted that this pathology is treated not only at home, but also in the hospital. The second option is necessary only if a complex examination or even a surgical intervention is provided.

In order to cure the child, there are no ready-made therapies. That is, in each individual case, a set of procedures is selected, which depends on the type and severity of the pathological condition.

In therapy, breathing exercises, exercises of therapeutic gymnastics, phytotherapy, massage are used.

Features of the development of the disease in adults

It should be noted that the presented disease can manifest itself not only in children. There are cases of diagnosing mutism, even in adults. The cause of this pathological condition is organic brain damage or severe mental disorders (shocks).

Men suffer from this pathology less often than women. At representatives of the weaker sex there can be a hysterical mutism. The fact is that women are more sensitive and emotional. They have a natural predisposition to excessive impulsiveness.

Recommendations for parents

In order for a small patient to overcome pathology as soon as possible, adults should help him. If elective mutism in children is diagnosed, the recommendations to parents are as follows:

• Do not show your child his concern, otherwise he will close in himself even more.
• We need to help him to believe in himself, the fact that the baby can talk when he is ready for it.
• It is necessary to encourage every positive desire of the kid to contact other people, peers.
• Parents should not be surprised if the baby first started talking, and then stopped.
• In any case, adults should show their love, attention and support to the child. Naturally, parents will have to be patient. Otherwise, all efforts of specialists can be leveled. One careless word can destroy months of diligence.

The process of treatment is not fast, but it is by no means impossible to hurry.

Prognosis of pathology

Elective mutism in children has in most cases a positive prognosis. However, there is one nuance: everything will be fine if the symptoms of the disorder disappear within a year after the appearance.

Otherwise, silence can become a habit and become a part of personal development. That is, this disease can stay with the child even after he grows up. That's all the features of this disease. Be healthy!