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Elective mutism

Selective mutism is a social anxiety condition, in which a person who is quite capable of speech, is unable to speak in given situations. more...

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Description

In the DSM-IV selective mutism is described as a rare psychological disorder in children. Children (and adults) 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 They function normally in other areas of behaviour and learning, though appear severely withdrawn and might be unwilling to participate in group activities. It is like an extreme form of shyness, but the intensity and duration distinguish it. As an example, a child may be completely silent at school, for years at a time, but speak quite freely or even excessively at home.

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it can be easily confused with autistic spectrum disorder, or Aspergers, especially if the child acts particularly withdrawn around his or her psychologist. Unfortunately, this can lead to incorrect treatment.

Selective mutism is usually characterised by the following:

  1. The person does not speak in specific places such as school or other social events.
  2. The person can speak normally in at least one environment. Normally this is in the home.
  3. The person's inability to speak interferes with his or her ability to function in educational and/or social settings.
  4. The mutism has persisted for at least a month and is not related to change in the environment.
  5. The mutism is not caused by another communication disorder and does not occur as part of other mental disorders.

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 willful 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.

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Shaping
From Gale Encyclopedia of Childhood and Adolescence, 4/6/01 by Zoran Minderovic

Shaping, or behavior-shaping, is a variant of operant conditioning. Instead of waiting for a subject to exhibit a desired behavior, any behavior leading to the target behavior is rewarded. For example, B. F. Skinner (1904-1990) discovered that, in order to train a rat to push a lever, any movement in the direction of the lever had to be rewarded, until finally, the rat was trained to push a lever. Once the target behavior is reached, however, no other behavior is rewarded. In other words, the subject behavior is shaped, or molded, into the desired form.

Although rejected by many orientations within the field of psychology, behavioral techniques, particularly shaping, are widely used as therapeutic tools for the treatment of various disorders, especially those affecting verbal behavior. For example, behavior shaping has been used to treat selective, or elective,mutism, a condition manifested by an otherwise normal child's refusal to speak in school. Using candy and toys as a reward (Masten, Stacks, Caldwell-Colbert, and Jackson, 1996), a therapist succeeded in eliciting speech from an eight-year-old selective mute Mexican American boy.

Therapists have also relied on behavior shaping in treating cases of severe autism in children. While autistic children respond to such stimulus objects as toys and musical instruments, it is difficult to elicit speech from them. However, researchers (Koegel, O'Dell, and Dunlap, 1988) have noted that behavior shaping is more effective when speech attempts are reinforced than when speech production is expected. When unsuccessful efforts to produce speech are rewarded, the child feels inspired to make a greater effort, which may lead to actual speech.

While recognizing the effectiveness of behavior shaping in the laboratory and in therapy, experts, particularly psychologists who do not subscribe to behaviorism, have questioned the long-term validity of induced behavior change. For example, researchers have noted that people have a tendency to revert to old behavior patterns, particularly when the new behavior is not rewarded any more. In many cases, as Alfie Kohn has written (Kohn, 1993), behavior-shaping techniques used in school, instead of motivating a child to succeed, actually create nothing more than a craving for further rewards.

Further Reading

For Your Information

Books

  • Kohn, Alfie. Punished by Rewards: The Trouble with Gold Stars, Incentive Plans, A's, Praise, and other Bribes. Boston: Houghton Mifflin, 1993.
  • Nye, Robert D. The Legacy of B. F. Skinner: Concepts and Perspectives, Controversies and Misunderstandings. Pacific Grove, CA: Brooks/Cole, 1992.

Periodicals

  • Koegel, R. L., and M. Mentis. "Motivation in Childhood Autism: Can They or Won't They?" Journal of Child Psychology and Psychiatry 26, 1985, pp. 185-91.
  • Koegel, Robert L., Mary O'Dell, and Glen Dunlap. "Producing Speech Use in Nonverbal Autistic Children by Reinforcing Attempts." Journal of Autism and Developmental Disorders 18, no. 4, December 1988, pp. 525-38.
  • Masten, William G., James R. Stacks, A. Toy Caldwell-Colbert, and Jacqueline Jackson. "Behavioral Treatment of a Selective Mute Mexican-American Boy." Psychology in the Schools 33, no. 1, January 1996, pp. 56-60.
  • Skinner, B. F. "Can Psychology Be a Science of the Mind?" American Psychologist 45, no. 11, November 1990, pp. 1206-10.

Gale Encyclopedia of Childhood & Adolescence. Gale Research, 1998.

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