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Selective 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 They function normally in other areas of behaviour and learning, though appear severely withdrawn and might be unwilling to participate in group activities.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it can be easily confused with autistic spectrum disorder, or Aspergers, especially if the child acts particularly withdrawn around his or her psychologist.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.

Read more at Wikipedia.org


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Shyness in children
From Pediatrics for Parents, 10/1/03 by Archana Khambekar

When your toddler turns bashful around unfamiliar people you consider it a developmental stage. But when the shyness lasts way beyond that phase you find yourself feeling concerned. You see your six year old hang back at birthday parties and wonder if your child's disposition could be a potential problem. Realistically speaking, it is natural for children to be shy in some situations such as around adult authority figures or when starting a new school.

However, sometimes the awkwardness or inhibition is ongoing and can interfere with pursuing opportunities and forming friendships. Fortunately, children can learn to overcome shyness and parents can facilitate the process.

Why Shy?

An understanding about some of the causes of shy behavior can provide you an insight. Shyness has long been a subject of research of psychologists. One study conducted with infants by Jerome Kagan at Harvard University suggests a genetic predisposition. But there is also evidence that such a temperament is aggravated by upbringing as well as by factors outside the home. Professor Zimbardo of the Shyness Institute, Palo Alto, California, who has studied shyness for over 20 years, ascribes it in part to a changing societal environment and advances in technology.

Factors That Contribute to Shyness

When kids grow up in nuclear families and without the benefit of having relatives living close by, there are fewer people to interact with in their immediate circle.

With families being more mobile, children are required to adjust to new people and surroundings. This can be more difficult for them than for adults.

When both parents work full-time they may have little time and energy for family recreational activities or socializing with neighbors and friends. This leads to fewer opportunities for children to learn social skills by observation.

Sometimes within the home itself there are situations that cause kids to become withdrawn. Examples are recurring discord between parents, a difficult relationship with parents, a dominating sibling or insecurity of attachments.

Parents may indulge in practices that are counterproductive, such as over-protectiveness, excessive involvement or lack of interest in their child's life.

Frequent criticism at home for not overcoming fears, for embarrassing the family, or negative comments from relatives or other acquaintances can damage a child's already fragile self-esteem.

A stressful school environment, coupled with the pressure to do well in various activities can be overwhelming.

Present day children spend long hours by themselves watching television, playing CD-ROM games or on the Net so there is reduced face-to-face exchange and less need to connect with other people.

Due to fear of crime, fewer children can play with their friends on the neighborhood streets without close adult supervision. Consequently they do not learn social skills on their own.

The upshot of these various influences is that some children find themselves uncomfortable in social settings while others become more seriously inhibited. The behavior manifests in many ways--nervousness, difficulty maintaining eye contact, trouble expressing thoughts clearly, excessive self-consciousness, and self-criticism. This can lead to reluctance to join in extra-curricular activities, not speaking up in school, difficulty in being assertive, and a smaller network of friends.

Parents' Role

So what can you do to help your child become more outgoing? A good start is to accept your child's personality and preferences. Children vary in how they relate and how long it takes to warm up to new settings. It's best to allow them the time to socialize at a comfortable pace. Pushing children into interacting or into activities that they do not enjoy is not likely to be beneficial. Instead, it is far more conducive to provide an encouraging environment at home, listen actively to their anxieties and get across that they are loved unconditionally.

Strategies

When your child is afraid of starting a new activity empathize by sharing an incident when you were afraid to do something.

Shy children tend to judge themselves negatively so teasing them about it or labeling them reinforces those feelings. If someone else comments about your child's shyness, disagree politely.

Talk with the teachers at school about your child's personality so that they can interact better in the classroom.

Provide opportunities to develop social skills by enrolling your child in a class that is to his or her liking, arranging time to play in a small group or with a younger child.

Children's self-image is molded by their parents' responses so express appreciation when your child does things well.

Gently introduce your child to new settings and talk beforehand about who will be there and what activities are involved.

Children learn by example. Model outgoing behavior by inviting friends and family members over, visiting neighbors, and speaking to friendly looking strangers in grocery store lines.

Nothing succeeds in getting past shyness as much as a positive social experience, and every pleasant encounter contributes to building self-confidence to interact in various situations.

If you have done all you can but your child continues to avoid all interactions or is chatty at home but never talks in public (selective mutism), or you suspect may have a disability, consider seeking the advice of a professional for a more specific approach.

As for your own anxiety about how your child will fare in life, take heart in the fact that there are high achievers in various arenas who happen to be innately shy. Just by being a supportive parent you can do wonders to realize your child's potential.

Archana Khambekar is a freelance writer of health and lifestyle related articles. She regularly contributes to

COPYRIGHT 2003 Pediatrics for Parents, Inc.
COPYRIGHT 2004 Gale Group

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