Elective mutism is a pathology in which, for various reasons, a child refuses to speak. If it is diagnosed in a timely manner, then there is a high chance of a patient recovering completely. The disease is considered neurological.
What is a disease?
Elective mutism is a kind of disease, which is characterized by the possession of oral and written speech, normal mental development. The child does not get hung up on himself. In addition, the centers of speech located in the brain are not functionally damaged.
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 the 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, such a psychological deviation is diagnosed at the age of 3 to 9 years. Moreover, such a peculiar dumbness is not always manifested, it all depends on the situation. Elective mutism affects very sensitive and vulnerable children.
Diagnosis of this pathology should be differential. Otherwise, the child may be attributed to a severe mental illness and prescribe a completely incorrect treatment.
Features of the development of the disease
Selective mutism has some nuances:
- More often, the pathology is diagnosed in girls.
- The risk group includes those children who have adults with speech development problems in their family history.
- The disease appears in most cases in those families where the situation is dysfunctional.
- Almost all sick children have cerebral pathology.
- Violations of facial expressions, motor skills and behavior are absent.
- In most cases, a child is diagnosed with selective mutism. That is, the patient’s behavior depends on a specific 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 child’s lack of ability to verbally articulate his desire.
- The baby does not have its own space for expressing negative feelings, so it just stops talking.
- Problems with articulation.
- Dysfunctional situation in the family.
- The 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 parents, misunderstanding in the family.
- Some mental disorders: increased anxiety, tics of various etiologies.
- Speech disorder or mental retardation.
- Banal obstinacy.
These causes can cause other pathologies. However, it is necessary to determine the elective mutism as accurately as possible so that the treatment is effective.
Symptoms of pathology
In addition to the fact that the child is silent, there are other signs of the presented disease:
- The incomplete disappearance of vocalization, that is, a small patient can communicate with a narrow circle of people, for example, only parents.
- Frequent depression, increased anxiety.
- Fears that can turn into a phobia.
- Enuresis.
- Possible impaired speech development.
- Some problems with intelligence.
- Difficulties with the process of adaptation in society.
- Violation of the volitional activity of the person, manifested in the fact that the child categorically refuses to talk with those people who are not members of his circle of proxies.
- Timidity.
- Impaired sleep and appetite.
Elective mutism in adults, as well as adolescents, manifests itself much more complicated. The clinical picture in this case is more diverse.
Varieties of mutism
Mutism can be classified according to various criteria:
1. The intensity of manifestation:
- Short-term (situational).
- Permanent (elective).
- Total.
2. By duration of character:
3. Depending on the impact of psychological 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 mutism is more inherent in students. It arises from an irresistible fear of hearing your own speech. In adults, this type of pathology is practically not found.
- Mixed.
In preschool as well as in primary school age, patho-characterological mutism is manifested. The main reason for this condition is a change in the familiar environment of the child. It is characteristic of those children who have a very strong attachment to home, shyness.
There is another classification of pathology:
- Elective mutism, the correction of which in most cases is successful. It lies 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.
- Apalic. This is the most complex form of the disease, which is expressed in the complete lack of response to external stimuli.
Diagnostic Features
In order to accurately determine the presented pathological condition, you need to contact a psychologist, clinical psychotherapist, neurologist and speech therapist. These specialists will not only see signs of elective mutism, but will also be able to cure the child. But it should be borne in mind that if the child did not start talking before the age of three, then this condition may be normal, since the formation of mental processes in different children does not occur the same.
In addition to psychological tests, specialists can prescribe such procedures to the child:
- Electrocardiogram.
- Electroencephalography.
- MRI
- Chest x-ray.
How is pathology treated?
It should be noted that the treatment of elective mutism with drugs is extremely rare. Most often, drugs that promote the synthesis of serotonin are prescribed to the patient. The doctor may prescribe such drugs: antipsychotics, nootropics, antidepressants.
Basically, 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 baby in a group of interlocutors of the same age. Moreover, it is gradually increasing. First, only two people. If the child is trying and he has a positive tendency, then he needs to be encouraged and encouraged in every way.
In addition, elective mutism in children is treated with the help of family and speech therapy. That is, the parents themselves play an important role in the treatment. They should encourage any verbal contact of their child. In addition, it is important for the baby to feel the parents' attention, their emotional support.
Much depends on the environment of the small patient. If such dumbness manifests itself in kindergarten or school, then in these institutions, teachers and peers of the child should act according to a predetermined therapy regimen.
It should be noted that this pathology is treated not only at home, but also in the hospital. The second option is only necessary if a complex examination or even surgical intervention is provided.
In order to cure a child, there are no ready-made treatment regimens. That is, in each case, its own set of procedures is selected, which depends on the type and severity of the pathological condition.
In therapy, breathing exercises, therapeutic exercises, herbal medicine, massage are used.
Features of the development of the disease in adults
It should be noted that the presented disease can occur not only in children. There are cases of diagnosing mutism, even in adults. The cause of this pathological condition is organic damage to the brain or severe mental disorders (shocks).
Men suffer from this pathology less often than women. Representatives of the weaker sex may experience hysterical mutism. The fact is that women are more sensitive and emotional. They have a natural predisposition to excessive impulsiveness.
Recommendations to parents
In order for the small patient to quickly overcome the pathology, adults should help him. If elective mutism is diagnosed in children, the recommendations to parents are as follows:
- You should not show your baby your concern, otherwise he will become isolated in himself even more.
- It is necessary to help him believe in himself, that the baby will be able to talk when he is ready for this.
- Every positive desire of the baby to communicate with other people, peers should be encouraged.
- Parents should not show surprise if the baby first started talking and then stopped.
- In any case, adults should show the child their love, attention and support. Naturally, parents will have to be patient. Otherwise, all the efforts of specialists can be leveled. One careless word can destroy months of effort.
The treatment process is not fast, but in no case should you rush.
Pathology prognosis
Elective mutism in children has in most cases a positive prognosis. However, there is one caveat: everything will be fine if the symptoms of the disorder disappear within a year after the appearance.
Otherwise, silence can become a habit and will become part of the development of personality. That is, this disease can remain with the child even after he grows up. That's all the features of this disease. Be healthy!