Mutism: types, causes, symptoms and treatment of “voluntary” muteness

Selective mutism is a kind of disease in which the patient refuses to speak. The pathology occurs in both adults and children. The person does not have any physical defects or organic lesions. In childhood, the disease manifests itself more noticeably. Correction and treatment of selective mutism will be required. Symptoms may appear in different ways. Various drugs can be used for therapy.

Symptoms of selective mutism

The most important symptom is a selective method of communication. There may be no speech in certain situations. Selective mutism in children manifests itself in schools and kindergartens. The child cannot speak in the room or office. The baby does not communicate in front of strangers or teachers. In rare cases, children may not speak at home, but in kindergarten or school they talk willingly.

Patients may not use verbal contact, but use facial expressions and pantomimes. If the disorder is in an advanced form, the child may freeze, hide his head and tuck his legs. There may be a pathological attachment to the mother. The following symptoms of selective mutism may be added: delayed speech development, phobias, depression, enuresis.

Accompanying illnesses

Due to the fact that the speech apparatus does not work for a long time, it suffers from spasms, and other diseases and disorders arise against the background of elective mutism.

• Impaired mental function. The child does not pronounce important information and cannot fully master logical operations: analysis, synthesis, comparison, classification. This occurs in cases where parents, for some reason, do not themselves work with the child in conditions where he is comfortable and can speak.
• Delayed speech development. The less the speech apparatus and the brain structures responsible for speaking are trained, the more the child will lag behind his peers in speech development. The situation worsens for children in whose families the parents do not have the opportunity or desire to communicate with the baby as often as possible.
• Nervous tics. A child suffering from selective mutism is usually anxious and tense. The nervous system, trying to unload itself, turns on mechanisms that perform twitching of certain muscles or their groups, independent of the person.
• Enuresis. Anxious children often suffer from this disorder, which does not depend on their conscious choice to go to the toilet or not.

Diagnosis of selective mutism

To identify selective mutism, you will need to visit a neurologist, speech therapist, or psychologist. Doctors will not only help make a diagnosis, but also cure the pathology.

The following procedures may be prescribed to identify the disease:

• General collection of information. First of all, the doctor must know how the mother’s pregnancy went and what illnesses she suffered while carrying the child. After this, he will determine the baby’s reaction to the vaccine and monitor his development. The psychologist should look at the doctor's diagnosis and talk with the child so that he can talk about phobias. After this, comprehensive treatment for selective mutism is prescribed.
• Visit to a neurologist. The doctor conducts various studies, which include the quality of speech, breathing rhythm. The child’s blood pressure can be measured and neurological diseases analyzed.
• Craniogram. The procedure helps assess the condition of the brain.
• Magnetic resonance imaging and computed tomography. The procedures perform the same function as a craniogram, but with more accurate results.
• Electrocardiogram.
• Chest X-ray.
• Electroencephalography. Without this procedure, which helps to find out the level of electrophysiological processes, the disease cannot be detected.
• Blood and urine analysis. The doctor should check your hormone levels.

After selective mutism is diagnosed, the specialist prescribes treatment.

Selective mutism in adults

Most often, selective mutism in adults occurs in women. Representatives of the fairer sex are more emotional and sensitive. Thus, they are predisposed to be overly impulsive. Experts diagnose men too.

Pathology develops in the following cases:

• High sensitivity. If the problem is accompanied by hypertrophied suspiciousness, then after an emotional reaction the patient will acquire pathology.
• Stroke. If a person has suffered a disruption in blood supply, the area in the brain responsible for speech is affected.
• Problems with the vocal cords. They may be due to damage or complete paralysis of these muscle folds.

If a person's mutism is caused by hysteria, then the disease is temporary.

Treatment of selective mutism

It is mandatory to use drug treatment. It is not recommended to self-medicate, as this may worsen the situation.

After a thorough examination, the following drugs are prescribed:

• Antidepressants. They help solve the problem. Most often, experts prescribe Prozac and Fluoxetine.
• Neuroleptics. The substances help cure mental disorders. In this case, Frenolone, Gidazepam, Risperidone are prescribed.
• Benzodiazepines. Drugs in this group have sedative, hypnotic and anxiolytic effects. Doctors prescribe Gidazepam, Fluorphenazine, Alprazolam.
• Nootropic drugs. The main component is vitamin B15, it helps prolong life and combats stressful situations well. These drugs include Pirecetam, Salbutamine and Oxiracetam.

The disease can be treated not only at home, but also in a hospital setting. It is important to begin treatment for selective mutism in a timely manner. If time is lost, then neuroses, mental disorders, and social phobias will develop in the future.

Complex of therapeutic measures

There is no universal method for treating psychogenic mutism; in each case, methods are selected individually, depending on the patient’s condition and the causes of the disorder. The main goal of treatment is to eliminate the consequences of injury and normalize the patient’s mental state.

As part of therapy, medications from the group of nootropics and antipsychotics are prescribed, and antidepressants may be recommended.

The patient also needs psychotherapeutic treatment, help in getting rid of anxiety and overcoming stress. In addition, additional activities may be prescribed, for example, massage, therapeutic and breathing exercises, etc.

In most cases, mutism of psychogenic origin is treatable, and patients have a good chance of a full recovery and a full life in the future.

Correction of selective mutism

In fact, there are many ways to help a patient cope with pathology.

Correction of selective mutism is carried out as follows:

• Breathing exercises. In such a situation, a good specialist is looked for. It will help you learn deep, shallow, rare, frequent and mixed breathing. If you master these basics, you can start doing yoga. It helps coordinate the spiritual and physiological functions of the body.
• Massage treatments. Massage is necessary not only to warm up muscles. Thanks to the procedure, a person will be able to become calmer and recover faster from psychological trauma. Hydromassage is also available.
• Acupuncture. The procedure will help a patient with mutism cope with problems of the nervous system. Acupuncture is prescribed only by your doctor.
• Art therapy. Most people think that the procedure is only for children. Correcting mutism in adults involves working with colors and using it to find unexpected solutions.
• Phototherapy. People love looking through family photos. If the patient is silent, then you can make him talk with the help of photographs. When he sees the exciting moment in the photo, he may start talking.

The goal of treatment is to eliminate the causes of the disease. Eliminate neurotic disorders, as well as improve interpersonal contact.

Correction of selective mutism in children

Selective mutism is mostly a childhood pathology. If even slight deviations in the baby’s behavior appear, you should contact a specialist. Correction of selective mutism in children must be carried out without fail.

You can help your child in the following ways:

• Create a positive environment. In a home where there is peace, kindness and mutual understanding, in rare cases a child suffers from selective mutism. The baby must know that he is loved and listened to, no matter what he says.
• Adequate punishment. Don't listen to your child's whims. Most often, children cannot withstand cruelty from their parents, since they have a fragile psyche. You shouldn’t physically punish your child; it’s best to explain that you can’t do that.
• To fulfill promises. All children believe that adults always keep their words.
• Change the baby's environment. If mutism occurred due to psychological trauma, it is recommended to find a new kindergarten or school.
• Visit specialists on an ongoing basis. It is not recommended to treat neurologists or psychologists as those people who cannot help a child.

If the baby stops talking or behaves strangely, then certain measures should be taken. Many people believe that visiting a psychiatrist will affect the child's life. If there is any problem with the child, you should contact a specialist. Failure to act may cause harm to the child and the disease will become permanent.

Causes and features of the violation

Voluntary psychogenic muteness can develop against the background of psychological trauma under various circumstances.
This could be the death of loved ones, severe fear, as well as failure resulting from physical and psychological violence. Unlike other types of mutism, with a psychogenic disorder a person can retain gesticulation, in addition, there is increased motor activity.

At the same time, the patient is quite capable of talking, there are no visible obstacles to this, however, he refuses to do so.

Psychogenic type mutism can be accompanied by various motor and emotional disorders. These accompanying signs greatly facilitate diagnosis.

Selective mutism in children

The disease can occur for various reasons, they are all different from each other.

The following factors lead to selective mutism in children:

• The child does not know how to talk with other people and find a common language.
• The baby cannot verbally formulate his desire.
• The child does not have his own space to express unpleasant feelings.
• Negative atmosphere in the house.
• Brain damage.
• Early development of schizophrenia or autism.
• Hysterical neurosis.
• Excitement due to severe fright or loss of a loved one.
• Lack of attention from adults, as well as misunderstanding in the family.
• High anxiety, as well as nervous tics.
• Stubbornness.
• Speech problems.

Such reasons can lead to other problems. Selective mutism will need to be identified in order to prescribe comprehensive and effective treatment. The pathology is an anxiety disorder. The child can feel good and communicate with friends and relatives. If the baby changes the situation, he stops talking. The child cannot say a word because he is afraid.

Selective mutism can persist into adulthood. In this case, various social phobias appear. The problem occurs in those children who have a labile nervous system, as well as isolation, resistance or anxiety for no reason. If a child has anxiety, then he needs parental support in difficult situations.

Most often, pathology occurs in those families where the psychological climate is uncomfortable. Many doctors say that a type of mutism is a neurotic disorder. Children can suffer not only from muteness, but also from depression, timidity, and vulnerability. The pathology is most severe in adolescents. The disease can be inherited.

Treatment of selective mutism in children

Therapy should be aimed at eliminating social phobias, as well as anxiety and depression.

The following methods of treating selective mutism in children are used:

1. Cognitive-behavioural. The procedure is carried out individually for each child. A psychotherapist helps to establish contact and helps to express and overcome bad moments.
2. Behavioral. Group trainings will help develop communication and verbal interaction skills. Correct actions should be supported by attention and praise. The child comes into contact with other people of any age, so he overcomes shyness and embarrassment.
3. Family counseling. The doctor tells adults how to properly communicate with the child. You will need to approve and praise the baby.

Psychotherapy can be supplemented with speech therapy sessions. Encouraging your child to pronounce words correctly will help reduce the child's insecurities.

Selective mutism can be eliminated within the first six months. The patient's condition will gradually improve if there is psychotherapeutic intervention. Disease prevention means giving the child the opportunity to choose, express himself emotionally, and have the right to express his opinion.

How can parents help their child?

The child spends most of his life in the family. The conditions in it should be the most comfortable for him, so that selective muteness gradually recedes. Therefore, parents should take care of the baby, slightly adjusting their life to suit him.

What can parents do?

• Accept the child and his condition. Do not scold for silence, do not try to force someone to speak, as these actions will only lead to the opposite effect. When other people try to communicate with him, do not answer questions for him, but inform the interlocutor that the child will speak when he is ready.
• Build relationships with each other. A child whose parents constantly quarrel often blames himself for this. As a result, his self-esteem decreases. Fears appear. Phobias and anxieties, which are often a trigger for the development of selective mutism.
• Reconsider your relationship with your child. Parents often do not notice how they themselves create high anxiety in their child. For example, with authoritarian parents, a child often has problems communicating in specific situations due to the fear of making a mistake and receiving a portion of disapproval for it. And with parents who themselves have a high level of anxiety, children read information that the world is dangerous and subconsciously conclude that it is better to remain silent in it than to speak.
• Increase self-esteem. The more often a child is praised for his achievements, the more confident he feels.
• Give free rein to emotions. If a child is aggressive at home, teach him appropriate methods of expressing anger, for example, tearing paper or hitting a pillow. If you are nervous, you can give your child or schoolchild a bowl of sand or cereal. By moving and pouring from hand to hand, the child gradually calms down and relaxes.