In contrast, traumatic mutism occurs when a child develops mutism in all situations because of a trauma experienced, like when the child was physically abused or witnessed an accident. The child is unable to process the traumatic event and becomes mute in all settings.
Some of the causes of psychogenic mutism may be general anxiety or past trauma. For example, a child who is learning to speak might stop speaking if he or she is molested or threatened.
Mutism may be due to apraxia, that is, problems with coordination of muscles involved in speech. Another cause may be a medical condition impacting the physical structures involved in speech, for example, loss of voice due to the injury, paralysis, or illness of the larynx.
Posttraumatic stress disorder (PTSD) with dissociative features has also been associated as a potential precursor of selective mutism. Although it is an uncommon explanation for selective mutism, several cases of children who experienced severe abuse and trauma fit the classification of selective mutism.
When mutism occurs as a symptom of post-traumatic stress, it follows a very different pattern and the child suddenly stops talking in environments where they previously had no difficulty. Another misconception is that a child with selective mutism is controlling or manipulative, or has autism.
Conversion and somatoform types of dissociation may also occur in people with DID or DDNOS/OSDD. Thus, they may experience physical symptoms affecting their sensory or motor functions for which no physical cause in the present can be identified – e.g. blindness, deafness, mutism, paralysis, pain, seizures.
In other words, these children are anxious about being around others. It simply manifests for them as an inability to speak. Notably, selective mutism is different from mutism caused by trauma. In traumatic mutism, a child that could previously speak usually stops speaking altogether after the event.
Organic mutism is mutism caused by brain injury, such as with drug use or after a stroke. Cerebellar mutism is mutism caused by the removal of a brain tumor from a part of the skull surrounding the cerebellum, which controls coordination and balance.
Maltreated toddlers typically exhibit language and speech delays. They fail to use language to communicate with others, and some do not talk at all. Speech may be absent, delayed, or hard to understand.
After a coma lasting from 5 to 25 days, the seven patients who suffered from post-traumatic mutism went through a period of total absence of verbal production lasting from 5 to 94 days, associated with the recovery of non-verbal communication skills and emotional vocalization.
Mutism is defined as an inability or unwillingness to speak, resulting in the absence or marked paucity of verbal output. It is a common presenting symptom seen in various disorders, including psychiatric as well as medical disorders.
It is hard to differentiate environmental influences (i.e., parental behaviors) from genetic factors (i.e., inherited anxiety). Though it is important to be aware that both nature and nurture play a role in the development and maintenance of a child's Selective Mutism.
Children with traumatic mutism usually develop mutism suddenly in all situations. An example would be a child who witnesses the death of a grandparent or other traumatic event, is unable to process the event, and becomes mute in all settings.
As a result, communicating with others becomes increasingly difficult for trauma survivors because they are protecting themselves from being hurt again. As well, they feel like danger lurks around the corner at all times. This is a common response for individuals who have survived traumatic experiences.
Again, their anxiety can transfer to other people in that environment. When mutism occurs as a symptom of post-traumatic stress, it follows a very different pattern and the child suddenly stops talking in environments where they previously had no difficulty.
What are the symptoms of PTSD in a child? Children and teens with PTSD feel a lot of emotional and physical distress when exposed to situations that remind them of the traumatic event. Some may relive the trauma over and over again. They may have nightmares and disturbing memories during the day.
Damage to a discrete part of the brain in the left frontal lobe (Broca's area) of the language-dominant hemisphere has been shown to significantly affect the use of spontaneous speech and motor speech control. Words may be uttered very slowly and poorly articulated.
Studies show that children with selective mutism have a low threshold of excitability in a portion of their brain called the amygdala, which explains most of the behavioral issues these children exhibit. The amygdala senses potential danger by processing signals from the sympathetic nervous system.
Another hallmark of this type of aphasia is difficulty understanding speech. The most common type of nonfluent aphasia is Broca's aphasia (see figure). People with Broca's aphasia have damage that primarily affects the frontal lobe of the brain.
Selective mutism doesn't necessarily mean your child is autistic. But some research suggests that more kids have both conditions than previously thought, so consider asking for an ASD screening as well.
Some professionals falsely view selective mutism as a form of autism or a learning disability. Children with learning disabilities or autism may demonstrate symptoms of the disorder, but selective mutism is not commensurate to an autism or learning disability diagnosis.
This is referred to as progressive mutism and results in children being mute in all settings with all people, even at home. Selective mutism affects children's lives significantly by interfering with their academic performance and relationships.
Some of the symptoms of dissociation include the following. You may forget about certain time periods, events and personal information. Feeling disconnected from your own body. Feeling disconnected from the world around you.