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Elective Mutism (Selective Mutism): Our Child does not Speak Anymore ; Social Anxiety Disorder in Children

Abstract: Children with Elective Mutism Disorder, can not or do not want to speak in certain situations, even though he or she is able to speak in other situations. It is related to social anxiety disorder (social phobia), and need to be treated by an experienced child psychiatrist.

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Elective Mutism (Selective Mutism): Our Child does not Speak Anymore ; Social Anxiety Disorder in Children

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Question(s): 
Written by: Martin Winkler
First version: 22 Jul 2008.
Latest revision: 01 Aug 2008.

What is elective/selective mutism? Is it the same as Social Phobia (Social Anxiety Disorder) in Children?

Our child does not speak at all anymore in certain situations (particularly in the school). Because of this it is possible that she is going to be demoted, even though she is a good student and has good grades in her written tests. What can we do?

Answer:

If your child refuses to speak in certain situations (or for a longer period), even though she is able to speak, she may suffer from "Elective Mutism" (F .0 of ICD-10).

This special form of a disorder of social functioning has it's onset during early childhood. Often the children show an excessive emotional sensibility. Frequently you can find other personality problems, like to withdraw from someone or something, anxiety in social situations as well oppositional behaviour.

A combination with other disorders (like the Predominantly Inattentive Type of ADHS=Attention Deficit Hyperactivity Disorder) occurs oftentimes ( more ) . One specific characteristic of selective mutism is the "refusal to speak" by children with a fear of seperation. In this case the mutism indicates the fear to be abandoned (for example after removal, divorce or illness of a close person).

The diagnostic and therapy should be done by an experienced child psychiatrist or psychologist. Self-help would not be appropriate for this kind of pathology. But the information and support of a self-help group could be very helpful.

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