Академический Документы
Профессиональный Документы
Культура Документы
MUTISM
PREPARED BY:
Daquel, Michelle
Sagaral, Abdel-Aziz
WMSU Timol, Judd-Andrea
Shyness,
Social anxiety, fear of social
embarrassment, and/or social isolation
and withdrawal.
Use of gestures to get message across.
Difficulty maintaining eye contact, blank
expression and reluctance to smile;
Stiff and awkward movements.
Difficulty expressing feelings, even to
family members.
Difficulty eating , or speaking in front of
audience.
Tendency to worry more than most people
of the same age, and sensitivity to noise
and crowds (Silver, 1989).
A proportion of children with selective
mutism have developmental delays.
DSM V Criteria
Consistent failure to speak in specific social
situations in which there is an expectation for
speaking (e.g. in classroom), despite speaking in
other situations (e.g. with mom in classroom).
Disturbance interferes with educational/occupational
achievement or social communication.
Disturbance must last for at least one month.
Failure to speak is not due to lack of knowledge of
or comfort with the language in use.
Disturbance is not better explained by
communication disorder (ex. Stuttering) (APA,2013)
Co morbidity
Selective mutism is co-morbid with a numberof
disorders including:
Social anxiety disorder / social phobia.
Expressive language disorder.
Self-regulation. Ability to adjust arousal and emotion
in appropriate manner.
Developmental speech delay.
Enuresis – bedwetting or daytime holding of urine for
prolonged intervals.
Separation anxiety disorder, depression.
Motor developmental disorders and oppositional
defiance disorder.
(Steinhausen, & Juzi, 1996)
SELECTIVE MUTISM-STAGE OF COMMUNICATION
COMFORT SCALE
Non- Communicative
-non verbal or verbal. No engagement
- NO responding or No initiating
• Chloe's parents knew something was wrong when they were told by
the four-year-old's preschool teacher that she had spoken in school
that day for the first time after attending preschool for almost eight
months. When Chloe entered the classroom, she appeared hesitant
and self conscious and avoided eye contact. She would engage in
an assigned task, but not with other children. Her comfort level
dropped in a larger group, and she would not interact with the others
in a group. If the other children talked to her, she would turn away.
• She also did not speak in church or with distant family members, but
she was a chatterbox at home. In elementary school, it was not until
third grade that Chloe spoke to her teacher for the first time after a
devoted teacher did behavioral therapy exercises with her in the
summer and prior to and after school. Now in fourth grade, Chloe
has made much progress and recently read a report on video.
Chloe's battle with this disorder is not completely over, but she has
made tremendous progress. (Adopted from actual testimonials from
the Selective Mutism Foundation)
Treatment
Behavioral treatment:
The speech-language pathologist may coordinate a
behavioral treatment program to increase
verbalizations. Behavioral treatment is based on the
premise that the child who is selectively mute is
using the behavior in response to anxiety in social
situations. The focus of the speech language
pathologist’s intervention is to reinforce
communication with a gradual progression from non-
verbal to verbal
(Steinhausen, & Juzi, 1996).
Stimulus fading
In stimulus fading, the speech-language pathologist sets
simple goals (e.g., using a gesture to communicate) and
gradually increases expectations until speech is
achieved.
Cunningham & Melanie 2005, Blake & Moss 1967, Silver 1989-
MedlinePlus Trusted Health Information for You