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Child Behavior (Expert Forum)
Re: Selective Mutism
This forum is for questions and support regarding child behavior issues such: Child Discipline (behavior management), Normal Child Development, Parent-Child Communications, Social Development
Re: Selective Mutism
by HVM Ph.D. - KDK, Jan 01, 1995 12:00AM
Posted By HVM Ph.D. - KDK on January 14, 1999 at 09:23:07:
In Reply to: Selective Mutism posted by Karen on January 13, 1999 at 14:48:26:
My son just turned four on January 9, 1999. He has had a very significant medical past, which includes several Hospital visits and 2 surgeries. He had a kidney removed at 3 weeks and exploratory throat surgery right before he turned three. At his 3 year checkup I told the doctor that his language and social skills were not proceeding as well as his peers so he sent me to a developmental pediatrician. My son has always been difficult he never slept much or ate much and always had night terrors and thew frequent tantrums. The developmental pediatrician went solely on my questionnaire and diagnosed him with pdd-nos because of speech delay, inconsistent eye contact, his fascinations with a theme i.e.: dinosaurs later swords and Peter Pan, and his alienation from other children. I got him immediately in an early childhood program where he has made great strides at home but is still difficult and very uneasy at school. Within the last year my son has been playing with all toys appropriately and has been more on a regular schedule as far as eating and sleeping. Night terrors are almost a thing of the past and his language skills have become tremendous at home. He is speaking approximately 5 to 7 word sentences at home. The school has disagreed with the pdd-nos diagnosis early into my sons school year, they said he is very smart and very intune to everything. He often tries to communicate non-verbally at school and often shares things with others in a non-verbal way. He participates in music and dance only non-verbally and would initially whisper single words to the teacher. He has not spoken at school since August with the exception of a few whispered words. The last year he has also began a pattern where he completely stopped talking to the babysitter (who he had all of his life) and talking to my husband and I anywhere outside of the home. He communicates by hand gestures. I started researching his strange behaviors and I am certain he has selective mutism. He talks constantly at home and plays by himself and with brother appropriately. He will talk to strangers that enter our home but gets very uneasy out in public. The school has sent a psychologist to watch my sons behaviors and I have not gotten the report yet. I have made an appointment with an outside psychologist after I discussed the selective mutism with the developmental pediatrician. The appointment is 2/15/99. My family has two cases of "social phobia" that I can verify. My mother had not left the house for 6 years and after seeking help is currently taking Zoloft and I believe Prozac. My 1st cousin suffers from panic attacks and is on medication as well. My husband has a niece that appears to have this disorder but family "avoids" dealing with it and has never sought help. His niece is 15 and in the eight years I have been in the family she has only said 1 word, "no". She does speak to her parents in private on a very limited basis. My question is it a possibility my son has Selective Mutism and not pdd-nos or is it possible to have selective mutism as a result of pdd? I feel he really is not showing autistic traits anymore but the language is becoming a real problem. At school they will not give him credit for counting or color recognition because he is not verbalizing. He is a very strong willed child who has difficulty sharing and everything is certainly on his terms. I started a new babysitter and he was saying single word to her after a couple of days but only no and yes. From what I have read it is important to know if the lack of verbalizations are due to anxiety or a control thing. I think he displays both issues and I am so anxious to get him help. My son is 2 totally different people; he is outgoing and loving at home and a nightmare in public. I am sorry if I have written too much I am desperate to help my son and would like to get and outside opinion. Thank you for your help in advance.
___
Dear Karen,
Well, you've certainly done your homework and have acquired a significant amount of valuable information in the process. As you may know, selective mutism (refusal/reluctance to speak to certain people and in certain situations, despite the ability to do so) is a pretty rare condition. Some do accept that there is an association between selective mutism and social phobia (in teens and adults). And, with the family history, your son may be predisposed to anxiety disorder (social phobia is one type of anxiety disorder), given the hereditary nature of some of these conditions. You should be encouraged by the progress your son has displayed in his communication, social interactions, and frustration tolerance/impulse control at home. The challenge ahead is how to replicate that same progress in his verbal communication and social interactions outside of the home.
From your detailed description, some of the qualitative impairments (in social interaction and communication) that resulted in the diagnosis of Pervasive Developmental Disorder have abated (particularly in the home setting). That is a reason for optimism. Your son may well still meet the threshhold criteria for a diagnosis of PDD (this will be clarified via your consults with clinicians). Selective mutism is not regarded as a remnant or derivative of PDD. It may well be that your son displays PDD (but that now he is further along the spectrum of functioning), alongside Selective Mutism. I wouldn't get too preoccupied with the diagnostic minutiae, but rather remain focused on the central issue of how to enhance your son's social and verbal communication abilities. He may well require placement in a special educational program, with a clinical component, that is prepared to teach him in these areas as well as in the more formal academic areas. Please persist in your pursuit of clinical and special educational help - your son's progress at home indicates he has the capacity to achieve similar results outside of the home.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
*Keyword: Selective Mutism, Pervasive Developmental Disorder
In Reply to: Selective Mutism posted by Karen on January 13, 1999 at 14:48:26:
My son just turned four on January 9, 1999. He has had a very significant medical past, which includes several Hospital visits and 2 surgeries. He had a kidney removed at 3 weeks and exploratory throat surgery right before he turned three. At his 3 year checkup I told the doctor that his language and social skills were not proceeding as well as his peers so he sent me to a developmental pediatrician. My son has always been difficult he never slept much or ate much and always had night terrors and thew frequent tantrums. The developmental pediatrician went solely on my questionnaire and diagnosed him with pdd-nos because of speech delay, inconsistent eye contact, his fascinations with a theme i.e.: dinosaurs later swords and Peter Pan, and his alienation from other children. I got him immediately in an early childhood program where he has made great strides at home but is still difficult and very uneasy at school. Within the last year my son has been playing with all toys appropriately and has been more on a regular schedule as far as eating and sleeping. Night terrors are almost a thing of the past and his language skills have become tremendous at home. He is speaking approximately 5 to 7 word sentences at home. The school has disagreed with the pdd-nos diagnosis early into my sons school year, they said he is very smart and very intune to everything. He often tries to communicate non-verbally at school and often shares things with others in a non-verbal way. He participates in music and dance only non-verbally and would initially whisper single words to the teacher. He has not spoken at school since August with the exception of a few whispered words. The last year he has also began a pattern where he completely stopped talking to the babysitter (who he had all of his life) and talking to my husband and I anywhere outside of the home. He communicates by hand gestures. I started researching his strange behaviors and I am certain he has selective mutism. He talks constantly at home and plays by himself and with brother appropriately. He will talk to strangers that enter our home but gets very uneasy out in public. The school has sent a psychologist to watch my sons behaviors and I have not gotten the report yet. I have made an appointment with an outside psychologist after I discussed the selective mutism with the developmental pediatrician. The appointment is 2/15/99. My family has two cases of "social phobia" that I can verify. My mother had not left the house for 6 years and after seeking help is currently taking Zoloft and I believe Prozac. My 1st cousin suffers from panic attacks and is on medication as well. My husband has a niece that appears to have this disorder but family "avoids" dealing with it and has never sought help. His niece is 15 and in the eight years I have been in the family she has only said 1 word, "no". She does speak to her parents in private on a very limited basis. My question is it a possibility my son has Selective Mutism and not pdd-nos or is it possible to have selective mutism as a result of pdd? I feel he really is not showing autistic traits anymore but the language is becoming a real problem. At school they will not give him credit for counting or color recognition because he is not verbalizing. He is a very strong willed child who has difficulty sharing and everything is certainly on his terms. I started a new babysitter and he was saying single word to her after a couple of days but only no and yes. From what I have read it is important to know if the lack of verbalizations are due to anxiety or a control thing. I think he displays both issues and I am so anxious to get him help. My son is 2 totally different people; he is outgoing and loving at home and a nightmare in public. I am sorry if I have written too much I am desperate to help my son and would like to get and outside opinion. Thank you for your help in advance.
___
Dear Karen,
Well, you've certainly done your homework and have acquired a significant amount of valuable information in the process. As you may know, selective mutism (refusal/reluctance to speak to certain people and in certain situations, despite the ability to do so) is a pretty rare condition. Some do accept that there is an association between selective mutism and social phobia (in teens and adults). And, with the family history, your son may be predisposed to anxiety disorder (social phobia is one type of anxiety disorder), given the hereditary nature of some of these conditions. You should be encouraged by the progress your son has displayed in his communication, social interactions, and frustration tolerance/impulse control at home. The challenge ahead is how to replicate that same progress in his verbal communication and social interactions outside of the home.
From your detailed description, some of the qualitative impairments (in social interaction and communication) that resulted in the diagnosis of Pervasive Developmental Disorder have abated (particularly in the home setting). That is a reason for optimism. Your son may well still meet the threshhold criteria for a diagnosis of PDD (this will be clarified via your consults with clinicians). Selective mutism is not regarded as a remnant or derivative of PDD. It may well be that your son displays PDD (but that now he is further along the spectrum of functioning), alongside Selective Mutism. I wouldn't get too preoccupied with the diagnostic minutiae, but rather remain focused on the central issue of how to enhance your son's social and verbal communication abilities. He may well require placement in a special educational program, with a clinical component, that is prepared to teach him in these areas as well as in the more formal academic areas. Please persist in your pursuit of clinical and special educational help - your son's progress at home indicates he has the capacity to achieve similar results outside of the home.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
*Keyword: Selective Mutism, Pervasive Developmental Disorder
