What causes selective mutism?

Many people do not understand selective mutism. In fact, it is a mental disorder. Patients are prone to show speech communication disorders, especially in specific situations. It may be mainly caused by psychological disorders or behavioral disorders.

1. Psychological barriers

Early SM case studies attributed the problem to family factors or difficult-to-resolve inner conflicts, such as overprotective parents, but recent studies have suggested a close relationship between SM and anxiety disorders. Some experts even believe that SM is a type of anxiety disorder and should be called childhood social phobia. Children with SM have many common characteristics with adults with social phobia. Another strong evidence linking SM and anxiety disorders is the effectiveness of anti-anxiety drugs in treating SM.

2. Behavioral disorders

Behavioral scientists believe that SM is a behavioral problem caused by a series of reinforced negative learning patterns.

Speaking is a habitual response to the external environment." In other words, the silent state is a behavioral manifestation of the child's processing of the relationship between the child and the environment in which he lives. Behavioral experts believe that the silent behavior of children is functional, and argue that the adverse external environment is a factor that maintains the persistence of this state. Therefore, the silent state of children is an adaptive behavior, not a pathological behavior.

4. Intellectual development disorder

Kristensen et al. believed that SM was related to intellectual development disorder and pregnancy or delivery disorders, and was often accompanied by chewing and swallowing disorders, motor coordination disorders and sleep disorders. Anxiety symptoms may be caused by cognitive difficulties. For example, working memory impairment may lead to anxiety symptoms. When completing cognitive tasks that exceed cognitive ability, the child's individual working memory resources are scarce, anxiety increases, and he or she adopts a compromising approach (passive, silent) to complete the task. However, SM children usually do not have cognitive impairment. The study by Katharina et al. showed that there was no significant difference in cognitive function between SM children and the control group.

5. Speech or language disorders

Some studies have found that SM children have speech or language disorders. Kolvin and Fundudis[study confirmed that SM children start speaking significantly later than normal children, and 50% of the SM children have immature speech, while only 9% of the control group have immature speech. Wilkins et al. studied 24 children with SM. Although only 8% of the children had speech problems at the time of evaluation, 25% had speech delays and 21% had slurred speech.