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Dr.
Elisa Shipon-Blum is the Executive
Director of selectivemutism.org
- an organization dedicated to providing information about a much
misunderstood disorder called selective mutism. Questions were posed by
the editor of shykids.com and answered by Traci Castles and
Dr.Shipon-Blum.
Q. What
is Selective Mutism?
A. It is an adorable
6 year old boy who runs around boisterously in his backyard...but
stands expressionless, staring into space within the classroom.
It is the comical 6 year old girl who dances and sings in the
entertainment room while her family proudly watches on...but stands
motionless and cannot utter a sound when her class rehearses for the
school musical. It is a 9 year old boy cheering loudly and
intensely as he watches his favorite hockey team score a goal, but
sits alone at a party and sadly turns away when another child
approaches him. It is a sensitive and perceptive little 5 year
old girl who tells her parents all the exciting and fun things she
wants to do at her birthday party..but has never spoken a word to
anyone outside her home.
Q. How
do you determine if a child is shy and if the shyness is merely
developmental or if the child requires professional help?
A. Does your child have these
characteristics? 1. Does not speak in certain places such as
school or other social events? 2. But can speak normally in other
settings such as in their home or in places where they are
comfortable and relaxed? 3. Does the child's inability
to speak interfere with his/her ability to function in educational
or social settings. 4. The mutism has persisted for at least
one month? 5. Mutism is not part of another disorder, i.e.
autism, aspergers syndrome, schizophrenia.
Q. Do
you know the cause of selective mutism?
A. The cause of
Selective Mutism is ANXIETY. Specifically, social phobia.
...approx. 1 in 1000 children are diagnosed with Selective Mutism.
Social phobia, also called social anxiety, is a disorder
characterized by overwhelming anxiety and excessive
self-consciousness in everyday social situations. People with social
phobia have a persistent, intense, and chronic fear of being watched
and judged by others and of being embarrassed or humiliated by their
own actions.
Their
fear may be so severe that it interferes with work or school - and
other ordinary activities. While many people with social phobia
recognize that their fear of being around people may be excessive or
unreasonable, they are unable to overcome it. They often worry for
days or weeks in advance of a dreaded situation.
Social
phobia can be limited to only one type of situation - such as a fear
of speaking in formal or informal situations, or eating or drinking
in front of others - or, in its most severe form, may be so broad
that a person experiences symptoms almost anytime they are around
other people. Social phobia can be very debilitating - it may even
keep people from going to work or school on some days. Many people
with this illness have a hard time making and keeping friends
Physical symptoms often
accompany the intense anxiety of social phobia and include
blushing, profuse sweating, trembling, and other symptoms of
anxiety, including difficulty talking and nausea or other
stomach discomfort. These visible symptoms heighten the fear
of disapproval and the symptoms themselves can become an
additional focus of fear. Fear of symptoms can create a
vicious cycle: as people with social phobia worry about
experiencing the symptoms, the greater their chances of
developing the symptoms.. Social phobia often runs in
families and may be accompanied by depression or alcohol
dependence.
Q. What causes
social phobia?
A.
Research to define causes of social
phobia is ongoing
* Some
investigations implicate a small structure in the brain
called the amygdala in the symptoms of social phobia. The
amygdala is believed to be a central site in the brain that
controls fear
responses.
* Animal studies are adding to the evidence that suggests
social phobia can be inherited. In fact, researchers
supported by the National Institute of Mental Health (NIMH)
recently identified the site of a gene in mice that affects
fearfulness.
* One
line of research is investigating a biochemical basis for
the disorder. Scientists are exploring the idea that
heightened sensitivity to disapproval may be physiologically
or hormonally
based.
* Other researchers are investigating the
environment's influence on the development of social phobia.
People with social phobia may acquire their fear from
observing the behavior and consequences of others, a process
called observational learning or social modeling.
Q. Have case studies been
done following treated vs. non-treated children to determine
the need for intervention?
A.
As in other disorders. every child is different and
determination of who 'overcomes' SM is
variable. Unfortunately, the majority of SM children often
do not just overcome SM. Symptoms of social anxiety often
continue throughout childhood, adolescence and into
adulthood. Self-esteem is compromised as is proper social
development. From the tremendous amounts of SM teens and
adults that contact us we are convinced that 'waiting' is
not the answer. Most of the teens that contact us are still
suffering tremendously and have compromised the enjoyment of
their youth only to be falsely labeled as 'shy.'
Adults continuously tell
us that 'if only they knew what SM was years ago, then
perhaps they could have overcome SM when they were young and
had the opportunity to have a happy and fulfilled youth.
Taking a chance on whether a child will overcome SM is
certainly not worth the risk of the negative repercussions
that come along with untreated social anxiety. It is painful
and heart wrenching to the individual involved. With
intervention, SM children develop coping skills to be able
to handle various situations. Isn't it nice to give a child
the wonderful opportunity to overcome SM when they are
young, when behavior is not as 'set' and 'ingrained,' then
waiting and hoping a child will overcome SM on their own.
All one needs to do is to spend time with a Selectively Mute
child to see that they are not just shy, they are truly
suffering in silence.
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