Mutism: Symptoms and Treatment

Mutism is a disease that manifests itself in complete absence of speech, provided the speech device is fully preserved. This process should not be regarded as irreversible, since speech restoration is entirely possible under the condition of proper treatment, which is prescribed only by a doctor.



Etiology

There are such possible causes of the development of this disease:


  • acute impairment of cerebral circulation
  • brain tumor
  • inflammatory processes of the brain
  • craniocerebral trauma
  • strong emotional upheavals
  • mental illness;
  • moral and / or physical abuse of the child

Rarely, but still occurs, a disease with an unexplained etiology.

Classification

There are such forms of this disease in children:


  1. akinetic mutism — due to pathological processes in the brain, nervous system
  2. elective (selective mutism) — in a familiar environment, the child behaves normally, can speak. When changing the situation, the fear of speaking begins, communication skills are lost;
  3. Selective mutism — characterized by the fact that the clinical picture is selective, the child can normally communicate only with some people
  4. phobic — most often temporary, appears as a consequence of severe stress or psychological trauma
  5. Apallic — has the same etiology as the akinetic, but more complex flow. Complete recovery is extremely rare.

The most unfavorable prognosis is the apallic form of mutism in the baby — in such cases, even under the condition of timely treatment, full recovery is extremely rare.

Symptoms

It should be noted that with this disease, the overall clinical picture will be supplemented by specific signs of the form of the disease itself. General symptoms include the following:


  • speech may be absent only in certain circumstances;
  • the clarity of consciousness, the emotional perception of what is happening
  • the presence of a reaction to pain stimuli
  • There is no spontaneous and interactive speech
  • there are active motor reactions.

Elective mutism in children is accompanied by the following symptomatology:


  1. speech development disorder
  2. detachment, which can sharply turn into aggression;
  3. Silence
  4. acute reaction to change of situation, relocation
  5. An alarm when accessing a child

Akinetic mutism can be supplemented by such symptoms:


  • There is no speech;
  • low motor activity, in some cases, its complete absence;
  • the child performs all actions with apparent delay;
  • inhibition of the child’s mental activity

With selective mutism, the overall clinical picture can be supplemented by the following symptoms:


  1. the symptomatology of the disease is absent in the conditions familiar to the child
  2. if you fall into an unfamiliar environment, the child loses all communication skills
  3. there is a fear of speaking.

It should be noted that in adult life selective mutism can develop into various mental illnesses and social phobia.

The phobic form of this disease is characterized by the periodicity of the symptomatology — the clinical picture is manifested only with severe stress, psychological trauma or moral abuse of the child.

Appalic form does not have specific clinical manifestations, the symptomatology fully corresponds to the general list. However, with this form of illness, a full recovery is extremely rare. In medicine, there is an unofficial name for this form of illness — the «wakeful coma».

Diagnostics

If you have the above clinical picture, you should seek medical help as soon as possible. In this case, you may need to consult a neurologist, a psychotherapist, a speech therapist.




The diagnostic program may include the following:


  • physical examination with clarification of complaints, collection of a general anamnesis;
  • Neurological examination of the patient
  • electroencephalography
  • MRI of the brain.

As for standard laboratory survey methods, they are assigned only when necessary.

Treatment

Basal treatment will depend on the underlying cause. If the etiology of mutism is a pathological process in the brain area, then an operation may be required:


  1. removal of the hematoma and installation of drainage into the ventricles of the brain
  2. surgical removal of the brain tumor.

After the operation, rehabilitation is required both in the medical institution itself and in a specialized sanatorium where correction of the speech function and social adaptation of the patient are carried out.

Medication intake is minimized. In some cases, the doctor may prescribe sedatives and tranquilizers. To improve the functioning of the brain, nootropic drugs can be prescribed.

A separate place in the treatment of this disease is psychotherapy with a multimodal approach — complex treatment with elements of family, individual and behavioral therapy is carried out.

It should be understood that the effectiveness of treatment of such a disease in a child will depend not only on the therapy prescribed by the doctors, but also on the psychoemotional situation in the family. The baby should be protected from stress, moral trauma and nervous overexertion.

In addition to a specific individual course of treatment, one should also take into account such general recommendations:


  • Pay as much attention as possible to the child — talk with him, spend time developing games
  • daily walks in the open air are obligatory
  • gradual social adaptation in society — communication and games with children, visiting children’s institutions for learning and development.

Treatment of this disease can last for several months, and several years.

Forecast and possible complications

The prognosis will depend on the form and stage of the development of the disease. With regard to complications, against the background of mutism, the following social disorders may develop:


  1. labor and social disadaptation due to lack of speech
  2. development of psychological diseases, complexes
  3. social phobia

Prevention

Targeted methods of prevention, unfortunately, no. However, to minimize the risk of developing such an ailment in a child, you can, if you apply in practice the following:


  • exclusion of psychological traumas, stresses, stressful emotional situation
  • Maintaining a healthy lifestyle from the moment parents decided to conceive a child and during the gestation of a baby
  • daily walks with the child, active, developing games
  • sufficient attention from parents;
  • adherence to the daily routine, proper nutrition.




At the first symptoms, you need to consult a doctor, and not ignore the problem or try to eliminate it yourself.