Children who do not speak

Children who do not speak

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Selective Disability is defined as a kind of kaygı childhood anxiety disorder.. ELELE Child and Family Psychological Counseling Development and Training Center Psychologist and Special Education Specialist Bihter Mutlu Gencer, Ur It is the situation where the child does not talk in social environments where he / she is expected to speak in the environment where he / she feels comfortable and safe, such as at home, family or relatives, and in schools, friends and play environments. ”

What does Selective Mutism not understand?
Selective Disability is a form of childhood anxiety disorder. These children often do not make eye contact in environments where they seç choose not to speak, and when they are directed to a communication they may remain completely inactive, as if they had never heard. This is, of course, very difficult for parents as well as teachers and even therapists working with these children.

What are the diagnostic criteria?

According to DSM-IV, the diagnostic criteria for selective speechlessness are as follows:
● When the child speaks in other situations, he or she does not speak continuously in some social situations.
● Failure to speak of a child disrupts his / her education, professional achievement and social communication.
● The duration of this question is at least 1 month (except the first month after starting school)
● My inability to speak does not depend on not knowing the spoken language or not being able to speak that language.
● This problem cannot be explained by a communication disorder (eg stuttering), pervasive developmental disorder, or a psychotic process.

How often is it seen?
Selective speechlessness (SC) is less than 1% in the community, which is a very rare condition. It is usually diagnosed between the ages of 3-8. The problem can last a few months or a few years. Rarely seen in society and not known, these children may be characterized as shy and introverted and the problem cannot be fully understood until school age, thus delaying treatment.

What are the reasons?
The causes have not been determined yet. Although it was previously thought that SC was related to trauma or parental attitudes, recent research has shown that this is not true. Children with SC are generally thought to have a genetic predisposition to anxiety. These children may show signs of anxiety starting from infancy. They may experience problems such as difficulty in separation from the mother, hypersensitivity to sound, sleep problems, excessive crying, and difficult adaptation to new situations. When they grow up a little and start to participate in social environments outside the family, they develop a fear of talking and frostbite, an introverted body posture and dull facial expression.

Biologically, the section called the amygdala in the brain warns the person of the danger and gives instructions on what to do. Amygdala is thought to work in extraordinarily distressed individuals and send distress warnings even when the person is not really in danger. In children with SC, the danger signals from the brain are received in social settings. Because of the fear they feel in the face of danger, children develop speech-avoiding behavior to cope with this fear, and this behavior settles over time. The longer the initiation of treatment, the less chance of a positive outcome. After all, this behavior of a child or young person who has never spoken in a social environment until a certain age is well established.

How is the treatment planned?
Since SC is considered as a anxiety disorder, the goals of treatment should first be to reduce anxiety, increase self-esteem and self-esteem and try to provide relief in social situations. The treatment should include family therapy, a play therapy in which the child's behavior is well read, cognitive behavioral methods, and in addition, perhaps a combination of drug therapy. They should try to overcome the problem by working in cooperation with the family and school, accompanied by an experienced therapist.

What problems can be caused by lack of treatment?
If children with selective speechlessness are left untreated, their social development will be severely damaged, academically unsuccessful, self-confidence problems, socially isolated and introverted until adulthood; in adulthood, they are likely to become socially and occupationally inadequate, with anxiety disorder or predisposition to depression. For this reason, when parents find their children not to speak in one or more settings, they should immediately consult a specialist who is experienced in selective speaking and start treatment.

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