Elective mutism in children: A family systems approach

Abstract

Elective mutism in children is a relatively rare symptom which is more prevalent in the kindergarten population and has a higher incidence among immigrant families. Treatment strategies for this silent symptom include speech therapy, behavior modification, psychoanalytic, psychotherapeutic, family systems and a combination of these approaches. This paper reviews the types of elective mutism and proposes common characteristics of elective mutists' families. The potential for a redefinition of the term “elective mutism” is examined. It is concluded that family dynamics are an integral part of the elective mutism problem and need to be considered in a comprehensive treatment plan.     

Selective mutism in children: A structural family therapy approach to treatment

When children refuse to speak in some social settings, but can understand and speak in other settings, the diagnosis of selective mutism must be considered. A review of the literature describes the disorder, the various types of mutism, and related family dynamics. A family systems approach to treatment using structural family therapy is suggested. The case history presented illustrates one type of mutism as well as the family rules and hierarchy which appeared to be maintaining it. Structural and strategic family systems theory techniques that were used to move the family toward resolution of this problem are discussed.Diane Wolf Tatem, MA, MS, completed graduate work in marriage and family therapy at New Mexico State University, Las Cruces, NM. She is employed at Life Management Center of El Paso's Child Development Services and also has a private practice in marriage and family therapy in El Paso, Texas. Robert L. DelCampo, PhD is a professor of family science at New Mexico State University and maintains a private practice with Associates for Marriage and Family Therapy in Las Cruces, NM. Please address all correspondence to Dr. DelCampo at Box 3470, New Mexico State University, Las Cruces, NM, 88003-3470.Appreciation is expressed to Dr. Charles Huber, New Mexico State University in Las Cruces, for his insightful critique of the final draft of this paper. This paper was presented at the Texas Association for Marriage and Family Therapy Annual Conference, January 25–29, 1995 in Dallas, TX.     

MCMI-II personality traits and symptom traits in parents of children with selective mutism: a case-control study.

The etiology of selective mutism (SM) in children is unknown but is regarded as multifactorial. SM is frequently associated with social anxiety and language disorder or delay. The present study addresses SM and social anxiety as a familial phenomenon by comparing self-reported personality traits and symptom traits (Millon Clinical Multiaxial Inventory) in parents of 50 SM children with control parents. Personality and symptom traits reflecting social anxiety are also explored separately in the parents of SM children with and without a comorbid communication disorder. The results confirm SM and social anxiety as a familial phenomenon. Assessment and treatment planning should take this into account. The family data also suggest different family transmissions of SM and social anxiety in the SM group with and without a comorbid communication disorder.     

Concurrent individual and family therapy in a case of elective mutism

In this paper, following a literature review a family containing a child who had been electively mute for four years is described. A concurrent programme of individual and family therapy and the systemic hypothesis which guided these interventions is then presented in detail. Behavioural and psychometric data are presented to illustrate the dramatic improvement which the identified patient showed over the course of treatment. Finally, the probable mechanisms underpinning the child's improvement, and how these differed from our initial expectations, are discussed.     

A brief review of selective mutism literature

Selective mutism is a disorder characterized by a persistent failure to speak in certain social situations. It is typically diagnosed in childhood, and the disorder can last from just a few months to several years in some individuals. Debate surrounds the origins and causes of this disorder. Recent literature suggests that selective mutism may be a form of social phobia. The present article is a brief review of the literature on the etiology, assessment, comorbid diagnoses, and treatment perspectives from several theoretical orientations, including behavioral, family systems, and psychopharmacological.     

Stereotype development in Andalusian children

Social psychologists have shown a profound interest in intergroup relationships, but there are very few papers focusing on the developmental aspects that explain the psychological mechanisms involved in the construction of group and cultural identity. Our research aims to explore how the self-categorization of Andalusian children evolves. We tried to assess the degree to which they self-identify as Andalusian, Spanish, and European, and how this identification changes with age. We were also interested in the affective evaluation of different groups (French, Italian, English, German, Spanish, Catalonian, and Andalusian) made by Andalusian children. Furthermore, we analyzed the relationship between self-categorization and the evaluation of these groups. Results show that the development of national (autonomous community) identity in these children is influenced by their cognitive development, as well as by the relationships among the regional communities of Spain and the relationships between Spain and other countries. The peculiarity of Andalusians as a group is that they assume both identities: Spanish and Andalusian, from a very early age. In-group favoritism is an extended phenomenon at all ages, and Andalusian children have a negative stereotype of the other Spanish groups and other European communities.     

Number development in young children

This paper presents new data on children's acquisition of counting skills. Three aspects of counting were studied: the formation of the cardinality rule that the last number named during counting denotes the number of objects in an array, the mastery of the counting procedure or the coordination of ordered number names and objects counted, and the growth of the knowledge that x + 1 is greater than x. A model was outlined which posits the hierarchic integration of six number skills to account for the growth of the knowledge that x + 1 is greater than x and the development of number conservation. The six skills are: the cardinality rule, the counting procedure, acquisition of more x's, judgments of relative numerosity, pattern recognition of small numbers, and one-to-one correspondences.     

The development of metasuggestibility in children

One component of metasuggestibility is the understanding that a person's statements can influence another person's reports. The purpose of the present study was to examine the development of this understanding in school‐aged children. We produced a short video in which a boy makes a false allegation about being hit following an adult's suggestive interview. Children aged 6–13 years (N = 196) watched the video and answered open‐ended and forced‐choice questions about why the boy made a false allegation. The 6‐ and 7‐year‐olds performed poorly on all question types, whereas the 12‐ and 13‐year‐olds were at ceiling. There were developmental increases in metasuggestibility between 8 and 11 years. Our findings indicate that metasuggestibility undergoes prolonged development well into the school years. Implications for child witness training programs are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

The development of risk-taking in children

Since clear relationships exist between age, gender, and the occurrence of different kinds of accident, safety researchers and educators need to take account of recent work in developmental and environmental psychology, which is leading to a revised view of children’s environmental competence. Studies of the development of risk perception and risk-taking are first reviewed: these have identified three broad phases through which children proceed, culminating in an understanding of the interaction between their own perspective, that of other participants, and characteristics of the situation itself in the causation of accidents. This broad picture is in line with the reformulations of Piagetian stage theory which have occurred in recent years: rather than being “pre-operational” or “egocentric” in a global sense, young children’s main limitations seem to be in applying the principles of routines or drills from one setting to another, and studies of attention and memory show that the amount of information children are able to process improves with age, as does their resistance to distraction. Three aspects of individual differences seem to have an influence upon risk-taking, namelygender, reflection-impulsivity, andfamily structure, and the findings are reviewed in each case. As children get older they experience an increasingly wide variety of unfamiliar situations, and it is essential to understand the interaction between these age changes in environmental circumstances and mechanisms of developmental change in formulating programmes for safety education.     

Dynamic self-organization and early lexical development in children

In this study we present a self-organizing connectionist model of early lexical development. We call this model DevLex-II, based on the earlier DevLex model. DevLex-II can simulate a variety of empirical patterns in children's acquisition of words. These include a clear vocabulary spurt, effects of word frequency and length on age of acquisition, and individual differences as a function of phonological short-term memory and associative capacity. Further results from lesioned models indicate developmental plasticity in the network's recovery from damage, in a non-monotonic fashion. We attribute the network's abilities in accounting for lexical development to interactive dynamics in the learning process. In particular, variations displayed by the model in the rate and size of early vocabulary development are modulated by (a) input characteristics, such as word frequency and word length, (b) consolidation of lexical-semantic representation, meaning-form association, and phonological short-term memory, and (c) delayed processes due to interactions among timing, severity, and recoverability of lesion. Together, DevLex and DevLex-II provide an accurate computational account of early lexical development.     

Lateral specialization and social-verbal development in preschool children

Forty-two 2 1/2- to 5 1/2-year-old children's social and verbal behaviors were observed during free play in a preschool. A test measuring lateral specialization of verbal function and a standardized psychometric test of verbal ability were also administered. Analysis of variance indicated that the right ear (left hemisphere) is predominant in processing verbal stimuli in children as young as 2 1/2. Multiple regression analyses revealed significant relations between the right ear accuracy score for dichotically presented verbal stimuli and both psychometrically measured verbal ability and a social-verbal factor score derived from play behavior. After the increase related to age was statistically partialled out from both verbal ability and social-verbal scores, verbal expression, length of verbal utterances, time spent in conversation, and peer social interactions increased and parallel play decreased as a function of right ear (left hemisphere) accuracy for verbal stimuli. The relationship between left ear (right hemisphere) accuracy scores for verbal stimuli and social-verbal behavior, however, was not linear. Very high and very low levels of left ear recall predicted an increase in the frequency of parallel play and low social-verbal behavior while moderate levels of left ear accuracy scores predicted the reverse.     

Memory development in Libyan and Dutch school children

Cross-cultural similarities and differences in memory were examined in two studies with Libyan and Dutch school children of two different grades. The first study analysed effects of word length and pronunciation speed on recall. Baddeley's phonological loop hypothesis could fully account for the somewhat larger digit span of the Dutch children. The second study investigated effects of rehearsal training on recall. Experimental groups showed a higher performance increase after training than did control groups; Libyan children with the same pretest scores as Dutch children showed higher posttest scores, which could be a consequence of sample differences in age or test-wiseness. The studies demonstrated that current theories provide more precise explanations of cross-cultural differences in structural memory features than in control processes. Implications for instructional practice are discussed.     

Assessment of motor development and function in preschool children

The process of identification of children with delays or disorders in motor development includes developmental screening, examination, and reexamination. Throughout this process, various types of measures are used, including discriminative and evaluative measures. Discriminative and evaluative measures of motor development and function that are commonly used for preschool-aged children include the Bayley Scales of Infant Development II, Peabody Developmental Motor Scales, 2nd edition, Toddler and Infant Motor Evaluation, Pediatric Evaluation of Disability Inventory, and Gross Motor Function Measure. Selecting an appropriate measure is a crucial part of the examination process and should be geared toward the purpose of testing and characteristics of the child. Evidence of reliability and validity are important considerations for selection of a measure.