Elective mutism: an analysis of 100 cases. 1996

H C Steinhausen, and C Juzi
Department of Child and Adolescent Psychiatry, University of Zürich, Switzerland.

OBJECTIVE An extended series of 100 children with elective mutism (EM) was clinically analyzed. METHODS The total sample included two subgroups of clinically referred children at different locations and a subgroup of nonreferred children with EM. The study was based on comprehensive item sheets and, in the nonreferred sample only, the Child Behavior Checklist. RESULTS EM is a rare disorder in the referred child psychiatric samples. It typically starts at preschool age, is more common in girls, and is seen in all social strata. A background of migration and early developmental risk factors is also quite common. Premorbid speech and language disorders play a role in one third of the clientele, and three quarters of children with EM had behavioral abnormalities during infancy and preschool age. School and unfamiliar people create the social context in which children with EM most frequently do not speak. Shyness and internalizing behavior problems are the most common personality features in EM, and comorbid diagnoses are quite frequent. CONCLUSIONS This large series of affected children has identified the most typical features of EM and thereby extends the limited knowledge of this rare disorder of childhood.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007805 Language Development Disorders Conditions characterized by language abilities (comprehension and expression of speech and writing) that are below the expected level for a given age, generally in the absence of an intellectual impairment. These conditions may be associated with DEAFNESS; BRAIN DISEASES; MENTAL DISORDERS; or environmental factors. Language Delay,Speech Delay,Auditory Processing Disorder, Central,Central Auditory Processing Disorder,Developmental Disorder, Speech or Language,Developmental Language Disorders,Language Disorders, Developmental,Semantic-Pragmatic Disorder,Speech or Language, Developmental Disorder,Delay, Speech,Delays, Speech,Development Disorder, Language,Developmental Language Disorder,Disorder, Language Development,Disorders, Language Development,Language Delays,Language Development Disorder,Language Disorder, Developmental,Semantic Pragmatic Disorder,Semantic-Pragmatic Disorders,Speech Delays
D008297 Male Males
D009155 Mutism The inability to generate oral-verbal expression, despite normal comprehension of speech. This may be associated with BRAIN DISEASES or MENTAL DISORDERS. Organic mutism may be associated with damage to the FRONTAL LOBE; BRAIN STEM; THALAMUS; and CEREBELLUM. Selective mutism is a psychological condition that usually affects children characterized by continuous refusal to speak in social situations by a child who is able and willing to speak to selected persons. Kussmal aphasia refers to mutism in psychosis. (From Fortschr Neurol Psychiatr 1994; 62(9):337-44) Kussmaul Aphasia,Selective Mutism,Kussmaul's Aphasia,Mutism, Conversion,Mutism, Elective,Mutism, Organic,Mutism, Selective,Mutism, Voluntary,Aphasia, Kussmaul,Aphasia, Kussmaul's,Conversion Mutism,Conversion Mutisms,Elective Mutism,Elective Mutisms,Kussmauls Aphasia,Mutisms,Mutisms, Conversion,Mutisms, Elective,Mutisms, Organic,Mutisms, Voluntary,Organic Mutism,Organic Mutisms,Voluntary Mutism,Voluntary Mutisms
D010552 Personality Assessment The determination and evaluation of personality attributes by interviews, observations, tests, or scales. Articles concerning personality measurement are considered to be within scope of this term. Assessment, Personality,Assessments, Personality,Personality Assessments
D010553 Personality Development Growth of habitual patterns of behavior in childhood and adolescence. Development, Personality
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002653 Child Behavior Disorders Disturbances considered to be pathological based on age and stage appropriateness, e.g., conduct disturbances and anaclitic depression. This concept does not include psychoneuroses, psychoses, or personality disorders with fixed patterns. Childhood Behavior Disorders,Behavior Disorder, Child,Behavior Disorder, Childhood,Child Behavior Disorder,Childhood Behavior Disorder,Disorder, Childhood Behavior
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females

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