Speech and language deficits in children with selective mutism - cause, comorbidity, or consequences?

  • Bojana Drljan University of Belgrade – Faculty of Special Education and Rehabilitation, Belgrade, Serbia
Keywords: selective mutism, speech-language deficits, etiological factors, comorbidity

Abstract


Introduction. Selective mutism (SM) is a disorder described from two aspects, psychological and language disorders. Researchers mainly focused on the psychological dimension of SM. However, there is an increasing number of studies indicating a significant speech and language (SL) impairment in children with SM and the possible connection between difficulties in language development and the occurrence of SM at school age. Objective. The aim of this paper was to review available research on SL deficits in children with SM, in order to clarify the cause-and-effect relationships between language and anxiety disorders in these children. Methods. Databases of the Library Consortium of Serbia and relevant Internet search engines were used for the literature search. Results. Nine research studies on SL abilities in children with SM are available in the literature. Mixed and expressive types of developmental language disorder, developmental phonological disorder, and language processing deficits are the most common SL impairments in children with SM. They occur significantly more frequently in children with SM than in children with anxiety disorders without SM and typically developing children. These deficits are often associated with learning disorders, social skills difficulties, and the risk of behavioral problems at school age. Conclusion. Existing studies have provided valuable insights into some aspects of the SL development in children with SM. However, the relationship between language deficits and anxiety symptoms is still not clear. Research on the early SL development in these children, which could shed light on the complex cause-and-effect dynamics of language and anxiety disorders seen in children with SM, is particularly scarce.

References

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.).

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Bar-Haim, Y., Henkin, Y., Ari-Even-Roth, D., Tetin-Schneider, S., Hildesheimer, M., & Muchnik, C. (2004). Reduced auditory efferent activity in childhood selective mutism. Biological Psychiatry, 55(11), 1061-1068. https://doi.org/10.1016/j.biopsych.2004.02.021

Benner, G. J., Rogers-Adkinson, D., Mooney, P., & Abbott, D. A. (2007). An investigation of the relationship between receptive language and social adjustment in a general sample of elementary school children. Journal of At-Risk Issues, 13(1), 13-21.

Black, B., & Uhde, T. W. (1995). Psychiatric characteristics of children with selective mutism: A pilot study. Journal of the American Academy of Child & Adolescent Psychiatry, 34(7), 847-856. https://doi.org/10.1097/00004583-199507000-00007

Carbone, D., Schmidt, L. A., Cunningham, C. C., McHolm, A. E., Edison, S., St Pierre, J., & Boyle, M. H. (2010). Behavioral and socio-emotional functioning in children with selective mutism: A comparison with anxious and typically developing children across multiple informants. Journal of Abnormal Child Psychology, 38(8), 1057-1067. https://doi.org/10.1007/s10802-010-9425-y

Chavira, D. A., Shipon-Blum, E., Hitchcock, C., Cohan, S., & Stein, M. B. (2007). Selective mutism and social anxiety disorder: all in the family? Journal of the American Academy of Child & Adolescent Psychiatry, 46(11), 1464-1472. https://doi.org/10.1097/chi.0b013e318149366a

Cleator, H., & Hand, L. (2001). Selective mutism: How a successful speech and language assessment really is possible. International Journal of Language & Communication Disorders, 36(S1), 126-131. https://doi.org/10.3109/13682820109177871

Cohan, S. L., Chavira, D. A., Shipon-Blum, E., Hitchcock, C., Roesch, S. C., & Stein, M. B. (2008). Refining the classification of children with selective mutism: A latent profile analysis. Journal of Clinical Child & Adolescent Psychology, 37(4), 770-784. https://doi.org/10.1080/15374410802359759

Cohen, N. J., Davine, M., Horodezky, N., Lipsett, L., & Isaacson, L. (1993). Unsuspected language impairment in psychiatrically disturbed children: Prevalence and language and behavioral characteristics. Journal of the American Academy of Child & Adolescent Psychiatry, 32(3), 595-603. https://doi.org/10.1097/00004583-199305000-00016

Conti-Ramsden, G., & Botting, N. (2004). Social difficulties and victimization in children with SLI at 11 years of age. Journal of Speech, Language, and Hearing Research, 47(1), 145-161. https://doi.org/10.1044/1092-4388(2004/013)

Cucinotta, F., Maggio, R., Gagliano, M., Venuti, M., & Gagliano, A. (2014). Good practices in bilingual children. Italian Journal of Pediatrics, 40(1), Article 80. https://doi.org/0.1186/1824-7288-40-S1-A80

Cunningham, C. E., McHolm, A. E., & Boyle, M. H. (2006). Social phobia, anxiety, oppositional behavior, social skills, and self-concept in children with specific selective mutism, generalized selective mutism, and community controls. European Child & Adolescent Psychiatry, 15(5), 245-255. https://doi.org/10.1007/s00787-006-0529-4

Cunningham, C. E., McHolm, A., Boyle, M. H., & Patel, S. (2004). Behavioral and emotional adjustment, family functioning, academic performance, and social relationships in children with selective mutism. Journal of Child Psychology and Psychiatry, 45(8), 1363-1372. https://doi.org/10.1111/j.1469-7610.2004.00327.x

Dimoski, S. (2016). Savremena shvatanja selektivnog mutizma. Specijalna edukacija i rehabilitacija, 15(3), 347-369. https://doi.org/10.5937/specedreh15-11562

Dow, S. P., Sonies, B. C., Scheib, D., Moss, S. E., & Leonard, H. L. (1995). Practical guidelines for the assessment and treatment of selective mutism. Journal of the American Academy of Child & Adolescent Psychiatry, 34(7), 836-846. https://doi.org/10.1097/00004583-199507000-00006

Drljan, B., Vuković, M., Arsenić, I., i Jovanović Simić, N. (2015). Detekcija pragmatskih deficita kod dece sa specifičnim jezičkim poremećajem. U M. Vuković (Ur.), Specijalna edukacija i rehabilitacija danas (str. 27-34). Univerzitet u Beogradu – Fakultet za specijalnu edukaciju i rehabilitaciju.

Drljan, B. (2017). Leksičke sposobnosti kod dece sa specifičnim jezičkim poremećajem [doktorska disertacija, Univerzitet u Beogradu]. NaRDuS. https://nardus.mpn.gov.rs/handle/123456789/9925

Drljan, B., i Vuković, M. (2017). Leksička raznovrsnost u narativnom diskursu dece sa specifičnim jezičkim poremećajem. Specijalna edukacija i rehabilitacija, 16(3), 261-287. https://doi.org/10.5937/specedreh16-14408

Drljan, B., & Vuković, M. (2019). Comparison of lexical‐semantic processing in children with developmental language disorder and typically developing peers. Govor, 36(2), 119-138. https://doi.org/10.22210/govor.2019.36.07

Durkin, K., & Conti‐Ramsden, G. (2007). Language, social behavior, and the quality of friendships in adolescents with and without a history of specific language impairment. Child Development, 78(5), 1441-1457. https://doi.org/10.1111/j.1467-8624.2007.01076.x

Elizur, Y., & Perednik, R. (2003). Prevalence and description of selective mutism in immigrant and native families: A controlled study. Journal of the American Academy of Child & Adolescent Psychiatry, 42(12), 1451-1459. https://doi.org/10.1097/00004583-200312000-00012

Ford, M. A., Sladeczek, I. E., Carlson, J., & Kratochwill, T. R. (1998). Selective mutism: Phenomenological characteristics. School Psychology Quarterly, 13(3), 192-227. https://doi.org/10.1037/h0088982

Hipolito, G., & Johnson, M. (2021). Selective mutism. In L. Cummings (Ed.), Handbook of pragmatic language disorders (pp. 247-281). Springer. https://doi.org/10.1007/978-3-030-74985-9_10

Kearney, C. A., & Rede, M. (2021). The heterogeneity of selective mutism: A primer for a more refined approach. Frontiers in Psychology, 12, Aricle 700745. https://doi.org/10.3389/fpsyg.2021.700745

Klein, E. R., Armstrong, S. L., & Shipon-Blum, E. (2013). Assessing spoken language competence in children with selective mutism: Using parents as test presenters. Communication Disorders Quarterly, 34(3), 184-195. https://doi.org/10.1177/1525740112455053

Kolvin, I., & Fundudis, T. (1981). Elective mute children: Psychological development and background factors. Journal of Child Psychology and Psychiatry, 22(3), 219-232. https://doi.org/10.1111/j.1469-7610.1981.tb00548.x

Kopp, S., & Gillberg, C. (1997). Selective mutistn: A population‐based study: A research note. Journal of Child Psychology and Psychiatry, 38(2), 257-262. https://doi.org/10.1111/j.1469-7610.1997.tb01859.x

Kristensen, H. (2000). Selective mutism and comorbidity with developmental disorder/delay, anxiety disorder, and elimination disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 39(2), 249-256. https://doi.org/10.1097/00004583-200002000-00026

Kristensen, H., & Oerbeck, B. (2006). Is selective mutism associated with deficits in memory span and visual memory?: An exploratory case-control study. Depression and Anxiety, 23(2), 71-76. https://doi.org/10.1002/da.20140

Kussmaul, A. (1877). Die Störungen der Sprache [The disturbances of speech]. Benno Schwabe.

Le Pichon, E., & de Jonge, M. (2016). Linguistic and psychological perspectives on prolonged periods of silence in dual-language learners. International Journal of Bilingual Education and Bilingualism, 19(4), 426-441. https://doi.org/10.1080/13670050.2015.1007918

Manassis, K., Fung, D., Tannock, R., Sloman, L., Fiksenbaum, L., & McInnes, A. (2003). Characterizing selective mutism: Is it more than social anxiety? Depression and Anxiety, 18(3), 153-161. https://doi.org/10.1002/da.10125

Manassis, K., Tannock, R., Garland, E. J., Minde, K., McInnes, A., & Clark, S. (2007). The sounds of silence: Language, cognition, and anxiety in selective mutism. Journal of the American Academy of Child & Adolescent Psychiatry, 46(9), 1187-1195. https://doi.org/10.1097/CHI.0b013e318076b7ab

McInnes, A., Fung, D., Manassis, K., Fiksenbaum, L., & Tannock, R. (2004). Narrative skills in children with selective mutism: An exploratory study. American Journal of Speech-Language Pathology, 13(4), 304-315. https://doi.org/10.1044/1058-0360(2004/031)

Melfsen, S., Walitza, S., & Warnke, A. (2006). The extent of social anxiety in combination with mental disorders. European Child & Adolescent Psychiatry, 15(2), 111-117. https://doi.org/10.1007/s00787-006-0510-2

Muris, P., & Ollendick, T. H. (2021). Current challenges in the diagnosis and management of selective mutism in children. Psychology Research and Behavior Management, 14(1), 159-167. https://doi.org/10.2147/PRBM.S274538

Nowakowski, M. E., Cunningham, C. E., McHolm, A. E., Evans, M. A., Edison, S., Pierre, J. S., Boyle, M. H., & Schmidt, L. A. (2009). Language and academic abilities in children with selective mutism. Infant and Child Development, 18(3), 271-290. https://doi.org/10.1002/icd.624

Oerbeck, B., Stein, M. B., Wentzel‐Larsen, T., Langsrud, Ø., & Kristensen, H. (2014). A randomized controlled trial of a home and school‐based intervention for selective mutism – defocused communication and behavioural techniques. Child and Adolescent Mental Health, 19(3), 192-198. https://doi.org/10.1111/camh.12045

Remschmidt, H., Poller, M., Herpertz-Dahlmann, B., Hennighausen, K., & Gutenbrunner, C. (2001). A follow-up study of 45 patients with elective mutism. European Archives of Psychiatry and Clinical Neuroscience, 251(6), 284-296. https://doi.org/10.1007/PL00007547

Sharp, W. G., Sherman, C., & Gross, A. M. (2007). Selective mutism and anxiety: A review of the current conceptualization of the disorder. Journal of Aanxiety Disorders, 21(4), 568-579. https://doi.org/10.1016/j.janxdis.2006.07.002

Simkin, Z., & Conti-Ramsden, G. (2006). Evidence of reading difficulty in subgroups of children with specific language impairment. Child Language Teaching and Therapy, 22(3), 315-331. https://doi.org/10.1191/0265659006ct310xx

Snowling, M. J., Bishop, D. V. M., Stothard, S. E., Chipchase, B., & Kaplan, C. (2006). Psychosocial outcomes at 15 years of children with a preschool history of speech‐language impairment. Journal of Child Psychology and Psychiatry, 47(8), 759-765. https://doi.org/10.1111/j.1469-7610.2006.01631.x

Standart, S., & Le Couteur, A. (2003). The quiet child: A literature review of selective mutism. Child and Adolescent Mental Health, 8(4), 154-160. https://doi.org/10.1111/1475-3588.00065

Steinhausen, H. C., & Juzi, C. (1996). Elective mutism: An analysis of 100 cases. Journal of the American Academy of Child & Adolescent Psychiatry, 35(5), 606-614. https://doi.org/10.1097/00004583-199605000-00015

Steffenburg, H., Steffenburg, S., Gillberg, C., & Billstedt, E. (2018). Children with autism spectrum disorders and selective mutism. Neuropsychiatric Disease and Treatment, 14(1), 1163-1169. https://doi.org/10.2147/NDT.S154966

Toppelberg, C. O., Tabors, P., Coggins, A., Lum, K., & Burger, C. (2005). Differential diagnosis of selective mutism in bilingual children. Journal of the American Academy of Child and Adolescent Psychiatry, 44(6), 592-595. https://doi.org/10.1097/01.chi.0000157549.87078.f8

Tramer, M. (1934). Elektiver mutismus bei kindern [Selective mutism in children]. Zeitschrift für Kinderpsychiatrie, 1, 30-35.

Viana, A. G., Beidel, D. C., & Rabian, B. (2009). Selective mutism: A review and integration of the last 15 years. Clinical Psychology Review, 29(1), 57-67. https://doi.org/10.1016/j.cpr.2008.09.009

Vuković, I., i Vuković, M. (2007). Odnos razvijenosti leksikona i socijalne zrelosti kod dece sa razvojnom disfazijom. Beogradska defektološka škola, 2(3), 111-122.

Wadman, R., Durkin, K., & Conti-Ramsden, G. (2011). Social stress in young people with specific language impairment. Journal of Adolescence, 34(3), 421-431. https://doi.org/10.1016/j.adolescence.2010.06.010

World Health Organization. (1994). International statistical classification of diseases and related health problems (10th rev.).

World Health Organization. (2020). International Classification of Diseases for Mortality and Morbidity Statistics (11th rev.).

Yeganeh, R., Beidel, D. C., Turner, S. M., Pina, A. A., & Silverman, W. K. (2003). Clinical distinctions between selective mutism and social phobia: An investigation of childhood psychopathology. Journal of the American Academy of Child & Adolescent Psychiatry, 42(9), 1069-1075. https://doi.org/10.1097/01.CHI.0000070262.24125.23

Young, B. J., Bunnell, B. E., & Beidel, D. C. (2012). Evaluation of children with selective mutism and social phobia: A comparison of psychological and psychophysiological arousal. Behavior Modification, 36(4), 525-544. https://doi.org/10.1177/0145445512443980

Published
2022/06/01
Section
Review Paper