Selective mutism

Introduction Selective Mutism (SM) is a persistent "rejection" of a child in a situation where a child needs to communicate (such as a school, a stranger or a crowded environment). A clinical syndrome characterized by normal speech in other occasions. Selective slang refers to children who have no organic disease in their speech organs, have normal intelligence, and have acquired language function. Under the influence of certain spiritual factors, it shows stubborn silence. This disease is considered to be a special form of neurosis in children, and it usually starts at 3 to 5 years old. Neuropsychiatric diseases such as rickets, schizophrenia, childhood autism, and mental retardation can also be accompanied by silent symptoms, but not in this disease.

Cause

Causes of selective mutism:

Selective mutism often occurs in children with sensitive, timid, and secluded personality. Parents often suffer from excessive love, protection, illness due to initial leave of the family, and environmental changes. Some cases may be related to genetic factors. Patients with rickets, affective disorders, and schizophrenia may also experience silent symptoms.

an examination

Related inspection

Nervous system examination

Examination of selective mutism:

Silence, no words, can not say a word for a long time. Children with selective mutism are silent about certain people, people, or in certain circumstances, while speaking to others and the environment.

Differential diagnosis

Selective mutism is confusing:

Hysterical mutism: Sometimes it can occur at the same time as rickets. If there is no stupidity, it will only be agile, writing, gestures, etc. The facial expressions are also very lively. Silent performance, like other clinical symptoms, has the characteristics of seizures, sudden recovery, and easy acceptance of cues.

Catattonic mutism: The patient is silent, or has a fragmented language, and can be accompanied by symptoms such as rejection, violation, stupor, waxy flexion, and impulsivity. The patient has a clear consciousness, no intelligence deficit, and lack of self-awareness. The diagnosis should be based on a typical medical history of schizophrenia or a typical symptom of a stress disorder.

Delusinonal mutism: system paranoia and delusional schizophrenia can be silent. It is common for the surrounding people to disagree with the delusional content of the patient, and refuse to talk to the surrounding people and to remain silent because the hallucinations or delusions of the content "command" the patient. The patient has no violations, impulsiveness, or stiffness.

Depression of depression: (melancholiac mutism) Depression can be expressed as stupor or muttering, the patient's face is mournful, sometimes accompanied by paroxysmal anxiety, and the severe condition is absolutely silent. Although the performance of chronic cases is like "dementia", the medical history has early pessimistic delusions and emotional depression, and can be restored after electroconvulsive treatment.

Malingering mutism: There is no disease in simple scams. It is completely disguised as "no language". There is a certain real condition in the expansion of scams, but silence is not the performance of the original condition.

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