Selective mutism

Definition: Selective mutism is defined as a type of childhood anxiety where the child or the child chooses where and when to speak. Regularly choose not to speak in the school context and other social spheres. According to this definition agrees with that of several psychologists who have dealt with cases of selective mutism as is the case of Enrique Gelpi, Clinical Psychologist at St George's Hospital in San Juan Puerto Rico. Gelpi said that selective mutism is a childhood anxiety that prevents the child (a) to speak in certain contexts. It also indicates that selective mutism is not a problem of speech or language, rather it is a perception problem. On the other hand, Luis Rodriguez, Clinical Psychologist in Bayamon Puerto Rico said that selective mutism is a self-punishment that the child is imposed as a result of past trauma. Courage or discomfort related past and not to express it again against the same, self-punishment. Luis also notes that can be related to extreme shyness. Some professionals suggest that selective mutism is more common in girls than in boys. Description: Selective mutism is characterized by an inability of the child (a) to speak in certain social contexts.

The child (a) feel frightened and insecure to express themselves however they are highly intelligent children and very perceptive ability to differentiate between good and evil. It should be noted that children are defying their parents or teachers, making the cold war. They simply can not express themselves in that moment until you feel safety. Importantly, the children talk with their parents and some relatives. The child has the ability to speak, including some children in tests with speech pathologists have risen on average. Possible causes: Abuse was originally thought that children were abused by their parents. This was one of the first theories about it, but it was abandoned as the majority of parents of children treated were exemplary parents.

Heritage On the other hand, one possible cause is said to be hereditary. The result of selective mutism is the anxiety that although the latter is subjective psychosomatic leaving footprints are evident, so this theory that selective mutism is genetic sense. Parents who suffer from some type of anxiety you may be genetically transmitted it to the child (a). The genotypes when transferred to manifest are called phenotype. Ideotype is called the set of possibilities to express a character that shows an individual. Genes have to be identical so that they can play in the other person. Luis Rodriguez, Clinical Psychologist in Bayamon Puerto Rico says that trait anxiety may be inherited. Biological Luis Rodriguez, said the imbalance of serotonin and dopamine can cause anxiety which in turn may lead to the child to develop selective mutism. The levels of stress hormones (which regulate mood, anxiety, shyness, nervousness and stress reactions) if they are not balanced can cause anxiety.

Another possible cause is overprotection overprotection of parents. If the child's parents (a) choose to overprotect this can cause insecurity (outside the protection of their parents) and in turn fear and dependence on their parents. When the child leaves your face safe environment for school, when most selective mutism occurs because of fear, insecurity and the dependence of their parents. Perception Moreover, the child who is diagnosed with selective mutism is said to have a great ability to appreciate, however, some professionals believe that selective mutism is a perception problem. The child senses that the place is not reliable for him, most of the time is wrong as the school, where more frequent silent, is a place for growth. Combining theory with perceptual overprotection might cause in the child's selective mutism. For example, a child who is overprotected when you leave your safety to be in another environment may misperceive that this new environment is not safe. Environmental factors / behavioral impairment A home in a divorce, parental fights, hostile environment, loss of relatives, among others can also cause anxiety in children which in turn will induce selective mutism.

Fathers and mothers authoritarian unnoticed in children can cause insecurity that prevents them from speaking or expressing themselves. Note that the polarities can lead to the same end. I mean, as an overprotective father and a mother who is careless with your child can do the same thing in the least.

Not overcome trauma or stages in Erickson's psychosocial stages are two stages in which the child may not be able to overcome. The stage of autonomy vs. shame and doubt and initiative vs. guilt stage, reflected the ages of 1 to 3 years and 4 to 5 years respectively. If the stage of autonomy the child is embarrassed by their parents or someone else may not exceed that period. Similarly, in the stage of initiative if it is repressed as a child certainly does not exceed that period, which may eventually cause you do not have the initiative to speak in front of others. Poor feeding

Unbalanced diets in which there is an insufficient intake of carbohydrates, vitamins and minerals, nutrients, all necessary for the proper functioning of the nervous system.

Meal Times anarchic, making only 2-3 meals / day very far between ...

Restlessness

It is essential to bear in mind the fact that food plays a crucial role in the overall functioning of the brain. everything and everything, what we eat goes to the brain. What the person consumes energy directly affects your mood and brain function. The human brain requires a large amount of nutrients and energy for its operation. Poor nutrition and chemical changes alter neuronal function. After all the food is the most powerful drug in existence. The quantity and quality of nutrients affect several levels of neurotransmitters. Excess or lack of one vitamin, mineral or fatty acid can wreak havoc on our system, a direct influence on our mental wellbeing.

Countless studies confirm the relationship of feeding disorders such as ADD, cerebral palsy, ADHD and anxiety among others. The relationship between diet and mental problems is extensive. This connection is alarming. Because the human being as a social organism is in the worst nutritional status of all time. We live literally in a toxic pool, which flowed constantly invade our brains. Contamination of food, water, air and general environment are added to our body.

The child learned behavior may have learned the behavior of other people seeing it shut close to him. On the other hand, there are dolls that add nothing to the child's language as is the case of the Teletubbies, who do not speak and when they do not complete or correct words. Other programs are the Pink Panther, Tom and Jerry among others. We know that even our children and we like this kind of dolls, but it is the behavior of our children. We do not want to be exaggerated preventing our children to see something they like but we must have oversight of what they see and if they like is any of the above cartoon is good somehow let them know the importance of speaking and expressing . Origins: The roots of selective mutism are anxiety, fear and social phobia. We will meet each of these in depth.

Anxiety Anxiety is the fear of something unknown or undefined, is a subjective fear of something that has not happened and that there is or is not present, there is still only in the mind of the person and the future that person thinks he knows and wants to anticipate. It is believed that anxiety can serve as a motivating force or emotion to carry out projects. But there are more adverse features but you have control of it. Studies have shown adverse health effects it causes anxiety. Anxiety is a psychosomatic illness. Anxiety can cause stress, chronic fatigue and somatic terms is related to blood pressure, asthma, peptic ulcers, arthritis, constipation and more. Anxiety as stated above is subjective, or internal. When a person feels anxious, feels incapable of doing that you have in mind. The role of anxiety is warning us of something we can go wrong, but the alteration of this function can paralyze us, sick and unable to perform well.

Trait anxiety, state anxiety and trait anxiety is a permanent anxiety. May cause neurosis and end phobias, panic attacks and physical disorders. This kind of anxiety can lead people to avoid anxiety, what can succumb eventually to a decrease in consciousness and loss of flexibility. Within this type of trait anxiety chronic anxiety that can lead a person to seek a solution and calm in alcohol, drugs, tranquilizers, cigarettes and more. State anxiety and state anxiety and can help us make our actions more effective. Whether to perform a task or test a certain degree of anxiety is good as a motivating force. However, if you have no control, in the same example may be counterproductive because it will help us to perform well. Anxiety as a state is transient, ie it is triggered by certain events. Fear Fear is an emotional response to danger or threat. Fear is a defense mechanism intended to protect us from dangers, dangers usually already know and have experienced. Unlike anxiety, fear is not subjective, or is caused by external aspects.

Fear avoidance reaction occurs making it impossible for the person to experience new things or sensations as they almost always avoid the situation that causes fear. Fear is not the same as the fear, the fear is respect for something or someone, avoiding fear is that something or someone. Fear can result in social phobia. Social Phobia Social phobia is an exaggerated fear of social contexts and combined with anxiety. This is because the person who has applied social phobia avoidance is the product of fear in your mind and anticipate any embarrassment or shame even without these exist. The person who has a phobia or social anxiety fear being with large groups of people and avoid situations where you need to participate. Social phobia can lead a person to agoraphobia. Agoraphobia is a fear of open spaces. A person with social phobia may end up not wanting to leave home and develop a fear of open spaces such as stadiums, plazas, among others. These people prefer to be alone to be in a mall. Claustrophobia Fear of enclosed spaces is part of social phobia and that prevents you from going to the movies, theater, workshops, meetings, among others.

Statistics according to the center support of the APA Phobias Approximately 3.2 million adults have agoraphobia, characterized by fear of leaving home. (National Institute of Mental Health - NIMH) Social phobia usually begins in childhood or adolescence. (National Institute of Mental Health) Approximately 5.3 million adults in the United States, 18 to 54 years, have social phobia. (National Institute of Mental Health) People with eating disorders tend to withdraw from social contact and hide their behavior with regard to food. Anxiety Disorder More than 19 million adults in the U.S. have an anxiety disorder. (National Institute of Mental Health) Anxiety disorders often occur simultaneously with depressive disorders, eating disorders or substance abuse. (National Institute of Mental Health) Women are more likely than men to have anxiety disorders. (National Institute of Mental Health - NIMH) Children and adolescents is estimated that between 10 and 20% of children worldwide have one or more mental health problems or behavioral. (World Health Organization) Between 20% and 50% of depressed children and adolescents with a family history of depression.

(Survey of the U.S. Surgeon General, 1999) mental health disorders More than 44 million people in the United States has a mental health problem. (National Institute of Mental Health - NIMH) Approximately 4 million children and adolescents between 9 and 17 years, have a serious mental health problem. (Report of the Surgeon General on Mental Health, 1999.) Selective Mutism Symptoms Extreme shyness · Inability to speak in certain social contexts, however, talk with their parents and some relatives. Long-term complications is believed that selective mutism, but is treated by a specialist, can lead to social phobias, claustrophobia, agoraphobia, and several anxiety disorders that can complicate the picture and you can create psychosomatic problems that will eventually be reflected in gastrointestinal diseases, ulcers, cardiac arrhythmia, hypertension, asthma, constipation and more. It is advisable to treat the child with a specialist from the first symptoms to minimize these risks. In the short term the children will not communicate with their teachers and other students can affect their academic performance and school. This does not mean that selective mutism affects your intelligence because as mentioned above, there are children in tests with speech pathologists have risen on average, but in the school area but is communicated to the teachers, the latter can be interpreted as a challenge .

It is recommended that parents seek help with a professional psychologist or recommend that teachers like working with children with selective mutism. Selective mutism from different angles Psychoanalysis From the point of view of psychoanalysis may be related to trauma or attachment between anal and phallic stages. A psychoanalyst would deepen in these stages to discover unsurpassed trauma that is perhaps this which prevented the child to speak in certain social contexts. Cognitive-behavioral From the standpoint of cognitive behavior may be related to a learned behavior or a classical or operant conditioning. Another point would be that the child has learned to be silent for a profit or has learned to shut up because it brings a result that you want to avoid. Gestalt Approach From the standpoint of Gestalt may be related to a retroflection, a managing emotions that the child wants to express but dare not for some reason and ends up turning that emotion against him. This theory can be related to what Dr. Luis mentions that selective mutism is a self-punishment. Examples of this can be a fight against child marriage in such a situation the child may be wishing that their parents keep their mouths shut and not daring to express himself as retroflects.

Another theory could be a deflection which is a deviation from a situation or conversation. The deflector prevents or diverts attention to pass unnoticed. Structuralism / Psychosocial Based on Erickson's stages is possible that the child has not passed any specific stage of autonomy and initiative. You may have some erroneous internal law says you must be silent in certain social contexts and this structuring that idea that keeps you from expressing speech. Neuropsychology From this point of view is likely to have to do with a genetic predisposition and an imbalance of chemicals and neurotransmitters in the brain. Neuro Linguistic Programming (NLP) You could try an anchor to a bad experience. Each time the child is in certain social contexts may be anchored to frustration or experience where the silence was his best resource. In terms of submodalities (the colors, sounds, visual images, internal and internal feelings that the child is inside at the time of an experience or situation) may be that certain experiences in certain social contexts to process internally in a way that causes anxiety. Later we will explain in depth the submodalities.

Treatments / Psychotherapy has been recommended cognitive behavioral therapy, however there are many therapies that are effective against selective mutism which will be discussed below. Behavioral therapy in this type of therapy is to direct the child to stop the behavior patterns that have been silenced in certain social contexts. It will work on a biophysical approach to discover the origins of such behavior and to ensure rapid handling.

Group Therapy In this therapy the child meets other children to relate to them. You can use play therapy.

Occupational therapy is a type of therapy that is directed to adults with social and interpersonal problems but in order for integrating the individual into society is precisely what we want with the child with selective mutism.

Therapy of the Imagination (PNL) In this therapy I will stop for a moment because it is one I used just a case of selective mutism, and the results were wonderful. This therapy may not have heard because it is my authorship, however there may be rather similar therapies. This consists of the following, we searched the child as a way to react quieting internal structure in certain social contexts. He leaves noting the submodalities and feelings that generate that behavior. Then look for the emotions and feelings that the child is in the social context in which speech and feels safe. Finally, the child dissociate the feelings and emotions you have in the social context that does not speak and then associated the feelings and emotions you have when speaking to the social context does not speak. This example can explain it better. When I asked my daughter to feelings she had at school said she did not feel safe and therefore did not speak. Then I asked because in the entertainment center for children she had spoken to a child with her and took classes in college would not speak.

She replied that in that place of amusement she was having fun and felt much emotion. The therapy consisted of an imaginary game where every morning on their way to school, Mom had to take it like for that entertainment center instead of going to school. During this week the school became a center of entertainment for the baby, of course imaginary. The results were great because my daughter on the fifth day I talk to classmates and their teachers and even the sun continues to do so today. Note that the feelings and emotions that the girl was in the entertainment center were transmitted and associated with the school context that produced the confidence to speak it at school. It is important to know that in my case, my daughter has confidence and that facilitated the discovery of information to give me a clue to guide me to help her. It is recommended that if the child does not speak to a psychologist, this is who I authorized instructions and parents to perform the therapy of the imagination, because surely the child speaks to them and this can facilitate the process.

Ericksonian Therapy Milton Erickson was one of the most influential hypno therapists and successful United States. Your method of hypnosis is merited bearing his name since he changed hypnosis and out of the disrepute into which it was. His therapy approach was to use stories, metaphors, anecdotes and stories that often were invented at the time. Erickson did not need anyone to modify sleep behavior, simply believed that when relating a story that distracted the individual's conscious but the story itself was the message he wanted to install in the subconscious of the person. This type of therapy was a very successful and it is noteworthy that Erickson was a genius installing subconscious messages to individuals thus causing the change that people wanted. Remember that most of the time we humans act unconsciously. The unconscious is that which directs our actions and habits. In the case of children with selective mutism, therapies stories that are selected precisely to work and to encourage public speaking unconsciously are effective for the child.

Psychodrama This therapy is based on Moreno's psychodrama, the same can be used in play therapy by giving your child an imaginary drama where you see yourself in a situation where silence is usually regular, but in this drama where he is the character will act facing the situation and talking on it. It is good that the therapist is directed to disassociate or insensible to the situation that causes anxiety and fear. On the other hand, you have to associate situations where the child feels comfortable and wants to talk and to integrate those feelings that drama where the child faces trauma status.

Mono is an drama This therapy gestalt therapy and is an expanded version of psychodrama. It basically consists of the same elements as mentioned in previous therapy only in this version the boy plays all the lead roles, the child plays or be the same but also during the course of the game will be the other child and the teacher and so on. Recommendations It is good to integrate the child to social groups or sports art. Whether in art, drawing, dance, ballet, fencing, taek wan do, baseball, basketball, tennis, soccer, gymnastics, among others. That will help you acquire both social security and independence. What is sought is that the child is losing their fear of social groups. Furthermore, studies have confirmed that people who work in sports suffer less from anxiety, stress and depression. According to the investigations said that exercise stimulates a chemical called norepinephrine neuromodulator, which helps the brain to better handle stress. He says this has a direct effect on the neurotransmitters that work directly with stress. Psychologists believe it is the exercise if he increases the body's ability to respond to stress.

Situations where parents have to work · More children are going to say it's dumb · Family members or parents of other children will comment "I ate mice tongue? or "so shy child who does not speak?

Tips · Explain to other children if the child talks about but is currently too shy to do so, they made very little friends of him to gain confidence but will not force him to talk. • Explain to parents that the child has a condition and eventually speak. · The child's parents should not force or pressure to speak, as this may aggravate selective mutism. · It is good to keep the child in activities which promote their confidence. · When talking to each other in their situation do not do it in front of the child. Do not treat the child as having a disability. Important Notes • Children with selective mutism develop an ability to read body language in others. · The discernment of good and evil are so well developed. · The child with selective mutism usually talk a lot in dreams or sleep. According to Freud this is due to be released in dreams all the repressed desires that emerged during the day. The child with selective mutism to not talk during the day even looking forward to it, as manifested in dreams.

· Also the child may estrille teeth while sleeping. This is called bruxism, which is not yet known but his motives are attributed to emotional stress, anxiety, sleep position, parasites and certain disorders. ·

Conclusion We are in an age that advances and technology, environmental and psychological phenomena continue to grow with age. As professionals need to go evolving and innovating to keep up with the times we are living. Science and mental illness are increasing and our knowledge must go hand in hand with them. Selective mutism has entered into this psychological terrain and have been surprised many by its unique and unpredictable. However, as parents, psychologists, psychiatrists, speech therapists, nutritionists and other professionals have an interest in the subject.

Bibliography / Sources · Interview with Dr. Enrique Gelpi, Clinical Psychologist · Interview with Dr. Luis Rodriguez, Clinical Psychologist · Interview parents of children with selective mutism · Information on the internet · · Experience www.centrodeapoyoapa.org own Course of Master of Gestalt Psychology, East · Interview with Rolando Real, Fitness Coach Author: Joel Acevedo Nieto. Master Thesis course in Gestalt Psychology