Biology 202
2003 Second Web Paper
On Serendip

Among the vast range of anxiety induced disorders that exist, Selective Mutism may be the most disabling to its victims. It has been estimated that approximately one in a thousand children suffer from this presumed psychiatric ailment wherein the ability to speak is limited to the household or other areas of comfort. (2) Public places and schools elicit so much anxiety within these children that their natural capacity to speak is suppressed. Once a child under five years of age exhibits the behavior described, for over a month, and without having other speech impeding barriers affecting them such as autism or a second language, he or she will most likely be diagnosed with selective mutism. (2)

Many hypotheses have been posed as to what causes selective mutism, however, no determinate conclusions have been made. In most cases it has been proven that anxiety disorders are hereditary, thus, nearly all children who become selectively mute have family members who were afflicted with the same or more serious anxiety disorder, like obsessive compulsive disorder, schizophrenia, or social phobia. The fact that anxiety disorders pass through generations implies that brain chemistry is perhaps genetic or that serotonin levels are inherited. Other suggested causes of selective mutism have been speculated upon, however, little research has been instated. Abuse, neglect, extreme shyness, extremely embarrassing experiences like vomiting or having diarrhea in a classroom setting, or living in a home environment with exceptionally nervous parents may also lead to become selectively mute. These theorized causes tend to describe the background of children who have no similar disorders running in the family. (4)

Doctors, for the most part, lean towards medication for those afflicted with selective mutism; however, other methods are practiced as well. (6) Environmental support, confidence boosting, therapy, and behavioral management classes have been known to aid in their struggles. A strong emphasis has been put on the necessity of treatment; for it has been proven that those enduring the disorder selective mutism, will only worsen. Eventually, the disorder will carry on into adulthood.

It should be clarified that children suffering from selective mutism do not choose not to speak, but rather cannot speak under anxiety ridden circumstances. For instance, many cases have been described wherein a therapist will bribe one of these children with a toy. They will offer to give to them the toy; a Barbie and a truck have been used as examples, if they can say what the object is. (1) The selectively mute child will strain themselves to say the word, but cannot force the sound out of their mouths.

Is the choice to speak or not speak a conscious or subconscious choice? It would seem that their desire to obtain the toy would be stronger than their desire to avoid the stressful situation of having to speak since these children are attempting to formulate the sound. Thus, the desire is repressed by a subconscious decision. Moreover, the fact that anxiety disorders are inherently hereditary goes to prove the lack of control over their ability to speak; low serotonin levels or genetics may inhibit their ability to express themselves verbally under high stress situations. This suggests selective mutism should be considered more a neurological disorder than a psychiatric disorder.

While the I - function has been known to instigate behavior human beings cannot normally imitate on their on accord, for instance, attempting to replicate the same eye movements which occur while following the movements of a pencil, perhaps the I - function also inhibits behavior that human beings would normally be able to perform by themselves. A correlation could be made between the disabled voice of the selectively mute who intensely desire to speak, as seen in the previous example wherein the patients tried speaking in order to receive the toy, and the I-function. Maybe the I-function is genetically differentiated and may be altered through certain medications.

An interesting phenomenon has emerged in relation to selective mutism. The children who suffer from this disorder, which essentially limits the basic form of human expression, usually compensate for that lack through artwork or music. It has been estimated that a great deal of those afflicted, for the period in which they undergo immense amounts of silence, gradually improve drastically in their creative abilities as artists and musicians. Often, their talent significantly surpasses that of their peers. Because most doctors prefer to elect medical treatment for those who suffer from selective mutism, namely prescribing them Prozac, the troubled children usually become verbally inclined once again. Once they are able to speak confidently, parents have reported that their children's artistic or musical abilities subside. Dr. Shipon - Blum, a specialist in the field of selective mutism, imparts, "Often, months after I have treated a child for selective mutism, parents will call me and want to know where their Picasso went." (1) Several explanations could be given as to the mystery behind this finding: perhaps there is a correlation between brain chemistry and creativity, or maybe Prozac or other anti depressants stunt creativity, or great expression through creativity could be a psychological method of release in the place of a lost sense.

In accepting medical treatment as a verifiable one, it is implied that selective mutism is a brain disorder, wherein the chemistry of the brain is erroneous. Low levels of serotonin can be heightened with the use of Prozac and other antidepressants. Also, it has been proven that most anxiety disorders are hereditary. If selective mutism is predestined, what accounts for the actual repression of speech as well as the associated artistic inclination? Conceivably, it would seem that along with the hereditary aspect of selective mutism as a disorder, there could be a hereditary gene, with which it is correlated, for creativity. When the disorder is cured through medicine, their creative ability is diminished along with it. On the other hand, a possibility lies in the notion that the I-function could be responsible for impeding the natural facilities of a person given these unfortunate genes, and could be adjusted through the use of modern medicine.

References

1)Selective Mutism, a general information site on selective mutism
2)The Selective Mutism Foundation, a support sight to better understand the disorder
3)Philadephia Page, a site with excerpts about selective mutism from the Philadelphia Inquirer
4)Selective Mutism UK, an interesting article about the seriousness of selective mutism
5)Anxiety-Panic Website, a site which describes several other anxiety disorders
6)Mental Health web page, a helpful site providing several articles about selective mutism
7)Anxiety Network, illustrates well the treatment available for those selectively mute


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