Jump to content

Muteness: Difference between revisions

From Wikipedia, the free encyclopedia
Browse history interactively
← Previous edit
Content deleted Content added
VisualWikitext
No edit summary
m Reverted edit by 2601:152:4A80:3C60:ACB2:A2E7:8D64:12AE (talk) to last version by CUA 27
 
(122 intermediate revisions by 92 users not shown)
Line 1: Line 1:
{{Infobox medical condition (new)
{{Infobox medical condition (new)

| name = <!--{{PAGENAME}} by default-->
| name = <!--{{PAGENAME}} by default-->
| synonym =
| synonym =
| image =
| image = Jan de Stomme - Self-portrait.jpg
| image_size =
| image_size =
| alt =
| alt =
| caption = [[Jan Jansz. de Stomme]], a [[deaf-mute]] 17th century [[Dutch Golden Age]] portrait [[painter]].
| caption =
| pronounce =
| pronounce =
| specialty = <!-- from Wikidata, can be overwritten -->
| specialty = <!-- from Wikidata, can be overwritten -->
Line 25: Line 24:
| deaths =
| deaths =
}}
}}
'''Muteness''' or '''mutism''' ({{ety|la|mutus|silent}}) is an inability to speak, often caused by a [[speech disorder]] or surgery. Someone who is mute may be so due to the unwillingness to speak in certain social situations.


In human development, '''muteness''' or '''mutism'''<ref>({{ety|la|mutus|silent}})</ref> is defined as an absence of speech, with or without an ability to hear the speech of others.<ref>{{Cite journal|last1=Grippo|first1=J.|last2=Vergel|first2=M. F.|last3=Comar|first3=H.|last4=Grippo|first4=T.|date=2001|title=[Mutism in children]|journal=Revista de Neurología|volume=32|issue=3|pages=244–246|doi=10.33588/rn.3203.2000376|issn=0210-0010|pmid=11310279}}</ref> Mutism is typically understood as a person's inability to speak, and commonly observed by their family members, caregivers, teachers, doctors or [[speech and language pathologist]]s. It may not be a permanent condition, as muteness can be [[Cause (medicine)|caused]] or manifest due to several different phenomena, such as physiological injury, illness, medical side effects, [[psychological trauma]], [[Developmental disorder|developmental disorders]], or [[Neurological disorder|neurological disorders]].<ref>{{Cite journal|last1=Grippo|first1=J.|last2=Vergel|first2=M. F.|last3=Comar|first3=H.|last4=Grippo|first4=T.|date=2001|title=[Mutism in children]|journal=Revista de Neurología|volume=32|issue=3|pages=244–246|doi=10.33588/rn.3203.2000376|issn=0210-0010|pmid=11310279}}</ref> A specific [[physical disability]] or [[communication disorder]] can be more easily diagnosed. Loss of previously normal speech ([[aphasia]]) can be due to accidents, disease, or surgical complication; it is rarely for [[Psychology|psychological]] reasons.
==Symptoms of [[selective mutism]]==
* The inability to maintain eye contact
* Sensitive in loud crowded situations
* [[Social isolation]] and withdrawal
* Symptoms when arriving home from a stressful event, includes stubbornness, aggression, shyness, and uneasiness {{Citation needed|date=July 2018}}
* Acting awkward after a stressful event (mostly due to another person performing neglectful action) {{Citation needed|date=July 2018}}


Treatment or management also varies by cause and this can often determined after a speech assessment.<ref>{{Cite web|url=https://www.cdc.gov/ncbddd/childdevelopment/language-disorders.html|title=Language and Speech Disorders in Children {{!}} CDC|last=CDC|date=2019-01-30|website=Centers for Disease Control and Prevention|language=en-us|access-date=2020-04-10}}</ref> Treatment can sometimes restore speech. If not, a range of assistive and augmentative communication devices are available.
''Hearing mutism'' is an obsolete term used in the late nineteenth and early twentieth century for [[specific language impairment]].<ref>[https://books.google.com/books?id=BYiMgQytRU8C&pg=PA6&lpg=PA6&dq=%22hearing+mutism%22&source=web&ots=W2ypNqM5Zm&sig=abMOBzrb9WReh8MYU9lkVie9UnM&hl=en Page 6] in: {{cite book |author=Leonard, Laurence B. |title=Children with specific language impairment |publisher=The MIT Press |location=Cambridge, Massachusetts |year=1998 |pages= |isbn=0-262-62136-3 |oclc= |doi= |accessdate=}}</ref>


== Biological causes ==
[[Akinetic mutism]] is a state in which the individual is unable to speak or move.<ref>{{cite web|url=http://www.medicinenet.com/script/main/art.asp?articlekey=6990|title=Definition of Akinetic mutism|publisher=|deadurl=no|archiveurl=https://web.archive.org/web/20141226162921/http://www.medicinenet.com/script/main/art.asp?articlekey=6990|archivedate=2014-12-26|df=}}</ref>
Biological causes of mutism may stem from several different sources. One cause of muteness may be problems with the physiology involved in speech, for example, the mouth or tongue.<ref>{{Cite web|url=http://www.personal.rdg.ac.uk/~llsroach/phon2/artic-basics.htm|title=2 The production of speech sounds|website=www.personal.rdg.ac.uk|access-date=2020-04-11}}</ref> Mutism may be due to [[apraxia]], that is, problems with coordination of muscles involved in speech.<ref>{{Cite web|url=https://www.mayoclinic.org/diseases-conditions/childhood-apraxia-of-speech/symptoms-causes/syc-20352045|title=Childhood apraxia of speech - Symptoms and causes|website=Mayo Clinic|language=en|access-date=2020-04-13}}</ref> Another cause may be a medical condition impacting the physical structures involved in speech, for example, loss of voice due to the injury, paralysis, or illness of the [[larynx]].<ref>{{Cite web|url=https://www.enthealth.org/conditions/vocal-cord-fold-paralysis/|title=Vocal Cord (Fold) Paralysis|website=ENT Health|language=en-US|access-date=2020-04-19}}</ref> Anarthria is a severe form of [[dysarthria]], in which the coordination of movements of the mouth and tongue or the conscious coordination of the lungs are damaged.<ref name="mozgi">{{cite web|url=http://www.sulinovadatbank.hu/letoltes.php?d_id=467|title=Ajánlások mozgáskorlátozott gyermekek, tanulók kompetencia alapú fejlesztéséhez|date=2006|website=Dombainé Esztergomi Anna|publisher=suliNova Közoktatás-fejlesztési és Pedagógus-továbbképzési Kht.|location=Budapest|language=hu|archive-url=https://web.archive.org/web/20140219224104/http://www.sulinovadatbank.hu/letoltes.php?d_id=467|archive-date=19 February 2014|access-date=1 May 2017}}</ref>


Neurological damage due to [[stroke]] may cause loss or impairment of speech, termed [[aphasia]]. Neurological damage or problems with development of the area of the brain involved in speech production, [[Broca's area]], may cause muteness.<ref>{{Cite web|url=https://www.britannica.com/science/Broca-area|title=Broca area {{!}} Definition, Function, & Facts|website=Encyclopedia Britannica|language=en|access-date=2020-04-11}}</ref> Trauma or injury to Broca's area, located in the left inferior [[frontal cortex]] of the brain, can cause muteness.<ref>{{Citation|title=Aphasia|url=https://medical-dictionary.thefreedictionary.com/Aphasia|work=The Free Dictionary|access-date=2020-04-11}}</ref> Muteness may follow brain surgery. For example, there is a spectrum of possible neurobehavioural deficits in the [[Poterior fossa|posterior fossa]] syndrome in children following [[Cerebellum|cerebellar]] [[tumor]] surgery.<ref>{{Cite journal|last1=Catsman-Berrevoets|first1=Coriene E.|last2=Aarsen|first2=Feke K.|date=2010|title=The spectrum of neurobehavioural deficits in the Posterior Fossa Syndrome in children after cerebellar tumour surgery|journal=Cortex; A Journal Devoted to the Study of the Nervous System and Behavior|volume=46|issue=7|pages=933–946|doi=10.1016/j.cortex.2009.10.007|issn=1973-8102|pmid=20116053|s2cid=206983595}}</ref>
== Causes ==


== Psychological causes ==
Those who are physically mute may have problems with the parts of the [[human anatomy|human body]] required for human speech (the [[esophagus]], [[vocal cords]], [[lungs]], [[mouth]], or [[tongue]], etc.).
When children do not speak, psychological problems or [[emotional stress]], such as [[anxiety]], may be involved. Children may not speak due to [[selective mutism]]. Selective mutism is a condition in which the child speaks only in certain situations or with certain people, such as close family members.<ref>{{Cite web|url=https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589942812&section=Signs_and_Symptoms|title=Selective Mutism: Signs and Symptoms|website=American Speech-Language-Hearing Association|language=en|access-date=2020-04-13}}</ref> Assessment is needed to rule out possible illness or other conditions and to determine treatment.<ref>{{Cite journal|last=Manassis|first=Katharina|date=2009|title=Silent suffering: understanding and treating children with selective mutism|journal=Expert Review of Neurotherapeutics|volume=9|issue=2|pages=235–243|doi=10.1586/14737175.9.2.235|issn=1744-8360|pmid=19210197|s2cid=25263166}}</ref> Prevalence is low, but not as rare as once thought.<ref>{{Cite journal|last1=Bergman|first1=R. Lindsey|last2=Piacentini|first2=John|last3=McCracken|first3=James T.|date=August 2002|title=Prevalence and description of selective mutism in a school-based sample|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=41|issue=8|pages=938–946|doi=10.1097/00004583-200208000-00012|issn=0890-8567|pmid=12162629|s2cid=20947226 }}</ref> Selective mutism should not be confused with a child who does not speak and cannot speak due to physical disabilities. It is common for symptoms to occur before the age of five. Not all children express the same symptoms.{{cn|date=November 2024}}


Selective mutism may occur in conjunction with [[autism spectrum disorder]] or other diagnoses.<ref>{{Cite journal|last1=Steffenburg|first1=Hanna|last2=Steffenburg|first2=Suzanne|last3=Gillberg|first3=Christopher|last4=Billstedt|first4=Eva|date=2018-05-07|title=Children with autism spectrum disorders and selective mutism|journal=Neuropsychiatric Disease and Treatment|volume=14|pages=1163–1169|doi=10.2147/NDT.S154966|issn=1176-6328|pmc=5944454|pmid=29765220 |doi-access=free }}</ref> [[Differential diagnosis]] between selective mutism and language delay associated with autism or other disorders is needed to determine appropriate treatment.
Trauma or injury to [[Broca's area]], located in the left inferior frontal cortex of the brain, can cause muteness.<ref>{{cite web|url=http://medical-dictionary.thefreedictionary.com/Aphasia|title=Aphasia|publisher=|via=The Free Dictionary}}</ref>


Adults who previously had speech and subsequently ceased talking may not speak for psychological or emotional reasons, though this is rare as a cause for adults.<ref>{{Cite journal|last1=Koźmin-Burzyńska|first1=Agnieszka|last2=Bratek|first2=Agnieszka|last3=Zawada|first3=Karolina|last4=Krysta|first4=Krzysztof|last5=Krupka-Matuszczyk|first5=Irena|date=2015|title=Psychogenic speech disorder--a case report|journal=Psychiatria Danubina|volume=27|issue=Suppl 1 |pages=S411–414|issn=0353-5053|pmid=26417806}}</ref> Absence or paucity of speech in adults may also be associated with specific psychiatric disorders.<ref>{{Cite journal|last1=Cohen|first1=Alex S.|last2=McGovern|first2=Jessica E.|last3=Dinzeo|first3=Thomas J.|last4=Covington|first4=Michael A.|date=December 2014|title=Speech Deficits in Serious mental Illness: A Cognitive Resource Issue?|journal=Schizophrenia Research|volume=160|issue=1–3|pages=173–179|doi=10.1016/j.schres.2014.10.032|issn=0920-9964|pmc=4310829|pmid=25464920}}</ref>
==Variations==
[[Selective mutism]] previously known as "elective mutism" is an anxiety disorder very common among young children, characterized by the inability to speak in certain situations. It should not be confused with someone who is mute and cannot communicate due to physical disabilities. Selectively mute children are able to communicate in situations in which they feel comfortable. About 90% of children with this disorder have also been diagnosed with social anxiety. It is very common for symptoms to occur before the age of five and do not have a set time period. Not all children express the same symptoms. Some may stand motionless and freeze in specific social settings and have no communication.<ref>{{cite web|url=http://www.selectivemutismcenter.org/aboutus/whatisselectivemutism|title=What is Selective Mutism|publisher=|deadurl=no|archiveurl=https://web.archive.org/web/20150202233608/http://www.selectivemutismcenter.org/aboutus/whatisselectivemutism|archivedate=2015-02-02|df=}}</ref>


== Developmental and neurological causes ==
[[Speech delay|Alalia]] is a disorder that refers to a delay in the development of speaking abilities in children. In severe cases, some children never learn how to speak. It is caused by illness of the child or the parents, the general disorders of the muscles, the shyness of the child or the fact that the parents are close relatives.<ref name="gyogyped">{{cite book|author1=Illyés Sándor|author2=Mesterházi Zsuzsa|author3=Bánfalvy Csaba|author4=Fonyódi Ilona|author5=Hámori József|author6=Papp László Tivadar|author7=Pataki László|author8=Kullmann Lajos|author9=Gósy Mária|author10=Csépe Valéria|author11=Márkus Attila|author12=Vetró Ágnes|author13=Gordosné Szabó Anna|author14=Nagy Gyöngyi Mária|author15=Csányi Yvonne|author16=Hatos Gyula|author17=Gaál Éva|author18=Kovács Krisztina|author19=Farkas Miklós-Perlusz Andrea|author20=Benczúr Miklósné|author21=Hári Mária|author22=Torda Ágnes|author23=Volentics Anna|author24=Balázs Anna|title=Gyógypedagógiai alapismeretek|date=2000|publisher=Bolyai Tudományegyetem Távoktatási Központ Pszichológia és Neveléstudományok Kar Tanító és Óvodapedagógus Szak|location=Budapest|isbn=9637155287|url=http://www.konyvbarlang.hu/oktatas-tankonyv/felsooktatas/gaal-eva-balazs-anna-gosy-maria-hamori-jozsef-illyes-sandor-hatos-gyula-csepe-valeria-volentics-anna-markus-attila-banfalvy-csaba-kullmann-lajos-gordosne-szabo-anna-vetro-agnes-mesterhazi-zsuzsa-kovacs-krisztina-gyogypedagogiai-alapismeretek-73780.html|accessdate=1 May 2017|archiveurl=https://web.archive.org/web/20170501225529/http://www.konyvbarlang.hu/oktatas-tankonyv/felsooktatas/gaal-eva-balazs-anna-gosy-maria-hamori-jozsef-illyes-sandor-hatos-gyula-csepe-valeria-volentics-anna-markus-attila-banfalvy-csaba-kullmann-lajos-gordosne-szabo-anna-vetro-agnes-mesterhazi-zsuzsa-kovacs-krisztina-gyogypedagogiai-alapismeretek-73780.html|archivedate=May 1, 2017|language=Hungarian}} {{hu icon}}</ref>
Absence of speech in children may involve [[communication disorder]]s or language delays. Communication disorders or developmental language delays may occur for several different reasons.<ref>{{Cite web|url=https://www.cdc.gov/ncbddd/childdevelopment/language-disorders.html|title=Language and Speech Disorders in Children {{!}} CDC|last=CDC|date=2019-01-30|website=Centers for Disease Control and Prevention|language=en-us|access-date=2020-04-19}}</ref><ref>{{Cite web|url=https://medlineplus.gov/speechandcommunicationdisorders.html|title=Speech and Communication Disorders|website=medlineplus.gov|access-date=2020-04-20}}</ref>


Language delays may be associated with other developmental delays.<ref>{{Cite journal|last1=Marrus|first1=Natasha|last2=Hall|first2=Lacey|date=2017|title=Intellectual Disability and Language Disorder|journal=Child and Adolescent Psychiatric Clinics of North America|volume=26|issue=3|pages=539–554|doi=10.1016/j.chc.2017.03.001|issn=1056-4993|pmc=5801738|pmid=28577608}}</ref> For example, children with [[Down syndrome]] often have impaired language and speech.<ref>{{Cite journal|last1=Martin|first1=Gary E.|last2=Klusek|first2=Jessica|last3=Estigarribia|first3=Bruno|last4=Roberts|first4=Joanne E.|date=2009|title=Language Characteristics of Individuals with Down Syndrome|journal=Topics in Language Disorders|volume=29|issue=2|pages=112–132|doi=10.1097/tld.0b013e3181a71fe1|issn=0271-8294|pmc=2860304|pmid=20428477}}</ref><ref>{{Cite web|url=https://www.ndsccenter.org/programs-resources/speech-and-language/|title=Speech and Language Resources {{!}} National Down Syndrome Congress|language=en-US|access-date=2020-04-19}}</ref>
Anarthria is a severe form of [[dysarthria]]. The coordination of movements of the mouth and tongue or the conscious coordination of the lungs are damaged.<ref name="mozgi">{{cite web|title=Ajánlások mozgáskorlátozott gyermekek, tanulók kompetencia alapú fejlesztéséhez|url=http://www.sulinovadatbank.hu/letoltes.php?d_id=467|website=Dombainé Esztergomi Anna|publisher=suliNova Közoktatás-fejlesztési és Pedagógus-továbbképzési Kht.|accessdate=1 May 2017|archiveurl=https://web.archive.org/web/20140219224104/http://www.sulinovadatbank.hu/letoltes.php?d_id=467|archivedate=19 February 2014|location=Budapest|date=2006}} {{hu icon}}</ref>


Children with [[autism]], categorized as a [[neurodevelopmental disorder]] in the [[DSM-5]], often demonstrate language delays.<ref>{{Cite journal|last=Volkers|first=Nancy|date=2018|title=Untangling the Language Challenges of Autism|journal=The ASHA Leader|language=EN|volume=22|issue=4|pages=54–59|doi=10.1044/leader.FTR2.22042017.54}}</ref><ref>{{Cite web|url=https://www.nidcd.nih.gov/health/autism-spectrum-disorder-communication-problems-children|title=Autism Spectrum Disorder: Communication Problems in Children|date=2015-08-18|website=NIDCD|language=en|access-date=2020-04-19}}</ref>
[[Aphasia]] can rob all aspects of the speech and language.<ref>{{cite web|url=http://medical-dictionary.thefreedictionary.com/asemia|title=asemia|publisher=|via=The Free Dictionary}}</ref> It is a damage of the cerebral centres of the language.


==Treatment==
[[Aphonia]] is the inability to produce any voice. In severe cases the patient loses phonation. It is caused by the injury, paralysis, and illness of the [[larynx]].<ref name="gyogyped"/>
Evaluation of children with language delays is necessary to determine whether the language delay was caused by another condition.<ref name=":0">{{Cite journal| url= https://www.aafp.org/afp/2011/0515/p1183.html|title=Speech and Language delay in children| publisher= American Association of Family Physicians|date=May 2011| journal= American Family Physician| volume=83|issue=10|pages=1183–1188|pmid=21568252|last1=McLaughlin|first1=M. R.}}</ref> Examples of such conditions are [[autism spectrum disorder]], hearing loss and [[apraxia]]. The manner of treatment depends on the diagnosed condition. Language delays may impact expressive language, receptive language, or both. Communication disorders may impact articulation, fluency ([[stuttering]]) and other specified and unspecified communication disorders. For example, speech and language services may focus on the production of speech sounds for children with [[phonological]] challenges.<ref name=":3">{{Cite web| url=http://www.oralmotorinstitute.org/mons/v2n2_marshalla.html|title=Oral Motor Institute |website= oralmotorinstitute.org |access-date= 2020-04-13}}</ref><ref name=":1">{{Cite web |url= https://www.cdc.gov/ncbddd/actearly/whyActEarly.html|title=Why Act Early if You're Concerned about Development?| date=2019-12-09| publisher= Centers for Disease Control and Prevention| website= CDC.gov |language=en-us|access-date=2020-04-17}}</ref><ref>{{Cite journal| last1= Roberts |first1= Megan| last2= Kaiser |first2= Ann| date= 2015-03-02 |title= Early Intervention for Toddlers With Language Delays: A Randomized Controlled Trial | journal= [[Pediatrics (journal)|Pediatrics]] |volume= 135 |issue=4|pages=686–693| doi= 10.1542/peds.2014-2134|pmid=25733749|pmc=4379460}}</ref>


Intervention services and treatment programs have been specifically developed for autistic children with language delays. For example, [[pivotal response treatment]] is a well-established and researched intervention that includes family participation.<ref>{{Cite journal| last1= Lei |first1= Jiedi |last2= Ventola|first2=Pamela|date=2017-06-20|title=Pivotal response treatment for autism spectrum disorder: current perspectives| journal= Neuropsychiatric Disease and Treatment|volume=13|pages=1613–1626|doi=10.2147/NDT.S120710|issn=1176-6328|pmc=5488784|pmid=28790824 |doi-access= free }}</ref> Mark Sundberg's verbal behavior framework is another well-established assessment and treatment modality that is incorporated into many [[applied behavior analysis]] (ABA) early intervention treatment programs for young children with autism and communication challenges.<ref>{{Cite web|url=https://www.autismspeaks.org/verbal-behavior-therapy|title=Verbal Behavior Therapy|website=Autism Speaks| language=en|access-date=2020-04-20}}</ref>{{unreliable source|date=September 2024|reason=No one likes autism speaks}}
[[Conversion disorder]] can cause loss of speaking ability.<ref>{{cite book|last1=Bánki M.|first1=Csaba|title=A beteg elme|date=1981|location=Budapest|isbn=9632408845|url=https://moly.hu/konyvek/banki-m-csaba-a-beteg-elme|accessdate=1 May 2017|archiveurl=https://web.archive.org/web/20170501231625/https://moly.hu/konyvek/banki-m-csaba-a-beteg-elme|archivedate=May 1, 2017|language=Hungarian}} {{hu icon}}</ref>


[[Feral child]]ren grow up outside of human society, and so usually struggle in learning any language.<ref name="Kassai"/>


Some people with [[autism]] never learn to speak.<ref name="gyogyped"/>


Treatment for absence of speech due to apraxia, involves assessment, and, based on the assessment, [[occupational therapy]], [[physical therapy]], and/or [[speech therapy]].<ref>{{cite web|url=https://www.apraxia-kids.org/wp-content/uploads/2013/01/BHSM-Fact-Sheet-2.pdf| title=Treatment Approaches for Children with Childhood Apraxia of Speech (CAS)| first= Sue| last= Caspari|year=2018| website= apraxia-kids.org}}</ref><ref>{{Cite web|url=https://www.mayoclinic.org/diseases-conditions/childhood-apraxia-of-speech/symptoms-causes/syc-20352045| title= Childhood apraxia of speech - Symptoms and causes|website= mayoclinic.org| publisher= Mayo Clinic|language=en|access-date=2020-04-13}}</ref><ref>{{Cite web| url= https://kidshealth.org/en/parents/speech-therapy.html|title=Speech-Language Therapy (for Parents) | publisher= Nemours KidsHealth|website=kidshealth.org|access-date= 2020-04-20}}</ref> Treatment for selective mutism involves assessment, counseling, and positive supports.<ref>{{Cite web|url=https://www.nhs.uk/conditions/selective-mutism/| title= Selective mutism| date= 2017-10-19| website= nhs.uk |language=en|access-date=2020-04-20}}</ref> Treatment for absence of speech in adults who previously had speech involves assessment to determine cause, including medical and surgery related causes, followed by appropriate treatment or management. Treatment may involve counseling, or rehabilitation services, depending upon cause of loss of speech.<ref>{{Cite journal |last1= Lincoln |first1=Tania M.| last2= Riehle| first2= Marcel| last3= Pillny |first3= Matthias |last4= Helbig-Lang| first4= Sylvia| last5= Fladung |first5= Anne-Katharina| last6= Hartmann-Riemer |first6= Matthias |last7= Kaiser|first7=Stefan|date=2017-12-05| title= Using Functional Analysis as a Framework to Guide Individualized Treatment for Negative Symptoms |journal= Frontiers in Psychology |volume= 8| pages= 2108| doi= 10.3389/fpsyg.2017.02108| issn= 1664-1078 |pmc= 5723417|pmid=29259567|doi-access=free}}</ref><ref>{{Cite encyclopedia| url= https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=34&ContentID=22953-1|title=Learning to Speak Again After Laryngeal Surgery |encyclopedia= Health Encyclopedia | publisher= [[University of Rochester Medical Center]]| via= urmc.rochester.edu| access-date=2020-04-20}}</ref>
Most [[Intellectual disability|intellectually disabled]] children learn to speak, but in the severe cases they cannot learn speech (IQ 20-25).<ref name="Kassai"/><ref name="Steven Pinker: A nyelvi ösztön" /> Children with [[Down syndrome]] often have impaired language and speech.<ref name="Kassai">{{cite web|title=Nyelvi és beszédbeli rendellenességek a nyelvtudomány történetében|url=http://www.nytud.hu/nyk/101/kassai.pdf|publisher=Kassai Ilona|accessdate=1 May 2017|archiveurl=https://web.archive.org/web/20070607030147/http://www.nytud.hu/nyk/101/kassai.pdf|archivedate=June 7, 2007}} {{hu icon}}</ref><ref name="Steven Pinker: A nyelvi ösztön">{{cite book|last1=Pinker|first1=Steven|title=A nyelvi ösztön – Hogyan hozza létre az elme a nyelvet?|date=2006|publisher=Typotex Kft|isbn=9789639664043|url=https://books.google.ca/books/about/A_nyelvi_%C3%B6szt%C3%B6n_Hogyan_hozza_l%C3%A9tre_az.html?id=jBa65DsVHGQC&redir_esc=y|accessdate=1 May 2017|language=hu}} {{hu icon}}</ref>


==Management==
==Management==
Management involves the use of appropriate assistive devices, called [[alternative and augmentative communication]]s. Suitability and appropriateness of modality will depend on users' physical abilities and cognitive functioning.<ref>{{Cite web|url=https://www.spectrumnews.org/opinion/viewpoint/families-need-guidance-buying-communication-app-autism/|title=Families need guidance before buying a communication app for autism|date=2019-04-23|website=Spectrum {{!}} Autism Research News|language=en-US|access-date=2020-04-14}}</ref>


Augmentative and alternative communication technology ranges from elaborated software for tablets to enable complex communication with an auditory component to less technologically involved strategies. For example, a common method involves the use of pictures that can be attached to velcro strips to create an accessible communication modality that does not require the cognitive or fine motor skills needed to manipulate a tablet.<ref>{{Cite web|url=https://www.livingmadeeasy.org.uk/communication/augmentative-and-alternative-communication-(aac)-3552/|title=Communication aids for disabled children - Living made easy|website=www.livingmadeeasy.org.uk|access-date=2020-04-14}}</ref>
Some mute patients have adapted to their disability by using machines that vibrate their vocal cords, allowing them to speak. [[Esophageal speech]] can give some speaking ability.<ref>{{cite web|url=http://www.informed.hu/betegsegek/betegsegek_reszletesen/orl/pharynx_larynx_tonsilla/larynx_cancer/?article_hid=22331|title=Gége nélküli hangképzés :: Gégerák és más daganatok - InforMed Orvosi és Életmód portál :: logopédia,gége,nélküli,hangképzés,hangképzés,gégedaganat,gégekiirtás,laryngectomia,nyelőcsőhangképzés|first=|last=InforMed|publisher=|deadurl=no|archiveurl=https://web.archive.org/web/20160508082640/http://www.informed.hu/betegsegek/betegsegek_reszletesen/orl/pharynx_larynx_tonsilla/larynx_cancer/?article_hid=22331|archivedate=2016-05-08|df=}} {{hu icon}}</ref> Others learn [[sign language]] to communicate.<ref>{{cite book|last1=Andrea|first1=Erdélyi|title=Nézd a kezem! Egyszerű gesztusjelek gyűjteménye... Új állapotú!|date=2005|publisher=Nemzeti Tankönyvkiadó – National Textbook Publishing House|isbn=9789631955804|url=https://bookline.hu/product/home.action?_v=Erdelyi_Andrea_Nezd_a_kezem_Egyszeru_g&trackingCode=j009e0m3-jhyu2frxjrg-S.ITEM_PAGE.C.c64_a68-0o65mwg&id=2104110014&type=10|accessdate=1 May 2017|language=Hungarian}} {{hu icon}}</ref>


[[Speech-generating devices]] can help people with speech deficiencies associated with medical conditions that affect speech, communication disorders that impair speech, or surgeries that have impacted speech. Speech-generating devices continue to improve in ease of use.<ref>{{Cite web|url=http://www.childrenshospital.org/Centers-and-Services/Programs/A-_-E/als-augmentative-communication-program/protocol-of-assessment-considerations/speech-generating-devices|title=ALS Augmentative Communication Program {{!}} Speech-Generating Devices {{!}} Boston Children's Hospital|website=www.childrenshospital.org|access-date=2020-04-20}}</ref>
Computers also facilitate communication, both with smart phones and the Internet. Many [[augmentative and alternative communication]] devices exist to allow people to communicate; these include "text-to-speech" devices and/or software programs, which turns typed text and/or a button loaded with messages into electronic vocalizations, enabling the mute and the speech-impaired to "speak".

Other techniques of the augmentative and alternative communication include:
*written notes
*helper pages, books with letters, words, iconic and Bliss symbols and pictures<ref>{{cite web|url=http://www.blissalapitvany.hu/|title=Bliss Alapítvány|deadurl=no|archiveurl=https://web.archive.org/web/20151007022826/http://www.blissalapitvany.hu/|archivedate=2015-10-07|df=}} {{hu icon}}</ref> and their tangible versions<ref>Rowland, C., & Schweigert, P. (1989). [https://archive.is/20120805160100/http://www.ohsu.edu/oidd/d2l/ts/index.cfm ''Tangible Symbol Systems'']: Symbolic communication for individuals with multisensory impairments. Augmentative and Alternative Communication, 5(4), 226-234.</ref><ref>Rowland, C., & Schweigert, P. (1996). Tangible Symbol Systems (DVD). Portland, OR: Oregon Health & Science University.</ref><ref>Rowland, C. & Schweigert, P. (2000a). Tangible symbols, tangible outcomes. Augmentative and Alternative Communication, 16 (2), 61-78.</ref><ref>Rowland, C., & Schweigert, P. (2000b). :Tangible Symbol Systems (2nd Ed.). Portland, OR: Oregon Health & Science University.</ref>
*lip-reading by the communication partner
*vocalization
*speech recording and replaying
*alternative pointers<ref name="mozgi"/>


==See also==
==See also==
*[[Aphasia]]
*[[Aphonia]]
*[[Aphonia]]
*[[Augmentative and alternative communication]]
*[[Autism]]
*[[Deafness]]
*[[Deafness]]
*[[Developmental disability]]
*[[Developmental disability]]
*[[Dysarthria]]
*[[Dyslalia]]
*[[Dyslalia]]
*[[Speech delay]]
*[[Speech delay]]
*[[Vocal cord paresis]]
*[[Vocal cord paresis]]
*[[Nonspeaking autism]]


==References==
==References==
{{reflist|30em}}
{{Reflist}}

{{Authority control}}


[[Category:Communication disorders]]
[[Category:Muteness| ]]
[[Category:Speech impediments]]
[[Category:Voice disorders]]
[[Category:Silence]]

Latest revision as of 01:41, 11 December 2024

Muteness
Jan Jansz. de Stomme, a deaf-mute 17th century Dutch Golden Age portrait painter.
SpecialtyNeurology, psychiatry Edit this on Wikidata

In human development, muteness or mutism[1] is defined as an absence of speech, with or without an ability to hear the speech of others.[2] Mutism is typically understood as a person's inability to speak, and commonly observed by their family members, caregivers, teachers, doctors or speech and language pathologists. It may not be a permanent condition, as muteness can be caused or manifest due to several different phenomena, such as physiological injury, illness, medical side effects, psychological trauma, developmental disorders, or neurological disorders.[3] A specific physical disability or communication disorder can be more easily diagnosed. Loss of previously normal speech (aphasia) can be due to accidents, disease, or surgical complication; it is rarely for psychological reasons.

Treatment or management also varies by cause and this can often determined after a speech assessment.[4] Treatment can sometimes restore speech. If not, a range of assistive and augmentative communication devices are available.

Biological causes

[edit]

Biological causes of mutism may stem from several different sources. One cause of muteness may be problems with the physiology involved in speech, for example, the mouth or tongue.[5] Mutism may be due to apraxia, that is, problems with coordination of muscles involved in speech.[6] Another cause may be a medical condition impacting the physical structures involved in speech, for example, loss of voice due to the injury, paralysis, or illness of the larynx.[7] Anarthria is a severe form of dysarthria, in which the coordination of movements of the mouth and tongue or the conscious coordination of the lungs are damaged.[8]

Neurological damage due to stroke may cause loss or impairment of speech, termed aphasia. Neurological damage or problems with development of the area of the brain involved in speech production, Broca's area, may cause muteness.[9] Trauma or injury to Broca's area, located in the left inferior frontal cortex of the brain, can cause muteness.[10] Muteness may follow brain surgery. For example, there is a spectrum of possible neurobehavioural deficits in the posterior fossa syndrome in children following cerebellar tumor surgery.[11]

Psychological causes

[edit]

When children do not speak, psychological problems or emotional stress, such as anxiety, may be involved. Children may not speak due to selective mutism. Selective mutism is a condition in which the child speaks only in certain situations or with certain people, such as close family members.[12] Assessment is needed to rule out possible illness or other conditions and to determine treatment.[13] Prevalence is low, but not as rare as once thought.[14] Selective mutism should not be confused with a child who does not speak and cannot speak due to physical disabilities. It is common for symptoms to occur before the age of five. Not all children express the same symptoms.[citation needed]

Selective mutism may occur in conjunction with autism spectrum disorder or other diagnoses.[15] Differential diagnosis between selective mutism and language delay associated with autism or other disorders is needed to determine appropriate treatment.

Adults who previously had speech and subsequently ceased talking may not speak for psychological or emotional reasons, though this is rare as a cause for adults.[16] Absence or paucity of speech in adults may also be associated with specific psychiatric disorders.[17]

Developmental and neurological causes

[edit]

Absence of speech in children may involve communication disorders or language delays. Communication disorders or developmental language delays may occur for several different reasons.[18][19]

Language delays may be associated with other developmental delays.[20] For example, children with Down syndrome often have impaired language and speech.[21][22]

Children with autism, categorized as a neurodevelopmental disorder in the DSM-5, often demonstrate language delays.[23][24]

Treatment

[edit]

Evaluation of children with language delays is necessary to determine whether the language delay was caused by another condition.[25] Examples of such conditions are autism spectrum disorder, hearing loss and apraxia. The manner of treatment depends on the diagnosed condition. Language delays may impact expressive language, receptive language, or both. Communication disorders may impact articulation, fluency (stuttering) and other specified and unspecified communication disorders. For example, speech and language services may focus on the production of speech sounds for children with phonological challenges.[26][27][28]

Intervention services and treatment programs have been specifically developed for autistic children with language delays. For example, pivotal response treatment is a well-established and researched intervention that includes family participation.[29] Mark Sundberg's verbal behavior framework is another well-established assessment and treatment modality that is incorporated into many applied behavior analysis (ABA) early intervention treatment programs for young children with autism and communication challenges.[30][unreliable source?]


Treatment for absence of speech due to apraxia, involves assessment, and, based on the assessment, occupational therapy, physical therapy, and/or speech therapy.[31][32][33] Treatment for selective mutism involves assessment, counseling, and positive supports.[34] Treatment for absence of speech in adults who previously had speech involves assessment to determine cause, including medical and surgery related causes, followed by appropriate treatment or management. Treatment may involve counseling, or rehabilitation services, depending upon cause of loss of speech.[35][36]

Management

[edit]

Management involves the use of appropriate assistive devices, called alternative and augmentative communications. Suitability and appropriateness of modality will depend on users' physical abilities and cognitive functioning.[37]

Augmentative and alternative communication technology ranges from elaborated software for tablets to enable complex communication with an auditory component to less technologically involved strategies. For example, a common method involves the use of pictures that can be attached to velcro strips to create an accessible communication modality that does not require the cognitive or fine motor skills needed to manipulate a tablet.[38]

Speech-generating devices can help people with speech deficiencies associated with medical conditions that affect speech, communication disorders that impair speech, or surgeries that have impacted speech. Speech-generating devices continue to improve in ease of use.[39]

See also

[edit]

References

[edit]
  1. ^ (from Latin mutus 'silent')
  2. ^ Grippo, J.; Vergel, M. F.; Comar, H.; Grippo, T. (2001). "[Mutism in children]". Revista de Neurología. 32 (3): 244–246. doi:10.33588/rn.3203.2000376. ISSN 0210-0010. PMID 11310279.
  3. ^ Grippo, J.; Vergel, M. F.; Comar, H.; Grippo, T. (2001). "[Mutism in children]". Revista de Neurología. 32 (3): 244–246. doi:10.33588/rn.3203.2000376. ISSN 0210-0010. PMID 11310279.
  4. ^ CDC (2019-01-30). "Language and Speech Disorders in Children | CDC". Centers for Disease Control and Prevention. Retrieved 2020-04-10.
  5. ^ "2 The production of speech sounds". www.personal.rdg.ac.uk. Retrieved 2020-04-11.
  6. ^ "Childhood apraxia of speech - Symptoms and causes". Mayo Clinic. Retrieved 2020-04-13.
  7. ^ "Vocal Cord (Fold) Paralysis". ENT Health. Retrieved 2020-04-19.
  8. ^ "Ajánlások mozgáskorlátozott gyermekek, tanulók kompetencia alapú fejlesztéséhez". Dombainé Esztergomi Anna (in Hungarian). Budapest: suliNova Közoktatás-fejlesztési és Pedagógus-továbbképzési Kht. 2006. Archived from the original on 19 February 2014. Retrieved 1 May 2017.
  9. ^ "Broca area | Definition, Function, & Facts". Encyclopedia Britannica. Retrieved 2020-04-11.
  10. ^ "Aphasia", The Free Dictionary, retrieved 2020-04-11
  11. ^ Catsman-Berrevoets, Coriene E.; Aarsen, Feke K. (2010). "The spectrum of neurobehavioural deficits in the Posterior Fossa Syndrome in children after cerebellar tumour surgery". Cortex; A Journal Devoted to the Study of the Nervous System and Behavior. 46 (7): 933–946. doi:10.1016/j.cortex.2009.10.007. ISSN 1973-8102. PMID 20116053. S2CID 206983595.
  12. ^ "Selective Mutism: Signs and Symptoms". American Speech-Language-Hearing Association. Retrieved 2020-04-13.
  13. ^ Manassis, Katharina (2009). "Silent suffering: understanding and treating children with selective mutism". Expert Review of Neurotherapeutics. 9 (2): 235–243. doi:10.1586/14737175.9.2.235. ISSN 1744-8360. PMID 19210197. S2CID 25263166.
  14. ^ Bergman, R. Lindsey; Piacentini, John; McCracken, James T. (August 2002). "Prevalence and description of selective mutism in a school-based sample". Journal of the American Academy of Child and Adolescent Psychiatry. 41 (8): 938–946. doi:10.1097/00004583-200208000-00012. ISSN 0890-8567. PMID 12162629. S2CID 20947226.
  15. ^ Steffenburg, Hanna; Steffenburg, Suzanne; Gillberg, Christopher; Billstedt, Eva (2018-05-07). "Children with autism spectrum disorders and selective mutism". Neuropsychiatric Disease and Treatment. 14: 1163–1169. doi:10.2147/NDT.S154966. ISSN 1176-6328. PMC 5944454. PMID 29765220.
  16. ^ Koźmin-Burzyńska, Agnieszka; Bratek, Agnieszka; Zawada, Karolina; Krysta, Krzysztof; Krupka-Matuszczyk, Irena (2015). "Psychogenic speech disorder--a case report". Psychiatria Danubina. 27 (Suppl 1): S411–414. ISSN 0353-5053. PMID 26417806.
  17. ^ Cohen, Alex S.; McGovern, Jessica E.; Dinzeo, Thomas J.; Covington, Michael A. (December 2014). "Speech Deficits in Serious mental Illness: A Cognitive Resource Issue?". Schizophrenia Research. 160 (1–3): 173–179. doi:10.1016/j.schres.2014.10.032. ISSN 0920-9964. PMC 4310829. PMID 25464920.
  18. ^ CDC (2019-01-30). "Language and Speech Disorders in Children | CDC". Centers for Disease Control and Prevention. Retrieved 2020-04-19.
  19. ^ "Speech and Communication Disorders". medlineplus.gov. Retrieved 2020-04-20.
  20. ^ Marrus, Natasha; Hall, Lacey (2017). "Intellectual Disability and Language Disorder". Child and Adolescent Psychiatric Clinics of North America. 26 (3): 539–554. doi:10.1016/j.chc.2017.03.001. ISSN 1056-4993. PMC 5801738. PMID 28577608.
  21. ^ Martin, Gary E.; Klusek, Jessica; Estigarribia, Bruno; Roberts, Joanne E. (2009). "Language Characteristics of Individuals with Down Syndrome". Topics in Language Disorders. 29 (2): 112–132. doi:10.1097/tld.0b013e3181a71fe1. ISSN 0271-8294. PMC 2860304. PMID 20428477.
  22. ^ "Speech and Language Resources | National Down Syndrome Congress". Retrieved 2020-04-19.
  23. ^ Volkers, Nancy (2018). "Untangling the Language Challenges of Autism". The ASHA Leader. 22 (4): 54–59. doi:10.1044/leader.FTR2.22042017.54.
  24. ^ "Autism Spectrum Disorder: Communication Problems in Children". NIDCD. 2015-08-18. Retrieved 2020-04-19.
  25. ^ McLaughlin, M. R. (May 2011). "Speech and Language delay in children". American Family Physician. 83 (10). American Association of Family Physicians: 1183–1188. PMID 21568252.
  26. ^ "Oral Motor Institute". oralmotorinstitute.org. Retrieved 2020-04-13.
  27. ^ "Why Act Early if You're Concerned about Development?". CDC.gov. Centers for Disease Control and Prevention. 2019-12-09. Retrieved 2020-04-17.
  28. ^ Roberts, Megan; Kaiser, Ann (2015-03-02). "Early Intervention for Toddlers With Language Delays: A Randomized Controlled Trial". Pediatrics. 135 (4): 686–693. doi:10.1542/peds.2014-2134. PMC 4379460. PMID 25733749.
  29. ^ Lei, Jiedi; Ventola, Pamela (2017-06-20). "Pivotal response treatment for autism spectrum disorder: current perspectives". Neuropsychiatric Disease and Treatment. 13: 1613–1626. doi:10.2147/NDT.S120710. ISSN 1176-6328. PMC 5488784. PMID 28790824.
  30. ^ "Verbal Behavior Therapy". Autism Speaks. Retrieved 2020-04-20.
  31. ^ Caspari, Sue (2018). "Treatment Approaches for Children with Childhood Apraxia of Speech (CAS)" (PDF). apraxia-kids.org.
  32. ^ "Childhood apraxia of speech - Symptoms and causes". mayoclinic.org. Mayo Clinic. Retrieved 2020-04-13.
  33. ^ "Speech-Language Therapy (for Parents)". kidshealth.org. Nemours KidsHealth. Retrieved 2020-04-20.
  34. ^ "Selective mutism". nhs.uk. 2017-10-19. Retrieved 2020-04-20.
  35. ^ Lincoln, Tania M.; Riehle, Marcel; Pillny, Matthias; Helbig-Lang, Sylvia; Fladung, Anne-Katharina; Hartmann-Riemer, Matthias; Kaiser, Stefan (2017-12-05). "Using Functional Analysis as a Framework to Guide Individualized Treatment for Negative Symptoms". Frontiers in Psychology. 8: 2108. doi:10.3389/fpsyg.2017.02108. ISSN 1664-1078. PMC 5723417. PMID 29259567.
  36. ^ "Learning to Speak Again After Laryngeal Surgery". Health Encyclopedia. University of Rochester Medical Center. Retrieved 2020-04-20 – via urmc.rochester.edu.
  37. ^ "Families need guidance before buying a communication app for autism". Spectrum | Autism Research News. 2019-04-23. Retrieved 2020-04-14.
  38. ^ "Communication aids for disabled children - Living made easy". www.livingmadeeasy.org.uk. Retrieved 2020-04-14.
  39. ^ "ALS Augmentative Communication Program | Speech-Generating Devices | Boston Children's Hospital". www.childrenshospital.org. Retrieved 2020-04-20.
Retrieved from "https://en.wikipedia.org/enwiki/w/index.php?title=Muteness&oldid=1262374097"