Muteness

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Muteness
SpecialtyNeurology, psychiatry Edit this on Wikidata

In human development, muteness or mutism (from

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.[2] 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, determined after a speech assessment.[3] Treatment can sometimes restore speech. If not, a range of assistive and augmentative communication devices are available.

Biological causes

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.[4] Mutism may be due to apraxia, that is, problems with coordination of muscles involved in speech.[5] 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.[6] 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.[7]

Neurological damage due to

tumor surgery.[10]

Psychological causes

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.[11] Assessment is needed to rule out possible illness or other conditions and to determine treatment.[12] Prevalence is low, but not as rare as once thought.[13]
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.

Selective mutism may occur in conjunction with

autism spectrum disorder or other diagnoses.[14] 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.[15] Absence or paucity of speech in adults may also be associated with specific psychiatric disorders.[16]

Developmental and neurological causes

Absence of speech in children may involve

communication disorders or language delays. Communication disorders or developmental language delays may occur for several different reasons.[17][18]

Language delays may be associated with other developmental delays.[19] For example, children with Down syndrome often have impaired language and speech.[20][21]

Children with

autism, categorized as a neurodevelopmental disorder in the DSM-V, often demonstrate language delays.[22][23]

Treatment

Evaluation of children with language delays is necessary to determine whether the language delay was caused by another condition.

phonological challenges.[25][26][27]

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.[28] 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.[29]

Treatment for absence of speech due to apraxia, involves assessment, and, based on the assessment,

speech therapy.[30][31][32] Treatment for selective mutism involves assessment, counseling, and positive supports.[33] 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.[34][35]

Management

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.[36]

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.[37]

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.[38]

See also

References

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  2. PMID 11310279
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  3. ^ CDC (2019-01-30). "Language and Speech Disorders in Children | CDC". Centers for Disease Control and Prevention. Retrieved 2020-04-10.
  4. ^ "2 The production of speech sounds". www.personal.rdg.ac.uk. Retrieved 2020-04-11.
  5. ^ "Childhood apraxia of speech - Symptoms and causes". Mayo Clinic. Retrieved 2020-04-13.
  6. ^ "Vocal Cord (Fold) Paralysis". ENT Health. Retrieved 2020-04-19.
  7. ^ "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.
  8. ^ "Broca area | Definition, Function, & Facts". Encyclopedia Britannica. Retrieved 2020-04-11.
  9. ^ "Aphasia", The Free Dictionary, retrieved 2020-04-11
  10. S2CID 206983595
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  11. ^ "Selective Mutism: Signs and Symptoms". American Speech-Language-Hearing Association. Retrieved 2020-04-13.
  12. S2CID 25263166
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  13. S2CID 20947226
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  14. PMID 29765220
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  15. PMID 26417806
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  16. PMID 25464920
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  17. ^ CDC (2019-01-30). "Language and Speech Disorders in Children | CDC". Centers for Disease Control and Prevention. Retrieved 2020-04-19.
  18. ^ "Speech and Communication Disorders". medlineplus.gov. Retrieved 2020-04-20.
  19. PMID 28577608
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  20. PMID 20428477
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  21. ^ "Speech and Language Resources | National Down Syndrome Congress". Retrieved 2020-04-19.
  22. doi:10.1044/leader.FTR2.22042017.54
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  23. ^ "Autism Spectrum Disorder: Communication Problems in Children". NIDCD. 2015-08-18. Retrieved 2020-04-19.
  24. PMID 21568252
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  25. ^ "Oral Motor Institute". oralmotorinstitute.org. Retrieved 2020-04-13.
  26. ^ "Why Act Early if You're Concerned about Development?". CDC.gov. Centers for Disease Control and Prevention. 2019-12-09. Retrieved 2020-04-17.
  27. PMID 25733749
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  28. PMID 28790824
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  29. ^ "Verbal Behavior Therapy". Autism Speaks. Retrieved 2020-04-20.
  30. ^ Caspari, Sue (2018). "Treatment Approaches for Children with Childhood Apraxia of Speech (CAS)" (PDF). apraxia-kids.org.
  31. ^ "Childhood apraxia of speech - Symptoms and causes". mayoclinic.org. Mayo Clinic. Retrieved 2020-04-13.
  32. ^ "Speech-Language Therapy (for Parents)". kidshealth.org. Nemours KidsHealth. Retrieved 2020-04-20.
  33. ^ "Selective mutism". nhs.uk. 2017-10-19. Retrieved 2020-04-20.
  34. PMID 29259567
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  35. ^ "Learning to Speak Again After Laryngeal Surgery". Health Encyclopedia. University of Rochester Medical Center. Retrieved 2020-04-20 – via urmc.rochester.edu.
  36. ^ "Families need guidance before buying a communication app for autism". Spectrum | Autism Research News. 2019-04-23. Retrieved 2020-04-14.
  37. ^ "Communication aids for disabled children - Living made easy". www.livingmadeeasy.org.uk. Retrieved 2020-04-14.
  38. ^ "ALS Augmentative Communication Program | Speech-Generating Devices | Boston Children's Hospital". www.childrenshospital.org. Retrieved 2020-04-20.
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