A follow-up study of 45 patients with elective mutism

Abstract

Forty five patients (23 boys and 22 girls) with elective mutism (8.7 +/- 3.6 years old), who were referred to a university department and a child guidance clinic within a 15-year-period, were followed up on average 12 years later. For 41 of them, sufficient information could be obtained at follow-up, and 31 patients could be investigated personally. At follow-up, an interview and a standardized psychopathological examination were carried out as well as two standardized biographic inventories. The main results were: 1) a high load of individual and family psychopathology was characteristic of the patients. The disorder started already at age 3 to 4 and referral age was 8 years on average. 2) In 16 out of 41 patients (39%), a complete remission could be observed. All other patients still revealed some communication problems. 3) The formerly mute patients described themselves as less independent, less motivated with regard to school achievement, less self-confident and less mature and healthy in comparison to a normal reference group. 4) A poor outcome could be best predicted by the variable "mutism within the core family"at the time of referral.

Selective Mutism: The Fraternal Twin of Childhood Social Phobia

“…This is in line with previous studies indicating that intraindividual factors predict the course of SM: Steinhausen et al [34] identified a more extended context of mute behavior, particularly towards peers, as the sole predictor of a poor symptomatic outcome of SM. Remschmidt et al [35] found mute behavior of the child within the core family to be the strongest predictor of a chronic course. Specific speaking patterns might either reflect or result in social withdrawal and thus impact the outcome.…”

Behavioral and Socio-emotional Functioning in Children with Selective Mutism: A Comparison with Anxious and Typically Developing Children Across Multiple Informants

“…Despite this early onset, children are not commonly referred for clinical assessment until they are between approximately 6.5 to 9 years of age (Ford et al 1998;Kumpulainen et al 1998;Standart and Le Couteur 2003). SM may persist for a few months to several years, and adults diagnosed with SM as children often continue to suffer with social anxiety and deficits in social communication, in addition to displaying other problems with socioemotional and daily adjustment (Remschmidt et al 2001). Despite being diagnostically well-documented (Dummit et al 1997;Kopp and Gillberg 1997;Sharp et al 2007), the etiology of SM remains equivocal.…”

Selective Mutism: An Update and Suggestions for Future Research

“…Multiple studies have found links between children with SM and first-order relatives. For example, Remschmidt and colleagues [20] found significant concordance rates of mutism in first-order relatives of children with SM (mothers, 18%; fathers, 9%; siblings, 18%). Additional support for familial vulnerability to anxiety exists in other studies.…”