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December 4, 2013
The mutism is a frustration at which the patient completely loses ability to vocalization, but at the same time keeps ability of understanding of the speech turned to it.
How the mutism is shown?
Mutism — one of the most serious changes of the speech, at its manifestation the person keeps full silence that leads to inability to come into speech contact with other people. The total mutism is diagnosed if the person remains incapable of speech contact under any circumstances. The partial mutism at adults and children is a state in which the person cannot carry on conversation with certain people or in a specific situation which is for it injuring. At the same time in other situation or he is capable to talk to other people. An elective mutism — a state in which silence at the patient arises incidentally. For example, the elective mutism at children can appear at school, at communication with a certain circle of peers.
If at the person the hysterical mutism is observed, then the patient cannot pronounce words even in a whisper though his language and lips can make the movements necessary for reproduction of the speech. Understands both oral, and written language of people with a mutism. To contact to people, such patients use a mimicry and gestures. As a rule, the people suffering from a hysterical mutism do not look suppressed and upset with such state. Manifestations of a hysterical mutism are often combined with other neurotic frustration. It can be enuresis, enkoprez, an amaurosis. As a rule, people with the increased emotionality, lability of nervous processes are inclined to manifestations of a hysterical mutism. This type of a mutism is more often shown at women.
The special form of a mutism which in medicine call a surdomutism is defined. In this case it is about a surdomutism which can be both inborn, and acquired. However in this case the patient has no organic defects of speech departments and the hearing aid.
Why the mutism is shown?
The mutism at children and adults is in most cases shown owing to the mental injuries which are an essential irritant for brain cells. As a rule, initially at the person the acute form of a mutism which is expressed by symptoms of hysterical neurosis is observed. That is a basis of such disease is the hysterical mechanism.
The mutism develops against mental disturbances. It can be functional and organic. Its type is defined depending on the reason of development of this symptom. The akinetic mutism at which the patient has no speech movements in connection with defeat of the activating departments of a brain is organic.
The selective mutism is shown as a peculiar reaction of mentality of the person to a certain irritant. Therefore, the serious conflict, strong offense, a fright can become a factor which is a releaser of development of a disease. The mutism in this case is directly connected with neurosis. Very often the mutism is diagnosed for children with the high level of the sensitivity expressed by sensitivity, physical weakness. In certain cases the child can be silent for many months and even years. In that case parents should not try to cope with a situation independently, trying to persuade or carry away the child. At the child the doctor has to carry out treatment of a mutism, considering all features of a condition of the patient.
During establishment of the diagnosis specialists always consider the fact that the children's mutism can have the most various psychological reasons. Therefore each such fact needs to be studied individually and very carefully. Sometimes the mutism at children is a certain form of a protest, expression of silent aggression.
The surdomutism, that is temporary deafness and dumbness can be shown at the child owing to an injury or reaction to a stress. The organic reasons of such defeat are not noted.
The mutism at adults is often observed against aphasia.
How to cure a mutism?
Treatment of a mutism is carried out after full confirmation of this diagnosis. In certain cases the mutism not only develops owing to a serious stress, psychological injuries, but also disappears under the influence of these factors.
Therapy of this disease is carried out, first of all, by psychotherapy methods, also complex treatment joins also reception of tranquilizers. Doctors use at treatment of a mutism at children multimodal approach: behavioural, individual and family therapy is applied. The new modern techniques of therapy directed to elimination of this disturbance of the speech practice.
If the child with a mutism shows oppositional behavior, the doctor can include reception of small doses of neuroleptics of sedative action in a treatment complex.
The selection mutism is always treated taking into account specific features of the patient. Universal methods of treatment do not exist. If the person suffers from the mutism provoked by organic lesions, then sometimes alternative to communication with the help of the speech is communication by means of gestures.
The selective mutism at children is not the reason for the child's exception of a circle of peers. On the contrary, such children need to conduct active communication with surrounding people and to learn to come into contact with them by all available methods.
The selective mutism provoked by a psychological injury sometimes can be overcome, having changed an environment of the sick child, helping it to realize a situation and to reconcile to it.
If the mutism at the adult developed owing to the had stroke, then start its treatment approximately in 4 weeks after a stroke. To resume speech function, the special techniques and exercises developed especially for recovery of people after a stroke practice. Complex treatment of a mutism often joins a relaxation, special breathing exercises.
The mutism provoked by a stress it is necessary to treat with participation of the professional psychotherapist. However effective overcoming of this problem requires interaction of different specialists — the logopedist, the psychologist, the psychiatrist.
Carrying out high-quality nervous correction by means of psychotherapy, physiotherapy exercises, etc. is not less important.