Selective Mutism Defined with DSM-Ⅳ-TR

The Diagostic and Statistical Manual of Mental Disorders(DSM) is widely used by many psychiatrists in the world to identify mental disorders. The first DSM, DSM-1, was published in 1952 and has been revised, resulting in the newest   DSM-Ⅳ-TR, the current(2011) version of the DSM.

  Selective mutism is defined with DSM-Ⅳ-TR as follows.

・Consistent failure to speak in specific social situations (in which there is an expectation for speaking, e.g., at school) despite speaking in other situations.

・The disturbance interferes with educational or occupational achievement or with social communication.

・The duration of the disturbance is at least 1 month (not limited to the first month of school).

・The failure to speak is not due to a lack of knowledge of, or comfort with, the spoken language is required in the social situation.

・The disturbance is not better accounted for by a Communication Disorder (e.g., Stuttering) and does not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder.

　

Although the DSMⅣ-TR refers to selective mutism, there is no meaning if psychiatrists don't know that.  At least in Japan, I think, a few pediatricians or psychiatrists note selective mutism conditions in spite of confronting children showing mute behaviors. They might think such children are just shy, timid, or subdued. So,  the population of  mute children probably remains underestimated until the concept of selective mutism becomes widespread.

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What is Selective Mutism?

 Selective mutism is a childhood anxiety disorder characterized by an inability to talk in one or more social settings, such as school. The symptom usually emerges when children start to go to school although some cases are later induced. Perhaps this condition could lead to anxiety disorders when they grow up to adolescents or even adults. Anxiety disorders include social phobia(social anxiety disorder), obsessive-compulsive disorder, panic disorder, and so on.

Unfortunately, selective mutism is little known and understood in the world, causing disappointment among people with selective mutism and parents of children with it. Some adults are surprised to recognize it because their conditions at younger ages look    the very same of description about selective mutism. Among those don't have the knowledge about it are psychotherapists, parents of children with potential mutism and preschool and school teachers. So, we don't have the knowledge of how many people with selective mutism don't know their conditions, I'm sure there are.