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.