Contemporary views on selective mutism

Abstract

The aim of this paper is to review contemporary literature on selective mutism (SM), available in our language. The paper includes a contemporary definition of the disorder, previous studies of selective mutism, theories about its origin, and treatment. SM is a disorder that occurs in childhood, when a child's speech is selectively lacking in certain social situations. School is the context in which the disorder is typically manifested, which is why SM is often diagnosed only after children start school. The paper gives a historical account of changes in views on this disorder. Modern conceptions emphasize selective inability of children to spontaneously and successfully express themselves verbally. In researching SM, case studies on children who have selective mutism are most commonly published. Etiological factors are not precisely defined, and different conceptions give their interpretations depending on various theoretical frameworks. Some studies consistently indicate a relation between SM and social anxiety, and some with opposing behavior and delays in language development. Based on theoretical explanations of SM, psychological interventions (behavioral and cognitive-behavioral, psychodynamic and projective techniques, counseling and family therapy) are created. Modern treatment of selective mutism includes an eclectic approach and emphasizes the role of teachers and school in general. Future studies should deepen the knowledge about selective mutism, specify the methodological procedure and stimulate the individualized treatment of children with SM.

Cilj rada je da pruži pregled savremene literature o selektivnom mutizmu (SM) koji bi bio dostupan na našem jeziku, budući da u našoj sredini ovaj poremećaj nije sistematski izučavan. Rad obuhvata savremeno određenje poremećaja, dosadašnja istraživanja SM, teorije o nastanku, tretman. SM je poremećaj koji se javlja u detinjstvu, kada govor deteta selektivno izostaje u određenim socijalnim situacijama. Škola je kontekst u kojem se poremećaj tipično ispoljava, zbog čega se SM često dijagnostikuje tek sa polaskom deteta u školu. U radu je dat istorijski prikaz promena u shvatanju ovog poremećaja. Savremena shvatanja naglašavaju selektivnu nesposobnost dece da se spontano i uspešno verbalno izražavaju. U izučavanju SM-a tipično je objavljivanje studija slučaja dece sa ovim poremećajem. Etiološki faktori nisu precizno definisani, a različita teorijska shvatanja koja su prikazana daju svoja tumačenja. Istraživanja konstantno pokazuju povezanost SM-a sa socijalnom anksioznošću, a neka i sa oponirajućim ponašanjem i kašnjenjem u jezičkom razvoju. Na osnovu teorijskih objašnjenja SM-a kreiraju se psihološke intervencije (bihejvioralne i kognitivno-bihejvioralne, psihodinamske i projektivne tehnike, porodično savetovanje i terapija). Savremen tretman SM-a podrazumeva eklektički pristup uz naglašavanje uloga nastavnika i škole u celini. Buduća izučavanja treba da prodube znanja, preciziraju metodološku proceduru i stimulišu individualizovan tretman deteta sa SM.