Ytzhak A, Doron Y, Lahat E, Livne A
Pediatric Neurology Department, Child Development Institute, Assaf Harofeh Medical Center, Zerifin, Israel.
Harefuah. 2012 Oct;151(10):597-9, 603.
Selective mutism is an uncommon disorder in young children, in which they selectively don't speak in certain social situations, while being capable of speaking easily in other social situations. Many etiologies were proposed for selective mutism including psychodynamic, behavioral and familial etc. A developmental etiology that includes insights from all the above is gaining support. Accordingly, mild language impairment in a child with an anxiety trait may be at the root of developing selective mutism. The behavior will be reinforced by an avoidant pattern in the family. Early treatment and followup for children with selective mutism is important. The treatment includes non-pharmacological therapy (psychodynamic, behavioral and familial) and pharmacologic therapy--mainly selective serotonin reuptake inhibitors (SSRI).
选择性缄默症在幼儿中是一种不常见的障碍,即他们在某些社交场合选择性地不说话,而在其他社交场合却能轻松交谈。关于选择性缄默症提出了许多病因,包括心理动力学、行为学和家族性等方面。一种综合了上述所有观点的发育性病因正获得越来越多的支持。因此,具有焦虑特质的儿童出现的轻度语言障碍可能是发展为选择性缄默症的根源。这种行为会因家庭中的回避模式而得到强化。对患有选择性缄默症的儿童进行早期治疗和随访很重要。治疗包括非药物治疗(心理动力学、行为学和家族性治疗)和药物治疗——主要是选择性5-羟色胺再摄取抑制剂(SSRI)。