Selective Mutism: What is it?

00:10:44
https://www.youtube.com/watch?v=0ML9Xwi_kk0

Résumé

TLDRThis video discusses selective mutism, its diagnosis, and treatment options. The speaker offers an apology for past misinformation and aims to correct it by providing accurate, research-based content. Selective mutism, an anxiety disorder, manifests as an inability to speak in specific social situations, often appearing before age five. The video outlines diagnostic criteria and explores treatment options, including SCAT, psychodynamic therapy, family therapy, and behavioral therapy. Additionally, medication like SSRIs and SNRIs may be considered if other treatments fail. Community feedback is appreciated to ensure the accuracy and helpfulness of information provided.

A retenir

  • 🔍 Selective mutism is an anxiety disorder characterized by difficulty speaking in certain social settings.
  • 📚 Diagnosis involves consistent failure to speak in expected situations, impacting school or work.
  • 👶 Typically starts before age 5, becoming noticeable with school pressures.
  • 💡 Treatment options include SCAT, focusing on social communication anxiety.
  • 🎭 Psychodynamic therapy allows children to express freely through play.
  • 👨‍👩‍👧 Family therapy addresses underlying family dynamics and support.
  • ✨ Behavioral therapy rewards positive communication efforts.
  • 💊 Medication may help, though often avoided for children; SSRIs and SNRIs can assist if necessary.
  • 🗣 Community feedback is crucial for ensuring content accuracy and helpfulness.
  • 🌐 Sharing accurate information helps those struggling to receive proper care.

Chronologie

  • 00:00:00 - 00:05:00

    The speaker addresses previous misunderstandings about selective mutism, apologizes for past mistakes, and highlights the importance of creating correct and helpful content. They explain selective mutism as a diagnosis primarily manifesting in young children due to intense anxiety, distinct from shyness or language comprehension issues. Key diagnostic criteria include consistent failure to speak in expected settings, interference with social or educational functioning, and the condition persisting beyond one month. The speaker emphasizes understanding its anxiety roots and individual experiences.

  • 00:05:00 - 00:10:44

    The speaker discusses treatment options for selective mutism, including SCAT which addresses initial causes and why previous treatments may fail, and enhancing support in daily life. Other treatments mentioned are psychodynamic therapy using play, family therapy to address environmental triggers, and behavioral therapy for promoting communication behaviors. They touch on medication as a last resort for persistent cases, specifically SSRIs or SNRIs to manage anxiety. The speaker encourages further research and collaboration within the community on effective strategies for help.

Carte mentale

Vidéo Q&R

  • What is selective mutism?

    Selective mutism is an anxiety disorder characterized by the inability to speak in certain social situations.

  • What are the main criteria for diagnosing selective mutism?

    The criteria include consistent failure to speak in social situations, interference with educational or social communication, lasting for at least one month, not due to lack of language knowledge, and not explained by other communication disorders.

  • At what age does selective mutism typically present?

    Selective mutism usually presents before the age of five.

  • What are some common treatment options for selective mutism?

    Treatment options include Social Communication Anxiety Treatment (SCAT), psychodynamic therapy, family therapy, and behavioral therapy.

  • Why do people develop selective mutism?

    Selective mutism may develop due to an intense feeling of social or generalized anxiety, often triggered by events such as trauma or family issues.

  • Can selective mutism continue into adulthood?

    While most people outgrow it, some individuals may experience selective mutism later in life or continue to struggle with it into adulthood.

  • Is medication an option for treating selective mutism?

    Yes, medication such as SSRIs and SNRIs, commonly used to treat anxiety, can be considered if other treatments are ineffective.

  • How important is community feedback for the creator?

    Community feedback is vital, as it helps ensure the creator's content is accurate and supportive, and fosters a positive and informed community.

  • What role does family therapy play in treating selective mutism?

    Family therapy helps address any household issues that might be contributing to the child's anxiety, creating a supportive environment for recovery.

  • How does psychodynamic therapy help children with selective mutism?

    It helps children communicate through play, allowing them to express feelings and thoughts without needing to speak.

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Sous-titres
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Défilement automatique:
  • 00:00:00
    - Hey everybody.
  • 00:00:01
    Today I'm gonna talk with you about selective mutism.
  • 00:00:03
    How do we diagnose it?
  • 00:00:05
    And what treatment options are out there?
  • 00:00:07
    (soft music)
  • 00:00:14
    Now I put a video out about this quite awhile ago,
  • 00:00:16
    and I actually got a lot of negative comments,
  • 00:00:19
    and hate about some missteps that I took in the video
  • 00:00:22
    and things that I said that were incorrect.
  • 00:00:24
    And I want to apologize whole-heartedly.
  • 00:00:27
    I would never create a video or content that I thought would
  • 00:00:30
    be harmful, hurtful, or in any way upsetting to any of you.
  • 00:00:34
    My goal is actually to put out positive helpful content
  • 00:00:37
    and so I'm here to kind of make amends
  • 00:00:39
    and create another video that is correct.
  • 00:00:42
    And I've done a lot more research
  • 00:00:43
    and hopefully this is much more helpful.
  • 00:00:45
    And I have since turned that video private,
  • 00:00:47
    so if you go searching for it you won't find it.
  • 00:00:49
    Because I'm hoping that this'll replace it
  • 00:00:51
    and I'm hoping that you'll forgive me.
  • 00:00:52
    And that's the great thing about our community
  • 00:00:54
    is that I do my best to research.
  • 00:00:56
    You always are asking and challenging me
  • 00:00:58
    to find new information about other disorders
  • 00:01:02
    and issues that you're struggling with
  • 00:01:04
    and together we will make things better, right?
  • 00:01:06
    So thank you for keeping me in line
  • 00:01:08
    and thank you for letting me know
  • 00:01:09
    and hopefully this sounds and feels much better to you.
  • 00:01:13
    So to start off, selective mutism is a diagnosis.
  • 00:01:16
    And as always, if I can get it off the table,
  • 00:01:19
    I'm reading from my handy dandy DSM.
  • 00:01:21
    Now, selective mutism has a set of criteria.
  • 00:01:24
    The first being consistent failure to speak in specific
  • 00:01:27
    social situations in which there's an expectation
  • 00:01:29
    for speaking, like at school.
  • 00:01:31
    Selective mutism usually presents itself
  • 00:01:34
    before the age of five
  • 00:01:36
    so usually we run into it and recognize it's happening
  • 00:01:39
    when they enter school because there's pressure to talk.
  • 00:01:42
    Like "Oh, the teacher called on me" or
  • 00:01:44
    "Oh I have to stand up and I have to tell kids about this"
  • 00:01:47
    or "I have to present my project" and there are a lot of
  • 00:01:49
    things that where we're pushed and there's pressure to talk.
  • 00:01:52
    And those with selective mutism will not be able to.
  • 00:01:57
    The second is the disturbance interferes with educational
  • 00:02:00
    or occupational achievement or with social communication.
  • 00:02:03
    And you can see why that would happen.
  • 00:02:04
    'Cause if I can't talk in school or work,
  • 00:02:07
    and I can't express or show my project,
  • 00:02:09
    or talk to friends or talk to my teacher or my boss
  • 00:02:12
    or coworkers, it's gonna effect the way that
  • 00:02:14
    we're able to function in those tasks.
  • 00:02:18
    The third is the duration of the disturbance is at least
  • 00:02:20
    one month, not limited the first month of school.
  • 00:02:24
    And they say that because school can be really
  • 00:02:26
    anxiety-provoking and we're starting a new school year.
  • 00:02:29
    And it can take us a little while to get adjusted,
  • 00:02:31
    to feel okay, to know what our teacher's wanting
  • 00:02:33
    and to feel like we can speak up.
  • 00:02:35
    A lot of people are shy from the get-go
  • 00:02:37
    and selective mutism is not shyness, okay.
  • 00:02:41
    Also, selective mutism, just so that you understand
  • 00:02:43
    where it comes from, is that it's an anxiety disorder.
  • 00:02:46
    So that kind of tells you the root of where this
  • 00:02:49
    difficulty speaking, and inability to speak is coming from.
  • 00:02:52
    It usually stems from a really intense feeling of
  • 00:02:56
    social anxiety or generalized anxiety.
  • 00:02:58
    So we'll get so anxious that we're unable to speak
  • 00:03:01
    in school, at work, with friends, at home, etc.
  • 00:03:05
    Now the next criteria, the 4th, is that they failure
  • 00:03:07
    to speak is not attributable to a lack of
  • 00:03:10
    knowledge or comfort with the spoken language
  • 00:03:13
    required in a social situation.
  • 00:03:14
    In one of the articles I was reading it talked about
  • 00:03:16
    children coming from other countries.
  • 00:03:18
    Let's say my native language is Mandarin,
  • 00:03:20
    and then I'm thrown into a school in Florida,
  • 00:03:23
    and I don't speak English that well and I'm
  • 00:03:25
    really anxious about it already and it makes me nervous
  • 00:03:27
    and I'm just not comfortable.
  • 00:03:29
    So I don't know the language well
  • 00:03:30
    enough to actually speak it.
  • 00:03:33
    It cannot be attributed to that.
  • 00:03:35
    That's not what selective mutism is.
  • 00:03:37
    The last criteria is that the disturbance is not better
  • 00:03:40
    explained by a communication disorder.
  • 00:03:43
    It could be childhood onset fluency disorder, or any other.
  • 00:03:47
    I have some videos, I'll actually link here,
  • 00:03:48
    where I talk about my friend Katherine who's
  • 00:03:51
    a speech pathologist and there are a lot of different
  • 00:03:53
    things that can go along with reasons children don't
  • 00:03:55
    speak, but that again is not selective mutism.
  • 00:03:58
    Selective mutism comes from an intense internal anxiety
  • 00:04:01
    which leads us to feeling like we actually cannot speak.
  • 00:04:05
    We'll want to, we'll have so much to say
  • 00:04:07
    and we literally physically cannot.
  • 00:04:10
    That like I said, the onset selective mutism
  • 00:04:12
    is usually before the age of five,
  • 00:04:14
    or around the age of five.
  • 00:04:16
    And a lot of the research that they've done
  • 00:04:17
    shows that the majority of people do grow out of it
  • 00:04:21
    but from what I've heard from you,
  • 00:04:22
    and from what I've been reading on other really
  • 00:04:25
    not actually supportive research studies
  • 00:04:27
    that doesn't mean they're not valid,
  • 00:04:29
    that some people don't, and many don't.
  • 00:04:31
    And some people have onset later in life.
  • 00:04:33
    So like I said, the DSM is not the end all, be all.
  • 00:04:36
    Everyone's experience is gonna be different,
  • 00:04:37
    however the majority, just meaning 50% or more,
  • 00:04:41
    find that it usually starts at a very young age
  • 00:04:44
    at the age of five or a little younger.
  • 00:04:46
    So now we know what selective mutism is.
  • 00:04:48
    It's an inability to speak due to intense internal anxiety.
  • 00:04:53
    So we have it, or our child has it.
  • 00:04:54
    What are our treatment options?
  • 00:04:56
    And know that they're are a lot out there.
  • 00:04:57
    I'm gonna offer up four to you today,
  • 00:04:59
    however you can do your own research,
  • 00:05:01
    talk to your own speech pathologist.
  • 00:05:04
    Maybe someone at the school, maybe the therapist
  • 00:05:06
    that your child or yourself is seeing.
  • 00:05:08
    And ask for other options or referrals
  • 00:05:10
    because they're always more options out there.
  • 00:05:12
    But these are the four that they talk about
  • 00:05:13
    the most frequently when we talk about treating this.
  • 00:05:16
    Now the first is actually something that I don't know myself
  • 00:05:20
    I've never done it in my own private practice,
  • 00:05:22
    but they talk it about it like it's the golden rule
  • 00:05:25
    for treatment of this and it's the best.
  • 00:05:27
    It shows the best outcomes.
  • 00:05:28
    It's called SCAT, or Social Communication Anxiety Treatment.
  • 00:05:33
    And that would make sense, it sounds very specific.
  • 00:05:35
    It sounds perfect for selective mutism.
  • 00:05:37
    So if you can find someone who specializes in this
  • 00:05:40
    I would encourage you to give em a call.
  • 00:05:42
    And what it really focuses on is addressing
  • 00:05:44
    the answers to these three questions.
  • 00:05:46
    The first is why did they develop selective mutism?
  • 00:05:50
    In many cases they find that children, if it starts in,
  • 00:05:53
    if the onset is in childhood, that there's
  • 00:05:55
    usually a triggering event.
  • 00:05:56
    Not always, but usually.
  • 00:05:58
    And that could be parents got divorced,
  • 00:06:00
    maybe they witnessed something traumatic.
  • 00:06:02
    It could be a number of things, but there is
  • 00:06:04
    a triggering event and then they just
  • 00:06:07
    completely lose the ability to speak.
  • 00:06:09
    And so finding out what caused it,
  • 00:06:11
    can usually help us figure out how to help them.
  • 00:06:14
    The second questions is why does it
  • 00:06:17
    persist despite past treatment?
  • 00:06:19
    If we've tried things, why is it still lingering?
  • 00:06:22
    If we've had them at a speech pathologist
  • 00:06:24
    or we've had them in therapy,
  • 00:06:25
    how come it's still hanging around?
  • 00:06:27
    And that can obviously show us what
  • 00:06:28
    work still needs to be done, and that would be,
  • 00:06:30
    I could apply that to my patients with eating disorders
  • 00:06:34
    who've already been in treatment.
  • 00:06:35
    How come it's still around, what's still going on?
  • 00:06:37
    Did we not really fix that root of the root
  • 00:06:40
    and the reason that it exists?
  • 00:06:42
    The answer's probably yes.
  • 00:06:44
    And the third question that they work to answer is
  • 00:06:46
    what can be done at home, school,
  • 00:06:48
    or in the real world to help them?
  • 00:06:50
    And that could be anything from do they
  • 00:06:52
    have a really close friend that can help them?
  • 00:06:54
    That they feel okay communicating with them
  • 00:06:56
    to get their needs met in school?
  • 00:06:57
    Maybe they have a teacher that they really like
  • 00:06:59
    and they feel comfortable with and they actually
  • 00:07:00
    talk a little bit in that class because
  • 00:07:02
    their anxiety is lowered.
  • 00:07:04
    Maybe they can get that teacher all day long.
  • 00:07:06
    Or we can increase the number of classes
  • 00:07:08
    that they have with that teacher.
  • 00:07:09
    There may be a lot that we can do, especially through IEP's.
  • 00:07:13
    I do this for clients all the time.
  • 00:07:14
    I'm going to schools, and working on
  • 00:07:16
    different education plans with the child to make sure
  • 00:07:20
    that we're getting them the help that they need.
  • 00:07:22
    The second treatment option is psychodynamic therapy.
  • 00:07:26
    And when it comes to children
  • 00:07:27
    that really means play therapy.
  • 00:07:29
    And this can be really healing and helpful for children
  • 00:07:32
    who struggle with selective mutism
  • 00:07:33
    because they can speak through play
  • 00:07:36
    without actually having to use their voice.
  • 00:07:38
    And this can often lead them to feeling more comfortable
  • 00:07:40
    and more understood, and maybe speaking a little
  • 00:07:43
    bit with a therapist over time.
  • 00:07:45
    But at the very least it gives them a way
  • 00:07:46
    to communicate what they're feeling and thinking
  • 00:07:48
    without having to say it.
  • 00:07:50
    The third treatment option, and the one I
  • 00:07:52
    think should be attached to everyone of
  • 00:07:53
    these options, is family therapy.
  • 00:07:56
    Because this happens most often in children,
  • 00:07:58
    if we go right back into our family household
  • 00:08:00
    and whatever chaotic or triggering event that
  • 00:08:03
    happened is still happening there,
  • 00:08:04
    it's gonna be really hard for us to keep
  • 00:08:06
    fighting against it, using our tools.
  • 00:08:08
    It's really difficult for children to, essentially speak up.
  • 00:08:11
    Not just verbally, but even physically.
  • 00:08:13
    Letting people know that they're upset.
  • 00:08:14
    And if they've already struggled with that,
  • 00:08:16
    we wanna make sure that we're working as a family
  • 00:08:18
    to create a healthy happy environment where
  • 00:08:20
    they can work on lowering their anxiety, dealing with
  • 00:08:22
    whatever caused it, and being able to finally feel
  • 00:08:25
    comfortable and at ease enough to speak.
  • 00:08:28
    And the fourth and final treatment option
  • 00:08:30
    is behavioral therapy.
  • 00:08:31
    And the way that this kind of works,
  • 00:08:32
    and I'm on the fence about this.
  • 00:08:34
    I do this a lot in my practice, but like I said
  • 00:08:36
    I don't specialize in selective mutism.
  • 00:08:38
    But the way that behavioral therapy work is that we,
  • 00:08:41
    in a way, reward like positive behaviors.
  • 00:08:44
    So if they are speaking, or they do express themselves
  • 00:08:48
    in some way we reward that behavior.
  • 00:08:49
    It could be in golden stars on a board,
  • 00:08:51
    it could be in treats or benefits at home
  • 00:08:55
    like oh, I get to go out and walk the dog by myself
  • 00:08:58
    or I get to spend extra time on the computer
  • 00:09:00
    or whatever it may be, they use those to help guide
  • 00:09:03
    the child to doing more of the positive behavior.
  • 00:09:06
    And like I said, I don't know how well this
  • 00:09:08
    would work necessarily for selective mutism.
  • 00:09:10
    The others sound better personally to me.
  • 00:09:13
    But we have to find what works best for us
  • 00:09:14
    and in our own scenarios.
  • 00:09:15
    So that's another treatment option.
  • 00:09:17
    And the last thing that I'll mention is medication.
  • 00:09:20
    I know this happens most commonly in children
  • 00:09:22
    and a lot of us don't want to put our children
  • 00:09:24
    on medication and I totally hear you out on that.
  • 00:09:26
    And that's why there's all those other options.
  • 00:09:28
    And like I said there's probably more out there,
  • 00:09:29
    so do some research, find something that works for you.
  • 00:09:32
    But if we're doing all those things and it's still not
  • 00:09:35
    getting better and we worry about how our child is feeling.
  • 00:09:38
    Or we ourselves are struggling and we're feeling worse,
  • 00:09:40
    medication is an option, and they always talk about
  • 00:09:43
    SSRI's or SNRI's, helping with anxiety.
  • 00:09:45
    And since we know selective mutism is an anxiety disorder,
  • 00:09:48
    there is some evidence to show that medication does
  • 00:09:52
    help alleviate that and maybe get us to the level
  • 00:09:55
    like we've talked about in other videos,
  • 00:09:57
    where the anxiety is low enough that we can start actually
  • 00:09:59
    doing the work and challenging ourselves and feeling better.
  • 00:10:02
    And so that's another thing to keep in mind.
  • 00:10:05
    Again, I wanna thank you all for letting me know
  • 00:10:07
    when I've messed up and when I've been misspoken
  • 00:10:09
    and said something that wasn't correct.
  • 00:10:11
    It's together, we're working together, right,
  • 00:10:14
    towards a healthy mind and a healthy body.
  • 00:10:15
    And I want you to know I always hear you out,
  • 00:10:17
    I always read your comments, and it really, really helps
  • 00:10:19
    that we have a wonderful working community behind us.
  • 00:10:22
    And it always helps to share videos.
  • 00:10:23
    If you are upset by the last video,
  • 00:10:25
    please share this video if you feel it's correct.
  • 00:10:27
    I've done as much research as I can,
  • 00:10:29
    I'm doing the best I can, it would really help to share it
  • 00:10:31
    on Facebook so that those out there who are struggling
  • 00:10:33
    can hopefully get the treatment that they need and deserve.
  • 00:10:36
    And if you wanna follow me on any other social medias
  • 00:10:38
    you can click down here, if you haven't
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    subscribed click up here, and I will see you next time.
Tags
  • Selective Mutism
  • Diagnosis
  • Treatment
  • Anxiety
  • SCAT
  • Psychodynamic Therapy
  • Family Therapy
  • Behavioral Therapy
  • Medication
  • Community Feedback