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Selective mutism (SM) is an anxiety disorder in which a person who is normally capable of speech does not speak in specific situations or to specific people. Selective mutism usually co-exists with shyness or social anxiety. People with selective mutism stay silent even when the consequences of their silence include shame, social ostracism or even punishment.〔("The Child Who Would Not Speak a Word" )〕 ==Description== Children and adults with selective mutism are fully capable of speech and understanding language but fail to speak in certain situations, though speech is expected of them.〔Adelman, L. (2007). (''Don't Call me Shy'' ), LangMarc Publishing〕 The behaviour may be perceived as shyness or rudeness by others. A child with selective mutism may be completely silent at school for years but speak quite freely or even excessively at home. There is a hierarchical variation among people with this disorder: some people participate fully in activities and appear social but do not speak, others will speak only to peers but not to adults, others will speak to adults when asked questions requiring short answers but never to peers, and still others speak to no one and participate in few, if any, activities presented to them. In a severe form known as "progressive mutism", the disorder progresses until the person with this condition no longer speaks to anyone in any situation, even close family members. Selective mutism is by definition characterized by the following: *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 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. Selective mutism is strongly associated with anxiety disorders, particularly social anxiety disorder. In fact, the majority of children diagnosed with selective mutism also have social anxiety disorder (100% of participants in two studies and 97% in another). Some researchers therefore speculate that selective mutism may be an avoidance strategy used by a subgroup of children with social anxiety disorder to reduce their distress in social situations.〔 http://www.selectivemutism.org/resources/library/SM%20General%20Information/Current%20Conceptualization%20of%20SM.pdf〕 Particularly in young children, SM can sometimes be confused with an autism spectrum disorder, especially if the child acts particularly withdrawn around his or her diagnostician, which can lead to incorrect treatment. Although autistic people may also be selectively mute, they display other behaviors—hand flapping, repetitive behaviors, social isolation even among family members (not always answering to name, for example)—that set them apart from a child with selective mutism. Some autistic people may be selectively mute due to anxiety in social situations that they do not fully understand. If mutism is entirely due to autism spectrum disorder, it cannot be diagnosed as selective mutism as stated in the last item on the list above. Selective mutism may co-exist with or cause the child to appear to have attention deficit disorder. Many people with the inattentive form of ADHD show little or no interest in other people. People with inattentive ADHD may appear to be "space cadets" or "out in their own world", and may be slower to respond to social stimuli. Children with selective mutism, especially when they have severe social anxiety, may also display this behavior. In addition, many children with selective mutism are highly sensitive, and they may be distracted from the task at hand by sensory input or their anxiety. The former name ''elective mutism'' indicates a widespread misconception among psychologists that selective mute people choose to be silent in certain situations, while the truth is that they often wish to speak but cannot. To reflect the involuntary nature of this disorder, the name was changed to ''selective mutism'' in 1994. The incidence of selective mutism is not certain. Due to the poor understanding of this condition by the general public, many cases are likely undiagnosed. Based on the number of reported cases, the figure is commonly estimated to be 1 in 1000, 0.1%.〔Chvira, Denise A., Elisa Shipon-Blum, Carla Hitchcock, Sharon Cohan, and Murray B. Stein. "Selective Mutism and Social Anxiety Disorder: All in the Family?" Journal of the American Academy of Child & Adolescent Psychiatry 46.11 (2007): 1464-472. Google Scholar. Web. 13 Mar. 2013.〕 However, a 2002 study in The Journal of the American Academy of Child and Adolescent Psychiatry estimated the incidence to be 0.71%.〔RL Bergman, J Piacentini, JT McCracken. (Prevalence and description of selective mutism in a school-based sample ).〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Selective mutism」の詳細全文を読む スポンサード リンク
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