Too Scared to Talk: Managing Selective Mutism in an Abandoned Girl

Selective mutism (SM) is a complex anxiety-related disorder, primarily prevalent in girls, and usually diagnosed in early childhood. The main diagnostic features include persistent failure to speak in some social situations, where there is an expectation for speaking, despite normal or near-normal s...

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Main Authors: Prahbhjot Malhi, Bhavneet Bharti
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-10-01
Series:Journal of the Scientific Society
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Online Access:https://journals.lww.com/10.4103/jss.jss_281_23
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author Prahbhjot Malhi
Bhavneet Bharti
author_facet Prahbhjot Malhi
Bhavneet Bharti
author_sort Prahbhjot Malhi
collection DOAJ
description Selective mutism (SM) is a complex anxiety-related disorder, primarily prevalent in girls, and usually diagnosed in early childhood. The main diagnostic features include persistent failure to speak in some social situations, where there is an expectation for speaking, despite normal or near-normal speech in other social settings. AD, an abandoned girl, about 3-year-old, from a child care institute was referred for a medical examination to a tertiary care pediatric hospital. The major complaints were poor appetite, failure to speak to others, and excessive aloofness. She had no major behavioral difficulties, was cooperative, and complied with all verbal instructions. She would use gestures to communicate. The child was diagnosed with SM and a comprehensive individualized therapeutic plan was implemented. The management plan focused on enhancing attachment, cognitive stimulation, and language skills. As a first step, AD was enrolled in a day care center. An enabling and enriching environment was provided with plentiful opportunities for play and interaction with peers. Defocused communication that involved sitting alongside the child rather than face to face, creating joint attention using tasks that the child enjoyed, not asking direct questions, giving the child adequate time to reply, and continuing with the conversation even if she did not respond verbally was used as the primary treatment strategy. Collaborative teams including pediatricians and mental health professionals can play an integral role in early diagnosis and in overseeing the challenging path of overcoming SM in young children from adverse circumstances.
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spelling doaj-art-33ea74e10a3e4493912ddcc0341f3e792025-08-20T02:18:01ZengWolters Kluwer Medknow PublicationsJournal of the Scientific Society0974-50092278-71272024-10-0151347547710.4103/jss.jss_281_23Too Scared to Talk: Managing Selective Mutism in an Abandoned GirlPrahbhjot MalhiBhavneet BhartiSelective mutism (SM) is a complex anxiety-related disorder, primarily prevalent in girls, and usually diagnosed in early childhood. The main diagnostic features include persistent failure to speak in some social situations, where there is an expectation for speaking, despite normal or near-normal speech in other social settings. AD, an abandoned girl, about 3-year-old, from a child care institute was referred for a medical examination to a tertiary care pediatric hospital. The major complaints were poor appetite, failure to speak to others, and excessive aloofness. She had no major behavioral difficulties, was cooperative, and complied with all verbal instructions. She would use gestures to communicate. The child was diagnosed with SM and a comprehensive individualized therapeutic plan was implemented. The management plan focused on enhancing attachment, cognitive stimulation, and language skills. As a first step, AD was enrolled in a day care center. An enabling and enriching environment was provided with plentiful opportunities for play and interaction with peers. Defocused communication that involved sitting alongside the child rather than face to face, creating joint attention using tasks that the child enjoyed, not asking direct questions, giving the child adequate time to reply, and continuing with the conversation even if she did not respond verbally was used as the primary treatment strategy. Collaborative teams including pediatricians and mental health professionals can play an integral role in early diagnosis and in overseeing the challenging path of overcoming SM in young children from adverse circumstances.https://journals.lww.com/10.4103/jss.jss_281_23child care institutecognitive behavioral therapydefocused communicationselective mutism
spellingShingle Prahbhjot Malhi
Bhavneet Bharti
Too Scared to Talk: Managing Selective Mutism in an Abandoned Girl
Journal of the Scientific Society
child care institute
cognitive behavioral therapy
defocused communication
selective mutism
title Too Scared to Talk: Managing Selective Mutism in an Abandoned Girl
title_full Too Scared to Talk: Managing Selective Mutism in an Abandoned Girl
title_fullStr Too Scared to Talk: Managing Selective Mutism in an Abandoned Girl
title_full_unstemmed Too Scared to Talk: Managing Selective Mutism in an Abandoned Girl
title_short Too Scared to Talk: Managing Selective Mutism in an Abandoned Girl
title_sort too scared to talk managing selective mutism in an abandoned girl
topic child care institute
cognitive behavioral therapy
defocused communication
selective mutism
url https://journals.lww.com/10.4103/jss.jss_281_23
work_keys_str_mv AT prahbhjotmalhi tooscaredtotalkmanagingselectivemutisminanabandonedgirl
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