Disorders of social functioning with onset specific to childhood and adolescence: elective mutism, attachment disorder

The main symptom of a disorder of social functioning (elective mutism, reactive attachment disorder) is a violation of social behavior that is adequate for childhood and adolescence. The main reason for the occurrence of such deviations is conditions that interfere with the normal development of the child for a long time. In this case, there are no gross violations of intellectual and emotional development, characteristic of defects that extend to all areas of functioning.

Elective mutism is a disorder of social functioning, the specificity of which is the inability to speak in certain social situations while maintaining the ability to speak and understand speech.

For example, complete dumbness is observed within the walls of the school as a whole or is limited only to the classroom, when the child does not speak to either teachers or classmates. Sometimes he is silent only in the presence of some teachers or one teacher/educator, freely and competently talking with children. knowledge quality control in these cases is carried out in writing through homework assignments, answers to questions, abstracts.

Often, children with elective mutism, avoiding verbal contact, willingly use facial expressions and pantomime for communication. In other cases, children freeze in the presence of certain people or all strangers, do not allow themselves to be touched, do not look into the eyes of the interlocutor, hold tight, sit low with their heads down and their shoulders pulled into it.

There are cases when a child refuses to speak in the presence of strangers, because he thinks his own voice is “funny”, “strange, etc. A history of many children with a similar deviation has a delay in speech development, impaired articulation, or dysarthria. Children can show shyness, anxiety, passivity, excessive stubbornness, a desire to manipulate others. They tend to be attached to their mother and feel unhappy when separated from her.

Reactive attachment disorder is a disorder of social functioning that occurs in infants and children under 5 years of age, caused by abuse or neglect of the caregiver (parent) and characterized by a persistent disturbance of emotional connection with him, mainly negativism, alertness, and aggressiveness.

Also characteristic is fearfulness, disturbed contact with peers, self-aggression, apathy and indifference, and in severe cases, impaired physical well-being and growth. Children are distinguished by contradictory emotional reactions: the child pushes adults away when trying to calm him down, approaches them, turning his face to the side, does not look into the eyes of loved ones, strives for them and at the same time avoids tactile contact, runs away when he meets with one of the parents, often sits motionless, cringing, with a frozen gaze, looks indifferent, is interested in the play of other children, but ambivalent emotional reactions, including unexpected aggression, interfere with contact with peers. In severe cases, there is often a delay or cessation of growth, frequent somatic diseases, mainly respiratory infections.

Treatment reviews
Mom Irina and daughter Vita. Kharkiv, Ukraine
My already 15-year-old daughter has elective mutism. She speaks only with a limited circle of people – in our case, with relatives and children – her peers. Doesn’t speak to outside adults at all. Plus a bunch of all sorts of fears, mostly far-fetched. Plus hyper-shyness and dislike for personal...
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