Elective mutism

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Abstract
Children [11] who received a diagnosis of elective mutism were followed up 8-18 yr later. The average age upon admission was 9 1/2 yr, and at the time of follow-up, 23 yr. Of the children 9 came from homes with a strong familial shyness and reservation, 8 lived in social isolation, 6 were particularly overprotected and 6 came from discordant families. All were diagnosed neurotic, 8 specified as compulsion-neurosis. All were of normal intelligence. Six children received extensive individual psychotherapy (4 upon admission to the clinic, 2 by out-patient treatment). The remaining 5 received no treatment. During the course of treatment, 3 of the admitted patients improved, the 4th and the 2 ambulatory patients remained unchanged after up to 4 yr of therapy. The 3 unchanged patients and the 5 who had not received treatment, were cured of the symptom [at follow-up]. Improvement took place in connection with a change of environment. The 5 who had not received treatment were better adjusted than those who were separated from home for several years, at a vulnerable age. The importance of early prophylactic intervention was emphasized.

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