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== Treatment ==
For language delays or communication disorders in children, early assessment is strongly recommended. <ref name=":0">{{Cite web|url=https://www.aafp.org/afp/2011/0515/p1183.html|title=Speech and Language delay in children|last=American Association of Family Physicians|first=|date=May 2011|website=American Family Physician|url-status=live|archive-url=|archive-date=|access-date=}}</ref> Language delays may impact expressive language, receptive language, or both. Communication disorders may impact articulation, fluency (stuttering) and other specified and unspecified communication disorders. Treatment focuses on the diagnosed condition. For example, Speech and Language Services may focus on the production of speech sounds for children with phonological challenges. <ref name=":3">{{Cite web|url=http://www.oralmotorinstitute.org/mons/v2n2_marshalla.html|title=Oral Motor Institute|website=www.oralmotorinstitute.org|access-date=2020-04-13}}</ref> Overall, early intervention for young children with language or other developmental delays is strongly recommended. <ref name=":1">{{Cite web|url=https://www.cdc.gov/ncbddd/actearly/whyActEarly.html|title=Why Act Early if You’re Concerned about Development?|last=CDC|date=2019-12-09|website=Centers for Disease Control and Prevention|language=en-us|access-date=2020-04-17}}</ref> <ref>{{Cite journal|last=Roberts|first=Megan|last2=Kaiser|first2=Ann|date=2015-03-02|title=Early Intervention for Toddlers With Language Delays: A Randomized Controlled Trial|url=https://www.researchgate.net/publication/273156617_Early_Intervention_for_Toddlers_With_Language_Delays_A_Randomized_Controlled_Trial|journal=Pediatrics|volume=135|doi=10.1542/peds.2014-2134}}</ref>

For toddlers with language delay who may also have Autism, early intervention services focusing on speech production is strongly recommended. When absence of speech is observed in children who may also be diagnosed with Autism, assessment is also strongly recommended. <ref name=":2">{{Cite web|url=https://www.autismspeaks.org/science-news/children-nonverbal-autism-overcome-severe-language-delays|title=Study shows that many nonverbal autistic children overcome severe language delays|website=Autism Speaks|language=en|access-date=2020-04-17}}</ref> Intervention services and treatment programs have been specifically developed for children with Autism and language delays. <ref>{{Cite journal|last=Lk|first=Koegel|last2=Lk|first2=Koegel|title=Intervention for Non-verbal and Minimally-Verbal Individuals with Autism: A Systematic Review|url=https://clinmedjournals.org/articles/ijpr/international-journal-of-pediatric-research-ijpr-5-056.php?jid=ijpr|language=en-US|doi=10.23937/2469-5769/1510056|issn=2469-5769}}</ref> For example, Pivotal Response Treatment is a well-established and researched intervention that includes family participation. <ref>{{Cite journal|last=Lei|first=Jiedi|last2=Ventola|first2=Pamela|date=2017-06-20|title=Pivotal response treatment for autism spectrum disorder: current perspectives|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5488784/|journal=Neuropsychiatric Disease and Treatment|volume=13|pages=1613–1626|doi=10.2147/NDT.S120710|issn=1176-6328|pmc=5488784|pmid=28790824}}</ref> Mark Sundberg's Verbal Behavior framework is another well-established assessment and treatment modality that is incorporated into many Applied Behavior Analysis (ABA) early intervention treatment programs for young children with autism and communication challenges.<ref>{{Cite web|url=https://www.autismspeaks.org/verbal-behavior-therapy|title=Verbal Behavior Therapy|website=Autism Speaks|language=en|access-date=2020-04-20}}</ref>

Treatment for absence of speech due to Apraxia, involves assessment, and, based on the assessment, Occupational Therapy, Physical Therapy, and/or Speech Therapy. <ref>https://www.apraxia-kids.org/wp-content/uploads/2013/01/BHSM-Fact-Sheet-2.pdf</ref><ref>{{Cite web|url=https://www.mayoclinic.org/diseases-conditions/childhood-apraxia-of-speech/symptoms-causes/syc-20352045|title=Childhood apraxia of speech - Symptoms and causes|website=Mayo Clinic|language=en|access-date=2020-04-13}}</ref><ref>{{Cite web|url=https://kidshealth.org/en/parents/speech-therapy.html|title=Speech-Language Therapy (for Parents) - Nemours KidsHealth|website=kidshealth.org|access-date=2020-04-20}}</ref>

Treatment for Selective Mutism involves assessment, counseling, and positive supports. <ref>{{Cite web|url=https://www.nhs.uk/conditions/selective-mutism/|title=Selective mutism|date=2017-10-19|website=nhs.uk|language=en|access-date=2020-04-20}}</ref>

Treatment for absence of speech in adults who previously had speech involves assessment to determine cause, including medical and surgery related causes, followed by appropriate treatment or management. Treatment may involve counseling, or rehabilitation services, depending upon cause of loss of speech. <ref>{{Cite journal|last=Lincoln|first=Tania M.|last2=Riehle|first2=Marcel|last3=Pillny|first3=Matthias|last4=Helbig-Lang|first4=Sylvia|last5=Fladung|first5=Anne-Katharina|last6=Hartmann-Riemer|first6=Matthias|last7=Kaiser|first7=Stefan|date=2017-12-05|title=Using Functional Analysis as a Framework to Guide Individualized Treatment for Negative Symptoms|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5723417/|journal=Frontiers in Psychology|volume=8|doi=10.3389/fpsyg.2017.02108|issn=1664-1078|pmc=5723417|pmid=29259567}}</ref><ref>{{Cite web|url=https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=34&ContentID=22953-1|title=Learning to Speak Again After Laryngeal Surgery - Health Encyclopedia - University of Rochester Medical Center|website=www.urmc.rochester.edu|access-date=2020-04-20}}</ref>

==Management==
==Management==
Management involves use of appropriate assistive devices sometimes called alternative or augmentative communications. Suitability and appropriateness of modality will depend on users physical abilities and cognitive functioning.<ref>{{Cite web|url=https://www.spectrumnews.org/opinion/viewpoint/families-need-guidance-buying-communication-app-autism/|title=Families need guidance before buying a communication app for autism|date=2019-04-23|website=Spectrum {{!}} Autism Research News|language=en-US|access-date=2020-04-14}}</ref>
Management involves use of appropriate assistive devices sometimes called alternative or augmentative communications. Suitability and appropriateness of modality will depend on users physical abilities and cognitive functioning.<ref>{{Cite web|url=https://www.spectrumnews.org/opinion/viewpoint/families-need-guidance-buying-communication-app-autism/|title=Families need guidance before buying a communication app for autism|date=2019-04-23|website=Spectrum {{!}} Autism Research News|language=en-US|access-date=2020-04-14}}</ref>

Revision as of 00:00, 21 April 2020

Muteness
SpecialtyNeurology, psychiatry Edit this on Wikidata

Muteness or mutism (from Latin mutus 'silent') is an inability to speak, often caused by a speech disorder or surgery. Someone who is mute may be so due to the unwillingness to speak in certain social situations.

Causes

Those who are physically mute may have problems with the parts of the human body required for human speech (vocal cords, lungs, trachea, esophagus, mouth, or tongue, etc.).

Trauma or injury to Broca's area, located in the left inferior frontal cortex of the brain, can cause muteness.[1]

Variations

Selective mutism is an anxiety disorder very common among young children, characterized by the inability to speak in certain situations. It should not be confused with someone who is mute and cannot communicate due to physical disabilities. Selectively mute children are able to communicate in situations in which they feel comfortable. About 90% of children with this disorder have also been diagnosed with social anxiety. It is very common for symptoms to occur before the age of five and do not have a set time period. Not all children express the same symptoms. Some may stand motionless and freeze in specific social settings and have no communication.[2]

Alalia is a disorder that refers to a delay in the development of speaking abilities in children. In severe cases, some children never learn how to speak. It can be caused by illness of the child, illness in utero, mutism of the parents or guardians, the general disorders of the muscles, the shyness of the child, and certain genetic disorders, among other causes.[3]

Anarthria is a severe form of dysarthria. The coordination of movements of the mouth and tongue or the conscious coordination of the lungs are damaged.[4]

Aphasia can rob all aspects of the speech and language.[5] It is a damage of the cerebral centres of the language.

Aphonia is the inability to produce any voice. In severe cases the patient loses phonation. It is caused by the injury, paralysis, and illness of the larynx.[3]

Conversion disorder can cause loss of speaking ability.[6]

Feral children grow up outside of human society, and so usually struggle in learning any language.[7]

Some people with autism never learn to speak.[3]

Most intellectually disabled children learn to speak, except the severe cases (IQ 20-25).[7][8] Children with Down syndrome often have impaired language and speech.[7][8]

Hearing mutism is an obsolete term used in the late nineteenth and early twentieth century for specific language impairment.[9]

Akinetic mutism is a state in which the individual is unable to speak or move.[10]


Treatment

For language delays or communication disorders in children, early assessment is strongly recommended. [11] Language delays may impact expressive language, receptive language, or both. Communication disorders may impact articulation, fluency (stuttering) and other specified and unspecified communication disorders. Treatment focuses on the diagnosed condition. For example, Speech and Language Services may focus on the production of speech sounds for children with phonological challenges. [12] Overall, early intervention for young children with language or other developmental delays is strongly recommended. [13] [14]

For toddlers with language delay who may also have Autism, early intervention services focusing on speech production is strongly recommended. When absence of speech is observed in children who may also be diagnosed with Autism, assessment is also strongly recommended. [15] Intervention services and treatment programs have been specifically developed for children with Autism and language delays. [16] For example, Pivotal Response Treatment is a well-established and researched intervention that includes family participation. [17] Mark Sundberg's Verbal Behavior framework is another well-established assessment and treatment modality that is incorporated into many Applied Behavior Analysis (ABA) early intervention treatment programs for young children with autism and communication challenges.[18]

Treatment for absence of speech due to Apraxia, involves assessment, and, based on the assessment, Occupational Therapy, Physical Therapy, and/or Speech Therapy. [19][20][21]

Treatment for Selective Mutism involves assessment, counseling, and positive supports. [22]

Treatment for absence of speech in adults who previously had speech involves assessment to determine cause, including medical and surgery related causes, followed by appropriate treatment or management. Treatment may involve counseling, or rehabilitation services, depending upon cause of loss of speech. [23][24]

Management

Management involves use of appropriate assistive devices sometimes called alternative or augmentative communications. Suitability and appropriateness of modality will depend on users physical abilities and cognitive functioning.[25]

Augmentative or assistive communication technology ranges from elaborated software for iPads to enable complex communication with an auditory component to less technologically involved strategies. For example, a common method involves use of pictures that can be attached to velcro strips to create an accessible communication modality that does not require the cognitive or fine motor skills needed to manipulate an iPad. [26]

Speech-generating devices can help individuals with speech deficiencies associated with medical conditions that affect speech, communication disorders that impair speech, or surgeries that have impacted speech. Speech-generating devices continue to improve in ease of use.[27]

See also

References

  1. ^ "Aphasia" – via The Free Dictionary.
  2. ^ "What is Selective Mutism". Archived from the original on 2015-02-02.
  3. ^ a b c Illyés Sándor; Mesterházi Zsuzsa; Bánfalvy Csaba; Fonyódi Ilona; Hámori József; Papp László Tivadar; Pataki László; Kullmann Lajos; Gósy Mária; Csépe Valéria; Márkus Attila; Vetró Ágnes; Gordosné Szabó Anna; Nagy Gyöngyi Mária; Csányi Yvonne; Hatos Gyula; Gaál Éva; Kovács Krisztina; Farkas Miklós-Perlusz Andrea; Benczúr Miklósné; Hári Mária; Torda Ágnes; Volentics Anna; Balázs Anna (2000). Gyógypedagógiai alapismeretek (in Hungarian). Budapest: Bolyai Tudományegyetem Távoktatási Központ Pszichológia és Neveléstudományok Kar Tanító és Óvodapedagógus Szak. ISBN 9637155287. Archived from the original on May 1, 2017. Retrieved 1 May 2017.
  4. ^ "Ajánlások mozgáskorlátozott gyermekek, tanulók kompetencia alapú fejlesztéséhez". Dombainé Esztergomi Anna (in Hungarian). Budapest: suliNova Közoktatás-fejlesztési és Pedagógus-továbbképzési Kht. 2006. Archived from the original on 19 February 2014. Retrieved 1 May 2017.
  5. ^ "asemia" – via The Free Dictionary.
  6. ^ Bánki M., Csaba (1981). A beteg elme (in Hungarian). Budapest. ISBN 9632408845. Archived from the original on May 1, 2017. Retrieved 1 May 2017.{{cite book}}: CS1 maint: location missing publisher (link)
  7. ^ a b c "Nyelvi és beszédbeli rendellenességek a nyelvtudomány történetében" (PDF) (in Hungarian). Kassai Ilona. Archived from the original (PDF) on June 7, 2007. Retrieved 1 May 2017.
  8. ^ a b Pinker, Steven (2006). A nyelvi ösztön – Hogyan hozza létre az elme a nyelvet? (in Hungarian). Typotex Kft. ISBN 9789639664043. Retrieved 1 May 2017.
  9. ^ Page 6 in: Leonard, Laurence B. (1998). Children with specific language impairment. Cambridge, Massachusetts: The MIT Press. ISBN 0-262-62136-3.
  10. ^ "Definition of Akinetic mutism". Archived from the original on 2014-12-26.
  11. ^ American Association of Family Physicians (May 2011). "Speech and Language delay in children". American Family Physician.{{cite web}}: CS1 maint: url-status (link)
  12. ^ "Oral Motor Institute". www.oralmotorinstitute.org. Retrieved 2020-04-13.
  13. ^ CDC (2019-12-09). "Why Act Early if You're Concerned about Development?". Centers for Disease Control and Prevention. Retrieved 2020-04-17.
  14. ^ Roberts, Megan; Kaiser, Ann (2015-03-02). "Early Intervention for Toddlers With Language Delays: A Randomized Controlled Trial". Pediatrics. 135. doi:10.1542/peds.2014-2134.
  15. ^ "Study shows that many nonverbal autistic children overcome severe language delays". Autism Speaks. Retrieved 2020-04-17.
  16. ^ Lk, Koegel; Lk, Koegel. "Intervention for Non-verbal and Minimally-Verbal Individuals with Autism: A Systematic Review". doi:10.23937/2469-5769/1510056. ISSN 2469-5769. {{cite journal}}: Cite journal requires |journal= (help)
  17. ^ Lei, Jiedi; Ventola, Pamela (2017-06-20). "Pivotal response treatment for autism spectrum disorder: current perspectives". Neuropsychiatric Disease and Treatment. 13: 1613–1626. doi:10.2147/NDT.S120710. ISSN 1176-6328. PMC 5488784. PMID 28790824.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  18. ^ "Verbal Behavior Therapy". Autism Speaks. Retrieved 2020-04-20.
  19. ^ https://www.apraxia-kids.org/wp-content/uploads/2013/01/BHSM-Fact-Sheet-2.pdf
  20. ^ "Childhood apraxia of speech - Symptoms and causes". Mayo Clinic. Retrieved 2020-04-13.
  21. ^ "Speech-Language Therapy (for Parents) - Nemours KidsHealth". kidshealth.org. Retrieved 2020-04-20.
  22. ^ "Selective mutism". nhs.uk. 2017-10-19. Retrieved 2020-04-20.
  23. ^ Lincoln, Tania M.; Riehle, Marcel; Pillny, Matthias; Helbig-Lang, Sylvia; Fladung, Anne-Katharina; Hartmann-Riemer, Matthias; Kaiser, Stefan (2017-12-05). "Using Functional Analysis as a Framework to Guide Individualized Treatment for Negative Symptoms". Frontiers in Psychology. 8. doi:10.3389/fpsyg.2017.02108. ISSN 1664-1078. PMC 5723417. PMID 29259567.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  24. ^ "Learning to Speak Again After Laryngeal Surgery - Health Encyclopedia - University of Rochester Medical Center". www.urmc.rochester.edu. Retrieved 2020-04-20.
  25. ^ "Families need guidance before buying a communication app for autism". Spectrum | Autism Research News. 2019-04-23. Retrieved 2020-04-14.
  26. ^ "Communication aids for disabled children - Living made easy". www.livingmadeeasy.org.uk. Retrieved 2020-04-14.
  27. ^ "ALS Augmentative Communication Program | Speech-Generating Devices | Boston Children's Hospital". www.childrenshospital.org. Retrieved 2020-04-20.
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