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the inability or refusal to speak that takes place in the absence of any organic lesions of the vocal apparatus. Occurring mainly in shy, timid, physically weak children, mutism results from a reaction to a traumatic mental stimulus such as fright, insult, conflict, or excessive demand. Mutism is also found in patients suffering from schizophrenia and hysteria. Hysterical mutism is usually complete, that is, the patient does not utter a single word; he does not maintain oral contact but communicates by writing. The ability to speak disappears suddenly and returns just as unexpectedly. Voluntary mutism is common in children: the child does not answer questions in school but talks normally at home and in the street. Sometimes he does not answer the questions of one teacher but does respond normally to others.
Mutism is temporary but varies in duration. It sometimes continues for years, in which case it causes mental retardation. Treatment involves the elimination of factors that traumatize the nervous system; treatment of the disease that caused the mutism; use of general restorative measures; and psychotherapy. Preventive measures include strengthening of the child’s nervous system and a proper upbringing that encourages independence, activity, and sociability.
Surdimutism—the functional impairment of hearing and speech—is a special form of the condition. Unlike deaf mutism, which is caused by the permanent organic impairment of hearing, surdimutism is temporary. It is generally observed in wartime as one of the symptoms of contusion. Speech and hearing in surdimutism are usually quickly restored by disinhibition therapy. Sometimes surdimutism can be corrected without any special treatment. In a few cases the disease becomes protracted and requires the coordinated attention of neurologists, otorhinolaryngologists, speech therapists, and specialists in the teaching of deaf-mutes.
L. V. NEIMAN