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What is selective aphasia? Why does it make people unable to speak in certain situations?
Selective Mutism is an anxiety disorder in which people are unable to speak in certain situations, even though they can speak normally in other situations. This condition usually occurs in children, but adults can also be affected. Patients remain consistently silent in some social situations where communication is expected (eg, school) but talk freely in other settings (eg, home). The reason behind this phenomenon is related to the body's "freeze response", that is, when an individual feels threatened, he or she chooses to remain silent.
Selective aphasia often co-exists with social anxiety disorder. Even when faced with the consequences of shame, social isolation, or punishment, patients choose to remain silent.
The symptoms of selective aphasia are very obvious. Although patients have good language skills and comprehension, they are completely unable to speak in certain situations. This behavior is often misunderstood by people around you as shyness or impoliteness. For children, they may remain silent all year at school, but be able to talk about everything when they get home. There are varying degrees of this behavior, with some people not speaking at all during social interactions, while others only respond to brief questions from peers or adults.
According to the Diagnostic and Statistical Manual, Fifth Edition (DSM-5), to meet the diagnostic criteria for selective aphasia one must demonstrate the following:
- Persistent inability to speak in certain social situations.
- The condition interferes with educational or occupational achievement and social interactions.
- The inability to speak persists for at least one month (not just the first month of school).
- The inability to speak is not due to a lack of knowledge of the required language.
- This condition is not explained by a communication disorder or autism spectrum disorder.
Studies have shown that selective aphasia is closely related to other anxiety symptoms, especially social anxiety disorder. Studies have found that many children diagnosed with selective aphasia are also affected by social anxiety disorder. Some experts believe that selective aphasia may be a strategy used by people with a certain type of social anxiety disorder to relieve anxiety in social situations.
Since many people with autism also have selective aphasia, this phenomenon is often misunderstood, which can lead to misdiagnosis and inappropriate treatment.
However, there is no consensus on understanding the causes of selective aphasia. It is speculated that many cases may be related to an individual's genetic predisposition and behavioral inhibition, which may stem from an overactive amygdala in the brain. This part is responsible for detecting potential threats and initiating the instinctive "flight or freeze" response. Studies have shown that children who are affected by behavioral inhibition are more likely to experience selective aphasia in certain situations.
As for treatment, selective aphasia does not automatically improve with age, so early intervention is very important for the healthy development of patients. Some traditional treatments include behavioral therapy and cognitive behavioral therapy, which aim to improve the patient's social communication skills. Depending on the individual situation, experts will adopt appropriate treatment strategies.
Social Communication Anxiety Treatment (S-CAT) is a common treatment method that integrates behavioral therapy, cognitive behavioral therapy, and insight-based strategies and has successfully helped many patients regain their ability to talk.
Treatment plans for children may also use the technique of "self-modeling", which allows patients to watch themselves communicating with the help of experts or trusted people through video clips. Boost their confidence. In some cases, medical professionals may even consider medication to aid in the psychotherapy process, especially for teens and adults who are already experiencing anxiety or depression.
In society, there are still many misunderstandings about selective aphasia, which may lead to missed opportunities for early treatment. Increasing awareness and understanding of the symptoms and creating a supportive environment are the first steps towards effective treatment. In the process of understanding selective aphasia, should we also re-examine our understanding of communication and value each person's unique way of expression?
