title: Suffering in silence: why a developmental psychopathology perspective on selective mutism is needed.
abstract: A developmental psychopathology perspective is offered in an effort to organize the existing literature regarding the etiology of selective mutism (SM), a relatively rare disorder in which a child consistently fails to speak in 1 or more social settings (e.g., school) despite speaking normally in other settings (e.g., home). Following a brief description of the history, prevalence, and course of the disorder, multiple pathways to the development of SM are discussed, with a focus on the various genetic, temperamental, psychological, and social/environmental systems that may be important in conceptualizing this unusual childhood disorder. The authors propose that SM develops due to a series of complex interactions among the various systems reviewed (e.g., a strong genetic loading for anxiety interacts with an existing communication disorder, resulting in heightened sensitivity to verbal interactions and mutism in some settings). Suggestions are provided for future longitudinal, twin/adoption, molecular genetic, and neuroimaging studies that would be particularly helpful in testing the pathways perspective on SM.
authors.affiliation: Department of Psychology, San Diego State University, San Diego, CA, USA. scohan@ucsd.edu
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Cohan
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Price
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
mesh_terms: D002648:Child; D002657:Child Development; D002675:Child, Preschool; D006801:Humans; D009155:Mutism / Q000503:physiopathology* / Q000523:psychology*; D002666:Psychology, Child