Elsevier

Biological Psychiatry

Volume 55, Issue 11, 1 June 2004, Pages 1061-1068
Biological Psychiatry

Original article
Reduced auditory efferent activity in childhood selective mutism

https://doi.org/10.1016/j.biopsych.2004.02.021Get rights and content

Abstract

Background

Selective mutism is a psychiatric disorder of childhood characterized by consistent inability to speak in specific situations despite the ability to speak normally in others. The objective of this study was to test whether reduced auditory efferent activity, which may have direct bearings on speaking behavior, is compromised in selectively mute children.

Methods

Participants were 16 children with selective mutism and 16 normally developing control children matched for age and gender. All children were tested for pure-tone audiometry, speech reception thresholds, speech discrimination, middle-ear acoustic reflex thresholds and decay function, transient evoked otoacoustic emission, suppression of transient evoked otoacoustic emission, and auditory brainstem response.

Results

Compared with control children, selectively mute children displayed specific deficiencies in auditory efferent activity. These aberrations in efferent activity appear along with normal pure-tone and speech audiometry and normal brainstem transmission as indicated by auditory brainstem response latencies.

Conclusions

The diminished auditory efferent activity detected in some children with SM may result in desensitization of their auditory pathways by self-vocalization and in reduced control of masking and distortion of incoming speech sounds. These children may gradually learn to restrict vocalization to the minimal amount possible in contexts that require complex auditory processing.

Section snippets

Participants

Sixteen children with SM (age range of 5–16 years) were recruited for this study. DSM-IV criteria for selective mutism were ascertained through a semistructured interview with the parents. Normal speech production at home was verified through homemade videotapes of the children fluently conversing with members of their nuclear family. Fifty-six percent of the children had a history of evaluation and treatment by a mental health professional, and none were medicated during the study's

Results

All children had normal speech reception thresholds, normal speech discrimination, and within normal range ABR wave latencies. t test analyses revealed no significant between-group differences for any of the measures. Table 2 presents means and SDs of absolute and interpeak ABR wave latencies at an intensity level of 85 dB HL and click presentation rate of 21/sec for the SM and control children. For brevity, only the standard (85 dB HL, 21/sec) ABR data are fully reported. Reducing the

Dicussion

The findings from this study provide evidence for aberrations in MEAR function and diminished right ear TEOAE suppression in selectively mute children. These aberrations in auditory efferent activity in children with SM appear along with normal pure-tone and speech audiometry and normal brainstem transmission as indicated by ABR latencies. Based on the literature describing the possible effects of self-vocalization on hearing, it may be the case that reduced efferent activity during

Acknowledgements

This study was supported in part by a grant from the Adams Super Center for Brain Studies at Tel-Aviv University (YB-H).

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