Electively mute children: An analysis of 37 Danish cases

The aim of this study is to describe sociodemographic and clinical aspects of a large treated group of children referred with elective mutism. This case-control study includes 37 children, all of whom fulfilled ICD-IO criteria for elective mutism (EM) and a comparison group of 37 children, who were referred to the same hospital. The study is a retrospective sociodemographic and clinical analysis of records of patients with EM. In the group of EM children there was a slight preponderance of boys. The children came from two-parent families, most from the lower social classes. Almost 50% of the children had speech difficulties, and in addition to this enuresis, encopresis, and eating disturbances were more frequent than in the comparison group. With regard to other comorbid symptoms the EM children did not differ from the comparison group. A traumatic experience during the development of speech, severe enough to be noted in the case-record, was present in more than one-third of the files. In most of the parents of EM children similar symptoms, such as shyness and speech difficulties in social situations, were observed, and in one-third mental illness was present (depression being the most frequent). More often than not the condition had an insidious onset, being present several years before referral. In most cases the referral was made by a school psychologist, significantly more than in the group of comparison patients (P < 0.001). More comparison patients than patients with EM came from a middle-class background (P < 0.001), and fewer came from a broken home (P < 0.05).