The Failure to Speak of Young Children with Selective Mutism: A Longitudinal Study of Psychophysiological Arousal During a Social Stress Task

The failure to speak of children with selective mutism (SM) has been conceptualized as a specific emotion regulation strategy to avoid extreme arousal in stressful (social) situations. However, the underlying psychophysiological mechanisms of their failure to speak, and the development of these children over time, are still not well understood. The current study examined the arousal (heart rate and heart rate variability) of 33 children with SM and 42 typically developing children (comparison group, CG), aged 4 to 8 years, during rest and during a verbal and non-verbal social evaluation stress paradigm. Moreover, 18 children with SM participated in a follow-up measurement after almost all of them had received treatment. Children with SM had a significantly higher arousal during rest. However, their reactivity arousal (performance minus baseline) during a verbal and non-verbal stress task did not differ from the CG. Moreover, at the follow-up measurement, children with SM showed...Show moreThe failure to speak of children with selective mutism (SM) has been conceptualized as a specific emotion regulation strategy to avoid extreme arousal in stressful (social) situations. However, the underlying psychophysiological mechanisms of their failure to speak, and the development of these children over time, are still not well understood. The current study examined the arousal (heart rate and heart rate variability) of 33 children with SM and 42 typically developing children (comparison group, CG), aged 4 to 8 years, during rest and during a verbal and non-verbal social evaluation stress paradigm. Moreover, 18 children with SM participated in a follow-up measurement after almost all of them had received treatment. Children with SM had a significantly higher arousal during rest. However, their reactivity arousal (performance minus baseline) during a verbal and non-verbal stress task did not differ from the CG. Moreover, at the follow-up measurement, children with SM showed significantly lower baseline arousal compared to the first measurement, and no difference in verbal and non-verbal reactivity arousal. The results indicate that children with SM have elevated stress levels compared to typically developing children, even in a non-verbal situation. Over time, after treatment, their stress levels tend to ‘normalize’. These findings do not support the avoidance hypothesis and might indicate a more inflexible stress response to a stressful situation in children with SM compared to typically developing children.Show less

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The Failure to Speak of Young Children with Selective Mutism: A Longitudinal Study of Psychophysiological Arousal During a Social Stress Task