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Selective Mutism is a complex childhood anxiety disorder characterized by a child's inability to speak and communicate effectively in select social settings, such as school. These children are able to speak and communicate in settings where they are comfortable, secure, and relaxed.

More than 90% of children with Selective Mutism also have social phobia or social anxiety.This disorder is quite debilitating and painful to the child. Children and adolescents with Selective Mutism have an actual FEAR of speaking and of social interactions where there is an expectation to speak and communicate. Many children with Selective Mutism have great difficulty responding or initiating communication in a nonverbal manner; therefore social engagement may be compromised in many children when confronted by others or in an overwhelming setting where they sense a feeling of expectation.

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Why does a child develop Selective Mutism?
The majority of children with Selective Mutism have a genetic predisposition to anxiety. In other words, they have inherited a tendency to be anxious from one or more family members.Very often, these children show signs of severe anxiety, such as separation anxiety, frequent tantrums and crying, moodiness, inflexibility, sleep problems,and extreme shyness from infancy on.

Children with Selective Mutism often have severely inhibited temperaments. Studies show that individuals with inhibited temperaments are more prone to anxiety than those without shy temperaments. Most, if not all, of the distinctive behavioral characteristics that children with Selective Mutism portray can be explained by the studied hypothesis that children with inhibited temperaments have a decreased threshold of excitability in the almond-shaped area of the brain called the amygdala. When confronted with a fearful scenario, the amygdala receives signals of potential danger (from the sympathetic nervous system) and begins to set off a series of reactions that will help individuals protect themselves. In the case of children with Selective Mutism, the fearful scenarios are social settings such as birthday parties, school, family gatherings, routine errands, etc.

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