Nicht nur schüchtern: Was Pädiater über Selektiven Mutimus wissen sollten

Zusammenfassung

Der Selektive Mutismus (SM) ist eine Angsterkrankung, die etwa 1 % aller Kinder betrifft; mehrsprachige Kinder erkranken mit einer Prävalenz von 2–3 % noch häufiger. Etwa 30–50 % der Betroffenen zeigen Sprachentwicklungsauffälligkeiten. Kernsymptom ist ein situationsspezifisches Unvermögen zu sprechen, während die Kinder in anderen Situationen ihre Sprachkompetenz weitgehend ungehemmt zeigen. Mutistisches Verhalten wird oft von einer psychomotorischen Gehemmtheit, bis hin zu Freezing-Phänomenen, begleitet. Der SM beginnt in der Regel mit 2–4 Jahren, fällt aber oft erst nach Eintritt in Kindergarten oder Schule auf. Aufgrund der starken Tendenz zur Chronifizierung, der schweren psychosozialen und schulisch-beruflichen Funktionseinschränkungen und der mit steigendem Alter zunehmenden Behandlungsresistenz sind ein pädiatrisches Screening im Kindergartenalter und sofortige diagnostische und ggf. therapeutische Maßnahmen für die Prognose entscheidend.

Abstract

Selective Mutism (SM) is an anxiety disorder that affects 1 % of children, bilingual children being even more prone with a prevalence of 2–4 %. Comorbid communication disorders are frequent (30–50 %). Core symptom is the failure to speak in selected situations, while children are widely uninhibited to speak in other situations. The mutistic behavior is often accompanied by psychomotor inhibition or even freezing phenomena. Onset of SM is usually between 2–4 years, but the condition may pass unnoticed prior to the start of extrafamilial daycare or school enrolment. Due to the frequent chronification of the disorder, the severe psychosocial and educational impairment and decreasing treatment efficacy with increasing age, the pediatric screening of preschoolers and the immediate initiation of diagnostic and therapeutic measures are crucial to ensure a favorable outcome.

Schlüsselwörter

Soziale Angst - Behaviorale Inhibition - Sprachentwicklungsstörungen - Mehrsprachigkeit - Früherkennung

Keywords

Social Anxiety - Behavioral Inhibition - Communication Disorder - Multilingualism - Early Screening

Publication History

Article published online:
10 February 2025

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