Refusal or inability to speak. Mutism may occur as a symptom of profound congenital deafness, severe manic–depressive illness, catatonic schizophrenia, or a rare form of conversion disorder. The term may also apply to a religious vow of silence.
Elective mutism is a rare childhood disorder (usually starting before age 5), in which the child can speak properly but refuses to do so most of the time.
Akinetic mutism describes a state of passivity caused by some brain tumours or by hydrocephalus. People with akinetic mutism are incontinent, require feeding, and respond at most with a whispered “yes” or “no”.
See under VOICE AND SPEECH.
n. inability or refusal to speak. Innate speechlessness most commonly occurs in those who have been totally deaf since birth; this was formerly referred to as deaf-mutism but the term is now deprecated, as it implies wrongly that those affected are unable to make vocal sounds or to communicate effectively in other ways (sign language). Inability to speak may result from brain damage (see aphasia). It may also be caused by depression, psychosis, or psychological trauma, in which case the patient either does not speak at all or speaks only to particular persons or in particular situations. This latter condition is called selective mutism.
Treatment of mutism due to psychological causes is now increasingly by behavioural means, such as *prompting: people that the patient does not address are slowly introduced into the situation where the patient does speak. This may be done either alone or in combination with more traditional psychotherapy. Psychotic or depressive mutism or *catatonia are addressed by treating the underlying condition. —mute adj., n.
Terms applied to the sounds produced in the upper AIR PASSAGES which form one of the means of communication between human beings. Air passes through the LARYNX to produce the fundamental notes and tones known as voice. This is then modi?ed during its passage through the mouth so as to form speech or song.
Voice This has three varying characteristics: loudness, pitch, and quality or timbre. Loudness depends on the volume of air available and therefore on the size of the chest and the strength of its muscles. Pitch is determined by larynx size, the degree of tenseness at which the vocal cords are maintained, and whether the cords vibrate as a whole or merely at their edges.
In any given voice, the range of pitch seldom exceeds two and a half octaves. Typically, the small larynx of childhood produces a shrill or treble voice; the rapid growth of the larynx around PUBERTY causes the voice to ‘break’ in boys. Changes in the voice also occur at other ages as a result of the secondary action of the SEX HORMONES. Generally speaking, the adult voice is bass and tenor in men, contralto or soprano in women. Timbre is due to di?erences in the larynx, as well as to voluntary changes in the shape of the mouth.
Speech Rapid modi?cations of the voice, produced by movements of the PALATE, tongue and lips. Infants hear the sounds made by others and mimic them; hence the speech centres in the BRAIN are closely connected with those of hearing.
Defects of speech See below, and also SPEECH DISORDERS. MUTISM, or absence of the power to speak, may be due to various causes. LEARNING DISABILITY that prevents the child from mimicking the actions of others is most common; in other cases the child has normal intelligence but some neurological disorder, or disorder of the speech organs, is responsible. Alternatively, complete DEAFNESS or early childhood ear disease may be the cause. STAMMERING is a highly individual condition, but is basically a lack of coordination between the di?erent parts of the speech mechanism. (See also main entry on STAMMERING.) DYSPHASIA is the inability to speak or understand speech, most commonly following brain disease, such as STROKE. APHONIA or loss of voice may be caused by LARYNGITIS or, rarely, a symptom of conversion and dissociative mental disorders – traditionally referred to as HYSTERIA. It is generally of short duration.... voice and speech
n. a loss of normal muscular tonicity or responsiveness. Akinetic rigid syndrome is used to describe such conditions as *parkinsonism and *progressive supranuclear palsy. In akinetic epilepsy there is a sudden loss of muscular tonicity, making the patient fall with momentary loss of consciousness. Akinetic mutism is a state of complete physical unresponsiveness although the patient’s eyes remain open and appear to follow movements. It is a consequence of damage to the *brainstem area of the brain. —akinetic adj.... akinesia
Health Encyclopedia