Down Syndrome and Selective Mutism 13 and 14 may 2010 Wies Laurijssens, speech therapist Marijke...

Down Syndrome and Selective Mutism13 and 14 may 2010

Wies Laurijssens, speech therapist

Marijke Tonino, MD.PhD

Bridge 2010, Bristol

Case Sarah

Symptoms

1. Language comprehension is very good

2. There is no evidence or indication for a

communication disorder or a psychotic

disorder.

© Laurijssens, Ipse de Bruggen

3. She could not take part in specific verbal work situations

4. Duration of several years

5. She did speak at home and on holiday but not at the daycentre


Aspects of communication

• vulnerable in their expressive language

• speech tends to be unintelligible

• language comprehension is of a higher level

than the level of expressive

language

•particular vulnerability in the capability to

cope with stress © Laurijssens, Ipse de Bruggen

Selective Mutism

The cardinal characteristic:

persistent failure to speak in specific

social situations


And

the diagnosis does not exclude other

forms of communication, such as

gesturing, shaking the head, pulling or

pushing, or grunting.


DSM-IV Selective Mutism

1. a persistent failure to speak in specific social

situations in which speech is typically expected,

despite speaking in other situations

2. It is not the result of an organic inability to

understand language or a lack of knowledge of , or

comfort with, the spoken language in the social

situation© Laurijssens, Ipse de Bruggen

3. it interferes with educational or occupational

achievement or with social communication

4. the duration is at least 1 month, not including the

first month of school


5. the disturbance is not be better

accounted for by a communication

disorder (e.d. stuttering) and does not

exclusively occur during the course of

a pervasive developmental disorder,

schizophrenia, or other psychotic

disorder


Case Kelly

DSM-IV1. Failure to speak in

social situations

2. not the result of an organic inability to understand language

Symptoms1. speaks in a

microfone and telephone. She uses other communication forms actively

2. wordvocabulary 8;1 years. She can read and write.


3. interferes with occupational achievement or with social communication

4. the duration is at least 1 month

5. It is not because of a communication disorder and does not exclusively occur during the course of a pervasive developmental disorder

3.She could no longer work at the social work place

4. It started in 1995 till now

5. There is no evidence for dementia and depression


Hypothesis Diagnosis

The diagnosis Selective Mutism can be used with adults with Down Syndrome


[email protected]

Ipse de BruggenBrasserskade 4

2631 NC Nootdorp

Treatment (best practice)

We think treatment should not only include pharamcological treatment but also psycho education, restructuring of environment, lowering of demands.

Also we recommend the use of augmentative or alternative communication (AAC) to enhance and to fascilitate speech, to structure life and life events.


To empahsize only the verbal communication lays an extra limitation in the communication and enhances the overloading of the person


Down Syndrome and Selective Mutism 13 and 14 may 2010 Wies Laurijssens, speech therapist Marijke...

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