Çocuk Sahibi Olmayı İstememek
26 Ocak 2024
Güven Oluşumu ve Güvenin Boyutları
19 Şubat 2024
Selektif Mutizm/ Seçici Konuşmazlık
Selektif mutizm yani seçici konuşmazlık, dil gelişiminde soruna bağlı olmayan bir konuşmama türünü içerir.
Kişi, dışarıdaki sosyal ortamlarda konuşmama eğilimi içindedir. Fakat aynı kişi, ebeveynleri, bakımverenleri ya da kardeşleri gibi aile içi ya da yakın ilişki kurduğu diğer kişiler ile konuşur. Anksiyete bozuklukları başlığı altında değerlendirilir. Selektif mutizm, daha çok çocukluk döneminde yaygındır ve aslında okulöncesi dönemde belirtilerini göstermeye başlar. Fakat bu durumun tam olarak fark edilmesi okul dönemi başlangıcında olur. Çocuğun bir aydan daha uzun bir süre sosyal ortamlarda konuşmaması ile tanıya başvurulabilir. Okul gibi büyük bir sosyal ortam ile ilk defa karşılaşan çocuklarda utangaçlık nedeniyle ilk bir ay konuşmama ya da kısık sesle konuşma gibi durumlar görülebilir. Bu sebeple çocuğun okul başlangıcından sonraki iki aylık sürecini izlemek önemlidir. Selektif mutizmin yaygınlığı düşük düzeydedir.
Selektif mutizmin oluşma nedenleri hakkında birçok çeşitli görüş vardır. Bunlardan birkaçı bireyin doğuştan getirdiği utangaç ve çekingen mizacı, yaşadığı travmatik olaylar, dil öğrenimi ve gelişimi sürecinde yaşanmış olabilecek eksiklikler ve bireyin diğer sosyal öğrenmeleri olarak sıralanabilir. Bunun yanı sıra, bireydeki sosyal kitlenme ve sosyal kaygı, sosyal izolasyona maruz kalması diğer etkenlerdir. Aşırı korumacı, aşırı kontrolcü ve müdahaleci ebeveyn tutumu da risk faktörleri arasında gösterilebilir.
Selektif mutizmin tedavisi için bilişsel davranışçı terapiler, duyarsızlaştırma ve pekiştirme gibi davranışsal teknikler, grup ve aile terapileri gibi destekleyici teknikler de kullanılır. Selektif mutizmle beraber seyredilebilecek obsesif kompulsif bozukluk ve depresyon gibi bazı ek sorunların oluşabilmesi durumunda ek destek alınması gerekebilir.
Selektif mutizm tanılı çocuklara yönelik konuşma ile ilgili baskılar, çocukta sosyal geri çekilmenin içinde bulunduğu bazı olumsuz sonuçları doğurabileceğinden, sosyal ortamlarda konuşmasına yönelik hiçbir baskı yapılmamalıdır. Özellikle oyun terapisi çocuğa baskı kurmayan, ona güvenli bir ortam ve koşulsuz kabül sağlayan, çocuğa oyun aracılığıyla iletişim kurmasına fırsat veren bir yöntem olduğu için yararlı sonuçları görülmektedir.
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