Child Maltreatment and Its Effects on Speech & Selective Mutism

By: Mazal Leviyev

Introduction

Although society has made progress in understanding the effects of psychological trauma and how to treat it, certain cases, specifically involving childhood maltreatment, are still overlooked. Child abuse—whether physical, emotional, sexual, or through neglect—can result in several neurological impairments towards an individual. One example is selective mutism, a communicative disorder frequently misinterpreted as “shyness.” However, this is far from true, and dismissing it as such can further undermine the complexity of its impact on language development. Understanding how child maltreatment can disrupt neuropsychological domains, including those related to communication, such as working memory, processing speed, and language, is a vital step toward developing effective treatment options.

Trauma and Speech Development

Psychological traumas, specifically childhood maltreatment, are often associated with speech impairments and are considered an early marker of neurodevelopmental delay. Changes to the superior temporal gyrus, which is responsible for speech and language processes, can lead to the development of thought disorders (Cai et al., 2023). According to Cabrera et al. (2020), their early years are the most critical in language acquisition: “Maltreated children are more likely to use fewer words, have difficulty producing complex sentences, and demonstrate poorer receptive language.” These traumas can often interfere with cognitive processes required for both generating speech and understanding language. Children who often experience maltreatment also learn to withdraw emotionally and struggle to communicate their feelings. The lack of proper emotional care from parents can interfere with brain development, and their emotional isolation can be noted in both their vocabulary and sentence structure. Additionally, these early difficulties of acquiring language skills can cause ripple effects later in life. Because these children do not learn to communicate properly in earlier years, they might also find it difficult to do well academically or even within their relationships. Hence, child abuse can hinder speech development.

Selective Mutism: A Trauma Response

Selective mutism is a behavioral disorder defined as the recurrent failure to speak in specific social settings, despite speaking in others (Bergman et al., 2013). For example, a child might feel comfortable speaking with friends but find it difficult to speak with their family. Cai et al. (2023) found that numerous studies discovered that abused children are more sensitive to threatening signals, specifically those that highlight angry emotional responses: “... abused children exhibited preferential attention to angry expressions…, increased sensitivity in the detection of angry expressions…, and have difficulty in transitioning from an angry facial stimulus to other emotions.” The heightened sensitivity to emotional stimuli, like anger, is likely one of the causes of selective mutism, as these children may feel particularly fearful or stressed. In relation to child maltreatment, children withdraw from situations as a defense mechanism when they might feel threatened, such as with their parents in fear of triggering a negative reaction. Therefore, the development of selective mutism can often serve as a defense mechanism because they are hyper-aware of potential threats.

Treatment Approaches for Trauma-Induced Speech Disorders

Several studies have attempted to find possible treatment options for selective mutism. Bergman et al. (2013) conducted a study to see the effectiveness of Integrated Behavior Therapy for Selective Mutism (IBTSM), which utilizes methods that expose the child to anxiety-inducing situations, such as speaking, to help minimize that fear over time. The results from this study showed that this form of behavior therapy has increased speaking behavior post-treatment for the majority of children with selective mutism, even three months after the intervention. Although this study demonstrates the positive outcomes of IBTSM, there are limited studies that directly treat the causes behind children developing selective mutism, like the emotional effects of childhood maltreatment. Hence, for a more effective treatment plan, researchers should treat both selective mutism—allowing the child to better communicate—and the root cause (in this case, child abuse) to help the child thrive in their life. 

Final Thoughts

Childhood maltreatment can severely impact speech development, leading to trauma-induced speech disorders like selective mutism. These disorders often result from the way the brain processes trauma, specifically in regions responsible for speech production. Research has shown that exposure-based therapies such as Integrated Behavior Therapy for Selective Mutism (IBTSM) could help address this disorder in children. However, beyond continued exploration of therapies to help treat this disorder, it is also vital for future studies to gain a deeper understanding of the root causes of selective mutism, particularly in relation to childhood maltreatment.

References

Bergman, R. L., Gonzalez, A., Piacentini, J., & Keller, M. L. (2013). Integrated Behavior Therapy for Selective Mutism: A randomized controlled pilot study. Behaviour Research and Therapy, 51(10), 680–689. https://doi.org/10.1016/j.brat.2013.07.003

Cabrera, C., Torres, H., & Harcourt, S. (2020). The neurological and neuropsychological effects of child maltreatment. Aggression and Violent Behavior, 54, 101408-. https://doi.org/10.1016/j.avb.2020.101408

Cai, J., Li, J., Liu, D., Gao, S., Zhao, Y., Zhang, J., & Liu, Q. (2023). Long‐term effects of childhood trauma subtypes on adult brain function. Brain and Behavior, 13(5), e2981-n/a. https://doi.org/10.1002/brb3.2981