4
$\begingroup$

I've been trying to figure this out for a long time, but I don't understand much about classification of disorders and I feel uncertain after looking at the definitions. Based on what I've read, I think these don't qualify as communication disorders, but are instead anxiety disorders.

I've looked at this: https://www.asha.org/policy/rp1993-00208/ and this https://www.medicalnewstoday.com/articles/communication-disorders

If I look at the the second one, it first gives this:

Communication disorders affect a person’s ability to detect, receive, process, and comprehend the concepts or symbols necessary for communication. It can affect hearing, language, and speech. Causes include neurological damage due to a stroke.

But then it gives this definition:

Communication disorders are a group of conditions involving problems with receiving, processing, sending, and comprehending various forms of information and communication.

On the surface, selective mutism and social anxiety disorder would seem to meet the criteria for involving "sending" information, even if they don't meet the other conditions.

And it would seem to me that articulation disorders also do not meet every criteria either, but are included.

An articulation disorder is the atypical production of speech sounds characterized by substitutions, omissions, additions or distortions that may interfere with intelligibility.

If I look at the ASHA definition, I can almost understand that social anxiety disorder would be excluded.

A communication disorder is an impairment in the ability to receive, send, process, and comprehend concepts or verbal, nonverbal and graphic symbol systems. A communication disorder may be evident in the processes of hearing, language, and/or speech. A communication disorder may range in severity from mild to profound. It may be developmental or acquired. Individuals may demonstrate one or any combination of communication disorders. A communication disorder may result in a primary disability or it may be secondary to other disabilities.

I can sort of understand why it would be useful to separate anxiety disorders from these, but I'm not very knowledgeable in psychology, so I was hoping someone could verify what the answer is.

$\endgroup$

1 Answer 1

5
$\begingroup$

One thing to remember is that classification systems, especially in the field of psychology, are not absolute. All human brains search for patterns and attempt to label them in a way that makes it easier for us to understand a phenomena and talk about it with others. However, research indicates that this categorical diagnostic system is actually not even close to how psychological disorders present in reality. We want to put people into boxes (for example, "your symptoms are a communication disorder!", "yours are an anxiety disorder!") but reality doesn't care about our little boxes. So moral of my ramblings, I'd encourage you not to get too hung up on sorting these concepts into distinct boxes. Heres a little article from NAMI that touches on this issue: https://www.nami.org/Blogs/NAMI-Blog/August-2021/The-Transdiagnostic-Dimensional-Approach-Another-Way-of-Understanding-Mental-Illness

To hopefully actually address your question, there is no physical or neurological issue preventing an individual from detecting, processing, or producing language in selective mutism or social anxiety. That is because the lack of speech is not due to a problem with the sensory or communication parts of the nervous system. The problem lies in anxiety. Kids with selective mutism are perfectly capable of detecting, understanding, and producing speech. Many of them won't talk at all in one setting, but will be little chatterboxes in other settings, so long as they feel safe and comfortable there. It's the anxiety that prevents them from speaking. If we remove anxiety, we remove the communication difficulties.

HOWEVER, that's not to say that there can't be some co-occurring problem that impacts speech IN ADDITION to the anxiety. Lots of kids with selective mutism do also have some actual neurobiological communication difficulties. Technically a diagnosis of a communication disorder rules out selective mutism, but they can definitely co-occur, so long as you determine that the anxiety is also a contributing factor (which kinda brings me back to my first point about diagnoses. We see soooo much overlap between "different" disorders, yet we consider them different disorders).

Here are a few scientific articles on issues with categorical classification and diagnosis: https://psycnet.apa.org/record/2008-11035-001 https://psycnet.apa.org/record/2017-12889-001 https://onlinelibrary.wiley.com/doi/pdf/10.1002/mpr.284

Here are a few on selective mutism and social anxiety etiology and comorbidities: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861522/ https://www.sciencedirect.com/science/article/abs/pii/S0005796716301115 https://link.springer.com/article/10.1007/s11920-011-0201-7

$\endgroup$
0

Your Answer

By clicking “Post Your Answer”, you agree to our terms of service and acknowledge you have read our privacy policy.

Not the answer you're looking for? Browse other questions tagged or ask your own question.