Selective Mutism Is Paralyzing Shyness, Not Psychosis

Aug. 29, 2007 — -- Years ago, when a young child couldn't respond verbally to a question, parents called it "cocking a deaf ear."

Now that inability to speak has a medical name — selective mutism — and some suggest that it may have led Seung Hui Cho to cock a gun and shoot 32 victims and then himself at Virginia Tech in April.

Cho was treated for selective mutism as a high school student in the Fairfax County, Va., schools, according to media reports this week.

His emotional condition was considered so severe — he was virtually unable to speak in social settings — that he was placed in a special education program, and a plan was devised to help him.

The condition was one of an array of psychological disorders that the troubled student displayed throughout his short life.

Selective mutism is a type of social anxiety disorder, though some research suggests a biological link to the amygdala, the part of the brain that governs emotions and the "fight or flight" mechanism.

Those who suffer from the disorder "feel afraid," Dr. Elisa Shipon Blum, director of the Selective Mutism Anxiety Research and Treatment Center in Jenkintown, Pa., told ABC News.

"Many of them say, 'The words won't come out,'" she said. "Their voice box feels like it's closing up. Their stomach hurts. Their body won't let them speak."

In a classic case, the child can be a chatterbox at home and with familiar friends, but be paralyzed and speechless in group settings or around strangers. Like a panic attack, the behavior becomes learned, especially when parents speak for the child.

Most selective mutes "self correct" or start talking on their own between grades 3 and 5, due to peer pressure, according to Bill Garrison, professor of pediatrics at University of Massachusetts Medical School.

"The boys do not, however, become highly verbal," he said. "They just begin to talk enough so that they are not noticed," Garrison said.

The cause of the disorder is not known, though it may be inherited. It can strike at any age, but most develop sufferers will develop selective mutism before the age of 5.