著者

内山 喜久雄

出版者

The Kitakanto Medical Society

雑誌

北関東医学 (ISSN:00231908)

巻号頁・発行日

vol.9, no.4, pp.772-785, 1959-07-01 (Released:2009-10-21)

参考文献数

45

被引用文献数

1 1

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The statistical survey has been made on the forty-six cases of the childhood mutism from among the 24, 245 pupils of the whole elementary schools in the City M., by means of the diagnostic interview and the questionnaire method. The childhood mutisms were observed Tin 0.19% of the whole pupils, girls exceeding boys in the frequency.The personal and environmental factors which may bring about anxiety and feeling of isolation on the part of the patients producing negativistic responses such as mutism are as follows : The personal factors contributing to infantile mutism were intellectual retardation and consequently poor academic achievement with delayed commencement of speech and walking. Notable diseases in the past, and nervous habits in the past and present are often considered as contributing factors. Although the problem of the heredity of the mutistic trends needs further considerations, patients' near relatives surveyed showed comparatively frequent occurrences of mutism. The psychiatric survey of the patients' present physical conditions revealed no direct relationships with mutism, with the exceptions of some physical indications for some of the mentally deficient subjects.As for environmental factors, the attitudes of their parents' laissez-faire and their mothers' over-protection may be influential in producing mutism. It was noticed that the academic career and socio-economic status of the parents were considerably low. Among the effects of the grandparents' attitudes contributing to the formation of the symptom, the grandmothers' over-protection should be emphasized. In some cases, sibling rivalry might also be regarded as a factor, but in this respect, further observation may be demanded. The numbers of the patients' friends and playmates are remarkably few, which might in turn promote the mutistic trends. Situations causing the childhood mutism are found chiefly in and around schools and unacquainted places, being scarcely seen in the home and neighbourhood situations.

著者

内山 喜久雄

出版者

The Kitakanto Medical Society

雑誌

北関東医学 (ISSN:00231908)

巻号頁・発行日

vol.9, no.4, pp.786-799, 1959-07-01 (Released:2009-10-21)

参考文献数

16

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A psychotherapeutic device involving both desensitization and supportive therapy was applied to twenty-two mutistic pupils in elementary schools. The desensitization is based upon the principle of reconditioning, and the supportive therapy, upon the principle of the group effect. The therapeutic effect, then, was expected through the gradual increment of tolerance on the part of the patient.The procedures were consisted of the following five therapeutic stages, the interval between each stage being approximately one week.1) Introductory stage : Therapist has a personal therapeutic interview in a small room with the patient, who is requested simple oral answers.2) Inuring stage : The therapist and the patient are in the classroom with a few of his intimate friends. The task here is to give some oral salutations.3) Promoting stage : The number of the friends attending is increased to more than five in the same classroom. Reading some short sentences aloud is the task here.4) Reality stage : The usual class-work situations. The patient is asked to read loudly the sentences he read in the preceding stage.5) Spontaneity stage : The patient is charged with oral messages from one teacher to another in the various situations. Spontaneous speaking was expected.The method was effective for seventeen case; (77%), almost ineffective for two (9%), and incurable for three (14%). In ineffective and incurable cases, where the symptom formation was long-dated and stable, the functions of both reconditioning and group effect were observed to be of little effect.