Reduced auditory efferent activity in childhood selective mutism

Yair Bar-Haim*, Yael Henkin, Daphne Ari-Even-Roth, Simona Tetin-Schneider, Minka Hildesheimer, Chava Muchnik

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Background Selective mutism is a psychiatric disorder of childhood characterized by consistent inability to speak in specific situations despite the ability to speak normally in others. The objective of this study was to test whether reduced auditory efferent activity, which may have direct bearings on speaking behavior, is compromised in selectively mute children. Methods Participants were 16 children with selective mutism and 16 normally developing control children matched for age and gender. All children were tested for pure-tone audiometry, speech reception thresholds, speech discrimination, middle-ear acoustic reflex thresholds and decay function, transient evoked otoacoustic emission, suppression of transient evoked otoacoustic emission, and auditory brainstem response. Results Compared with control children, selectively mute children displayed specific deficiencies in auditory efferent activity. These aberrations in efferent activity appear along with normal pure-tone and speech audiometry and normal brainstem transmission as indicated by auditory brainstem response latencies. Conclusions The diminished auditory efferent activity detected in some children with SM may result in desensitization of their auditory pathways by self-vocalization and in reduced control of masking and distortion of incoming speech sounds. These children may gradually learn to restrict vocalization to the minimal amount possible in contexts that require complex auditory processing.

Original languageEnglish
Pages (from-to)1061-1068
Number of pages8
JournalBiological Psychiatry
Issue number11
StatePublished - 1 Jun 2004


FundersFunder number
Tel-Aviv University


    • Auditory processing
    • middle ear acoustic reflex
    • otoacoustic emission
    • selective mutism
    • social anxiety
    • vocalization


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