Monday, April 18, 2011
Medical Mondays: These Lips Are Sealed...For Now.
Happy Monday! Jen Daiker at Unedited has a great question for today. She asks:
"I have a main character who only speaks when it rains...now while that doesn't really matter for someone who lives in Oregon or Washington but for someone who lives in sunny LA that could took forever.
My question: How long could one go without speaking? Would something happen to their vocal cords?"
Well, this question stumped me. I'm going to answer as best I can, but I do have an ENT friend I consulted on this, so when I hear back from him I'll addend this post.
I think Jen is talking about is a problem called Selective Mutism. Adults and children (but more kids are affected, in general) with this condition cannot talk in certain situations (usually social situations) because of anxiety. Often, it's not that they choose not to speak, but that they are forced into a mute state by their extreme anxiety.
(Think Speak, by Laurie Halse Anderson, or the character Charles Wallace in A Wrinkle In Time by Madeleine L'Engle)
Sufferers are fully able to talk and understand language when the problematic situation goes away. Jen's character, for mysterious reasons (fascinating, right?), would start talking again when it rains.
But what if a person couldn't/didn't speak for a really long time? As in, months or years?
I did my best to find case studies of long term, exclusive mutism, and nothing came up. Nothing! So I'm left with hypothesizing instead.
Phonation, or the ability to produce sound is extremely complex. Speech is additionally very complicated. It's not just about the vocal cords, but the multiple soft tissues, nerves, and different cartileges that comprise the "voice box", AND the throat, the lungs, air pressure, the mouth, teeth and tongue, the brain of course, and the speech centers...
My best guess is that without talking for months and months, the first time someone did talk they'd have some difficulty. Possibly some hoarseness, from atrophy of the muscles related to phonation; possibly some dysarthria (poor enunciation of words) from lack of practice and all those other anatomic items you need to speak well. I'd guess that speech would be slow as well.
Thanks Jen for stumping me on a Sunday. Again, if my ENT friend gets back to me, I'll probably addend this post.
In the mean time, speak up and wish everyone within ear-shot a Happy Monday!