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Introduction ELECTIVE mutism is a descriptive term which was originally utilized by Tramer in 1934 to describe children who tended to be abnormally silent with all but a small group of intimate relatives and peer friends. This peculiar type of mutism was a chronic one, persisting over a period of many years. There was, however, no demonstrable organic basis for this disorder. Various authors have emphasized that one must differentiate elective mutism from mental retardation, schizophrenic mutism, and various other types of psychogenic mutism such as stage fright, mutism associated with military combat, and acute stress mutism following naturally occurring disasters such as floods, fires, tornadoes, etc. It is the purpose of this paper to focus on the follow-up study of four definitely proven cases of psychogenic elective mutism who had received residential inpatient treatment on the Children's Service of the Lafayette Clinic in
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