Are you or someone you love being affected by selective mutism? Selective mutism is a relatively rare disorder in children causing inability to speak at specific social situations, despite the ability to speak normally in other situations. However, the condition is likely to be ignored due to poor understanding of this condition by the general public.

Symptoms usually begin between 2.7 and 4.2 years of age, and they last for longer than one month, excluding the first month of school because it takes time to adjust to new environment. This inability to speak is not by choice, but by extreme anxiety preventing the individual from speaking. It can have a negative impact on social and academic function. So it’s necessary to learn to deal with selective mutism.

To overcome selective mutism, you can get others to help. Start with the most comfortable person you can talk with and progress gradually to the most uncomfortable person for you to talk to. In this way, the anxiety caused by the persons you feel uncomfortable with will “fade” away.

Also you can first imagine yourself in the situation where you can’t speak, and then imagine speaking, and then try to interact with persons in that situation in indirect ways. The idea of this method is to overcome the anxiety causing inability to speak by gradual to exposure to increasing level of the anxiety-causing stimulus (刺激物).

In addition, there are many other ideas you can do to overcome selective mutism. For example, you try making a record of your own voice, then replaying the speech to develop comfort with speaking, or practice speaking in a low voice at a public place, and then practice gradually increasing the volume to a talking level. It’s also helpful to focus on positive thinking to overcome the anxiety. Instead of thinking “I can’t talk…”, think “I can try to talk and make it possible if I work at it!”

Before my daughter, Evelyn, was born, I eagerly expected her first year of life. I imagined celebrating every milestone --- bonding with her as a newborn, seeing her smile for the first time, hearing her say her first word. 1 didn't think of feeding tubes, long hospital stays or an organ transplant(移植). For Evelyn, the first year included all and more.

Evelyn came into this world at just 34 weeks, weighing less than 3 pounds. Genetic testing revealed she had Alagille syndrome, a genetic disorder that can damage the liver(肝脏),heart and other organs. Soon, we received the news that baby Evelyn needed a liver transplant.Our family moved nearer to UPMC Children's Hospial of Pittsburgh so that we were closer if a liver was available for Evelyn.

When Evelyn was added to the organ donation wait list, I was under the liver allocation policy in place at that time,which was map-based. This policy lacks any special consideration for transplant candidates.We were told it would likely take three months. Just then, a new policy for liver allocation was tried out.Under the new system, the sickest child patients get first priority(优先).The new policy was only in effect for a little over a week, but in that period, Evelyn received her liver transplant.Had it been just one week earlier or later, we would not have received the call.

As Evelyn recovers from her transplant, we are grateful for the change.I am also sad, because the new policy was short-lived. That means another mom like me might not receive that phone call with good news.

Other children should have the same opportunity as Evelyn to live healthy, happy lives. When it comes to liver transplant policy, we can and must do better for children.

Stephen Hawking, the world respected Oxford physicist, who died at the age of 76, once said he felt “lucky” his motor neurone diseasc (MND) did not prevent him from doing his lifelong research on the origins of the universe. “I have been so lucky that my disease has not been a serious block, indeed it has probably given me more time than most people to search for knowledge.” he once said.

The author of the 1988 bestseller A Brief History of Time was given only a few years to live when he was diagnosed (诊断) with MND as a 22-year-old student in 1964.

MND is the collective name for a group of diseases that affect the nerves (神经) in the brain. The progressive disease kills more than half within two years and about ninety percent within five years of diagnosis. There is no cure for MND and no treatment to halt the progression of the disease at the present time. However, it is possible to live with it for many years.

The disease affects the muscles that produce movements like walking and talking, and damages parts of the nervous system which leads to muscle weakness. MND most commonly happens to people in their 50s and 60s. However, it can affect people of any age, as in Prof Hawking’s case.

Experts believe that Hawking’s rare slow-progressing form of MND and its early onset were likely to be factors in why he was able to live with the disease into his seventies. Leo McCluskey, a medical director, said his excellent care and the variation (变异) of his disease are likely to have prolonged his life. “The common way people die is of breathing failure. And the other thing is swallowing muscles’(吞咽肌) becoming worse. If you don’t have these two things, you could probably not live for a long time — even though you’re getting worse. What’s happened to Hawking is just surprising. He’s certainly an outlier,” he said.