intermediateselective mutismpediatricanxiety disordersASD differentialspeech-language disorderDSM-5 criteriachild psychiatry
A 6-year-old girl speaks normally at home with her parents and siblings. At school, she has not spoken a single word in 4 months despite appearing to understand instructions and participating nonverbally. Her teacher reports she nods, points, and writes answers but will not speak. Her developmental milestones were normal. Her parents say she has "always been this way at school." What is the MOST likely diagnosis?