A first-grade teacher is concerned about a 6-year old girl in her class who has not spoken a single word since school staed. The little girl paicipate appropriately in the class activities and uses gestures and drawings and nods and shakes her head to communicate. The parents repo that the little girl talks only in the home and only in the presence of her closest relatives. Which of the following is the most appropriate diagnosis?

In selective mutism, a child voluntarily abstains from talking in paicular situations (usually at school) while remaining appropriately verbal at home. Some children only speak with their parents and siblings and are mute with relatives and friends. Children with selective mutism do not have a language impediment, nor do they display the lack of social interactions, lack of imagination, and g behavior characteristic of autism. On the contrary, they can be quite interactive and communicative in a nonverbal way, using drawing, writing, and pantomime. Children with school phobia refuse to go to school but do not have problems communicating through language. Oppositional defiant disorder is characterized by persistent refusal to follow rules and defiance toward authorities, not by failure to speak.