A nurse assisting with the care of a child whose guardians report that the child is consistently unable to speak during class and other social situations. The nurse should identify that the child is experiencing which of the following anxiety disorders?

Choice A reason: Agoraphobia involves fear of being in places where escape might be difficult, often leading to avoidance of public spaces. It does not manifest as consistent inability to speak in social situations. Choice B reason: Separation anxiety disorder is characterized by excessive fear or anxiety when separated from attachment figures. It does not explain the child’s inability to speak in class or social settings. Choice C reason: Generalized anxiety disorder involves excessive worry across multiple domains of life. While it can cause social difficulties, it does not specifically present as consistent mutism in social situations. Choice D reason: Selective mutism is the correct diagnosis. It is an anxiety disorder in which a child consistently fails to speak in specific social situations, such as school, despite speaking normally in other settings like home. The child’s inability to speak in class and social situations matches this condition.