A teacher is concerned that a 7-year-old girl does not talk in class. She only talks when she is alone or with specific close friends. This scenario is most consistent with which psychiatric condition?

Choice A reason: Rett syndrome is a genetic disorder primarily affecting females, with developmental regression, hand stereotypies, and loss of purposeful hand skills, not selective speaking behavior. Choice B reason: Selective mutism is an anxiety disorder characterized by consistent failure to speak in specific social situations (such as school) despite speaking in other settings. It typically presents in children around age 5–7 and is associated with social anxiety. Choice C reason: Autism spectrum disorder involves social communication deficits, restricted interests, and repetitive behaviors. While mutism may occur, the key feature here is situation-specific silence rather than global social communication deficits. Choice D reason: Rumination disorder involves repeated regurgitation of food and is unrelated to selective speech behavior.