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 neurodevelopmental disorder primarily affecting girls and is characterized by developmental regression, loss of purposeful hand movements, and motor abnormalities. Selective silence in specific settings is not a feature. Choice B reason: Selective mutism is an anxiety disorder in which a child consistently fails to speak in specific social situations (e.g., school) despite speaking normally in other contexts, which aligns with the observed behavior. Choice C reason: Autism spectrum disorder may involve social communication deficits, but children with autism typically demonstrate broader social and behavioral challenges, not isolated selective speech patterns limited to school settings. Choice D reason: Rumination disorder involves repeated regurgitation of food, which is unrelated to speech or selective communication, making it irrelevant in this context.