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Phillip is a 5-year-old boy who is in care after being referred for failure to speak at school

Phillip is a 5-year-old boy who is in care after being referred for

failure to speak at school. He has been in kindergarten for 5 months, and initially his teacher thought he was just shy, so she did not focus on him. However, it has become increasingly apparent that he flat out will not speak at school. Phillip’s parents are adamant that there is not any problem at home and that Phillip talks with them and his older sister routinely. Further assessment reveals that he has always been extremely shy and that he doesn’t like it when people make a fuss over him. The PMHNP suspects that Phillip has selective mutism, which is closely related to:

A. A history of sexual abuse
B. Fetal alcohol syndrome
C. Early onset schizophrenia
D. Social anxiety disorder

 
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