A first-grade teacher is concerned about a 6-year-old girl in her class who has not spoken a single word since school started. The little girl participates appropriately in the class activities and uses gestures and drawings and nods and shakes her head to communicate. The parents report 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 likely diagnosis?

a. Autism

b. Expressive language disorder

c. Oppositional defiant disorder

d. School phobia

e. Selective mutism

the answer is below…

The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.

The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.

This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.

The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.

All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.

Medical doctors with an M.D. degree are required to pass this examination before being permitted to practice medicine in the United States of America

The correct answer is e; Selective mutism.[1]

In selective mutism, a child voluntarily abstains from talking in particular situations (usually at school) while remaining appropriately verbal at home. Some children speak only 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 stereotyped 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.