]> 2026-07-31T07:51:33+00:00 WBR1130 0 en Refer to behavioral pediatrician This is a case of selective mutism and does not need a behavioural intervention. Screen for learning disabilities Consider screening for social phobia Consider screening for selective mutism Selective mutism is by definition characterized by the following: * Consistent failure to speak in specific social situations (in which there is an expectation for speaking, e.g., at school) despite speaking in other situations. * The disturbance interferes with educational or occupational achievement or with social communication. * The duration of the disturbance is at least 1 month (not limited to the first month of school). * The failure to speak is not due to a lack of knowledge of, or comfort with, the spoken language required in the social situation. * The disturbance is not better accounted for by a communication disorder (e.g., stuttering) and does not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorder. * Shyness, social anxiety, fear of social embarrassment, and/or social isolation and withdrawal * Difficulty maintaining eye contact * Blank expression and reluctance to smile * Stiff and awkward movements * Difficulty expressing feelings, even to family members * Tendency to worry more than most people of the same age * Desire for routine and dislike of changes * Sensitivity to noise and crowds. Take the child into your custody and report to child protective services. There is no history suggestive of child abuse. Selective mustism is suspected when the symptoms are restricted to a particular environment and child is otherwise normal.<br/> '''Educational Objective:''' Selective mustism is suspected when the symptoms are restricted to a particular environment and child is otherwise normal.<br/> '''References:''' http://www.wikidoc.org/index.php/Selective_mutism http://www.wikidoc.org/index.php/Learning_disabilities http://www.wikidoc.org/index.php/Social_phobia A 40 years old woman comes to a pediatrician with her 6 year boy. They recently shifted from Houston to Boston. The boy was enrolled in a new school. In a recent teachers-parents meeting, a mother was surprised to learn that boy was keeping quiet in the class. He hardly talked to anybody in the class. He is very reserved with other kids in class. However, mother says that the boy is very social at home and enjoys leisure time with cousins. Which of the following is the next best step in management? A 40 year old woman comes to a pediatrician with her 6 year boy. They recently shifted from Houston to Boston. The boy was enrolled in a new school. In a recent teacher-parents meeting, mother was surprised to learn that boy was keeping quiet in the class. He hardly talked to anybody in the class. He is very reserved with other kids in class. However, mother says that the boy is very social at home and enjoys leisure time with cousins. Which of the following is the next best step in management? D 2020-10-28T02:42:25Z 2459150.6127894 WBR1130