Review Question - QID 214523

A 5-year-old girl is brought to the office by her mother due to problems at summer camp. She has not yet started kindergarten but her mother enrolled her at a children’s summer camp 1 month ago. The patient’s summer camp counselor reports that she is very quiet during group activities. She refuses to participate when called upon and remains quiet while other children sing camp songs. During free time, she plays by herself and does not speak to other children. The patient’s mother states that she has not had any similar issues at home. At home, she talks and plays with her siblings comfortably. The patient was born at term with no prenatal or delivery issues. She is able to dress herself, skip, tie her shoelaces, and draw a triangle. On physical examination, she is initially shy during the interview but gradually warms up. She is able to speak fluently in 5-word sentences and exhibits appropriate comprehension. No other physical exam abnormalities are noted. Which of the following is the most likely diagnosis in this patient?