ABSTRACT
This chapter presents a case of a 10-year-old girl who is brought to her general practitioner by her mother. Her mother says that she has always been shy, but her school reports that she has not spoken in class for several months. At school she has one close friend who she plays with at playtime but no other real friends. She will happily get on with her work and follows instructions. She takes a packed lunch to school and it is always finished. A referral to a child mental health professional seems likely and they would be able to explore this problem further in individual or family work. Many children, however, seem to develop this condition without any specific trauma, and it is likely that genetics and temperament play a part. Treatment should be instituted as early as possible, as the longer the problem continues the more difficult it may be to achieve improvement.
