Mary's parents have been struggling to help her at school. She is 5 years old and is having difficulties with peers and with her teacher. Although she appeared to adjust well to daycare, the grade Kindergarten year has been much more challenging. Her teacher reports that Mary still does not know her numbers and letters, she seems to still need help getting dressed and following the classroom routine, and she does not know how to engage in play with her fellow students. What might a clinician consider as a possible diagnosis?

Autism if she is having difficulty with social relationships, language development, and unusual behaviours.

Oppositional Defiant Disorder if her teacher reports that she is trying to hurt other children and appears to lack any sad feelings about hurting others.

Intellectual disability if she is only having difficulty with school work.

ADHD if she is having difficulties with peers and daily living skills, but not with academics.