A Blended Family Has Six Children, Ages 2, 4, 4

A blended family has six children, ages 2, 4, 4, 5, 7, and 10. During a visit to the home, the nurse notices that the 7-year-old seems quiet and withdrawn, whereas the other children are playing loudly in the garage. Which of the following conclusions can the nurse make from this observation?

A) This child has most likely been abused.
B) This child is one of multiple children closely spaced in age.
C) This family suffers from low self-esteem.
D) This family provides harsh punishment for their children.