Suamasi, an Eight-Year-Old Student from Pakistan, Avoids Eye Contact with Adults

Suamasi, an eight-year-old student from Pakistan, avoids eye contact with adults in her classroom. Suamasi also avoids personal involvement with any adult. Suamasi will not answer questions presented to her by the teacher. Consequently, the teacher is concerned about Suamasi's behavior. Should Suamasi be referred for consideration of emotional disturbance?

A) No, the behavior is age appropriate.
B) Yes, the behavior is frequent and intensive.
C) Yes, the behavior occurs to a marked degree
D) No, the behavior may be connected to cultural issues.