Social Anxiety Disorder in Children

Social Anxiety Disorder in Children Social Anxiety Disorder Print Social Anxiety Disorder in Children How to Recognize and Treat SAD in Kids By Arlin Cuncic Arlin Cuncic, MA, is the author of Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder and 7 Weeks to Reduce Anxiety. Learn about our editorial policy Arlin Cuncic Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on August 12, 2019 Social Anxiety Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children In This Article Table of Contents Expand Types Symptoms Causes Diagnosis Treatment Tips for Parents View All Children and teenagers with social anxiety disorder (SAD) may live with symptoms into adulthood without ever being diagnosed. Although SAD is the third most common mental health disorder,?? many parents and teachers are not familiar with the signs and symptoms in children and teenagers. Social anxiety disorder involves an intense fear or phobia of social and performance situations. Although most teenagers go through periods of normal anxiety related to the changes that go along with adolescence, those with SAD experience fear that is out of proportion to the situations that they face. For some teenagers, social anxiety becomes chronic, affecting school performance, extracurricular activities, and the ability to make friends. Types Children and teenagers can be diagnosed with a more generalized form of social anxiety disorder or with the performance-only specifier (only performance situations cause anxiety).?? General vs. Performance-Only SAD Symptoms Symptoms in children can vary by age. As a parent or loved one, know that not all of these behaviors necessarily reflect SAD, but if you consistently recognize them and have cause for concern, consider seeking further evaluation with a psychotherapist. Pre-School Children Fear of new thingsIrritability, crying, or whiningFreezing or clingingRefusing to speak?? School-Aged Children Fear of reading aloud or answering questions in classFear of talking to other kidsFear of being in front of the classFear of speaking to adultsFear of musical or athletic performance activitiesFear of ordering food in a restaurantFear of attending birthday partiesFear of having friends visitWorry about being judged by othersRefusal to participate in activities or school?? In addition, children with SAD are more likely than adults to experience physical symptoms like headaches, stomach aches, and nausea.?? Teens Temperament Look for a teenager who... is quietkeeps to him/herselfbecomes more withdrawn if encouraged to talkis hesitantis passiveis overly concerned about negative evaluationfears being embarrassed or humiliatedcrosses his/her armskeeps his/her head downdisplays few facial expressionshas nervous habits such as hair twirling or fidgeting?? School Behavior potentially does poorly in schooldoesnt raise his/her hand in classavoids classmates outside classfears performing in front of others/public speaking fears speaking up in classis uncomfortable in the spotlightsits alone in the library or cafeteriais afraid to ask the teacher for helpis afraid to walk into class latemay refuse to go to school or drop out?? Behavior With Peers is uncomfortable in group settingshas few friendsis afraid to start or participate in conversationsis afraid to ask others to get togetheris afraid to call othersavoids eye contactspeaks softly or mumblesappears to always be on the fringesreveals little about him/herself when talking to others?? Teenagers with social anxiety disorder are at a disadvantage in all areas of life. They may perform poorly at school and may have trouble attending classes. Students with the disorder are also less likely to make friends and participate in extracurricular activities.?? Those with severe SAD may drop out of school or refuse to leave home. In addition, untreated social anxiety disorder in adolescence may lead to increased risk of other mental health problems later in life such as depression, eating disorders, substance abuse, and even suicidal ideation. Causes Just as with adults, social anxiety disorder in children and teenagers may be caused by genetic factors, environmental factors, societal factors, and brain/biological factors. Many parents may blame themselves, but know that its usually a combination of things that cause the disorder. The most important thing you can do know is support the child and help them find help.?? Understanding the Causes of Social Anxiety Disorder Diagnosis Diagnosis of social anxiety disorder in children and teenagers involves an evaluation of symptoms in several contexts. This evaluation will often include the perspective of parents and teachers and may involve the use of school records. Often, children and teenagers with SAD will go undetected because parents and teachers will believe that the child or adolescent is just shy. However, early detection and intervention are crucial in the prevention of long-term impairment. Potential underlying medical conditions are explored and other explanations for the behavior such as bullying are also considered. If the student is at risk of self-harm or suicide, these issues are addressed immediately. The same diagnostic criteria used to diagnose adults also apply to children and teenagers. However, there are some additional caveats. Children and teenagers may not recognize that their fear is unreasonable and their anxiety must be present when interacting with their peers, not just adults.?? How SAD Is Diagnosed Treatment Treatment of SAD in children and teenagers is aimed at helping to alleviate anxiety and allow the student to cope with school and day-to-day functioning. Effective treatments may include the following: cognitive-behavioral therapy (CBT)family therapymedication such as selective serotonin reuptake inhibitors (SSRIs), for example: Paxil, Zoloft, Prozac,  and Xanax?? In addition to standard treatments, there are a number of coping strategies that can be employed by teachers, parents,  and students to manage social anxiety both in and out of school. Schools can play an important role in this process, as it is the place where social anxiety disorder can often have the most negative effect on a teens functioning. School-based interventions led by psychologists, social skills training, and academic skills training are all helpful ways that schools can intervene in cases of SAD.?? As a parent, read about the disorder and increase your awareness of what your teen is experiencing. Be in touch with your school to coordinate efforts with teachers, school counselors, and other personnel. Together, you can work toward improving the situation for a child or teen with SAD. Try One of the 9 Best Online Therapy Programs Tips for Parents As a parent of a socially anxious child, it can be hard to know how best to offer your support. Its important to manage your childs social anxiety in a constructive way. Give your child or teen chances to expose him or herself to feared situations. Dont speak for your child or teen and offer praise when a feared situation is faced. Choose realistic goals for your child or teen such as joining a club or making a new friend. Then, outline steps that can be taken to achieve this goal. Also, encourage activities that help your child or teen to relax such as arts and crafts, music, yoga, and writing. Be a good listener and let your child or teen know that what he or she is experiencing can be overcome. Remind your child or teen of past successes and build his or her confidence. Finally, seek help for your child or teen if anxiety becomes severe. Some problems are too big for you to handle on your own and require intervention such as medication or professional therapy.?? How to Parent Teens With Social Anxiety A Word From Verywell If you have a child or teen who you believe is living with social anxiety, it is important to make an appointment for a diagnosis and potential treatment. The longer this disorder goes undiagnosed, the more impairment your child will experience. By the same token, if you are a teen living with social anxiety, reach out to a parent, teacher, or guidance counselor about the symptoms you are experiencing so that you can receive help.