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There are certain phases during childhood in which social anxiety is experienced by a majority of children; it is a very common condition. This phase is not permanent but passes away as the child gets older. However, some children are unable to overcome such anxiety, which may turn into a source of ore serious anxiety disorders.

Social anxiety disorder is usually divided into two main categories: the first one focuses on social performance, which includes abnormalities such as talking in the classroom, and throwing tantrums. The other is targeted on social interactions, such as when the child is afraid of making new friendships, advair commercial actors or has a fear of going to school.

The average age of onset of social anxiety disorder in children is 13 years, but in fact this phobia may start even at the age of 3 or 4 years. Parents need to prioritize early treatment of the condition before it worsens.

Symptoms of Social Anxiety Disorder in Children

Children with social anxiety disorder show some signs and symptoms not seen in normal children. These may be physical, emotional, or behavioral. They include:  

• Excessive crying
• Excessive reliance on parents or caregivers
• Throwing tantrums very frequently
• Avoidance of interactions with friends as well as with adults
• Having problems with meeting other children or mingling with groups
• Fear of going to school and taking part in classroom activities such as responding to teachers, and avoiding participating in school performances and social events
• Showing excessive shyness.
• Having very few friends
• Frequent avoidance of social situations where they might draw attention or have to be in front

Causes

The main causes of social anxiety disorder are explained below in brief:

• Situations where the child fails to perform properly and experiences embarrassment as a result
• Familial social anxiety may occur, when the parents have genetic predispositions to such a temperament, and this sets up the children to experience this later

Treatment Methods

Patients with childhood social anxiety respond well to psychological therapy compared with self-help treatment methods in such children. The main aim of treatment is to change the child’s behavior from provoking the disorder.
The two common techniques of treatment of social anxiety in children are psychotherapy and pharmaceutical therapy.

Psychological Therapy

Psychological treatment may be summarized by the two chief modes of therapy, namely:

• Cognitive behavioral therapy: This type of treatment is very effective, especially for children with anxiety disorder. Here, the term “cognitive” means the process of producing thoughts. Cognitive behavioral therapy works to improve the child’s attitude enabling better coping with the social environment during anxiety-producing situations. This therapy also helps to teach children to overcome their fear and change the structure of their anxious thoughts.

• Exposure therapy is the other technique of treatment under the psychological treatment methods. The therapist gradually exposes the child gradually to situations associated with anxiety. This slowly reduces the intensity of the fear response in the child’s mind. It is an important method which is associated with much success in reducing the severity of social anxiety disorder in children.

Pharmaceutical Treatment

This treatment technique involves the use of medication in order to alleviate the symptoms of anxiety when the child confronts the anxiety-inducing situation. Behavioral therapy is helpful and effective in a subcategory of children. However, drugs such as SSRI (selective serotonin reuptake inhibitors) have been experimented with and have been found to be effective in managing several symptoms of social anxiety disorder. Beta blockers are one category of medication that help in confronting the fear and reducing symptoms such as sweating and palpitation.

Involvement of Parents and Caregivers

Children usually trust their parents. The connection or bond between the child and parents is very strong. So it is very important that parents should participate actively and have the leading role in guiding their children through anxious situations or dealing with the anxiety disorder. To this end, some tips are available to help parents and caregivers to facilitate successful management of this disorder at home, such as:

• Paying more attention to the feelings of the child
• Not punishing the child for mistakes
• Not punishing the child for getting low grades or for lack of progress
• Adjusting one’s expectations of the child during challenging phases of life
• Participating in and enjoying the child’s activities
• Recognizing and also praising even small accomplishments
• Remaining calm when the child becomes anxious about a situation or event
• Making a normal and simple routine for the child’s daily activities, which is flexible enough to be altered in accordance with the child’s progress

To some extent, social anxiety disorders may add stress to family life. Therefore, it will be helpful for parents to build a support network with relatives and friends, or with their peers in similar situations.

References

• https://www.adaa.org/living-with-anxiety/children/childhood-anxiety-disorders
• http://careforyourmind.org/when-young-people-suffer-social-anxiety-disorder-what-parents-can-do/
• https://childmind.org/guide/social-anxiety-disorder/
• https://www.adaa.org/living-with-anxiety/children/tips-parents-and-caregivers
• https://www.healthychildren.org/English/health-issues/conditions/emotional- problems/Pages/Childhood-Depression-What-Parents-Can-Do-To-Help.aspx
• https://www.adaa.org/living-with-anxiety/children
• http://www.jaacap.com/article/S0890-8567(09)63173-7/pdf
• http://raisingchildren.net.au/articles/social_anxiety.html
• https://www.anxietybc.com/parenting/social-anxiety-disorder

Further Reading

• All Social Anxiety Disorder Content
• Social Anxiety Disorder (SAD) – Social Phobia
• When to Get Help for Social Anxiety
• Social Anxiety Disorder History
• Treatment Options for Social Anxiety

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.