Social Anxiety In Toddlers
Toddlerhood is defined as the age range from 12 to 36 months. During this period, a childs emotional and cognitive development grows by leaps and bounds, as do their social skills. This also coincides with the time when children are likely to go into a daycare environment or head off to preschool. As they engage more often with other children and adults, it may also be the stage when a toddlers social fears begin to emerge.Just as with adults, some children are comfortable with social interactions while others may not be. Each group of kids will have the social butterfly as well as the shy child who quietly observes and doesnt interact as much. It is one thing to be shy, however, and another to be intensely fearful and anxious in a social setting. Because we know it can show up early in life, a toddler who shows such strong reactions in a social environment is often regarded as having social anxiety.
When Should I Talk To My Doctor About Social Anxiety
First, it’s important to know that you are not abnormal if you have social anxiety. Many people have it. If you have unusually high anxiety and fear about social situations, talk openly with your doctor about treatment. If left untreated, social anxiety disorder may lead to depression, drug or alcohol problems, school or work problems, and a poor quality of life.
The Connection With Learning And Thinking Differences
Kids with learning and thinking differences can struggle with unstructured social interaction. They may get confused by the words people are using. They may misread body language or other subtle social cues.
As a result, they may get anxious and withdraw from the situation. Its social anxiety, but its caused or made worse by the underlying learning or thinking differences. Here are a few examples:
- ADHD: A child may blurt out something inappropriate. A negative reaction from classmates may lead that child to start avoiding group conversations.
- Dyslexia: A child may try to avoid reading aloud in class by asking to go to the bathroom or to the school nurse. Separation from class can reinforce the fear of reading aloud. The longer kids with reading issues go without effective reading interventions, the more likely they are to develop social anxiety.
Each time kids are in a situation where they dont believe theyll be successful, their brain interprets that as a threat and says, Lets get out of here. Their fear centers activate. The part of their brain that controls their executive functions shuts down.
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Targeting Children’s Anxiety And Autonomy
This brief integrative review has highlighted the importance of granting autonomy to youth and that specific parenting behaviors observed within SAD samples may restrict such autonomy. Perceived competence has been found to moderate the relationship between low autonomy granting and child emotional reactivity, and children who perceive high self-control over adverse life events report less anxious reactivity and more use of emotion regulation skills, such as problem solving . It therefore follows that increasing autonomy among at-risk youth may prove particularly effective in preventing or ameliorating symptoms of SA. In support of this notion, family cognitive behavioral therapy , has been found to increase autonomy granting parenting and decrease overprotective parenting , which may have significant promise for use among parents with SAD. Of note, previous research on the efficacy of FCBT on decreasing child anxiety found that adolescents, 13 years and older, improved less on anxiety symptomatology as compared to younger children ages 8â12 , therefore providing further support for early intervention. In addition to FCBT, children with ADHD and comorbid SAD may wish to pursue treatments targeted at increasing executive functioning, such as âUnstuck and on Targetâ . Incorporating such treatment methods may increase social communication skills, thus decreasing feelings of inadequacy and promoting an increased sense of self-control.
Medication And Socially Anxious Infants And Toddlers
It is considered best practice to not give medication to children under the age of 5, except in extreme cases. Social anxiety does not typically warrant medication at this age. Young children are sensitive to the effects of medication. Medicating too early may cause unwanted side effects. If the anxiety persists when the child is older, consult a professional about the next step for treatment.
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Targeting Parenting Behaviors And Anxiety
As noted earlier, parents with SAD have been found to demonstrate low warmth toward their offspring , which may potentiate anxiety symptoms. Therefore, treatment programs promoting parental warmth may prove particularly effective. In support of this notion, âTuning in to Kidsâ has been proposed as an early intervention parent training program that improves emotional socialization practices in parents with preschool aged children. Parents participating in TIK for six sessions reported increased emotional awareness and regulation, increased emotional coaching of their child, and decreases in emotionally dismissive behaviors . Similarly, in a study using TIK for Dads , fathers reported a greater use of expressive encouragement and empathy, and increased prosocial skills in their children . Thus, adaptations of these parent training approaches have the potential to act as a protective factor against youth social avoidance and anxiety by increasing prosocial behaviors in youth via parent’s use of empathy and encouragement.
Where To Get Help For Anxiety
An appointment with a GP is a good place to start.
You can talk to the GP on your own or with your child, or your child might be able to have an appointment without you.
If the GP thinks your child could have an anxiety disorder, they may refer them for an assessment with your local children and young people’s mental health services .
Specialist CYPMHS are NHS mental health services that focus on the needs of children and young people. CYPMHS workers are trained to help young people with a wide range of problems, including anxiety.
If your child does not want to see a doctor, they may be able to get help directly from a local youth counselling service. For more information, visit Youth Access.
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Anxiety In Children Is Caused By Frightening Experiences And Events
The development of anxiety in children is linked to a situation or perceived event that is frightening or traumatizing. For example, Sarah’s parents contacted me, frantically stating that their five-year-old daughter no longer wanted to go to school. She was clinging to her mother, crying, and was inconsolable at school for the first hour or so. They were not sure what had happened or why their daughter was so upset all of a sudden. In further discussion, it turned out that their daughter had watched her friend’s mother being taken to the hospital by an ambulance in her neighborhood. Her parents didn’t think that this would affect her, as their neighbor was fine and returned home that same day. However, their five-year-old daughter was traumatized by this experience and believed that if she went to school, the same thing may happen to her mother. As a result, she wanted to stay home and make sure that her mother was okay. Take note that this experience was observed and did not directly impact her or her family. However, for children, the frightening experience may be indirectly experienced or observed and still strongly affect the child.
Diagnosis And Treatment Of Social Anxiety
A pediatrician or pediatric psychiatrist will diagnose social anxiety based on the toddlers signs and symptoms noted by the parents. Some amount of social anxiety is normal in toddlers. A child psychologist will examine the following factors to diagnose social anxiety disorder .
- The toddler displays extreme anxiety during social situations and constantly fears being ridiculed by those around them.
- The toddler always avoids at least one social situation with extreme resistance. If the toddler is forced into the social situation, they display severe distress and physical symptoms.
- Social anxiety interferes with the toddlers social development and normal activities, such as attending playschool, making friends, and interacting with other people.
Normal social anxiety does not require treatment. Social anxiety disorder could be treated through various methods, depending on the toddlers age, the triggering factors, and the presence of other issues.
A good child psychologist will first assess the case for severity and later, starts with a series of therapies to help your child
Cognitive behavioral therapy is the most common treatment method used to help the toddler get over social anxiety . The therapy contains several lifestyle-related interventions customized to meet the toddlers requirements. Parents are involved and are guided on ways of helping the toddler manage triggers and reduce anxiety. The therapy helps in the improvement of social anxiety disorder eventually.
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Types Of Clinical Therapies That Treat Anxiety
We treat social anxiety with a combination of neurofeedback and psychotherapy. With our BrainBehaviorReset Method. It is imperative that central nervous system be calmed, so a child or teen with social anxiety can be calm enough to do the work in psychotherapy to address their anxieties and worries.
You can get her books for parents and professionals, including:Its Gonna Be OK: Proven Ways to Improve Your Childs Mental Health, Teletherapy Toolkit and Brain Under Attack: A Resource For Parents and Caregivers of Children With PANS, PANDAS, and Autoimmune Encephalopathy.
Are you a professional who wants more training from Dr. Roseann?
Purchase her book, Teletherapy Toolkit: Therapist Handbook for Treating Children and Teens.
If you are a business or organization that needs proactive guidance to support employee mental health or an organization looking for a brand representative, check out Dr. Roseannsprofessional speaking page to see how we can work together.
Dr. Roseannis a Childrens Mental Health Expert and Therapist who has been featured in/on hundreds of media outlets including, CBS, NBC, FOX News, PIX11 NYC, The New York Times, The Washington Post,, Business Insider, USA Today, CNET, Marth Stewart, and PARENTS. FORBES called her, A thought leader in childrens mental health.
How Is Social Anxiety Diagnosed
Since no specific psychological or laboratory social anxiety test exists, a mental health professional needs to diagnose Social Anxiety Disorder as part of the clinical interview process. . During intake, the trained clinician can assess the presence of excessive and irrational worry, as well as their impact on that childs or individual’s life and functioning.
At our center with use a QEEG brain map or brain check in the intake process to understand exactly how the anxiety is impacting the brain, so we can recommend the right type of therapy and make a customized treatment plan.
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Helping A Child With Social Anxiety Disorder
Shyness is a universal experience. So does that mean social anxiety disorder is no big deal? Not really. Theres a distinction to be made here. Shyness and social anxiety are two different things. Shyness is a normal experience, but anxiety can be a source of tremendous suffering for the child and can pervade the entire family.
Definition Of Social Anxiety Disorder
SAD is extreme fear and anxiety in social situations leading to significant levels of distress . Social situations may include carrying on a conversation with another person, public speaking, or eating a meal. A person with SAD fears acting in a way that will offend someone, humiliation from exposing anxiety symptoms in public, and scrutiny and negative evaluation from others . The marked level of distress experienced by someone with SAD is often out of proportion to the actual situation . Avoidance or anxious anticipation of the feared situation is common . In young children, social anxiety symptoms may include severe and prolonged crying episodes, becoming physically immobilized, shrinking away from others, excessive clinging, or being unable to speak in social situations .
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Social Anxiety In Children: Helping Children With Social Phobia
Social anxiety, also known as social phobia, commonly begins at age 10. While some people think social anxiety in children is simply “extreme shyness,” this is not the case. Social phobia in children is a recognized mental disorder and goes beyond mere shyness .
According to the latest version of the Diagnostic and Statistical Manual of Mental Disorders , the criteria for social anxiety in children includes:1
- Distinct and persistent fear of one or more social or performance situations with peers
- Exposure to feared situation produces anxiety. In children with social anxiety this may be tantrums, crying, freezing or shrinking away.
- Feared situations are avoided
- The social anxiety symptoms interfere with normal day-to-day life
- The duration is longer than six months
Social phobia in children is also related to selective mutism where a child cannot or will not talk in certain situations.
The causes of social phobia in children are unclear only theories are currently available. Social anxiety in children may be due to:
- Dysfunction in the pathways of the brain chemical serotonin
- Dysfunction in a part of the brain known as the amygdala
How Are Anxiety Disorders Diagnosed
Anxiety disorders can be diagnosed by a trained therapist. They talk with you and your child, ask questions, and listen carefully. They’ll ask how and when the child’s anxiety and fears happen most. That helps them diagnose the specific anxiety disorder the child has.
A child or teen with symptoms of anxiety should also have a regular health checkup. This helps make sure no other health problem is causing the symptoms.
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Some Tips To Spot When Social Anxiety Disorders In A Child Are Serious
Shyness can make childhood difficult, but most grow up and out of it. However, for children with social anxiety disorder waiting to outgrow it will only make things worse. But what is the difference between being an introvert and having this disorder? What can parents do to help their child if they suspect social anxiety disorder.
What Does It Feel Like
Again, the experience may be different for everyone, but if you have social anxiety and youâre in a stressful situation, you may feel:
- Very self-conscious in social situations
- A persistent, intense, and chronic fear of being judged by others
- Shy and uncomfortable when being watched
- Hesitant to talk to others
- The need to avoid eye contact
You also might have physical symptoms such as:
- Rapid heartbeat
- Inability to catch breath
- An âout-of-bodyâ sensation
You may start having symptoms and getting anxious immediately before an event, or you might spend weeks worrying about it. Afterward, you could spend a lot of time and mental energy worrying about how you acted.
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When And Where To Seek Help If Your Child Has Social Anxiety
If you feel you need help to support your child and help them manage things better, a family coach can help. If however whats going on is causing distress for your child or you, see a healthcare professional.
Hows Roxanne doing now?
Roxanne has, with professional help, developed some ways to calm herself down. Her parents too got lots of advice on how to help her. Shes figured out that she can overcome her challenges, one step at a time. With each success, shes become more self-confident. She understands that fear is an enemy she can beat.
If your child, like Roxanne, has social anxiety that persists despite all your support, take the next step and see a healthcare professional as soon as possible.
Fortunately, with persistence and the right help, things can get better. By learning to face their fears, children develop skills and attitudes that will serve them for the rest of their lives.
How To Help Your Child Cope With Social Anxiety Disorder
The best first step to help your child cope with it is to name it. Children with social anxiety disorder know that they feel fearful and anxious in social situations, but they dont always know why. Helping them connect the dots between emotional responses, physical symptoms, and triggers is an important first step toward learning to cope. Educating your child about the ways in which anxiety impacts thinking and behavior is a powerful lesson in learning to work through negative emotions.
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How Can It Affect Your Life
Social anxiety disorder prevents you from living your life. Youâll avoid situations that most people consider ânormal.â You might even have a hard time understanding how others can handle them so easily.
When you avoid all or most social situations, it affects your personal relationships. It can also lead to:
- Low self-esteem
- Poor social skills that donât improve
Social Anxiety Treatment At Home
For social anxiety symptoms that appear mildor that seem to have a direct cause, like social isolation from the COVID-19 pandemic Dr. Franklin recommends communication and preparation. For example, if your child is nervous about summer camp after a year of virtual schooling, you can help by giving detailed descriptions. Knowing what to expect can make a huge difference, says Dr. Franklin.
You can also try addressing your child’s fears directly. Ask them exactly what’s making them nervous, then brainstorm solutions accordingly. For example, if they’re worried about talking to other campers at lunch, come up with some go-to conversation topics beforehand. Also teach your child ways to self-soothe in case anxiety hits .
Although you want to protect your child, don’t let them avoid their triggers altogether. Ordering their meal at a restaurant might not seem like a big deal in the short term, but it actually reinforces their fears. To overcome this worry, your child can try taking baby steps: They can start by saying “thank you” when the waitress drops off their meal. Then, after a few weeks, they can order their own drink. Eventually they might feel comfortable ordering their whole dinner.
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