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It's not unusual and, in fact, it is normal for children under the age of three to exhibit anxiety when separated from their main caregivers. About the time they begin to make friends and attend preschool, this anxiety usually dissipates. However, for some children, anxiety in social situations remains, which can impede their social development and academic success.
Social Anxiety Defined
Children with social anxiety or social phobia exhibit fear in social situations, such as play dates, family gatherings, religious events, childcare and preschool. Children with social anxiety not only resist and avoid social situations, they often show signs of anxiety in anticipation of an event. Symptoms of social anxiety in preschoolers include:
- Few friends outside of family
- Clinging to caregiver
- Immobility (e.g., forcing the caregiver to carry the child)
- Somatic issues such as stomach or headaches
- Difficulty sleeping
- Excessive worry or fears
A 2009 study in the Journal of Child Psychology Psychiatry found that 15 percent of children ages five months to five years exhibited anxiety and depression, and that these children were more likely to have mothers who also suffered from anxiety or depression. While it wasn't clear whether the development of anxiety was based on environment or a genetic predisposition, the author indicated the results suggested a need for early identification and intervention.
Another factor in identifying anxiety in young children was temperament. Infants who were described as having a difficult temperament were more likely to meet the diagnosis of anxiety as a young child.
Children who have an impairment, physical disability or other characteristic that makes them feel different are also at risk for social anxiety. Children who are laughed at or teased learn to associate social situations with pain.
Finally, some children develop social anxiety after a traumatic event such as experiencing something scary or embarrassing in a social situation.
Unfortunately, parents and other adults in a child's life may sometimes dismiss the symptoms of anxiety as manipulation or irritating behavior. However, studies suggest that failing to treat childhood anxiety can lead to learning and behavior problems. Experts indicate that untreated social anxiety can lead to social dysfunction, poor academic results, truancy, major depression and substance abuse.
Fortunately, the prognosis for treating social anxiety is good, especially if it is identified and treated early. The first step in helping a preschooler with social anxiety is for parents and caregivers to understand the anxiety and not belittle or shame the child. Parents can offer support and encouragement to help children face their fears. They can teach their child to use words to articulate and understand their feelings.
The American Academy of Child and Adolescent Psychiatry warns that anxiety that interferes with a child's functioning should be treated by an expert. There are a variety of treatment methods, including teaching coping skills through cognitive therapy. This, along with learning how to use relaxation techniques, can help children recognize and deal with their feelings. Other forms of therapy look at family dynamics and provide interventions to family behavior that might be producing the anxiety.
In serious cases, prescription medicine can be used to reduce anxiety. However, any medication should be used in conjunction with another form of therapy that allows for the development of essential coping skills.