Social anxiety in children

What is social anxiety in children?

Social anxiety typically affects older children and teenagers, but it can also be diagnosed in children as young as four.

Children with social anxiety usually:

are shy or withdrawn
have difficulty meeting other children or joining in groups
have a limited number of friends
avoid social situations where they might be the focus of attention or stand out from others – for example, talking on the telephone and asking or answering questions in class.

Social anxiety can have some physical signs too, including nausea, stomach aches, blushing and trembling.

It’s easy not to notice social anxiety. This is because children who have social anxiety are often quiet and obedient in preschool or school. They might not talk about their fears or worries.

Shyness or social anxiety?
Shyness in itself is not a problem. Many shy children have satisfying, long-term friendships with others and happy and fulfilled lives. Shyness is an issue only when it stops your child from joining in everyday activities like classroom discussions and enjoyable events like parties, or from making lasting friendships. If so, it’s worth doing something about it.

Helping children with social anxiety

If your child is suffering from social anxiety, she’ll need your support. There are lots of things you can do at home with your child, when you’re out in social situations, and whenever you’re talking with your child about her anxious feelings.

At home

Prepare your child for situations that make him feel worried or fearful. Act out the situation at home and practise things he can do to make it easier.
Encourage your child to do some ‘detective thinking’. For example, if she thinks that everyone will laugh at her if she answers a question in class, get her to ask questions like ‘What’s the evidence they’ll laugh?’ or ‘How do I know?’
Tell your child about times you’ve felt anxious in social situations and how you’ve faced your fears. This will help him understand that it’s OK to talk about anxious feelings. He’ll also feel that you understand and support him.

At preschool or school or in other social situations

Gently encourage your child to join in social situations and start new activities. Avoiding social situations will make the problem worse.
Don’t force your child to talk or do things in front of other people. Use gentle encouragement. When you’re with other people, avoid saying things like ‘Come on. Say hello to Jane. Don’t be shy’. If your child has an anxious reaction to a situation, don’t worry. Try the situation again another time with more preparation. Don’t punish or scold your child for ‘failing’.
Try to avoid speaking for your child, because this can make the problem worse.
Tell your child’s preschool, kindergarten or school about her anxiety. Also let them know what you’re doing to help your child. This way, other people in your child’s environment can give her consistent support.

When talking with your child

If your child does something that normally makes him anxious – for example, talking on the phone – acknowledge his bravery with lots of praise. Tell him that you’re proud he’s trying his best. If other people are around, praise him quietly and make a big deal when you’re alone. This helps to foster your child’s self-esteem.
Avoid labelling your child as ‘shy’. If other people comment on your child’s behaviour in social situations, you could say something like ‘Actually, she’s quite outgoing around people she knows well’.
No matter how frustrated you feel, avoid criticising your child or being negative about his difficulty in social situations.

Using the stepladder approach to help with social anxiety

The stepladder approach is a gentle behaviour technique that can be used to help children who suffer from social anxiety. It involves starting small and tackling little things before you face the really scary things.

For example, if your child has trouble talking in front of others, she could start by practising whispers or non-verbal responses at home. Then you could record your child’s answers to rehearsed questions at home, and play the recording back to trusted people like close friends or family while your child is in the room. Then your child could build up to answering those questions in a conversation.

Professional help for social anxiety in children

You know your child best. If you’re worried about his anxiety and feel that it’s affecting his enjoyment of life, consider seeking professional help. Here are some places to start:

your child’s teacher at preschool or school, or a school counsellor
your child’s GP or paediatrician, who will be able to refer you to an appropriate mental health practitioner
your local children’s health or community health centre
a specialist anxiety clinic (present in most states)
your local mental health service.

If your child is aged 5-8 years, she can talk with a Kids Helpline counsellor by calling 1800 551 800, or using the Kids Helpline email counselling service or the Kids Helpline web counselling service.

Financial support for children with social anxiety

Your child might be able to get Medicare rebates for up to 20 mental health service sessions from psychologists, social workers and occupational therapists each calendar year.

To get these rebates, your child will need a mental health care plan from a GP (this covers what services your child needs and the goals of the treatment), or a referral from a psychiatrist or paediatrician. It doesn’t matter how old your child is.

Social anxiety disorder

Around 1-9% of children and teenagers develop social anxiety disorder. This is when a child’s social anxiety has gone on for more than six months and has a significant impact on the child’s life.

Children with social anxiety disorder might avoid many situations that mean they have to interact with other people. These situations include talking on the phone, joining teams or clubs, and answering questions in class. If you feel your child might have social anxiety disorder, it’s a good idea to seek professional help.