Ease your child's anxieties

Is your child shy? Wondering how to handle it? In "Nurturing the Shy Child," psychologists Barbara Markway and Gregory Markway give parents and educators practical advice to help kids overcome their shyness and anxieties. Read an excerpt.

Because adults represent authority and are in a position of power, it’s not uncommon for children to be uncomfortable and quieter around them. For this reason, to be diagnosed with social anxiety disorder children must demonstrate anxiety with both peers and adults.

My seven-year-old son seems to have no awareness that his fears are unreasonable. Does that matter?

The DSM-IV guidelines for diagnosing social anxiety disorder state that the person must realize that his or her fears are greatly exaggerated. This criterion does not need to be met for children, however. Given their less mature cognitive development, we would not expect them to have insight into the unreasonableness of their fears and reactions.

My child has a bad case of test anxiety. Could this be a part of social anxiety disorder?

Yes. Test anxiety can be a part of the social anxiety spectrum. Drs. Sam Turner and Deborah Beidel, two prominent researchers in the area of social anxiety, found that 24 percent of test-anxious children also met the criteria for social anxiety disorder. If a child has only test anxiety, it is considered a specific form of social anxiety. If the test anxiety goes along with other social fears, it is part of generalized social anxiety disorder. In addition, test anxiety may be unrelated to social anxiety. For example, if a child has a severe learning disability in math, you would obviously expect some anxiety before a math test. Many of the treatment strategies we discuss throughout this book can help children overcome test anxiety.

Shyness and social anxiety in children and adolescents: A very common problem
Shyness in children and adolescents is by no means uncommon. According to Jerome Kagan, Ph.D., a professor of psychology at Harvard University, roughly 10 to 15 percent of kids in kindergarten through eighth grade are very shy, 25 percent tend to be outgoing and sociable, with the rest falling somewhere in between. In a separate study, Bernard Carducci, Ph.D., a shyness expert at Indiana University, has found that the percentage of shy teens is about the same as shy adults—around 40 percent.

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According to Jerilyn Ross, president of the Anxiety Disorders Association of America, about 13 percent of youth aged nine to seventeen suffer from anxiety disorders, making them the most common mental disorder in young people. Depending on the research study reviewed, between 5 and 6 percent of children and adolescents have generalized social anxiety disorder.

In addition, the prevalence of problems that coexist in children with a primary diagnosis of social anxiety is similar to those in adults. A research study conducted by Drs. Beidel and Turner found that in children with social anxiety disorder:

• 20 percent had other specific phobias
• 16 percent had generalized anxiety disorder
• 8 percent had depression
• 16 percent had attention deficit hyperactivity disorder
• 16 percent had learning disabilities

These figures illustrate the fact that children with social anxiety disorder often exhibit numerous problems and complex symptoms. In fact, another respected researcher, Dr. Murray Stein, admits that it can be difficult to diagnose social anxiety disorder in children and thus it’s difficult to obtain a true picture of how many youth are affected. This is because of the numerous interwoven fears some children have. He uses the term “anxious triad” to describe how separation anxiety disorder, generalized anxiety disorder, and social anxiety disorder often overlap in children. We discuss these disorders and their overlap with social anxiety throughout the book and more specifically in Chapter 11.

The spectrum of shyness and social anxiety disorder
As we mentioned, making a diagnosis of social anxiety disorder in children and adolescents is not always simple. Part of what makes it a challenge is that shyness and social anxiety disorder actually exist on a continuum. Let’s look at a number of brief examples.

Shy but basically secure and successful. Sixth grader Vanessa fits into the category of someone who is shy but also someone who is basically secure and successful. She has always been on the quiet side. In fact, every teacher throughout her elementary school years commented that she was “reserved.” She doesn’t like giving oral book reports or having to stand in front of the class, but she is able to do so when required. She has a few good friends, although not a very wide circle. She attends parties of kids she knows well, although she frequently turns down invitations for slumber parties.

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