Q&A -- Social Anxiety in a 3-year-old

Julie recently sent us this question:

Is it possible for a 3-year-old to have social anxiety?

My son turned 3 on August 12.  He does not like to play with other children.  I understand the concept of "parallel play," but I don't think this is a case of "he's just content to parallel play with kids."

When we get ready to go to the park, he says, "I hope there aren't any other kids there."  When I ask him why he doesn't want there to be other kids there for him to play with, he says either "The kids don't like me," or "I don't like kids."

This summer, I tried to take him to Bible School.  On the ride over, he kept saying, "I'm so excited to go to school."  He completely understood that there would be a teacher there and he said, "I know I have to listen to the teacher."  He then asked if there would be kids there.  When I said, "yes," his whole expression changed, like he was terrified of the thought that there would be other kids there. 

The minute we got to the registration table, he was completely overwhelmed and had a major meltdown.  I took him to the room for the 3-year-olds and introduced him to the teacher and tried to get him to sit on the rug with the other kids.  My son ran out of the room crying and didn't want anything to do with the teacher or the kids.  I told him I would stay with him, but he kept saying, "let's just go, Mama.  I don't want to stay here."  He wouldn't even sit on my lap with me on the rug while the teacher started the lesson.  He is registered to start preschool this fall, and I know that the scene above is destined to be replayed if I don't figure out how to handle his "anxiety."

Also, you should know by way of background that I'm working mom.  For two and half years, my son attended an in-home daycare situation where there were other kids for him to play with.  He was generally fine going there.  Occasionally, he'd have phases of separation anxiety, but nothing I ever thought was abnormal.  I had another baby last fall, so for the last 6 months, we've had a nanny.  He does not have the day-to-day interaction with other kids his age, but we do spend time with kids in the neighborhood, and he goes to the library, the pool, the park, etc., where there are other kids, but he never wants to interact with them.

Julie, there isn't a whole lot of literature on social phobia in young children.  What I can tell you, though, is that it's very common for preschoolers aged 3 to 5 to exhibit anxiety, especially social anxiety (Spence, Rapee, McDonald, & Ingram, 2001).  And, a child with a shy temperament is more likely to have more social fears than kids who are more active and extroverted (Lieberman, 1993).  Temperamentally shy children tend to be highly sensitive to stimulation, they require time to gradually adapt to change, and they usually try to avoid anxiety-inducing situations. 

What's interesting is that your son worries about interacting with other kids prior to their even being present.  This worry and his comment that "kids don't like me" suggest he may be concerned about being judged by them. Being judged is a major fear for people diagnosed with Social Phobia, an anxiety disorder that typically emerges during the mid-teen years but can emerge in early childhood.  BUT -- being judged is also the reason behind social fears in older preschoolers, generally aged 4 to 5 years (Spence, et al., 2001).  Also, children suffering from SP typically have the capacity for social relationships with familiar people of all age groups and only fear strangers -- but again, from all age groups.  In fact, playing with other kids is a social situation children diagnosed with SP usually don't fear (Chandler).  So, it's also interesting that your son was excited to meet his teacher for the first time and was only distressed at the thought of meeting his peers. 

(Obviously, I don't know whether or not your son has a shy temperament or Social Phobia, but I thought information regarding both might be useful to you.)

Now, having said all that, to help your son with his transition to preschool, I suggest providing him with gradual exposure to peer social situations before school begins.  Gradual exposure is not only helpful for temperamentally shy children, it's also a very common and highly effective behavioral treatment for people experiencing phobias. 

You could start the exposure by inviting a neighborhood child (or, even better, a child he'll be attending preschool with) and his or her parent over for a play-date.  Tell your son in advance of the play-date.  If he expresses worry, try to talk with him about it without pressuring him.  Also, don't tell him there isn't anything to be worried about.  Instead, just listen to him and tell him that the two of you will work through his concerns together.  You can say something along the lines of, "I don't know what's going to happen during the play-date, but why don't we just see what happens, and if you feel uncomfortable, I will be here the entire time and we can talk about it."  You want to validate his feelings while providing reassurance.

Have someone else watch your baby so you can give your son your full attention and support while he's experiencing this possible anxiety-inducing situation.  You may also want to have your husband there to entertain the visiting parent if necessary.  When the child and parent arrive, have toys available so the visiting child can begin playing.  Suggest to your son that he play with the toys as well but don't suggest he play with the child.  If he refuses the toys, tell him it's okay, he doesn't have to.  But try keep him in the same room as the visiting child.  If the stress proves to be too much for him, give him time to calm down and talk through his concerns a bit, but then tell him you need to visit with the guests.  Give him the option to play by himself in the other room or visit.  Giving him this option shows support and provides quiet encouragement since he may want to be near you.  If your son opts to stay near you and watch the other child with the toys, this is good.  Watching is actually considered another type of play in and of itself and is referred to as onlooker play. 

As the visit continues, see if your son's anxiousness dissipates at all before your guests leave. Then, a day or two later, try another play-date with the same child, if possible. 

From there, you can try taking him to the park where there are more kids.  Again, have someone else watch your baby, so you can provide your son with your full attention and support.  If he chooses to only watch the other kids play, as I said earlier, this is good and normal.  He just may not be ready to engage in associative play (wherein two or more kids interact together).  Again, observe his anxiousness level before arriving at that park and see if it dissipates prior to leaving it.

In all these situations, document his behavior so you can see if there's any improvement.  You may find that with each exposure, it takes less time for his anxiety to dissipate.

This gradual exposure may show him that other children aren't scary, which will help him when he starts preschool.  Also, before school starts, talk to his teacher about his situation so s/he can provide your son support as he makes the transition.  He will most likely still have a meltdown when he starts school, but having the gradual exposure first may lesson the occurrence of those meltdowns. 

If, however, you feel your son's response to these situations is extreme (absolutely refusing to go to go to the park, or school every single time), then you may want to have a child psychologist evaluate him.  Behavioral interventions with phobias are highly successful -- especially with children. 

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Spence, S.H., Rapee, R., McDonald, C., Ingram, M. (2001).  The structure of anxiety symptoms among preschoolers.  Behavior Research and Therapy, 39, 1293-1316.

Comments

[Chelsea]

I love how well laid out your advice is and that you reference other experts in your work. It gives a reader confidence that what you are proposing/ suggesting has some "meat" to it.

My son is still very small and so this doesn't apply yet but I've mentally filed it away to use at a later date!

Thank you for taking the time to answer so thoughtfully, I love checking in here to see what you have to say!

[lacey]

I believe that my daughter may also have social phobia. She is 3 years old and ever since the age of two has been very shy. Especially when an entering a room full of people and especially other children. I am not sure how to handle or help her...

[Eileen D]

I have a 3 year old son who is having the same issues. He cries at parties, parks, even his grandmothers. Anytime there are kids around. I just starting looking into a child therapist to see what can be done.
I just feel so bad for him.
If he/she gives me information to share......I will keep you posted.

[Eileen D]

I have a 3 year old son who is having the same issues. He cries at parties, parks, even his grandmothers. Anytime there are kids around. I just starting looking into a child therapist to see what can be done.
I just feel so bad for him.
If he/she gives me information to share......I will keep you posted.

[baby blues]

I'm diagnosed with social phobia and I clearly remember how (in my early childhood years) I used to fear the other children, but loved teachers and other grownups (even strangers)!

[Andrea H.]

I have a 3 year old daughter who seems to display heightened anxiety when we have playdates with children her age. She tends to want me to hold her the majority of the time, often cries and shows no interest in interacting with her peers. I have a hard time getting together with other moms who have children the same age because it takes so much of my time and energy to try and calm my daughter and engage her in an activity with another child. It is interesting though that she loves older children and adults. She feels very comfortable interacting with children older than her (elementary school age or older) but to get her to interact with children her age is like pulling teeth, painful to both her and me.

[Kelly]

My 3 (almost 4) year old son exhibits anxieties when he is around a group of children (e.g., tee ball, preschool). He will mention to me that "the kids don't like me or they won't be my friend." However, he does remarkably well when he is with one other child. It seems that entering group situations with children really stresses him out, but he feels more confident when he's with only one or two friends. I don't really know what to make of this?

[Marjie Braun Knudsen]

I found it difficult to find good fiction books for my school age son with social anxiety. My friend, a child psychologist, suggested we write together. The following book is the start of a series of books on different anxiety related issues and most importantly, help and understanding for kids with social anxiety.
Publication Date: Aug. 1, 2008:

BRAVE: Be Ready and Victory’s Easy, A Story About Social Anxiety by Marjie Braun Knudsen & Jenne R. Henderson, Ph.D.

A story about a fifth grade boy learning to manage his fears of social situations and criticism. He uses the acronym BRAVE, which stands for "be ready and victory's easy," to plan ahead for difficult situations at school and home.

“This book will appeal to kids of every age. It is informative, but also funny. Many kids will relate to Danny’s experiences. Reading BRAVE will help kids with social anxiety feel less alone and give them hope for the future.”
James J. Crist, Ph.D., author of What to do when You’re Scared & Worried

ISBN: 978-0-9815759-0-2
Price: 11.95
Distributor: Baker & Taylor and Summertime Press

This book is currently available for pre-sale at Barnes & Noble online, and can also be viewed on the web at: http://www.summertimepress.com.

[Marjie]

The book BRAVE: Be Ready and Victory's Easy, A Story About Social Anxiety
is currently sold out at Amazon, B&N, and there is one left at Powells. It is in stock at the website www.summertimepress.com.
The bookstores should have more soon.

[KattyK]

My son is almost three and just started really freaking out around other children. He cries and wants to leave at playgroup and will cover his ears in any situation when there are children. He loves adults and at home he's so happy and outgoing and full of fun. But recently he would be paralyzed with fear even in places he associates with children like Toys R Us and the park. I work from home and have a live in nanny so he has lots of interaction with adults, but not so much with other children. He has been going to the playground ever since he was 1 year old and loved it until just about two weeks ago. I'm glad to see your suggestions and also the comments of the other moms. I feel so bad for him and I thought he was the only one. Thanks for all the comments.

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my son is 3 years and 8 months he has social anxiety and i don't thing the therapy makes a big diferent with him.
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[Jodie]

Well written and informative. But I was amazed at the last few comments where parents are quick to resort to medications. Before you do the lazy thing and get your kid hooked on a drug that will no doubt lead to benzo addiction or dependence later in life, please look into therapy, small play groups or other non medicinal options. The only thing I'd recommend is Bachs "rescue remedy" which is a homeopathic remedy known to naturally help calm anxiety. Please avoid drugs unless absolutely neccessary. Starting kids on "calm-me-down" drugs is paving the way to substance abuse.

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[Yvette]

I grew up with social anxiety and was not diagnosed til 21 years old. I look back at all the years of failed friendships and skipping out of class to avoid people and speaking situations. The psycho-therapist was very helpful and gave my exercises for breathing and changing my thinking. Later, I started Paxil and that really worked as well. Now, I am a Speech Pathologist and had to give speeches in school every week and was able to do it without drugs but good thinking skills and also preparation for the speech was key...diaphragmatic breathing is always helpful.
Now, I am noticing social anxiety with my 4yr old with groups and with some kids that he is intimidated by (those that are naturally confident) we practice breathing and positive thinking. I did buy some books for social anxiety but he doesn't really care for them...will try the Brave book......thanks for this site:)