Sometimes social anxiety disorder develops after an embarrassing incident.
(See also Overview of Anxiety Disorders in Children and Adolescents and Social Phobia in adults.)
Usually, social anxiety disorder is first noticed when
They may then refuse to go to school or social events. The reason they give is often a physical symptom, such as stomachache or headache.
Children are terrified that they will humiliate themselves in front of their peers by giving the wrong answer, saying something inappropriate, becoming embarrassed, or even vomiting. When the fear is excessive, children may refuse to talk on the telephone or to leave the house.
The diagnosis of social anxiety disorder is based on symptoms, such as crying, tantrums, freezing, clinging, and refusing to speak in social situations. For the disorder to be diagnosed, symptoms must last 6 months or more. Also, children must feel anxious in all similar situations—for example, before all class presentations, not just for certain classes or teachers—and they must feel anxious when interacting with other children, not just adults.
Behavioral therapy is used most often. It involves not allowing children to miss school. Absence makes them even more reluctant to attend school.
If behavioral therapy is ineffective or children will not participate in it, a drug that can reduce anxiety, such as a selective serotonin reuptake inhibitor (SSRI), may help. The drug may reduce anxiety enough to enable children to participate in behavioral therapy.