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Child Behavior (Expert Forum)
4 yr old son's social anxiety
Answered by
Kevin Kennedy, Ph.D. - Child and Adolescent Psychotherapy, Family Therapy, Crisis Intervention
Harvard Vanguard Medical Associates
This forum is for questions and support regarding child behavior issues such: Child Discipline (behavior management), Normal Child Development, Parent-Child Communications, Social Development
4 yr old son's social anxiety
by joeboxford, Mar 13, 2006 12:00AM
I wrote last year about potential Sensory Integration issues with my 4 yr old son. We had an eval done, with nothing significant found (minor fine motor issues). Recently we were relieved(?) to learn that his hearing was very poor (something that we should have checked prior to the SI eval). He just had tubes put in his ears and things seem to have improved. Nonetheless, we still have a few concerns with his levels of anxiety.
We had a recent conf with his preschool teachers. They are saying that he continues to withdraw from other kids, is afraid of strangers (to the point of hiding under a table once), does not handle transitions well and is not interested in many of the activities. He also has picked up a habit of clapping when he is annoyed (loudly).
At home and out of school he seems to interact fairly well with other children. He takes skating and swimming lessons and seems to enjoy it. He does clap now and then but it seems to be a nervous habit that occurs when he is excited. On the anxiety front though, there are a few things that are a worry:
1. He rarely sleeps through the night and is afraid of being alone.
2. He wants to sleep with mom and dad and not in his own bed. Whenever he doesn't sleep through the night he comes into our room and joins us (we sometimes take him back, other times do not).
3. He does not want to go to school. He used to love school but now he does not seem to care for it.
4. He sometimes says he doesn't want to go to parties.
5. At a recent party, another kid pushed him down and he became panicked, crying and pleading to leave (obviously fearful for his safety). I had to carry him from the party and talk him down (took approx 5 minutes) before he would return. In several other instances when he has done something wrong in front of starangers, he becomes overly embarassed and breaks down crying.
6. If his mother and I need to go out and leave him with others (even his grandma) he breaks down crying.
7. He is sometimes petrified of strangers. This seems like a regression as I can remember about a year ago when he thought nothing of breaking into conversations with complete strangers about their dogs.
8. He is currently afraid of going out of the house without a parent (Again a regression from when he previously went out on his own frequently).
9. He hates to lose to the point that he cannot even tolerate falling behind in a game lest he start crying. (fear of failure)?
The school is still concerned about sensory issues but I'm concerned that this is more of an anxiety problem and that we may be wasting time going back to that well. My son is 4 yrs and 8 months old now. At the age of three I would have predicted my son to be a social butterfly. During the past year he just seems to have become introverted and anxious. How concerned should we be? Is more SI evaluation worthwhile? Should we be speaking to someone else?
We had a recent conf with his preschool teachers. They are saying that he continues to withdraw from other kids, is afraid of strangers (to the point of hiding under a table once), does not handle transitions well and is not interested in many of the activities. He also has picked up a habit of clapping when he is annoyed (loudly).
At home and out of school he seems to interact fairly well with other children. He takes skating and swimming lessons and seems to enjoy it. He does clap now and then but it seems to be a nervous habit that occurs when he is excited. On the anxiety front though, there are a few things that are a worry:
1. He rarely sleeps through the night and is afraid of being alone.
2. He wants to sleep with mom and dad and not in his own bed. Whenever he doesn't sleep through the night he comes into our room and joins us (we sometimes take him back, other times do not).
3. He does not want to go to school. He used to love school but now he does not seem to care for it.
4. He sometimes says he doesn't want to go to parties.
5. At a recent party, another kid pushed him down and he became panicked, crying and pleading to leave (obviously fearful for his safety). I had to carry him from the party and talk him down (took approx 5 minutes) before he would return. In several other instances when he has done something wrong in front of starangers, he becomes overly embarassed and breaks down crying.
6. If his mother and I need to go out and leave him with others (even his grandma) he breaks down crying.
7. He is sometimes petrified of strangers. This seems like a regression as I can remember about a year ago when he thought nothing of breaking into conversations with complete strangers about their dogs.
8. He is currently afraid of going out of the house without a parent (Again a regression from when he previously went out on his own frequently).
9. He hates to lose to the point that he cannot even tolerate falling behind in a game lest he start crying. (fear of failure)?
The school is still concerned about sensory issues but I'm concerned that this is more of an anxiety problem and that we may be wasting time going back to that well. My son is 4 yrs and 8 months old now. At the age of three I would have predicted my son to be a social butterfly. During the past year he just seems to have become introverted and anxious. How concerned should we be? Is more SI evaluation worthwhile? Should we be speaking to someone else?
Doctor's Answer
by Kevin Kennedy, Ph.D., Mar 14, 2006 12:00AM
, Mar 14, 2006 12:00AM
The question about sensory integration problems was sensible, but you have already investigated this. I really don't see a reason to revisit it now, so soon after the other evaluation.
It would be reasonable to arrange an evaluation with a peduatric menatl health clinician for the purpose of taking a look at what appear to be symptoms of an anxiety disorder. It may be that the advice you receive is to simply carry on, exposing him to normal activities for a child his age. Or, some intervention might be recommended. Let the chips fall where they may; go ahead and have the evaluation. There's nothing to lose by doing so.
Be consistent in returning your son to his own bed, otherwise you reinforce that behavior.
It would be reasonable to arrange an evaluation with a peduatric menatl health clinician for the purpose of taking a look at what appear to be symptoms of an anxiety disorder. It may be that the advice you receive is to simply carry on, exposing him to normal activities for a child his age. Or, some intervention might be recommended. Let the chips fall where they may; go ahead and have the evaluation. There's nothing to lose by doing so.
Be consistent in returning your son to his own bed, otherwise you reinforce that behavior.
I would try to figure out what caused the regression. Did he start a new classroom? Does he like his teachers and friends? It may be worth seeing a child psychologist to help you with strategies to ease his fears and help with transitions. Also, keep in mind that if he had hearing problems, he may have some catching up to do to be emotionally on the same level as his peers.
Last, I will tell you that my son was recently diagnosed ADD. In working with the psychologist, we learned that a lot of his behaviors are strong indicators of ADD. Especially the poor self-confidence, frequent melt-downs, shyness, and difficulty interacting with his peers. Other signs he exhibited were constantly messing with his hands and feet, inability to sit still even when eating or reading books, interrupting and constant talking at home, conversation shifts constantly, and procrastination. You may want to keep that in the back of your mind when talking to someone.
Hope you find some of this useful. Good luck!
You said that your son is now well adjusted but that he only recently has been diagnosed ADD, which tells me that his ADD is being managed well. If you can share, what specifically are you actually doing? Also, how is he doing with peer relationships?
I would suggest 2 things to you. First, I would see about moving him to another classroom if there is one available. His being stressed out daily because he doesn't like his teacher will only make his problems worse as far as separating and controlling his own behaviors. The hand clapping is his way of expressing frustration, which is probably why his teacher sees it more than you. Second, I would educate myself on ADD. If you feel that this is a possibility, there are many suggestions and resources for behavior modification and socialization. I would hold off on having him tested until he is in school, unless you are positive he has it, though. He is still very young, and could lead to misdiagnosis.
Two interesting things we did learn, though. ADD kids are generally higher intelligence. My son is 2nd grade, yet his reading and math are on 3rd grade level. ADD kids are generally more creative, and excel at things such as music and art. (Although not the coloring sheets they get so much in kindergarten. LOL)
We have enrolled him in Kindergarten at another school for next year. We are also sending him to a summer program there (all play) in hopes of making the transition easier. Our primary concern at this point is that he is able to get his confidence back up and not think that school is a place where scary people reside.
We believe that SI or ADD is a minor possibility, but our gut feel is no at this point. He is scheduled for another evaluation in May and we'll see what the outcome of that is.