Social anxiety involves feelings of intense panic or fear during social interactions with others. It is one of the most common mental health disorders, with approximately 15 million Americans suffering from it. The fear experienced is disproportionate to the situations and can significantly impact someone’s wellbeing and enjoyment of life.
The average age for social anxiety disorder (SAD) to emerge is 13 years, and 75% of those suffering from social anxiety have an onset age of between 8 and 15 years. However, as the disorder is most commonly diagnosed in adolescents and young adults, it is not uncommon for many children with SAD to continue to struggle with their symptoms into adulthood without a diagnosis or support.
SAD has a lifetime prevalence of 12% and is one of the most prevalent anxiety disorders. This rate is markedly high when compared to 7% for post-traumatic stress disorder (PTSD), 6% for generalized anxiety disorder, 5% for panic disorder, and 2% for obsessive-compulsive disorder (OCD).
SAD can manifest quite differently in children as compared to adults, and it is imperative to recognize the signs and symptoms as early as possible so appropriate help can be given.
Social Anxiety in Children
In toddlers and infants, SAD will present itself very differently from its presentation in adolescents and adults. For children, social anxiety can become chronic and affect their development, learning, activities, creative play, and ability to form bonds and friendships.
The comfort levels in particular social situations will vary significantly depending on the individual. Our responses to situations are forged by our upbringing, life experiences, and personality traits. Some people are naturally outgoing and extroverted whereas others are more reserved or introverted.
It is natural for children to be shy when meeting strangers and to experience feelings of unease and discomfort or a lack of enthusiasm for certain social situations or if confronted by large groups of people.
Social anxiety disorder, however, is quite different from these natural levels of nervousness. SAD instigates strong emotions and difficult feelings that include intense anxiety, panic, and fear, the result of which will cause the child to avoid said situations and will interfere with all aspects of their life and development.
What’s more, it is not uncommon for SAD in children to progress to such an extent that they find all levels of social interaction challenging, including those with family members and close family friends.
Symptoms of Social Anxiety
Although SAD is one of the most common mental health disorders, many parents and teachers are not acquainted with the signs and symptoms in infants and toddlers. These may include:
- Extreme clinginess to their primary caregiver
- Prolonged crying and temper tantrums
- Refusal to speak
- Fear of new things
- Disinterest in trying new activities or meeting people
- Difficulty calming down
- Strong reactions to small changes
- Being upset by new people
- Negative reactions to loud or strange noises
- Tactile sensitivity
- Refusal to let go of routines
- Fussy eating
- Sleep issues
These behaviors can become stressful for parents, who may worry that they are raising a difficult child or that their parenting skills are lacking. As infants cannot clearly communicate the cause of their distress, it is common for parents to internalize the issues and think they are doing something wrong or to punish the child for bad behavior.
Punishing or criticizing a socially anxious child for their behavior will cause more harm than good as the child is rendered powerless over their reactions. Therefore, the child may turn away from their parents or refrain from expressing themselves. Punishing a child for signs of social anxiety can have the opposite effect of what is intended. Toddlers who are punished for anxiety-rooted behavior may “close off” from parents.
Therapy will assist in uncovering the behaviors that arise from SAD and can help the parents address the symptoms positively and constructively.
Causes of Social Anxiety in Children
Just as with adults, SAD in children can be caused by a wide variety of factors, including:
- Genetic factors – Genes are key in determining a child’s personality or disposition. Studies show that certain genetic traits, such as fear of being judged, increase the risk for phobias and anxiety.
- Societal factors – A history of childhood shyness can cause the onset of the disorder, and negative experiences such as harsh criticism, bullying, or trauma are known to exacerbate the condition.
- Environmental factors – A child’s environment, such as home life and school, can exacerbate potential risk factors.
Children with SAD recognize certain social situations as genuine threats, which trigger fight and flight responses and result in a state of stress and hyper-vigilance. The fight or flight response is an evolutionary reaction to threat and operates on an entirely unconscious level, rendering the child powerless over their behavior. 
The human brain is extraordinarily adaptive and through effective treatment can form new connections and neural pathways at any stage of life.
Numerous studies show that as children with SAD grow into teenagers the behavioral symptoms increase. Teenagers with SAD may drop out of school, are less likely to make friends, are unlikely to participate in extracurricular activities, and may have difficulty leaving home.
If SAD is left untreated, adolescents are at risk of developing co-occurring mental health disorders such as eating disorders, depression, self-injurious behavior, and substance use disorder.
The first step in helping a child with SAD is to assist them in identifying it. These children know that they are fearful but do not know why. Guiding them in connecting the dots among their physical reactions, difficult emotions, and their triggers is vital for finding a healthy homeostasis.
In addition to seeking professional therapeutic help, parents can help by praising and rewarding their children when they try something new as well as teaching them simple relaxation techniques.
Because SAD can become a debilitating and chronic mental health issue, early intervention is paramount for allowing the child to develop social skills, try new things, and grow into a confident teenager and adult.
 Anxiety and Depression Association of America, “Social Anxiety Disorder,” retrieved from https://adaa.org/understanding-anxiety/social-anxiety-disorder.
 Unlocking-Potential.Co.Uk, 2021, https://www.unlocking-potential.co.uk/wp-content/uploads/2019/06/Statistics-relating-to-Social-An
 Purdon, Christine et al. “Social Anxiety in College Students.” Journal of Anxiety Disorders, vol 15, no. 3, 2001, pp. 203-215. Elsevier BV, doi:10.1016/s0887-6185(01)00059-7. Accessed 3 Nov 2021.
 Grusec, J., & Danyliuk, T. (2014, December 1). Parents’ attitudes and beliefs: Their impact on children’s development. Retrieved from http://www.child-encyclopedia.com/parenting-skills/according-experts/parents-attitudes-and-beliefs-their-impact-childrens-development
 Sladky, Ronald et al. “Disrupted Effective Connectivity Between the Amygdala and Orbitofrontal Cortex in Social Anxiety Disorder During Emotion Discrimination Revealed by Dynamic Causal Modeling for Fmri”. Cerebral Cortex, vol 25, no. 4, 2013, pp. 895-903. Oxford University Press (OUP), doi:10.1093/cercor/bht279. Accessed 3 Nov 2021.
 “What is ‘Fight, Flight or Freeze’?”. North West Boroughs Healthcare, 2021, https://www.nwbh.nhs.uk/healthandwellbeing/Pages/Fight-or-Flight.aspx.
 Månsson, K N T et al. “Neuroplasticity in Response to Cognitive Behavior Therapy for Social Anxiety Disorder”. Translational Psychiatry, vol 6, no. 2, 2016, pp. e727-e727. Springer Science and Business Media LLC, doi:10.1038/tp.2015.218. Accessed 3 Nov 2021.