SOCIAL ANXIETY DISORDER (SAD)

SAD is usually diagnosed in the mid-teen years, but is found in children of preschool and grade school age. If not treated, SAD can persist into adulthood, and may place a child at risk for later depression and alcohol abuse.
What to look for:

• Fear of at least one social situation (such as recess) or performance situation (such as taking a test).
• Apparent fear when dealing with peers as well as when interacting with adults.
• When faced with feared situation the child suffers anxiety symptoms:

sweating racing heart stomachache dizziness crying tantrums freezing

• Avoidance or intense dread of feared situations.
• Interference with school performance/attendance, the ability to socialize with peers or develop and maintain relationships.

Childhood SAD can show up in a number of ways:
School Refusal/Avoidance
Separation Anxiety Disorder
Selective Mutism

School Refusal/Avoidance
A child experiencing more than just "school jitters" usually refuses to go to school on a regular basis, or has problems staying in school once there. This should not be confused with truant children who avoid school because of antisocial behavior or delinquency.

School refusal is often a symptom of a deeper problem and if not treated can have a negative impact on socialization skills, self-confidence, coping skills and, of course, education. Anxiety-based school refusal affects 2-5% of school-age children. It is common at times of transition, for example, graduating from elementary school to middle school and from middle school to high school. Anxieties tend to differ among age groups, but the most common stressors are:

separation anxiety concerns about academic performance anxieties about making friends fear of a teacher or bully.

The most common ages for school refusal are between five and six, and between ten and eleven. Children who suffer from school refusal tend to be average, or above average in intelligence.

Their stress may come out in the form of physical symptoms, such as:

headaches stomachaches nausea diarrhea

In addition to physical symptoms, there can be behavioral symptoms, which can manifest as:

tantrums inflexibility separation anxiety avoidance defiance

Older children not only experience the stress that goes along with transition from one school to the next, but there is added academic pressure in the higher grades as students begin to see their futures unfolding before them. These stresses may manifest themselves in an extreme preoccupation with appearance, sleeplessness, or rebellion. As with younger children, it is important to keep the child in school, although they may fight it. Missing school reinforces anxiety, rather than alleviating it.

Common School Fears:

• Being separated from caregivers;
• Riding on the bus;
• Eating in the cafeteria;
• Using the school bathroom;
• Being called on in class;
• Changing for gym;
• Interacting with other children or teachers;
• Being picked on by peers or older children.

TIPS FOR PARENTS AND EDUCATORS

Since every child is unique, each situation will be handled on an individual basis. The following  are some of the interventions that may be used to help your child:

·         Return the child to school. Make sure the school officials understand the situation and do not send the child home for the wrong reasons.

·         Consider family counseling if other problems exist.

·         Allow the child to speak and talk about his/her concerns and fears.

·         Slowly separating the parent from the child in school may also be used. One approach is to have the parent sit with the child in the classroom at first, and then the parent may attend school, but sit in another room.

·         Next, the parent may continue to get farther away.

·         A referral to a child psychologist or psychiatrist may become necessary.