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Our 5 years old (in a month) daughter has excessive apprehension about being immerged in new environments with people (especially children) she doesn't know. Basically, she will cry her heart out when we try to leave her in such an environment, then she will stay away from the group, near an adult if possible. I feel there is more than just timidity, I guess this qualifies somehow as social anxiety disorder ?

It has already reached a bothering level, because we cannot always prevent such situations to happen (e.g. during summer we can't afford to keep her at home so she had to follow a holiday camp, it was like sending her to Guantanamo every morning…), and because she is starting to miss fulfilling opportunities (we are cancelling a music and dance initiation program because she doesn't want to attend the class, despite her loving the topic and liking the teachers). This is less an issue in school because she already knows most children from the last two years (and she has good friends with whom she knows how to behave quite excited), yet teachers seem moderately concerned by her lack of involvement in group activities.

She went to a child psychiatrist last weeks, but he didn't help much, beside saying she was quite anxious (which was actually the reason for which we sent her to him, she is constantly and litteraly eating her fingers) and a bit egocentric, but had no strong issue (I guess he was only looking for some psychiatric disease).

What can we do to help her dealing with this issue ?

  • My five year old is quite similar, though he often gets over it once he's been in the situation for a time or two. I look forward to reading the answers here to apply to my situation... – Joe Oct 6 '16 at 22:05
  • Does she have this reaction when you stay with her in, say, a dance class with other kids/adults? – anongoodnurse Oct 6 '16 at 23:52
  • @Joe She also gets over it eventually, but it takes much more than a time or two. Just this morning her school teacher told me it was starting to slowly get better... Also, she fears in anticipation. – Skippy le Grand Gourou Oct 7 '16 at 7:50
  • @anongoodnurse When we are there she will just glue to us, and refuse to get involved as well. I have to mention I have reasons to believe she is Asperger, but it seems unlikely she gets diagnosed anytime soon, given how people overreact when I mention it. – Skippy le Grand Gourou Oct 7 '16 at 7:56
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In the UK about 1 in 10 children between the ages of 5 and 15 has a diagnosable mental health problem. Most of these are at the "mild" end, but they still cause some distress for the child and the parents.

There are good reasons why medical diagnoses are not made over the Internet. But, if you think your child's anxiety is interfering with her day to day life then you should seek treatment.

Psychiatrists can prescribe medication, but that's not the front line treatment for an anxiety disorder. (In fact, current advice is to avoid medication). You'll want to speak to a paediatric psychologist. Find one who has some professional registration.

(In England you'd see your GP, and keep pushing because paediatric mental health services are under considerable pressure).

Anxiety disorders are very treatable. I think any clinician would recommend a course of Cognitive Behaviour Therapy. This would be a short course of therapy (about 8 to 14 sessions, one per week, for about 45 minutes each time.)

CBT can be done 1 to 1 with a therapist; or as part of group sessions; or self-guided from books.

There's going to be some difficulty finding suitable CBT courses for such a young child.

Even if your child doesn't meet the threshold for an anxiety disorder, you'll find the concepts of CBT useful.

Here's the recommended treatment in England for anxiety disorders:

Here's the pathway: https://pathways.nice.org.uk/pathways/social-anxiety-disorder

Here's the recommendations: https://pathways.nice.org.uk/pathways/social-anxiety-disorder#path=view%3A/pathways/social-anxiety-disorder/interventions-for-children-and-young-people-with-social-anxiety-disorder.xml&content=view-node%3Anodes-treatment-for-children-and-young-people

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    Great resource, thanks ! I am surprised to read in Interventions that are not recommended that mindfulness-based interventions should be avoided. This is a path I was considering, so I'm quite interested in the reasons why it is listed among somewhat silly "cures". – Skippy le Grand Gourou Oct 9 '16 at 19:05
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    Mindfullness is great! It's a useful thing to teach. It's just not recommended as a treatment for anxiety. I think because anxiety disorders have an element of over-thinking, and mindfullness can set that off. – user19912 Oct 10 '16 at 20:13
  • That makes sense indeed. – Skippy le Grand Gourou Oct 10 '16 at 21:50
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One common approach to phobias in general is gradual acclimatisation. So going by this principle you should start small by leaving her for a few minutes and then coming back, then increase the time gradually.

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    While this strategy might work in theory, in most situations people in charge will refuse to accommodate such requests. Furthermore, in our case at least this doesn't affect the general behaviour : she has to go through the whole process of acclimatisation for each new situation (location + group). And each time it takes forever… – Skippy le Grand Gourou Oct 7 '16 at 20:49
  • Maybe a better gradual acclimatization approach would be to start introducing her to very small groups of people, then to larger groups, and so on. But again in practice this would not be quite easy to organize. – Skippy le Grand Gourou Oct 7 '16 at 20:52
  • Controlled exposure for phobia is carefully done. It's very easy to make the problem worse! – user19912 Oct 9 '16 at 17:00
  • Well, this is exactly the approach that worked for us! – aparente001 Oct 12 '16 at 5:47

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