Understanding Social Anxiety Disorder (Social Phobia) in Kids

By Anna Scetinina, MACP, RP, author of A Workbook for Kids Who Worry

Sometimes, a child may get anxious in social situations, such as meeting new people, speaking in front of classmates, participating in group activities, or being in new social environments (birthday parties or social gatherings). If their anxiety is not excessive, it is a normal response to everyday uncertainty, novelty, or change.

However, if they almost always feel anxious in social situations, experience intense and persistent fear, and worry about being negatively judged, embarrassed, or rejected, they may have a social anxiety disorder (social phobia). Social anxiety may significantly interfere with kids’ friendships, school performance, extracurricular activities, and overall well-being. Some kids have social anxiety only about their performance, for example, at school, or kids who do competitive sports or play music professionally experience social anxiety related to their performance but deal well with other social situations.

Social anxiety is one of the most common mental health conditions, affecting up to 17% of youth globally; it has an exceptionally high prevalence among young adolescents (Salari et al., 2024). The rise of technology use and the use of social media among kids and adolescents, coupled with a decrease in face-to-face interactions, continuously contributes to the increasing rates of social anxiety.

Causes of social anxiety in children

Risk factors for developing social anxiety in childhood include:
– Genetics
– Child’s temperament
– Mental health conditions in family members
– Childhood abuse
– Loss of a parent
– Family socio-economic status

How social anxiety shows up in kids’ behavior

Since younger kids may not have a language yet to express what they are fearful of, their social anxiety often manifests through avoidance, refusal, shutting down, or tantrums. It can also show up as clinging to parents, skipping school, crying, screaming, or, on the other hand, staying very quiet and refusing to speak with teachers. In addition to avoiding social situations, triggering environments, and social interactions, older kids may also engage in various safety behaviors that make them feel better at the moment. Here are some of the safety behaviors kids with social anxiety may engage in:

• Avoiding eye contact
• Avoiding conversations
• Speaking very softly and/or speaking very little
• Avoiding raising hand in class
• Rehearsing even simple conversations
• Seeking reassurance from parents
• Overthinking possible outcomes of social interactions
• Sitting at the back of the class or close to the door
• Wearing dark or neutral clothes
• Using their phone to appear busy
• Fidgeting
• Pretending to be occupied (reading, using a computer)
• Avoiding expressing opinions
• Standing further away from their peers in a group
• Avoiding eating or drinking in front of others
• Avoiding using public restrooms (‘shy bladder’ syndrome)
• Talking excessively to avoid silence
• Seeking approval excessively
• Covering face with hair or hood
• Over apologising
• Checking their appearance in mirrors frequently
• Overanalyzing how others interact with them

Though these safety behaviors may help a child cope with their anxiety at the moment, they reinforce the idea that feared situations are indeed dangerous and that a child will not be able to cope with any unwanted outcome. These behaviors also maintain a heightened level of anxiety around social interactions and prevent kids from learning that they are safe enough and can navigate those situations effectively.

Physical and cognitive symptoms of social anxiety

Kids with social anxiety may have physical symptoms such as nausea, sweating, blushing, rapid heartbeat, shaky voice, trembling, and difficulty speaking. They are highly self-conscious and tend to engage in negative self-talk; they may replay social situations and overanalyze what they say or do. They often catastrophize the unwanted outcomes of social interactions and worry about being judged as anxious, stupid, weak, crazy, or unlikable.

Impact of social anxiety on a child’s life

Avoiding social interactions and activities limits kids’ opportunities for growth, optimal development, and connection. Social anxiety negatively affects such areas of children’s lives as academic performance (kids with social anxiety avoid group presentations and class participation) and friendships (kids with social anxiety have difficulty making and maintaining friendships). It may impact a child’s ability to vocalize their needs, express their opinions, and it interferes with their desire to participate in extracurricular activities. Social anxiety in childhood and adolescence, if left unaddressed, increases the risk of developing other mental health conditions in adulthood and increases the risk of suicide (Salari et al., 2024).

How to help a child with social anxiety symptoms

Understanding social anxiety and its manifestations is the first step in supporting a child at home and coordinating support with the school.

Therapy
Reaching out for professional help and working with a therapist specializing in social anxiety can be life-changing. Social anxiety is treated with CBT or ACT and exposure therapy. In treatment, children will work on a gradual reduction of their safety behaviors, increasing their confidence in their ability to deal with triggering situations. Parents play a crucial role in supporting their child’s therapy progress. They can introduce incentives to reward the child’s brave actions, encourage dealing with triggering situations without reliance on safety crutches, and help their child increase tolerance of internal discomfort by doing things that seem scary but are very safe, such as making eye contact, initiating a small talk, sharing something about themselves with their friends and classmates, raising hand in class and more. Booking a session to talk more about a child’s social anxiety and better understand the treatment can be helpful.

Self-help books
Parents may also look into self-help resources like A Workbook for Kids Who Worry. This book uses the Acceptance and Commitment Therapy approach (ACT). It includes 50 activities for kids to develop emotional, cognitive, and behavioral flexibility and deal with all kinds of worries. The book provides exercises and practical strategies that a child can use to overcome their social anxiety.

Online trainings
Using online training for both adults and kids on how to combat social anxiety, such as Natasha Daniels’ courses, can be another great way of addressing a child’s social anxiety and parents’ response to it.

Anna Scetinina, March 16, 2025

Reference:
Salari, N., Heidarian, P., Hassanabadi, M., Babajani, F., Abdoli, N., Aminian, M., & Mohammadi, M. (2024). Global prevalence of social anxiety disorder in children, adolescents and youth: A systematic review and meta-analysis. Journal of Prevention, 45(5), 795–813. https://doi.org/10.1007/s10935-024-00789-9