Social Anxiety in Toddlers?

Is it possible for a toddler to have social anxiety? What would be the symptoms of social anxiety in toddlers that would differentiate it from separation anxiety? If it is possible for a toddler to have social anxiety, what would be a therapeutic approach to helping the toddler?

That is an excellent question!

First, it’s important to understand that the way that we diagnosis anxiety is not perfect. The DSM, which is the manual we use to guide us in diagnosis, is imperfect in many ways. Categories overlap and criteria are sometimes unclear.


The short answer is that most children develop social anxiety disorder or social phobia between 11-13. It is uncommon that toddlers are diagnosed with social phobia. The youngest child I have worked with who had a social phobia was 8.

However, a child may have what’s called behavioral inhibition which is a temperament that is associated with anxiety. Essentially these children are shy and reticent in unfamiliar social situations as toddlers and later this behavior has a high association with anxiety disorders. A child may have some social anxiety without having social anxiety disorder, but often that is associated with being separated from the parent.

What’s the difference between separation anxiety disorder and social anxiety disorder


The child with Social Anxiety Disorder is afraid to socialize. They are afraid of being judged and criticized by people and being embarrassed. A child with separation anxiety is not afraid of people, but afraid of being away from their caregiver.



Below the answer is explored in a little more detail.

First I will summarize what the criteria for Social Anxiety Disorder in a child.


Children with social phobia show a marked and persistent fear of situations where a person is exposed to people they don’t know or possible “scrutiny” by others.

The child is fearful of being embarrassed.

The anxiety must occur with peers as well as adults.

These children may display disruptive behaviors when forced to engage or think about engaging in social situations.

They will avoid the situations or experience great distress when forced into those social situations.


The anxiety also interferes with the child’s ability to be comfortable and successful in their life.

Social anxiety must last for six months.


Next let’s look at the criteria for Separation Anxiety Disorder.

A child with Separation Anxiety Disorder has inappropriate and excessive anxiety about being separated from home, or from the person to whom an individual is attached as evidenced by three of the criteria below.

The child exhibits severe distress when separation from home or the person the child is attached to occurs or is an anticipated.


The child worries about harm to a parent or attachment figure.


The child Worries that an event will occur which will lead to separation from parent or attachment figure (i.e. kidnapping).


The child has Fear or refuses to going to school because the child does not want to be separated from the caregiver.


The child has fear of being alone without caregiver or other known and trusted adult in different settings.


The child is fearful of sleeping alone or away from caregiver or parent

The child has nightmares related to separation.

The child complains of physical symptoms when the child thinks about or experiences separation.


These symptoms must last four weeks, and cause significant impairment in the child’s ability to function.

What would the therapeutic approach be to helping a toddler with social anxiety?


Really the only approach to therapy with a toddler is play therapy. Therapy would focus on assessing the child’s needs through the play, helping to communicate those needs to the parent, helping the parent come up with a plan to decrease the anxiety, and helping the child to process those fears and feel safer.


For example: One child I worked with who had selective mutism (sometimes considered a form of social anxiety) was fearful of dogs. Through play with the dogs and dolls he was able to understand that most dogs were not something to be feared and he verbalized to his mother after the session that he was no longer afraid of dogs. Play therapy is an amazing thing!