How Do You Know If Your Child Is Just Shy or Has Other More Serious Issues?

One of my daughters is a therapist and does play therapy with kids. Maybe you'd have better luck if you sought out someone who does play therapy?

His behavior isn't normal.
He needs help.
Test/evaluate away and get him the help he needs asap - don't wait until fall.
It's not going to get any better on it's own.

My daughter has anxiety disorders and depressive disorders, as well as about 5 or so major medical diagnoses. For a long time, when she went to see the doctor, she would pull her knees up to her chest and pull her t shirt over her knees and pull her hat down over her face so that she was just basically feet on a chair (she didn't have a coat on, otherwise she would have gone inside the coat).

But please believe me: testing and counseling do NOT make things worse. They enlighten. They explain. They offer relief. They provide reasonable explanations. They validate. They have a way of proving to the child that there is a physical and chemical reason why he or she feels like fainting when spoken to, or thinks his/her heart is beating about 300 beats per minute at the mere thought of answering a question out loud in class. They explain why after 18 hours of sleep, she still is too exhausted to even sit up. They validate that feeling that the child has that he believes just proves that he thinks he must be crazy, or he's the only one in the world that is this weird. No. There's a logical, rational, provable reason why it's happening (whatever IT happens to be). And the doctor can provide help, through all kinds of tools: counseling, medication, and many other means (biofeedback, certain psychiatric practices that a trained professional can use, acupuncture, behavioral modification, occupational therapy, light and sound therapy, etc).

My daughter visibly and literally cried with relief when one test showed she had an anxiety disorder, and when the doctor confirmed she had a sleep disorder.

She has had extensive neuro-psych evaluations, and they're not scary. She even thought they were kind of fun. The technicians are trained to work with kids, and the tests involve interesting puzzles, skill tests, and sometimes simply sitting, seeing how long the child can maintain a focus. At the end, my daughter said something about how that was useless since it was all just fun, and definitely wasn't a "test" (she was comparing it to a spelling test). But then after a 2 hour meeting with the psychiatrist about 2 weeks later, we got a full de-briefing and wow, he was spot on. It all explained so much. It helped us, her parents, learn how to help her and when not to help her and how much to help her. It gave us the tools to go to the school and get her a 504 plan. It showed how brilliantly intelligent she is, but how her illnesses have caused cognitive "sluggishness", and how her anxiety and depressive disorders affect her, and how her fatigue (which is from a medical condition) have affected her ability to process information. I re-read the pages of info they gave us numerous times and was amazed. She has now had three, about 5 years apart, and some things have improved measurably. Others are pretty chronic but we have found some good anti-anxiety methods and medications. Others respond to better management of her medical diagnoses.

The important thing is to look at this in a positive way. You tell him "we're going to help you find the right tools that you need to deal with the world, just like you'd need the right wrench to fix your bike or the right controller to play your Xbox". And please don't wait until fall. Don't be afraid.

Make an appointment with a psychiatrist, not a counselor or therapist or psychologist. Make it immediately. Ask about a neuro-psychiatric evaluation, and don't stop advocating for your son. No, shyness is not wearing your coat over your head in a private office and in a parking lot.

I don't think this is a question of shyness, but of being able to be socially appropriate by age 8. Many, many kids are shy, but there is still an expectation in our society for kids to be able to speak to adults, respond to them with friendly body language and eye contact and answer simple questions.

I have an 8 year old daughter, almost 9, who I would consider very shy. She has trouble responding to adults with more than a weak smile when they give her compliments or say hello/goodbye. But she would not be allowed to hide in her clothes or let a question go unanswered and she knows this. Those behaviors are not seen by others as shyness, they are seen as rudeness. Even shy kids should be socially aware enough to know that.

So if your son is unable to converse with people outside his family to the most minimal social expectations (which it sounds like he is not), I would say that this not just shyness that he might grow out of. It sounds more like anxiety or defiance, and I don't think either of those should go un-addressed for a kid. It's very hard for them to function and deal with those feelings without help and guidance from professionals. Why do you think counseling or testing would make it worse?

(just to add- I haven't read your previous questions so I am going in objectively on this question alone)

That kind of 'shy' display is normal for a 3 year old, but not in an 8 year old. Testing and therapies can only help, not hurt. I read your previous question and I would bet money that your son is not simply shy.

I can tell you that my older son (he is an honors student) was just peachy at home and with his family when he was young. He was not okay elsewhere. It took his 1st-grade teacher pointing out that there was something different about him because we were just used to it as being 'him'.

Don't wait for fall to get a school evaluation. The school mostly deals with educational implications. Your son needs a medical diagnosis. He should be seen my psychiatric specialists who handle pediatric neurology. The earlier you know what his needs are, the better you'll be able to get him the support he needs to be his best self going forward.

I'm hoping that you are writing to us for reassurance and strength. I think you know your son needs help relating to anyone outside his family. Now is the time. We will support you through the process.

Do not fear what any testing may show. Nothing anyone can tell you about your son will be different from what you have already observed. In fact, your observations should be written down and given to the test person, because you have many observations which could be very helpful to understanding when you son performs best and how he copes with people. Testing can tell you how to help him use all the skills he has and suggest ways of teaching him more.

From personal experience: do not wait for the school to get around to doing the eval. We have done school evals and what I've learned is that they only look for specific issues they can 'cover' therapeutically. They are NOT going to look for anything outside their 'box', as it were. Talk to your pediatrician and ask for a referral for a behavioral evaluation through an independent provider. We went that route first, and I'm glad, because it gave us so much more insight and hard (data-based) information which was super-helpful for us. (Our Kiddo isn't shy but has some attention and processing difficulties.) The clinic we did the evals through has great workshops for families and the doc we work with has a lot of expertise in what the kids need vs what the schools will tell us they need. Public school really is not set up to be a therapeutic environment. Don't wait... take matters into your own hands.

I understand being shy. But a shy 8 year old should be able to answer a direct question from a friendly adult, especially with a parent there for moral support (unless he knows you'll act as an enable for this behavior, then it might be worse with you present because he knows if he hides/doesn't answer, you'll do it for him).

What exactly did the teacher say? This is almost the end of the school year. If this has been going on all year, then why is she bringing it up now? If it is a new behavior, then it is even more concerning, but it suggests that something happened to trigger this new behavior.

I think you should go forward with the testing. Why wait until fall?

If you are waiting for Fall to have the school test him, please don't. While they do need to do their own, it is important for you to have your own set of doctors evaluate him independently. Schools do the best they can, but they are not the people you want to rely on when it comes to your child's mental health and what is the best course of action should something need to be addressed.

Now if the earliest evaluation you were able to get with a doctor/psychiatrist is Fall, I understand. It can take months to get children in for evaluations. However, you may want to check around or ask to be put on a will call list. I have had my kids evals moved up by calling to check for openings weekly (even on will call you might not get a call) and I also made appointments with several places to see which I could get into first.

In the meantime, I would continue visits with a therapist and engage a play therapist if you can. Call your medical insurance right up front and see who they suggest and who they cover. We have a mental health liaison at our insurance who helped us with a lot of stuff.

Good luck.

I agree that this is not normal behavior for a child this age. I can see that he might not want to talk to the counselor - a lot of kids have problems with that, especially at the first session or two. A skilled counselor knows to expect that and how to deal with it over time.

I agree with the counselor that testing is indicated - not sure why you have to wait until the fall.

Meeting new people, shyness is normal. But hiding inside his jacket at recess time? No, this is not "just shy" behavior. I'm not sure how you expect him to grow out of it when he doesn't have any skills at age 8 to deal with his regular, familiar teacher and classmates in May, the end of the school year.

I'd start advocating pretty hard for more (and sooner) testing and evaluation, and I'd push the counselor, the pediatrician and the school to help you put together a serious plan starting now. You've got to keep them all working together. Start a good notebook, even a simple 3 ring binder with sections in it for each practitioner plus what you observe at home. For your section, don't evaluate or dismiss or anything else - just note the dates and behaviors. In the other sections, note the dates of visits, what comments were made by the professional, and what your son did in that meeting/appointment. You will NOT remember everything, and it may turn out that a small detail becomes more important down the line.

First, I don't understand why you think testing and counseling would make it worse for your son. If he's jus shy, this would help him learn how to deal with his shyness. I wonder if you're trying to protect him from the real world. If so, he will remain shy and unable to manage social interaction. I suggest you want him to continue growing and learning how to interact with others.

I also don't understand why you have to wait until fall for testing. Because he's having difficulty in the classroom, the school district will test and provide help this summer, if he needs it, without cost to you. Federal law requires the district to provide this service so that all children will have success in learning.

The sooner he gets help, no matter if he's just shy or has more going on, the sooner he will be successful in school and in life.I urge you to get more information on what he needs

Why can't further testing happen until Fall? Why do you think testing and counseling is going to make things worse? If he is just shy, or has a more introverted personality, I would think the testing would tell you that. If there are other challenges, the sooner you know what you're dealing with, I would think the better. I think I would want testing done as soon as possible. The school year is almost over. If he's basically enriched and happy during the summer, I can maybe understand waiting on counseling. But I would want the information just to know how to help him or get him the support he needs starting next school year.

Call the nearest children's hospital and ask for their developmental lab. Then talk to them and see where they want to send you, keep pressing forward and don't give up.

Ask the person you finally get with how soon your son can be evaluated. He has something going on.

Hiding your head in the sand about it isn't going to make it easier on him. Something is going on.

Have you told him, no, you cannot hide in your coat. This is not acceptable behavior. You need to look at people and say hello. Take his coat off and put it away. I was extremely shy as a kid, but I was expected to shake hands, look people in the eye, and say hello. I think making him practice with other adults that are not family is going to help him realize that it's no big deal. My son was having some behavioral issues and seeing a child psychiatrist to work on it for a couple years was amazingly helpful. Definitely take away the coat so he cannot use that. It sounds like he has anxiety and there are a lot of things that a therapist can teach him about calming down and the proper way to react. Practice at home. Practice with neighbors or family friends. I don't think testing and counseling will make him worse, but letting him get his way and hide is going to reinforce the behavior. PS - Our son's therapist was very good at engaging a child. She knew to ask about favorite video games, get them to show her what they are good at, play a game together, play a board game or build something. She came across as very fun/cool and my son came to see her as a good friend. That way they bonded and were working together side by side...so that the child does not feel like a grown up is just staring at them and asking personal questions. You should ask around and find someone who is good with kids.

ETA:

I thought about how I've known something needed to be addressed. I think when you have to ask. That's how I've known. I go through denial for a while first. My husband will say "Oh it's just a kid thing" but I still keep worrying. Trust your gut. It doesn't necessarily mean it's anything major. With my kids, it was all something quite manageable. The worrying was worse. That's why I hope you will find a way to see someone else this summer.

I wrote what was 'normal' shy for my kids below. But I think really you're asking how do you know when something is 'up'. And that's a gut thing I think. Keep us posted. Most of us have gone through something like this ourselves.

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I like what the moms have written below.

I'm shy. In a new social situation, I can be very shy. But the minute someone talks to me (which is why I have to make myself say hello to someone then I'm fine) I am perfectly fine.

My kids are the same. I have a shy little one who the minute someone smiles - she's good. So I've gotten her to smile. But she's still very shy if an adult she doesn't know talks to her. She'll look away as she answers. I've coached her and she gets better with practice.

Same for my other kids. Just certain situations - mainly adults talking to them. Once they know them though - they can have lengthy chats.

I don't know about the coat behavior. To me that's showing he's not interested and disengaging. Did the counselor offer any ideas? It's too bad they didn't give you some idea of what you might be looking at - and you're expected to wait till the fall. I would think that would be very hard.

Could your child at least continue counseling? It might get better in time. Were you at the session? I don't go in with mine. I have an introverted kid who can be shy, but also is a leader. He can gives speeches etc. He's just socially awkward at times. Very bright. He's not diagnosed with anything - he just likes talking to the counselor. She gives him good tips and I think they role play. I'm just supportive.

So at the very least I think I would continue with just seeing the counselor if you could. Your child might do better on his own. Maybe try one session? If that's possible.

I think it's very encouraging he's comfortable at home and with people he knows.

What's his exposure to new groups and people? That helped mine get over their shyness. At the start of the new year in the fall, mine would be shy at first but could get over it. Came out of their shell so to speak.

If he's acting normally around family at home, but has limited ability to interact with others, I'd say that he might have social anxiety. Can he order food for himself and things like that when you are out at a restaurant? Does he get help from the teacher if he needs it? Does he raise his hand in class at all? How is he with reading in front of his classmates? Check these things out and if you think he's avoiding them, I'd look into social anxiety. There is work he can do with a child psychologist that helps a lot. There is also medication if it's extreme. He sounds very uncomfortable and I feel for him. He will need to learn how to push himself in social settings by taking it slow and learning confidence in himself. I wouldn't wait until fall, I'd start with your pediatrician to find a good psychologist to work with now.

First I would tell him this is not acceptable behavior and he is not to hide in his coat. You can also role play with him. Practice what to say when someone says hello, how are you etc. When you go to a restaurant have him order. When you go to the dentist or doctor have him check in with the receptionist.

Also, look into drama classes near you. Getting kids comfortable on stage will help tremendously with helping your son find his voice.

I don't think is is typical for a child not to have any friends. Does this seem to bother your son?