For kids afraid to interact, a way out

Study: Researchers are offering professional help to children who are terrified of socializing with others.

January 20, 2002|By Peter Jensen | Peter Jensen,Sun Staff

Adriana Randolph, age 13, stands at the front of the room, and after a minute or so composing herself, begins speaking slowly. Three adults are staring at her, including one who holds a decibel meter to make sure her voice is loud enough to be heard.

To the casual observer, the situation looks intimidating, but that's just the half of it. What the teen-ager is accomplishing at the moment was simply unimaginable just two months ago. She is reading aloud lines from a children's story, Alice in Wonderland, but more important, she is overcoming her lifelong fear of social interaction.

"Everything has just turned around," marvels her mother, Virlynn Randolph, 41, of Clinton. "She can hold conversations now. That's something she never could do outside the family. She's volunteering in class. She's become more independent."

Adriana has been diagnosed with a severe case of social phobia, an anxiety disorder that is estimated to affect from 2 percent to 5 percent of children. For fearful youngsters like Adriana, the mere thought of social contact -- from answering the telephone to being called upon by a teacher -- can make them physically ill.

Not only has Adriana always refused to speak in front of strangers, she wouldn't even answer her teacher in class, talk to classmates or participate in her own birthday party. Even today, she's still never called her best friend on the phone.

Her mother nearly lost hope that she could ever be helped -- until she was referred to a study being conducted by the University of Maryland College Park's Center for Anxiety Disorders. In nine weeks of therapy, her progress has been remarkable.

"Incrementally, we're getting there," says Roxanne Roberson-Nay, a post-doctoral fellow and the psychologist at the center who is treating Adriana. "She still avoids the telephone, but we're working on that one. At least she's talking."

Gradual exposure

What the Maryland researchers are studying is whether children ages 8 to 16 with moderate to severe cases of social phobia can be helped by gradually exposing them to the very things that frighten them most.

Over the course of 12 weeks, the youngsters spend 4 1/2 hours each week either in social skills training session -- practicing with a psychologist such tasks as introducing themselves to strangers or asking a friend over to play -- or by actually being thrust into social situations.

The latter includes weekend trips to pizza parlors and bowling alleys with other youngsters, including some who are not the least bit shy.

Financed by a $2.3 million grant from the National Institute of Mental Health, the study will chart the progress made by 250 youngsters drawn from College Park and from a second test site in Cincinnati, Ohio.

Ultimately, the research will compare the effectiveness of social training with the antidepressant Prozac which has been found to help socially phobic children and adults. Other participants will receive a placebo.

The Maryland researchers are confident that their drug-free methods will prove effective.

An earlier Maryland study involving slightly younger children found that 70 percent of youngsters who go through such "social effectiveness" therapy, overcome their anxieties and can no longer be diagnosed as socially phobic.

"This is a disorder that deserves to be taken seriously," says Deborah C. Beidel, the center's co-director and a psychology professor. "This is not about being a little shy and they don't 'just grow out of it.' These are kids with an anxiety that interferes with their functioning."

The difference between shyness and social phobia is essentially one of degree, Beidel adds. While it's perfectly normal for a shy child not to want to speak in class, a social phobic might dread even going to school -- and become flushed, nauseated, or suffer headaches or a rapid heart rate just at the thought of being around others.

'I felt kind of lonely'

Ryan Dempsey, 11, of Columbia was one of the first to enroll in the study when it was launched last summer. Teachers at his school had sent notes home beginning in 1st grade out of concern for his behavior. He wouldn't raise his hand in class or play with other children during recess.

Today, he's quite different. He's speaking up in class and even ordering pizza over the phone. His mother is complaining that he stays on the phone too long.

"I felt kind of lonely," says Ryan, a 6th grader says of his old ways. "I didn't want to go over to any friend's house or talk to anyone."

Carol Dempsey, his mother, says she was initially skeptical of the program. Ryan had already seen three different therapists, and her own efforts to draw him out by forcing him to play soccer and basketball and join a boy's club had failed.

Somehow, she says, this more intensive, but gradual exposure to social situations worked far better than her own cajoling or decision to make him play sports.

"When I pushed him to go, it just didn't help," she says. "It's just made a tremendous difference."

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