by tyler | Apr 27, 2023 | CNN, health
About 1 in 5 high school students in the United States has seen violence first-hand among people who are not related, including homicides involving guns. That’s according to a new report from the US Centers for Disease Control and Prevention, which calls community violence “a significant public health concern.”
In 2021, the most recent year for which data were available, 19.9% of high school students reported ever witnessing community violence and 3.5% reported carrying a gun during the past year, according to the CDC’s biennual Youth Risk Behavior Surveillance reports, released Thursday. The data also showed that students who witnessed community violence were more likely to report carrying a gun, engaging in substance use and considering or attempting suicide.
Overall, according to the report, suicide is the third leading cause of death among 14- to 18-year-olds.
“Previous research has demonstrated that young persons might carry weapons for self-defense to protect against future violence, particularly when they have been directly victimized or perceive high levels of community violence,” CDC researchers wrote in the new report. “Community violence and gun carrying are significant concerns for youths in the United States.”
The researchers found that 29.3% of Black and 26% of American Indian, Alaska Native or Native Hawaiian students reported witnessing community violence compared with 24.5% of White, 21.3% of Hispanic or Latino, 14.8% of multiracial and 9.3% of Asian students.
Among lesbian, gay, or bisexual students, 27% reported witnessing community violence compared with 18.2% of their heterosexual peers, the researchers found.
In 2021, a total of 8.5% of students reported experiencing physical violence in their dating lives, 9.7% reported sexual violence related to dating, 11% reported sexual violence by anyone, the researchers found. And having experienced forced sexual intercourse in their lifetime was reported by 8.5% of all students.
The researchers also examined that 22% of students have reported being bullied in the past year.
The findings indicate that “multiple forms” of teen dating violence, sexual violence and bullying are “common experiences” for US high schoolers, the researchers wrote, and “violence victimization among youths is a public health concern.”
The report also showed that “substance use was common” among US high schoolers in 2021.
Approximately one-third of students, 30%, reported current use of alcohol or marijuana or prescription opioid misuse.
Among those current users, alcohol at 22.7% and marijuana at 15.8% were the most commonly reported substances, and 12.2% reported having misused prescription opioids in their lifetime. Overall, in 2021, 36.2% of students reported ever using electronic vapor products, the data showed.
The majority of US high school students – 61.5% – reported that they felt connected to others at school. Prevalence of feeling connected to others at school was highest among male students, at 65.5%, Asians at 66.7%, 9th- and 10th-graders at 63.3.%, and heterosexual students at 65.1%, the data showed.
The lowest prevalence of feeling connected to others at school was reported among students who were female at 57.6%, American Indian or Alaska Native at 53.9% or Black at 53.9%, and students who had questioning or other sexual identities at 48.3%.
“This report provides the first national prevalence estimates of school connectedness among U.S. high school students stratified by sex, race and ethnicity, grade, and sexual identity and examines the associations between school connectedness and a range of youth risk behaviors and experiences,” the researchers wrote.
The researchers also found that overall, 13.6% of students did not report that their parents or other adults in their family know where they are going all or most of the time, or with whom they will be.
“Reports of high parental monitoring were protective for all risk behaviors and experiences,” the researchers wrote.
Additionally, in 2021, nearly half – 47.1% – of students had eaten fruit or drunk 100% fruit juices less than once a day, 45.3% had eaten vegetables less than one time a day and 75% had not eaten breakfast daily, according to the report.
In 2021, fewer than a quarter – 23.9% – of students had been physically active for at least 60 minutes a day on all seven days of the week, and 44.9% had exercised to strengthen or tone their muscles at least three days a week.
“Although healthy dietary and physical activity behaviors are important for adolescents’ overall physical health, this study found that none of the 11 behaviors examined in this report have improved since 2019,” the researchers wrote.
by tyler | Apr 26, 2023 | CNN, health
Symptoms linked to menopause such as hot flashes, night sweats and sleep disturbances can add up to billions of dollars in medical expenses and lost productivity in the workplace, according to a study published Wednesday in journal Mayo Clinic Proceedings.
Researchers surveyed about 5,000 women ages 45 to 60 who are primary care patients at the Mayo Clinic; 4,440 of the women were employed at the time of the study.
“A full 13% of the women we surveyed experienced an adverse work outcome related to menopause symptoms, and about 11% were missing days of work because of these symptoms,” Dr. Stephanie Faubion, the study’s lead author and the director of Mayo Clinic Women’s Health, said in a news release.
The survey, given in 2021, assessed the women’s symptoms using the Menopause Rating Scale (MRS).
Researchers found that the mean total MRS score was 12.1, which indicates a “moderate menopause symptom burden.”
“Menopause symptoms pose workplace challenges that may manifest as higher levels of lost work productivity (presenteeism), lost days of work (absenteeism), and greater numbers of outpatient medical visits,” the researchers wrote in the study.
Using 2020 US census data to identify the number of women between ages 45 and 60 in the United States, the researchers estimate that the annual cost of lost days of work is $1.6 billion and that nearly $25 billion in medical costs can be attributed to menopause.
“This estimate does not include the costs related to reduced hours of work or to the loss of employment, early retirement, or changing jobs,” the study said.
The study’s limitations include that the majority of the participants were White (93%), married (76.5%) and college-educated (59.3%).
There were some racial and ethnic differences noted, but more research is needed, according to Faubion.
“Clinicians need to ask women about menopause symptoms and offer guidance and treatment, and employers need to create and implement workplace strategies and policies to help women navigate this universal life transition,” Faubion said.
Menopause typically happens to women between the ages of 45 and 55, when their ovaries stop producing estrogen and progesterone, according to the US Centers for Disease Control and Prevention.
by tyler | Apr 25, 2023 | CNN, health
More than a dozen states have passed laws and more than a dozen are considering laws that ban the gold standard of care for people who identify as transgender, even though every major medical association recommends such care and says it save lives.
Gender-affirming care is medically necessary, evidence-based care that uses a multidisciplinary approach to help a person transition from their assigned gender – the one the person was designated at birth – to their affirmed gender – the gender by which one wants to be known.
By one estimate, more than 58,000 transgender youth 13 and older across the US are facing restricted access or proposals, and could soon lose access to gender-affirming care.
Those 58,000 live in 15 states that have enacted or are considering laws to restrict access by, in some cases, even penalizing health care providers and families who try to get such care, according to UCLA’s Williams Institute, which conducts independent research on sexual orientation and gender identity law and public policy. These states are home to nearly a third of the nation’s transgender youth.
In Texas, Gov. Greg Abbott ordered the Department of Family and Protective Services to investigate any instances of certain procedures used in such care, on the grounds that it is now considered child abuse according to an opinion issued by state Attorney General Ken Paxton. A Texas judge granted the ACLU’s request for a temporary restraining order, preventing the state from enforcing the order for now.
Despite the legislative push to end this kind of treatment, gender-affirming care is a recommended practice for people who identify as transgender, meaning they identify with a gender that is different than the one assigned at birth, or gender-diverse, with a gender expression that doesn’t strictly match society’s traditional ideas about gender.
Major medical associations – including the American Medical Association, the American Psychiatric Association, the American Academy of Pediatrics and the American Academy of Child & Adolescent Psychiatry – agree that gender-affirming care is clinically appropriate for children and adults.
The World Professional Association for Transgender Health’s guidelines, which are considered the gold standard and guide gender-affirming care around the world, say it should be a way for people to create “effective pathways to achieving lasting personal comfort with their gendered selves, in order to maximize their overall health, psychological well-being and self-fulfillment.”
People who identify as transgender or gender-diverse often face significant health disparities, as well as serious marginalization and discrimination in health care settings. In 2015, 1 in 4 adults who identified as transgender avoided a needed doctor’s visit because they feared being mistreated, according to the US Transgender Survey from the National Center for Transgender Equality.
Research shows that gender-affirming care can address some of these issues and greatly improve a person’s mental health and well-being.
For children, gender-affirming care is defined by the American Academy of Pediatrics as developmentally appropriate, nonjudgmental treatment that’s provided in a safe clinical space. The care is individualized and based on peer-reviewed scientific studies that show its effectiveness.
This kind of care takes a multidisciplinary approach. Providers work with counselors and the person’s family, as well as the person themselves. They may also work with the child’s school and community.
When someone needs this care really depends on the person. Some children have a sense about their true gender as early as 3 years old, experts say, others as they move into puberty and still others much later.
A growing number of clinics across the country have been created to specifically provide gender-affirming care, including for children. Many use a similar approach that involves a multidisciplinary team of experts who can tailor make the program to the patient and their needs.
At the Gender Identity Program at Columbia University Medical Center, Director Melina Wald says, the process usually starts with a phone call. The family speaks with an intake coordinator and completes a brief screening to give an initial assessment of where the child is in their development. Depending on the age of the child, they may also participate.
Next, the clinic schedules the family for a couple of visits with the team’s mental health care professionals. At the first appointment, the team gauges the family’s and child’s needs.
“It’s to really get a better sense of what’s bringing them into the clinic,” Wald said. “We are also looking to understand the child’s understanding of their own gender, gender expression, and a history related to that.”
The team also determines whether there are any additional mental health needs. A 2018 study on transgender youth found that the prevalence of mental health problems was sevenfold higher than among their cisgender peers. A 2019 study of transgender adults found that they had higher levels of anxiety and depression. And a 2019 survey found that 54% of transgender and nonbinary youth in the US reported considering suicide that year, and 29% made an attempt.
The mental health problems don’t stem from their identity itself but often happen because of social discrimination and what’s known as minority stress, a growing number of studies show. Stigma, marginalization, discrimination, bullying, harassment and even violence can lead to feelings of isolation and rejection.
At Wald’s clinic, after the initial screening and appointments, staffers offer feedback and their clinical impressions to the child and family. They then offer a specific treatment plan tailored for that child, based on who they are, how they identify and where they are developmentally.
“That treatment plan can include individual therapy. It can include parent support. We have an adolescent group for trans and nonbinary teens, and we also have a parent support group run by one of the psychologists on our team,” Wald said.
This part of the care will help with the social transition, said Dr. Madeline Deutsch, medical director of the UCSF Gender Affirming Health Program.
At this point, the child could start using a chosen name and pronoun. They may wear different clothing. This practice helps the young person have the confidence to present in the way that feels more genuine to them, Deutsch said.
“It’s very individualized and usually involves a mix of decision-making by parents and guardians and then maybe other stakeholders, like if the parents are accessing mental health care or if the school becomes involved to kind of help talk things through,” Deutsch said. “Usually, it’s like a no-harm-done thing. So some of it depends on the parent’s level of comfort and the community that they’re living in.”
Deutsch said that when children get to a certain stage of puberty – diagnosed by a medical provider – and still have a persistent, well-documented sense of that their gender does not align with the one assigned at birth, depending on the child’s age, they may move forward with reversible pubertal suppression, commonly called puberty blockers.
Originally, these gonadotrophin-releasing hormones were used to delay puberty for people with what’s known as precocious puberty, which is when a child’s body changes into that of an adult too soon.
“That just basically puts everything on pause, and children can be on that for a couple of years without any ill effects, and it’s totally reversible,” Deutsch said. “If it’s stopped, then everything just continues where you left off.”
Puberty blockers can reduce the distress that may happen when a child develops secondary sexual characteristics such as breast growth, protrusion of the Adam’s apple or voice change. Studies show that transgender adolescents who used puberty blockers were less likely to have suicidal thoughts than those who wanted the treatment but did not get it.
This part of the process may also include hormone therapy that can lead to gender-affirming physical change, but again, the care plan is flexible, Deutsch said.
“I think one of the big myths out there is that there’s a sense that kids are rushed into decisions related to medical care, like hormone therapy or surgery. That’s just not the case,” Wald said.
Deutsch agreed: “Kids don’t make stuff up about this, wanting to become trans because it’s trendy or something,” she said. “Trans youth and trans people in general do not have access to a hormone vending machine.”
With gender-affirming care, the team of experts will work with the young person and the family throughout the process to decide what treatment is appropriate.
The process can take several years, or it can move faster if a child is in the “throes of puberty” and has been struggling for a long time, Deutsch said. There is still an assessment of what’s needed.
Other options include voice and communication therapy. There are also gynecological and reproductive options, but most people get these treatments when they are older, if they opt to have surgery at all. Gender-affirming surgery could include facial feminization or what’s known as facial gender surgery.
Some may choose what’s commonly called top surgery, which for transgender men and nonbinary people removes breast or chest tissue, or genital reconstructive procedures, also known as bottom surgery. Generally, these are not procedures adolescents would need, Wald said.
Legal interventions can include a change in name or gender on a person’s legal documents.
How easy this is, or if it’s even possible, depends on where the person lives. The rules vary by state.
Changes to documents can include a person’s birth certificate, Social Security card, passport or driver’s license.
“For transgender and nonbinary children and adolescents, early gender-affirming care is crucial to overall health and well-being,” the US Health and Human Services Department Office of Population Affairs says. Delaying care can exacerbate stressors and health problems for kids.
Some critics of the process suggest that children should wait until adulthood to transition, but the American Academy of Pediatrics says this is an outdated approach. It assumes that gender identity is fixed at a certain age, but research shows that it’s healthier to value a child for who they are rather than for what they will become.
The association says this approach helps children feel safe “in a society that too often marginalizes or stigmatizes those seen as different” and strengthens family resiliency.
Wald says that waiting to transition can create additional psychological distress for a child and can raise a child’s risk of depression, suicidality, self-harm or substance misuse.
“Withholding intervention means that the child is going to go through a puberty that is discordant with their gender identity and would ultimately mean that later, at the age of 18, there would be changes to their body that they would make it even more difficult,” Wald said.
Gender-affirming treatment builds self-esteem and improves overall quality of life, according to the US Office of Population Affairs, and studies show that the care improves general well-being.
And although they’re at higher risk of mental health issues, not all transgender or nonbinary youth have them. If they do, they don’t have to struggle with these issues for life if they can get the right kind of care and have supportive adults around them.
“These children and teens can be incredibly resilient,” Wald said. “With support and access to care, they will thrive and can be just as successful as any kid.”
by tyler | Apr 25, 2023 | CNN, health
The US Department of Agriculture announced Tuesday that it’s considering changes to limit the amount of salmonella bacteria in some chicken products.
About 1.35 million people in the US get sick from salmonella every year, according to the US Centers for Disease Control and Prevention, and nearly a quarter of infections are attributed to eating poultry, the USDA said.
Salmonella infections cost the US $4.1 billion annually, the USDA said.
“USDA is taking science-based, decisive action to drive down Salmonella illnesses linked to poultry products,” Agriculture Secretary Tom Vilsack said in a news release. “Today’s proposal represents the first step in a broader effort to control Salmonella contamination in all poultry products, as well as a continued commitment to protecting American consumers from foodborne illness.”
The rule would declare salmonella an adulterant, a substance that ends up in a product when it’s being made or that is an unlisted ingredient, and it would apply to breaded stuffed raw chicken products like those found in a store’s freezer section. They may be stuffed with butter, cheese or ham and then breaded, like chicken Kiev or chicken cordon bleu.
Those products may look like they’ve been cooked or browned before freezing, but they are only heat-treated, and they contain raw chicken that needs to be thoroughly cooked to destroy salmonella, the USDA said.
The agency said that because of the products’ appearance, it may also be difficult to determine whether they’ve been cooked enough. The multiple ingredients also cook at different rates. To kill the bacteria, the chicken would need to reach an internal temperature of 165 degrees Fahrenheit.
Labeling of these products has changed significantly over time to be clearer that customers need to cook them thoroughly, the USDA said.
Under the proposed rule, any product that tests positive for salmonella at 1 colony-forming unit (CFU) per gram prior to stuffing and breading would not be allowed on store shelves. The company would have to recall any product found with this kind of contamination.
The proposed rule will be open for public comment for the next 60 days.
The USDA’s Food Safety and Inspection Service said it is suggesting this rule because there have been 14 outbreaks and about 200 illnesses associated with salmonella in breaded stuffed raw chicken products since 1998. The most recent outbreak, in 2021, had 11 illnesses.
Salmonella causes more foodborne illness than any other bacteria, according to the CDC. It’s a big problem for all chicken products, not just the ones that are breaded and stuffed. About 1 in every 25 packages of chicken at grocery stores is contaminated with the bacteria, the CDC says.
The USDA says the new proposal builds on efforts it announced in October to limit salmonella exposure from the nation’s poultry supply.
The agency said at the time that salmonella in poultry is a “complex problem with no single solution.” The framework would require growers to test incoming flocks for salmonella before the birds would be allowed to enter an establishment. There would also be enhanced process control monitoring requirements and an enforceable final product standard.
The National Chicken Council, which represents the broiler chicken industry, expressed “grave concerns” about the new proposed regulations and said they are not based in science or data.
Council President Mike Brown said that he recognizes that the products appear ready to eat and require special considerations that merit additional attention. But, he said, the council and its member companies have spent millions to develop best practices and to reduce bacteria to protect public health.
“These efforts have been paying off, demonstrated by a significant decline in illness over the past seven years,” Brown said in a statement.
The council said it has twice petitioned the USDA for stricter standards on labels to make sure consumers understand how to cook the products to make them safe, but it has not received a response.
Brown said the new proposal would shutter processing plants, drive smaller companies out of the market and take food off shelves without improving public safety.
Consumer Reports, an advocacy group for consumers, said Tuesday that that salmonella is “widespread” in chicken because the animals are often kept in “crowded and filthy conditions,” but the proposal is an “important first step.”
A 2022 investigation from Consumer Reports that focused on ground chicken found that a third of samples were contaminated with salmonella, and every strain was resistant to at least one antibiotic.
Consumer Reports has asked the USDA to set more aggressive goals and says it would like the agency to have more authority to inspect poultry plants and be able to close facilities immediately if tests show high rates of salmonella.
Symptoms of a salmonella infection include diarrhea, fever and stomach cramps that can start within hours or days of consuming the bacteria. Most people will recover with treatment but should seek immediate attention from a health care provider if they have severe symptoms, symptoms that don’t improve after a few days or signs of dehydration.
by tyler | Apr 25, 2023 | CNN, health
Since Dr. Anthony Fauci retired late last year as head of the National Institute of Allergy and Infectious Diseases, effectively ending his role as America’s Doctor during the Covid-19 public health emergency, he has been reflecting in a series of new interviews on the missteps – and missed opportunities – that characterized the pandemic response.
How could the United States, one of the wealthiest, best-resourced nations on Earth, rack up more than 1.1 million deaths from Covid-19 in just three years, a death toll that outpaced those of most other countries?
In interviews with New York Times science writer David Wallace-Wells in April, Fauci, the former chief medical adviser to President Joe Biden, gave some of his most extensive answers yet on the decisions that he and others made during the pandemic and how they shaped the country’s response.
An account of the interviews in the New York Times Magazine describes Fauci as defensive on topics about which he felt his own positions had been misconstrued, such as the origins of Covid-19, but “reflective and humble” about the pandemic and his own role in it.
On the whole, Fauci said, he sees two big problems that caused the US to stumble as it tried to control Covid-19.
The first is the divisiveness of politics, which led many conservatives to distrust public health recommendations to get vaccinated and wear masks in public.
“I understand that there will always be differences of opinion among people saying, ‘Well, what’s the cost-benefit balance of restriction or of masks?’ But when you have fundamental arguments about things like whether to get vaccinated or not – that is extraordinary,” Fauci said.
“Why do you have red states that are unvaccinated and blue states that are vaccinated? Why do you have death rates among Republicans that are higher than death rates among Democrats and independents? It should never ever be that way when you’re dealing with a public-health crisis the likes of which we haven’t seen in over a hundred years,” he added.
The second major problem, as he explained, is the fracturing of the US health care delivery system.
This point is also emphasized in a new book, “Lessons from the Covid War,” published Tuesday by 34 public health and policy experts called the Covid Crisis Group. They came together in preparation for a government Covid commission, envisioned as a blue-ribbon panel that would examine the policy failures of the pandemic in an effort to avoid duplicating those mistakes in future health emergencies.
That commission has not – and may never – come together, so the Covid Crisis Group decided to publish their findings in its stead. They contend that as many as half a million Americans may have died unnecessarily from Covid-19.
Their observation is that the US public health system, an underfunded patchwork of 2,800 state and local health departments, is largely disconnected from the for-profit health care system, which had not traditionally shared data that became vital to the nation’s pandemic response, such as hospital staffing and bed capacity.
Fauci said both arms of this health delivery system have been allowed to atrophy, putting the nation’s health in jeopardy.
But, Fauci pointed out to the Times, it wasn’t all bad.
Fauci says that US scientific enterprise was a boon to the world, developing vaccines against the coronavirus in less than a year, an incredible scientific feat.
“How much worse would it have been if we didn’t have a vaccine in 11 months? If it took three years to get a vaccine, we would have had five million deaths here,” he said.
There have been an estimated 20 million deaths from Covid-19 around the world, but that number might well have doubled, Fauci said.
“So I don’t think we should throw our hands up and say we could not have done any worse,” he said.
Going forward, he said, researchers are trying to make the development of new vaccines even faster, doing it within 100 days.
Fauci says a lot of the confusion of the pandemic had to do with the surprising nature of the SARS-CoV-2 virus itself.
“We were not fully appreciative of the fact that we were dealing with a highly, highly transmissible virus that was clearly spread by ways that were unprecedented and unexperienced by us. And so it fooled us in the beginning and confused us about the need for masks and the need for ventilation and the need for inhibition of social interaction,” Fauci said.
Scientists never imagined, for example, that people could spread the infection without having any symptoms themselves.
“To me, that was the game-changer,” he said.
When it comes to the nation’s poor vaccination rate – just 68% of Americans are fully vaccinated, making the US 69th in the world – Fauci says he wonders whether mandates ended up doing more harm than good.
“Man, I think, almost paradoxically, you had people who were on the fence about getting vaccinated thinking, why are they forcing me to do this? And that sometimes-beautiful independent streak in our country becomes counterproductive. And you have that smoldering anti-science feeling, a divisiveness that’s palpable politically in this country,” he said.
With regard to Covid-19’s origins, Fauci said, until there’s definitive proof of either a lab leak or spillover from animals into humans, it’s important to keep an open mind.
“But I want to highlight the difference between possible and probable. If you look at what’s possible, I absolutely keep an open mind until we get a definitive proof of one versus the other. However, as a scientist, I could not ignore the accumulation of evidence favoring one versus the other,” Fauci said, citing the bulk of evidence that points to a natural origin for the pandemic.
One thing that’s getting lost in the debate, he says, is that we should be trying to take steps now to prevent both scenarios in the future.
“But one other thing that is tough to talk about: Because both are possible, even putting aside probability, we should be strengthening whatever it takes to prevent both – to prevent a new natural occurrence or a new lab leak,” he said.
Finally, Fauci says, it is essential to take a moment now and try to listen to people who pushed back against public health advice during the pandemic.
He told the Times that one of the things he is proudest of in his career is that when he was fighting HIV, he got a lot of criticism from gay people because the government too rigid in how it set up clinical trials.
“One of the best things I did in my life was put aside their theatrics and their attacks on me and started listening to what they had to say. And what they had to say was not just a kernel of truth; it was profound truth. It was mostly all true,” Fauci said.
“So I have always felt when there are people pushing back at you, even though they in many respects are off in left field somewhere, there always appears to be a kernel of truth – maybe a small kernel or a big segment of truth – in what they say. One of the things that we really need to do is we need to reach out now and find out what exactly was it that made them push back. Because so many people cannot be completely wrong.”
by tyler | Apr 25, 2023 | CNN, health
Is shy something you feel or something you are? According to a new study, it could be either.
Whether shyness is part of your child’s personality or just something they feel when they are in front of a group of strangers, it is a typical experience, according to the study published Tuesday in the Society for Research in Child Development’s Child Development journal.
“Shyness is characterized by fear and nervousness in new social situations or when being the center of attention,” said lead study author Kristie Poole, a Banting Postdoctoral Fellow at Brock University in St. Catharines, Ontario, studying social and emotional development.
To look at shyness, researchers brought 152 children ages 7 and 8 into a lab and told them they would be giving a speech that would be filmed and shown to other kids, the study said.
Parents reported their child’s level of shyness tendencies leading up to the study, while researchers checked the children for nervous behavior, such as averting their gaze; their physiological danger responses through an electrocardiogram; and their affect response through how nervous the child reported they were, Poole said.
The study revealed about 10% of the children showed a high level of stress giving the speech as well as a pattern of relatively high levels of shyness over time, according to their parents. This finding provides evidence that shyness may be a part of these children’s temperament, Poole added.
Approximately 25% of study participants were not reported to be shy by their parents but showed a higher level of social stress reactivity from giving the speech, Poole said.
“It is likely that the experience of … shyness in response to a speech task is a relatively common, normative experience for children at this age,” Poole said. “For a smaller group of temperamentally shy children, however, being the center of attention may be stressful across time and various contexts.”
The study did have some limitations, notably that the children studied were largely White and from the same socioeconomic background, said Koraly Pérez-Edgar, associate director of the Social Science Research Institute and professor of psychology at The Pennsylvania State University. Pérez-Edgar was not involved in the research.
“We need larger, more diverse, studies that can help us see the emergence of groups of children across communities, and in large enough numbers, that we can track how well these children do over time,” Pérez-Edgar said.
A shy temperament isn’t always as socially valued as more outgoing personalities, but that doesn’t mean there is something wrong, Pérez-Edgar said.
“In the West, we tend to think about the exuberant, sociable ideal,” she said in an email. “We should step back and think about the wide range of traits and their unique contributions.”
Everyone can feel shy at times depending on the setting, Pérez-Edgar said. And those who are particularly shy often have happy social lives — they just aren’t likely to be the bubbliest person in a crowded room, she added.
But there are things to watch out for. Of the most persistently shy children, about half will develop an anxiety disorder, Pérez-Edgar said.
“Concerns arise for the most extreme kids, who cannot get over their shyness and have difficulty functioning at school, having friends, or engaging in typical activities (clubs, sports),” she said. “That is when parents should think about intervening.”
While shyness is not a problem in itself necessarily, families should be on the lookout for signs of anxiety particularly in their shy children, Pérez-Edgar said.
“Importantly, however, we know that not all shy children are alike, and that many shy children grow up to be well-adjusted adults,” Poole said.
If your child is avoiding situations that are important or could be enjoyable for them because they are feeling nervous, it might be time to intervene, said Dr. Erika Chiappini, a child and adolescent psychologist at Johns Hopkins Children’s Center in Baltimore.
That could mean “not speaking up in class, trouble making or keeping friends, and not joining activities they may otherwise enjoy,” she said via email.
Instead of labeling the child as shy, describe what you see and normalize their feelings, Chiappini advised.
She recommended saying something like: “You seem a little nervous or unsure about who everyone is/what to say. We haven’t met them before and that can feel a little uncomfortable.”
From there, you can prompt them to engage when they are ready — with assurance that you will be there to support them, she added.
The more we avoid situations, the more anxiety we will have about them in the future, which can make them harder to do the next time, Chiappini said. But that doesn’t mean to push your child into the deep end.
“We may have to tackle a situation gradually. For example, you may have to encourage your child just to make eye contact during an outing before expecting them to ask a question of someone,” she said.
And it you are concerned that the shy behavior is inhibiting your child, you can reach out for support from your child’s pediatrician or school counselor to help you find resources, Chiappini said.
There are therapies with and without medication support that can be particularly helpful for kids and teens experiencing anxiety, she added.
