Maria is a 9-year old Latina American referred to you by her pediatrician who is concerned about a range of behaviors including those that often

Maria is a 9-year old Latina American referred to you by her pediatrician who is concerned about a range of behaviors including those that often signal a child anxiety disorder. Maria’s parents report that she has difficulty paying attention and concentrating. She is also reluctant to do her school work and finds spelling and reading hard. Her parents report that Maria often seems detached and off in “her own little world”. She has an active imagination, which includes imaginary friends. Maria’s parents report concerns about her self-esteem and feel she is very shy. Maria experienced difficulty adjusting to her multi-grade class because she feels shy and nervous around older children. According to her parents Maria has always been shy and reluctant to participate with others. She is so shy, according to her parents, that she does not always answer when someone says “hi” or she speaks so softly that she can’t be heard. She generally appears shy with everyone. In addition, she is reluctant to leave home to go to school or on outings and errands. She needs to be coaxed and cajoled to leave the house and has missed several school days this year. Maria’s parents also described Maria as nervous and anxious. They report that when Maria is nervous she will get up and walk away or detach from the situation and withdraw into her imagination. Mother reports that Maria’s anxiety and withdrawal seems to have gotten worse after a sleep over at her grandparent’s house last summer.