It does seem to be mostly anxiety related and certainly seemed to diminish after she had blood test (DH refused to let her have emla gel to numb the area). I assume she was put off by the "bad" attention of the needles. There has been a lot of improvement this year, as she has really settle quite well into school. Even though the teachers say they are fine and have friends, they see it differently themselves. DD1 had to learn that "I don't want to play that game" did not mean "I don't want to be friends with you". She is also a perfectionist, so can get stressed if she does not know, or thinks she may not know it 100%. Thankfully her teacher has picked that up and is working with her on it.
I would suggest getting what tests you can, just in case there is something going on medically. Also work with his teacher as to what is going on, keep talking to them about how he is going at home and ask them about how he is going at school.
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