" Children struggling with affective and relational difficulties may not display the normal range of emotion, do not regulate their emotions well, have difficult relationships with others, and feel little pleasure or reward from normal experience. They may also display little age-appropriate empathy, have difficulty delaying gratification, or may have learning or memory difficulties. "

― Cathy A. Malchiodi , What to Do When Children Clam Up in Psychotherapy: Interventions to Facilitate Communication