byAlison C. Gardner, Psy.D.
The first days of school have long passed and parents, children and teachers have, in many cases, settled into a comfortable daily routine of work, school and/or child-care. Yet some children may still be expressing distress in saying good-bye to their parents/primary caretakers. How do we know when a child’s difficulty separating from parents or primary caretakers has reached a level where help is warranted?
It’s important to first understand separation anxiety in the context of normal child development and the purpose that it serves. Starting around 7 months of age, peeking at 10 to 18 months, and typically resolving around age 3 years, most children demonstrate upset feelings about separating from their caretakers. Children may cry and cling to caretakers when going to day care or school as well as when going to bed at night or even when parents simply go to another room in the house during the day. Separation anxiety is a sign that the child is attached to his or her primary caregiver and to a degree is adaptive in that it serves to keep the child safe from real harm (e.g., going off with a stranger etc.) In cases of typical separation anxiety, the child can calm down within 5 minutes of separating from their parents and positively engage in activities with his or her alternate caregivers and playmates.
Separation anxiety disorder may be diagnosed when a child becomes extremely distressed about separation and/or it begins to interfere significantly with his or her age appropriate activities that are important for social development. A child may take much longer than 5 minutes to calm down after parents leave, if at all. For the diagnosis to be made, the problem must be occurring consistently for longer than one month. Children may also worry about something bad happening to their attachment figure or something bad happening to themselves that would keep them from being with caregivers e.g., being kidnapped. Resistance or refusal to go to school, repeated nightmares about separation, and physical symptoms of anxiety (headaches, nausea, stomachache, etc.) are also common symptoms.
Both temperamental and environmental factors can make a child more vulnerable to separation anxiety disorder. Children with irritable and/or difficult to sooth temperaments often have greater difficulty with transitions including separations. Children who tend to be slow to warm up to new situations and people may also be more prone to separation anxiety difficulties. Major changes in the family (divorce, death, moving, or birth of a sibling) or in the childcare setting (staff turnover) can trigger separation anxiety episodes. A child’s illness, tiredness and/or changes in routine can also increase his or her separation distress.
The following are strategies I often recommend to parents and teachers for supporting children in overcoming separation anxiety:
For Parents:
For Teachers:
If separation anxiety continues to be extremely distressing or impairing, consult with a mental health professional to assess the situation and to work collaboratively with you, your child, your pediatrician, and alternate caregivers/teachers.