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Separation Anxiety

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Parents may notice that at 7 to 14 months of age, babies become more clingy and fear strangers. At this stage in development babies understand object permanence – the idea that their parents exist even when they are not present – causing many children to experience fear when separated. This is normal and subsides by age 3, if not sooner. However, some children continue to be anxious or at a later age develop anxiety when separated from parents. Children who experience developmentally-inappropriate anxiety related to separation from parents might be suffering from separation anxiety disorder.

Separation anxiety disorder is most common when children enter elementary or middle school and are faced with new challenges. It occurs in 4-5% of children aged 7-11 but can occur in older or younger children as well. Children with this disorder have an intense fear that something bad will happen to a parent or themselves when they are separated. They may refuse to go to school or social gatherings or complain about headaches or stomachaches to avoid leaving the house. Many have difficulty going to sleep without a parent present. They may have nightmares related to separation. Many have tantrums and plead with parents to stay home. Symptoms such as these are common among children with separation anxiety disorder.

Separation anxiety disorder can be triggered by a trauma or stressor such as the loss of a family member or pet. Moving and changing schools can also cause or exacerbate symptoms. Overprotective parents are more likely to have children with separation anxiety disorder as they tend to feed into the cycle of fear and avoidance. When severe separation anxiety disorder goes untreated, it can have serious implications for a child’s social, emotional, and academic functioning. Children associate less with peers, miss school often, and are less engaged while at school. As adults, they are more likely to experience anxiety and panic attacks. Anxiety disorders in general have a genetic component, but they are triggered by environmental stresses.

Separation anxiety disorder can be treated effectively with cognitive-behavioral therapy (CBT). CBT helps children learn strategies for recognizing anxious feelings as well as the physical manifestations of anxiety. They learn to identify anxious thoughts and are provided with various coping strategies. Children practice these skills in therapy and in real life. Role-play, relaxation training, and modeling are often utilized. In addition, parental involvement in treatment is extremely effective as parents learn to recognize when they may inadvertently reinforce fears. Parents are encouraged to praise children for positive behaviors such as going to a friend’s house. For younger children, play therapy can be used so children can act out their fears with toys and have their feelings validated. Therapists can help children find alternative solutions to problems such as not wanting to leave the house.

It is important for children to learn not to fear their environment. Anxiety can be debilitating and children should learn effective coping strategies as early as possible to avoid becoming anxiety disordered adults. If your child is experiencing symptoms of separation anxiety disorder, seek professional help to lessen the effects. Luckily the research is very clear – therapy successfully helps children overcome their worries and function in school and in life in general.

Jaime Black earned her Doctorate in Clinical Psychology from Yeshiva University. She works in a private practice doing psychotherapy and evaluations. Jaime’s specialty is in working with individuals of all ages on the autism spectrum. www.spectrumservicesnyc.com. JaimeBlackPsyD@gmail.com. (914)712-8208.

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