Parenting Separation Anxiety Disorder in Your Children

Does your child "cling" to your leg while you're trying to leave for work? Do you feel so guilty that you don't want to leave? This can be very frustrating for both you and your child. Unfortunately, this is normal. But will it ever stop? And what happens when it doesn't?

Separation anxiety. It occurs in almost all children. But as the child becomes comfortable and feels secure that his parent(s) will return after an absence, the anxiety should cease. But when it doesn't stop, it becomes a problem, a disorder. Separation Anxiety Disorder is characterized by excessive anxiety when away from home or away from a specific person, also called an "attachment figure" (this is usually a parent), and is diagnosed in childhood. The difference between normal anxiety and the disorder is when the anxiety lasts longer than expected for the child's development level, lasts at least one month, begins before 18 years of age, and causes significant distress or impairment in functioning. The levels of child development are as follows: between 0-18 months, the child is usually calmed by a loving person regardless of the relationship; 18 months-3 years, the child feels anxious when without the parent but is calmed or distracted by activities; 4-5 years, the child should feel secure enough to be without the parent.

Children with this disorder are extremely distressed when away from home or a parent, or attachment figure. They need to know where the attachment figure is. They are terrified something such as an accident or illness will happen to the attachment figure, or to themselves. Some children will become homesick and miserable. They are scared of being lost and never seeing their parents again. They may not want to leave the house or go anywhere by themselves. They refuse to attend school or camp, to visit a friend's house, or to go on errands. They don't feel comfortable by themselves and so "cling" to the parent or follow the parent from one room in the house to another.

Children may experience trouble at bedtime and insist someone is there in the room until they fall asleep. They may awake during the night and wander into the parents' bed or the bed of a sibling. If they are unable to go into the parents' room, they will sleep outside the door. Children may have nightmares about the destruction of the family through fire, murder, or other serious tragedy.

Children may complain about stomachaches, headaches, nausea, diarrhea, or vomiting when separation occurs or is expected. Dizziness or feeling faint may happen in older children. Persistent crying, anger, worry, and withdrawal may also occur.

Children with this disorder usually come from close-knit families. When away from home or attachment figures, they have difficulty concentrating on work or play, are sad, and are withdrawn. They may be afraid of animals, monsters, the dark, muggers, burglars, kidnappers, car accidents, plane travel, and other situations they feel are dangerous to themselves and family. Children may also feel unloved and depressed. In extreme cases, they may wish they were dead.

Separation Anxiety Disorder is diagnosed when the child shows signs of three or more of the following: 1. excessive worry when away from home or major attachment figures, or when separation is anticipated; 2. persistent and extreme concern that the child will lose major attachment figures, or that something will happen to them; 3. constant and excessive fear of being kidnapped or getting lost; 4. refusal to attend school or go places because of fear of separation; 5. afraid to be alone at home without major attachment figures; 6. persistent unwillingness or refusal to go to bed without being near major attachment figures; 7. frequent nightmares involving separation; 8. regular complaints of headaches, stomachaches, nausea, or vomiting when separation occurs or is anticipated.

Separation Anxiety Disorder may develop because of stress, such as the death of a relative or pet, a serious illness, or a change such as a new school or a new neighborhood. It may also occur because of a lack of trust in parents or other people, a lack of security in the home, and long absences away from parents or attachment figures. It may have a negative impact on the child's life and limit the child's ability to have healthy, loving relationships as an adult. Some effects include isolation, detachment, and related disorders, such as Panic Disorder, Social Phobia, Obsessive-Compulsive Disorder, etc.

Treatments for this disorder are used in combination with each other and include: 1. play therapy, which uses toys, puppets, games, and art materials to allow the child to express feelings; 2. cognitive behavioral therapy, which tries to teach the child to practice other behaviors and challenge his or her negative thoughts; 3. systematic desensitization, which is the gradual introduction of the separation and is measured by time and distance; 4. relaxation techniques, which help the child learn how to calm down by himself/herself; 5. and family therapy, which includes the parents as well as the siblings to create a sense of teamwork to overcome the anxiety.

There are also ways to help the child deal with separation and strengthen confidence about the absence. Avoid having too many caregivers so the child experiences a constant, loving bond the first few years of life. If there is a need for another caregiver, allow the child to adjust while the primary caregiver is there. Make sure to include the child in any changes taking place and assure the child he or she is loved and safe. Practice being away from the child for a few minutes and short distances, then praise him or her for doing well. When an absence is anticipated, inform the child where you are going and when you will return. Always listen to the child when he says something is bothering him; this may give away clues about fears.

So next time your child "clings" to your leg, and you are frustrated because you are late for work, take a deep breath. Your child is reaching out to you, so reach back. Always take the extra minute to reassure your child. And don't feel guilty for leaving. You are teaching your child to trust you and the world around him/her while you are gone. If your child is under 5, remember that this is normal behavior and it will eventually stop. If your child is over 5, look for the signs mentioned above. Separation Anxiety Disorder is a serious mental disorder that could lead to other problems for your child. Above all, love your child and make him or her feel safe at home, at school, at the store, in the world.