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Separation anxiety in children

What is separation anxiety disorder in

children ?

Feeling anxious when you say goodbye is a quite normal reaction for a young child. Separation anxiety builds up when a baby realizes that his or her mother or caregivers still exist even when they are out of sight. This period of separation anxiety is usually experienced when the baby is between ages 7 and 12 months. ‘Normal’ separation anxiety usually reaches its peak when the child is about 10 to 18 months of age. Usually, separation anxiety declines progressively by age 24 months. _________________________________________ Normal separation anxiety in children may cause parents or caregivers experience regularly serious difficulties with their babies becoming anxious and starting crying at bedtime or any other times of separation. _________________________________________ How fast and successfully a child manages separation anxiety by preschool age is determined by his or her temperament, by the coping skills with the separation and by the parents’ behaviour when responding to their child’s actions. Should you however notice that your child’s separation anxiety increases to such an extent that it interferes and endangers school activities, he or she may suffer from separation anxiety disorder .  As a matter of fact, children of anxious parents usually tend to also be anxious children likely to experience separation anxiety disorder . _________________________________________ Separation anxiety disorder in children is characterized by worries that are not in line with the experienced situation, i.e. any kind of temporary separation from the child’s loved ones. About five per cent of children and adolescents are said to suffer from separation anxiety disorder . - _________________________________________ Separation anxiety disorder is a so-called ‘mental health disorder’ that rarely needs professional treatment. As always, exceptions confirm the rule, but with a little discipline and cautious behaviour, parents can handle this problem ‘at home’ and have their child’s separation anxiety disappear slowly. ________________________________________ When is separation anxiety in children no longer ‘normal’? A child usually experiences separation anxiety between ages 7 and 12 months, and reactions, such as crying, throwing a tantrum, demonstrating clinginess, etc. are just healthy ones. Frustrating as it may be, separation anxiety may break through from time to time or even last until the child is four. Both the degree of intensity and the duration of separation anxiety are very individual for each child. Under normal circumstances, the best recommended method for calming a child’s separation anxiety is – for the parents – to remain quiet and consistent when facing their child crying, throwing a tantrum, or demonstrating clinginess, and to settle appropriate limits. _________________________________________ It can however also happen for some children that – despite of all parents’ efforts – their separation anxiety does not vanish with time.  Some must even re-experience such acute separation anxiety while already attending primary or elementary school that they can hardly come along with their school activities and are also incapable of developing proper friendship. When separation anxiety in children grows to such a level, it is a good idea to seek advice from a professional and so avoid the many larger problems associated with separation anxiety disorder in children . _________________________________________________ How to ease normal separation anxiety in children ? Parents of children suffering from normal separation anxiety can try to stick to following tips and recommendations in order to significantly facilitate the process of separation anxiety : Practicing separation – a way to ease separation anxiety in children To familiar best your child with the separation process, you can start with leaving him or her with a caregiver for a short time and repeat the exercise until you are satisfied with the result, i.e. when your child does not show signs of separation anxiety when you leave. _________________________________________________ Scheduling separation – a way to ease separation anxiety in children As babies are more likely to develop separation anxiety when they feel hungry or tired, it is recommended to schedule your separations after the baby’s naps or feedings. _________________________________________________ Installing a ‘goodbye’-separation ritual – a way to ease separation anxiety in children Children need assurance when they are separated from a loved one. Rituals are therefore the right answer as they have reassuring effects. Rituals do not have to be complicated: in many cases a simple goodbye kiss works perfectly and the child does not experience any separation anxiety . _________________________________________________ Keeping familiar surroundings – a way to ease separation anxiety in children  Familiar surroundings and familiar toys are extremely important for a baby or young child to feel safe. Causing the babysitter come to your place is a positive step for your baby not to develop separation anxiety when you leave. If you have to take your child away from home to be babysat, make sure that the beloved toy does not stay home. _________________________________________________ Keeping familiar caregivers – a way to ease separation anxiety in children  Like familiar surroundings, familiar caregivers are also extremely important for a baby or young child to feel safe. Should you have to hire such a person, do your best to keep him or her stay consistently with your child. This will help ease your child’s separation anxiety .  _________________________________________________ Making it short when leaving – a way to ease separation anxiety in children When you want to leave, tell your child in a few friendly words that you are leaving and that you will return soon, if it is the case. You then leave without showing any hesitation. Reassuring your child before closing the door behind you is a good way to ease your child’s separation anxiety . _________________________________________________

What are causes for separation anxiety

in children ?

Separation anxiety is a quite normal reaction for infants and toddlers when they realize that they are going to be separated from a loved one – generally the mother or a familiar caregiver – or when they are away from home and miss their familiar surroundings. For some children, circumstances such a moving to a new home, getting a new sibling, experiencing tension in the family, etc. can cause separation anxiety . _________________________________________________ What are causes for separation anxiety disorder in children ? Separation anxiety disorder in children is said to be triggered by the combination of genetic and environmental factors. The causes likely to generate separation anxiety are manifold; here are the most common one: _________________________________________________ Genetics – a cause for separation anxiety disorder in children Professionals suspect kind of genetic link to exist behind separation anxiety disorder in children and their parents’ history of panic disorder, anxiety, depression, etc. Moreover, children whose mothers experienced tension and stress during their pregnancy with them tend to be more at risk for developing separation anxiety disorder in children . _________________________________________________ Environmental factors – a cause for separation anxiety disorder in children Significant changes in environment, such as moving to another house or flat, changing or starting a new school or simply returning to school after a long illness or any significant traumatic event in the child's life, such as a stay in the hospital, the death or illness of a loved one, the loss of a pet, etc. are causes that can trigger separation anxiety disorder in children . _________________________________________________ Developmental factors – a cause for separation anxiety disorder in children When a child does not develop equally his social, intellectual or emotional areas of functioning, such as, and that one of these functions is significantly underdeveloped, he or she can experience intense anxiety and is at risk for developing separation anxiety disorder . _________________________________________________ Cognitive factors – a cause for separation anxiety disorder in children When a child intermittently develops intense fears and anxiety about getting hurt or humiliated in front of others by the boy next door, or losing a parent because of regular family tensions, he or she can come to the point where their own emotions are no longer controllable and always present. Such thoughts can foster impetuous or uncontrolled behaviours and contribute to the further development of separation anxiety disorder .   _________________________________________________ Behavioural factors – a cause for separation anxiety disorder in children The different behaviours adopted by a child to ‘handle’ the anxiety suffered when facing special situation or certain people have the sole objective of hiding his or her negative feelings. The problem with this crying and clinging method is that it only worsens the child’s situation and eventually become his or her ‘normal’ way of expressing anxiety. Such behaviours are counterproductive for the child and contribute for a large part to the further development of separation anxiety disorder . _________________________________________________ Stress factors – a cause for separation anxiety disorder in children Stress can be caused by situations, such as illness, not enough sleep, a change in routine, a move to another house, a divorce, a separation, switching schools, etc. Any of these situations can cause separation anxiety disorder in children . _________________________________________________ Over-protective parent – a cause for separation anxiety disorder in children An over-protective parent is likely to suffer from parental separation anxiety . The risk of feeding his or her own child’s separation anxiety is very high. Moreover, parent and child may not only feed but intensify one another’s fears and anxieties, an ideal constellation to develop the so-called separation anxiety disorder in children . _________________________________________________

How is separation anxiety disorder

diagnosed?

There are no dedicated laboratory tests yet capable of diagnosing separation anxiety disorder in children. The diagnosis is therefore performed on the basis of the signs and symptoms experienced by the child and of the doctor’s personal observation of the child's attitude and behaviour in general. However, mental health care professionals, psychologists or psychiatrists specialized in evaluating symptoms of children are best qualified to determine separation anxiety disorder in children .  Parents and children are usually interviewed separately in order to allow everybody to express openly their views. The doctor will start performing a complete medical history and a full physical examination, then check if other mental health problems can be responsible for the reported separation anxiety .  Some blood tests and other laboratory work may be performed additionally to exclude that any other medical problem is the cause of the separation anxiety . _________________________________________________ What are symptoms for separation anxiety in children ? Crying, screaming, fussing and also tantrums are typical signs of separation anxiety and are said to be quite normal reactions for infants and toddlers when they realize that they are going to be separated from a loved one – generally the mother or a familiar caregiver – or when they are away from home and miss their familiar surroundings. These symptoms of separation anxiety can be trigged at any time of the day, but also in the middle of the night when the child has a dramatic dream, awakes and starts crying for you. Such or similar symptoms of separation anxiety usually disappear when the child is about two years old. However, when the separation anxiety continues and interferes with school and/or other activities, it is best to see your child doctor, a mental health care professional, a psychologist, or a psychiatrist, and to possibly avoid that your child develops separation anxiety disorder ,  a much more serious condition.  _________________________________________________ What are symptoms for separation anxiety disorder in children ? In contrast to ‘normal’ separation anxiety, separation anxiety disorder in children is a serious condition that is usually characterized by the child demonstrating extreme anxiety and distress symptoms when realizing that he or she is going to be separated from a loved one – generally the mother or a familiar caregiver. ‘Normal’ separation anxiety and separation anxiety disorder in children have many symptoms in common, but there is however a very big difference between them in the way they are experienced by the child and perceived by the parents. The main feature can be observed in the intensity of the child’s fears and anxiety. While the child’s fears can still be seen as a “healthy reaction” in the case of a ‘normal’ separation anxiety ,  the intensity of the fears experienced by the child can become so intense – in case of separation anxiety disorder – that  they seriously interfere with the child’s school and/or other activities. _________________________________________________ Worries and fears – classic symptoms of separation anxiety disorder in children A child suffering from separation anxiety disorder can hardly think of anything else than feeding constantly his worries and fears about separation. Most of the time, the child is devastated and apprehensive and constantly expects negative things to occur, and cause never-ending separation. _________________________________________________ A child with separation anxiety disorder permanently believes that awful things are going to happen at any moment and will seriously hurt or handicap a loved one in his or her absence. _________________________________________________ A child with separation anxiety disorder also permanently worries to be separated from his or her parent for ever. The child may revive constantly threatening situations or scenarios where a parent is sick or has had an accident, and eventually dies in the hospital or where the child is kidnapped and has no chance of seeing his loved ones again, or where the child gets lost in a foreign country he does not speak the language. Such and similar thoughts are typical symptoms of separation anxiety disorder in children . _________________________________________________ A child with separation anxiety disorder is likely to experience regularly nightmares focusing on separation. They mostly have bad and scary dreams about the situations they worry about during daytime, i.e. scenarios in which a parent gets sick or has been hurt accidentally, and eventually dies in the hospital or in which he or she is kidnapped and has no chance of seeing his or her loved ones again, or in which he or she gets lost in a wild region. _________________________________________________
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Sickness and refusals – classic symptoms of

separation anxiety disorder in children

The intensity of the fears experienced by children with separation anxiety disorder can become so intense that they seriously interfere with the child’s school and/or other activities.  Following reactions are often displayed: _________________________________________________ Refusal to go to school – a classic symptom of separation anxiety disorder A child suffering from separation anxiety disorder can develop such irrational anxiety or panic of school that he or she will find thousands of excuses and do everything possible to stay home.  Very often the child complains about imaginary bellyache not to go to school because he or she fears that something bad will happen to the parent or caregiver while being at school. _________________________________________________ Throwing temper tantrums – a classic symptom of separation anxiety disorder A child suffering from separation anxiety disorder may throw repeated temper tantrums or even become hysterical when he or she is separated from the parent or the caretaker. Temper tantrums are not always a sign of disobedience, but are very often the only way a child can express his fears and separation anxiety. _________________________________________________ Refusal to go to bed – a classic symptom of separation anxiety disorder A child suffering from separation anxiety disorder can be extremely reluctant at going to bed without the parent or the caregiver staying close by. Parents may also expect a similar behaviour when the child is supposed to sleep at friends, i.e. away from home. This behaviour imputable to separation anxiety disorder can be triggered by the naked fear of having to stay alone or of anticipated usual scary dreams or nightmares. _________________________________________________ Bed wetting – a classic symptom of separation anxiety disorder A child suffering from separation anxiety disorder may also wet the bed out of fear for different reasons: he or she has had a bad dream associated with separation, or is afraid of falling asleep. Family-related situations that might trigger bed wetting include parents’ separation, divorce, remarriage, fighting, etc. _________________________________________________ Simulation of physical illnesses – a classic symptom of separation anxiety disorder A child suffering from separation anxiety disorder can be very creative and ingenious at finding a lot of excuses and doing everything possible to stay home.  Very often the child complains about imaginary headache or bellyache so that he or she can avoid going to school because of the fear that something bad will happen to the parent or caregiver while being at school. By the way, complaints of physical symptoms, such as headaches and stomach-aches, mainly occur on school days. _________________________________________________ Clinging exercise – a classic symptom of separation anxiety disorder A child suffering from separation anxiety disorder fears nothing more than separation from the loved one. So it is not astonishing that your child will want to always have you close by and cling to your arm or skirt as soon as he or she realizes that you are going to leave the house. _________________________________________________

Treatment of Separation Anxiety Disorder

First, the good news: the wide majority of mild cases of separation anxiety disorder do not require any medical treatment. In more severe cases of separation anxiety disorder ,  i.e. when the intensity of the fears experienced by the child become so intense that they seriously interfere with the school and/or other activities, or when the child refuses to go to school, appropriate  professional treatment may be required. Psychotherapy is by far the most commonly used treatment for separation anxiety disorder .  If you believe that your child suffers from separation anxiety disorder ,  do not hesitate and see your child doctor or a mental health care professional. Cognitive-behavioural psychotherapy is the first treatment approach for separation anxiety disorder .  Its objective is to teach the child a number of new skills that will enable him or her to pinpoint the negative thoughts and reactions associated with separation, to reshape the cognition and to ensure appropriate adaptation to the situations. Family therapy is often an ideal way to find out what causes can have triggered the child’s separation anxiety disorder .  Family therapy often shows that some causes for the child’s separation anxiety disorder can be found in the parents’ lives and/or parenting style.

Prevalence of Separation Anxiety Disorder

Separation anxiety disorder in children is believed to affect up to one in four children worldwide. In the United States, the prevalence of separation anxiety disorder in children is estimated to be between four and five per cent. Approximately one-third of the children diagnosed with separation anxiety disorder had an illness that lasted into adulthood. Girls and boys are almost equally affected by the disorder. About three in four children diagnosed with separation anxiety disorder develop irrational anxiety or panic of school. The most common ages to experience separation anxiety disorder in children are age five to seven years and again from age eleven to fourteen years. About 50 to 75 per cent of the children who suffer from separation anxiety disorder come from families of low socioeconomic status.

Home Remedies to fight Separation Anxiety in

Children

As young children do not have yet much sense of time and rarely appreciate your leaving, it is always a good idea to tell your child when you will come back. Here are a few home remedies to make separation easier for your child: Practicing goodbyes – a way to ease separation anxiety in children Do practice ‘goodbyes’ for a while and leave your child with a person that is familiar with him or her. The periods of time should be brief and the distances short at the beginning and can then increase progressively. Judicious timing – a way to ease separation anxiety in children A judicious timing for the separation is likely to save you a fit of rage when you leave the house. A just fed and ‘happy’ child is less susceptible to develop separation anxiety . Keeping your goodbyes short – a way to ease separation anxiety in children Children need assurance when they are separated from a loved one. Departing rituals do not have to be complicated or prolonged: in many cases a simple goodbyes kiss or a gentle wave works perfectly and the child does not experience any separation anxiety if you do not forget to tell when you will return. Providing a ‘loved’ object – a way to ease separation anxiety in children Providing your child with a comforting toy, such as a doll, a stuffed animal, etc. he or she can keep in your absence will increase feelings of safety, and is a good idea to avoid symptoms of separation anxiety . Keeping calm – a way to ease separation anxiety in children Keeping calm at the time of separation is very important. Children of anxious parents are at risk of developing symptoms of separation anxiety .  When your child sees and feels that you behave ‘cool’ during the separation, he or she will most probably behave the same way.

Relieving your own Stress to fight Separation

Anxiety in Children

Children of anxious parents are at risk of developing symptoms of separation anxiety . Should you happen to belong to the huge group of ‘stressed’ parents, it may be useful to take some measures to indirectly help your child defeat his or her separation anxiety disorder .   Following strategies have shown positive results: Talking about one’s feelings Do speak about your present problems and express openly what worries you most. It is irrelevant for the process whether you can solve them or not. Talking about your feelings will help you relieve your own stress and fight your child’s separation anxiety . Exercising regularly Practising regularly physical activities is not only healthy but very important to minimize or even rules out stress. Exercising regularly will help you relieve your own stress and fight your child’s separation anxiety . Caring for a balanced diet Good nutrition is very important and reinforces your resistance against the effects of stress. A well-balanced diet can help to combat your stress and indirectly fight your child’s separation anxiety . Practising relaxation Practising regularly relaxation techniques, such as meditation, deep breathing, yoga, drinking hot tea, self-massage, etc. will help you drop your stress levels and indirectly fight your child’s separation anxiety . Sleeping enough Not getting enough sleep usually affects your mood, leads to irritability and increases your stress. If you really want to help your child defeat his or her separation anxiety disorder ,  you may have to reconsider seriously your sleeping habits.  Maintaining a sense of humour While life can sometimes be very challenging, you can always use your sense of humour anytime and anywhere to combat your own stress and indirectly fight your child’s separation anxiety .

When to seek professional help for separation

anxiety disorder in children  ?

As an attentive parent of a young child showing symptoms of separation anxiety ,  you have learned and applied with more or less success various gentle behavioural techniques to help your child handle his or her separation anxiety . If your efforts and behavioural techniques do not bring significant improvements in your child’s separation anxiety disorder ,  and if you continue to be worried about his fears and anxiety, you may consider seeking professional help. To start with, you can see your child’s general practitioner or paediatrician or your local children’s health centre to check if your child really suffers from separation anxiety disorder . Should you however observe that your child demonstrates age- inappropriate clinginess or intense fear of leaving home, withdraws from friends, constantly complains of physical illnesses, or refuses to go to school, you should consider seeking professional help for your child’s separation anxiety disorder .   Does Prevention for Separation Anxiety Disorder exist? Preventive measures capable of effectively reducing the emergence of separation anxiety disorder in children have not been found yet. However, when early diagnosed and adequately treated, the severity of the symptoms of separation anxiety disorder in children can be reduced significantly. An early professional treatment of the child’s separation anxiety disorder can let him grow almost normally and improve seriously his quality of life.
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