Separation anxiety is discomfort a child feels when either anticipating the absence of a parent or primary caregiver or when such an absence really occurs. Some separation anxiety, especially in a child’s younger years, is a normal sign of a strong and healthy attachment to a parent or caregiver. This developmentally appropriate anxiety occurs most commonly between the ages of ten and eighteen months and generally subsides between 18 and 24 months of age. At this stage of development, children are becoming aware of what is called “object permanence.” They are moving from an “out of sight, out of mind” mentality to an understanding that objects still exist even when they are not present. This enables children to recognize that even when a parent is not in their presence, he or she is still around somewhere. Children at this stage, however, do not have a fully developed understanding of the passage of time. Their memory for the consistent return of their parents is limited and they are often unable to soothe themselves when their parents are absent, causing a need for pacifiers, blankets, and stuffed animals for self comfort.
Toddlers will often show great discomfort when a parent leaves by fussing, crying, whining, or holding onto their parents at the time of anticipated or actual separation. Transitions to babysitters, preschools, and even going to bed at night can be particularly difficult for older toddlers when separation anxiety is at its peak. Separation anxiety may be more problematic in children who are by nature more sensitive or difficult to soothe (i.e., children with a “difficult temperament”). For these children separation anxiety may return at various transition points in their lives, such as the transition to kindergarten or a move to a new home.
For most children separation anxiety normally fades with time and they recover quickly from individual episodes of separation anxiety. It helps if parents are “matter-of-fact” and not overly emotional at times of departure. A parent’s own anxiety about absences from their child may prolong the child’s sense of discomfort. Routine, brief absences from children are actually beneficial and encourage independence, the ability to self-soothe, and to develop trust in the fact that parents will consistently return. During these early years, parents may wish to seek professional consultation if their child’s anxiety remains extreme, continues past age 2, or develops into a more pervasive pattern of fearfulness in more situations and circumstances.
Separation Anxiety Disorder refers to a set of symptoms and behaviors in which older children show marked distress at the actual or anticipated absence of a parent or other attachment figure. In older children these symptoms and behaviors are distinguished from the normal separation anxiety experienced in infants and toddlers and are not considered to be developmentally or age appropriate. Often, but not always, children who develop Separation Anxiety Disorder have had a history of significant anxiety and fearfulness. There may also be a family history of problems with anxiety.
Symptoms associated with Separation Anxiety Disorder persist beyond what is considered normal and can include fears about and/or problems with going to or staying sleep, fears of being home alone in any circumstance, fears about something bad happening that results in separation from a parent, or physical complaints (e.g. headache, stomachache, nausea or vomiting, etc.) when anticipating separation from a parent.
An actual diagnosis of Separation Anxiety Disorder is based on the number and severity of specified symptoms and the length of time that these symptoms have persisted. Consulting with a professional at the first sign of symptoms makes this disorder easier to treat. However, even if the symptoms have been present for a long time, Cognitive-Behavioral Therapy (CBT) is very effective in treating this disorder. With proper intervention and follow-through, parents are likely to see positive changes very early in treatment.
At Silber Psychological Services our staff is ready to help parents find effective ways to deal with Separation Anxiety Disorder and the resulting distress experienced by both the child and parents.