AUGUST
Tip of the MonthDoes your child feel worried when you leave him with a babysitter or when you drop him off at school? Does he cling to you and cry when you try to sneak out at a birthday party or when you suggest a sleepover with a friend? Does the mere anticipation of these events cause your child tremendous distress? Does his anxiety tend to cause physical symptoms like stomach aches, nausea or headaches? Is this problem affecting your child's relationship with you or his friends? Is it getting in the way of your child having fun or learning in school? If so, your child might be suffering from separation anxiety.
Children tend to have normal worries and fears that come and go depending on their stage of development. For example, during the toddler years, kids have a difficult time distinguish fantasy from reality, and so they commonly express fears of the dark and of monsters. Adolescents, on the other hand, are especially preoccupied with their self-image and social identities, so they tend to develop anxiety about social situations like joining groups or asking someone out for a date. These types of worries are all appropriate and normal.
Separation anxiety is also a common worry of childhood. Infants are commonly reluctant to separate from their caregivers at various stages, typically at 8 months, 12 months, and anytime between 18 months to 3 years. Separation Anxiety most commonly begins at 9 months and peaks at about 12 months to 2 years. This occurs at the same time that children begin to develop a strong sense of attachment to their parents. Between 5 to 7 months, children are also developing a sense of "object permanence". This means that they are learning that their parents continue to exist even when they cannot see them. Although they know mommy has gone away, they do not have a good understanding of time, so they don't know when mommy will come back. So, understandably, they may become anxious and do anything to prevent the separation from happening. They might cry, scream and even through a tantrum.
Some children never develop separation anxiety, while for others it can be triggered or worsened by stressful life events like moving to a different home, a new sibling, parental divorce, or a family death or illness.
Factors that may protect your child from developing separation anxiety
- Introduce your child to other caregivers (a babysitter or a nanny) by 6 months. This helps the child grow use to being handled and cared for by others. It also helps the child have practice being away from his parents for planned periods of time.
- Begin to build a healthy foundation for developing friendships by introducing your child to other children by 12 months of age. By 2 or 3 years of age, you child can start to have short, closely supervised play dates.
- Many children enter preschool by 3 or 4 years old. This can also help a child establish good social skills and can increase her confidence that she is safe when she is away from her parents.
Tips for parents of children with Separation Anxiety:
- Gradually build on the amount of time that your child spends with other caregivers.
- Always prepare your child before entering a new situation by helping him know what he can expect. Reading books and drawing pictures about what might happen can be very helpful.
- When possible, visit a new setting in advance. For example, before the start of preschool, visit the classroom and let your child meet the teacher. Knowing what to expect will make him feel more comfortable and confident.
- Children feel safest when they have a clear and consistent routine. Having a predictable bedtime ritual can really help an anxious child ease into sleep.
- In an effort to protect your child, you might instinctually want to rescue her from being upset or scared. While understandable, this will only each her that the world is a dangerous place. Instead, gently encourage your child to take small risks, and reward her for being brave. This will teach her that she can cope with challenges and that she will be ok.
- Acknowledge that your child is scared, but encourage him to recall past times that he acted brave, and remind him that those situations turned out ok. Never deny your child's fears, joke about it, or tell him that he should "get over it."
- When leaving your child (to go to work, or during drop off time at school) say a quick goodbye, give her a hug and kiss, and turn and walk away. Do not return if your child is crying or calling for you. Although this is extremely difficult, prolonging your departure only makes the situation worse because it sends your child the message that there is something to be afraid of, and that only your reassurance can make her feel safe.
- Never sneak away when your child is distracted, and always return when you say you will. This will build your child's trust.
When should you get professional help?
- If your child's anxiety interferes with
• learning
• having fun
• making, keeping or enjoying friends - If the anxiety is causing your child extreme distress
- If your child cannot calm down after two weeks
Treatment:
The best form of treatment for Separation Anxiety Disorder is Cognitive Behavioral Therapy (CBT). CBT focuses on teaching children the skills they need to manage and confront their anxiety by helping them learn how to calm themselves down when they are preoccupied with fear, and how to change their negative thinking. For example, they learn to challenge unrealistic statements like "my mom will forget about me and will never pick me up", and replace them with more rational thoughts like "my mom has never forgotten me and always picks me up when she says she will.' Last, they learn how to change their behavior by gradually taking small steps to face their fear, with lots of support and small rewards along the way for encouragement.