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Most parents are familiar with separation anxiety—those tearful goodbyes at school drop-off or when leaving the house. But separation anxiety isn’t just about being “clingy.” When it becomes intense and ongoing, disrupting a child’s everyday life, it may be a sign of Childhood Separation Anxiety Disorder (SAD)—a condition that deserves attention.
This article explores the common symptoms, causes, and effective coping strategies for Separation Anxiety Disorder in Children, offering guidance to help parents support their children's healthy emotional development.
What is Separation Anxiety Disorder?
Separation Anxiety Disorder (SAD) is a mental health condition where a child experiences overwhelming fear or distress when separated from a parent or primary caregiver. These feelings go beyond what’s typical for their age and can interfere with daily routines.
It’s completely normal for young children—especially between 8 and 18 months—to go through a phase of separation anxiety. At this stage, they may become clingy or fearful around unfamiliar people or places.
According to psychiatrist Dr Sheila Chan, many parents notice signs of separation anxiety when their children start nursery or pre-kindergarten (often called N or PN classes). Some children become so upset after their parents leave that they may even vomit, which can be distressing for everyone involved. It’s perfectly normal for children to take time to adjust to new environments. Fortunately, this kind of reaction is usually temporary, and most children settle in after a few weeks.
However, if a child aged six or older continues to show signs of intense anxiety for more than four weeks, or if it significantly affects their daily life, it may be time to seek professional advice.
Symptoms of Childhood Separation Anxiety Disorder
Children with Separation Anxiety Disorder often show three or more of the following behaviours:
- Severe distress when separated from—or even thinking about being separated from—a parent or caregiver.
- Constant worry that something bad will happen to their caregiver (e.g. an accident or illness).
- Fear that they themselves might get lost, kidnapped, or harmed, leading them to avoid separation.
- Refusal to go to school or leave the house.
- Fear of being alone at home, insisting someone stays with them.
- Refusal to sleep without a parent or caregiver nearby.
- Frequent nightmares about separation (e.g. fires, disasters).
- Physical symptoms like stomach aches, headaches, nausea, or vomiting before or during separation.
How to Help Children Overcome Separation Anxiety?
Dr Sheila Chan shares several practical strategies to help children manage separation anxiety and gradually adapt to independence:
1. Build a Sense of Security
Reassure your child that you’ll always come back, and build trust by keeping your word (e.g. picking them up on time). Let them know they’re loved, even when you’re not physically there.
Example: “Mummy’s going to work now. You’ll play with Grandma this morning, then go to school. After your nap, I’ll be back to pick you up!”
2. Practise Separation Step by Step
Begin with short separations and slowly increase the duration. Use everyday moments—like popping to the loo, taking a shower, heading out —as practice. Arrange for your child to spend brief periods with trusted family members or friends in familiar settings to foster independence.
3. Use Positive Reinforcement
Celebrate small wins when your child manages separation well. This boosts their self-esteem and helps them feel more capable.Example: “You waited so calmly while I was in the bathroom—well done!”
4. Avoid Being Overprotective
While it’s natural to want to comfort your child, being overly involved or showing your own anxiety can make things worse. Give them space to explore and grow their independence.
5. Make Goodbyes Positive
Spend a few calm, happy moments together before parting—read a book or play a game. This helps your child associate separation with positive feelings and understand that it’s only temporary.
Treatment Options for Separation Anxiety Disorder
If your child’s anxiety continues or starts to severely affect his/her daily life, it’s a good idea to speak to a professional. During assessment, clinicians may also evaluate for other conditions such as autism spectrum disorder or generalised anxiety disorder. If Separation Anxiety Disorder is diagnosed, the following treatments may be advised:
1. Psychotherapy
- Cognitive Behavioural Therapy (CBT): Helps children identify and manage anxious thoughts and gradually face separation-related fears.
- Family Therapy: Supports parents in understanding their child’s emotional needs and learning effective coping strategies.
2. Medication
In more severe cases, doctors may prescribe anti-anxiety or antidepressant medications, such as Selective Serotonin Reuptake Inhibitors (SSRIs), to help stabilise mood. Common options include:
Parents should keep a close eye on how their child responds to medication and report any side effects—such as insomnia, appetite changes, or suicidal thoughts —to their doctor. Regular follow-ups with prescribing doctor are essential.
How to Prevent Separation Anxiety Disorder?
While Separation Anxiety Disorder can’t always be prevented, there are steps parents can take to reduce the chances of it becoming severe:
- Keep Communication Open: Encourage your child to talk about how they’re feeling, and reassure them that you’ll be there to support them through whatever they’re facing.
- Stick to Routines: A consistent routine helps children feel safe and gives them a sense of control over their day-to-day life.
- Gradually adapt to new environments: Help your child get used to new environments—like school or nursery—by introducing them gradually.
Conclusion
Separation anxiety is a normal part of growing up for many children. With patience, encouragement, and the right support, most children learn to manage it and become more confident over time. As a parent, you play a key role in helping your child feel secure, build independence, and seek help when needed.
If your child’s anxiety doesn’t improve or becomes overwhelming, don’t hesitate to speak to a paediatrician or child psychiatrist. Learning to cope with separation is an important step in every child’s emotional development.
Read more
- Circle of Security Parenting: Managing Exam Stress and Supporting Mental Health
- What Causes Autism/ASD?
References
- Cleveland Clinic (2024). Separation Anxiety Disorder: What It Is, Symptoms & Treatment. Available at: https://my.clevelandclinic.org/health/diseases/separation-anxiety-disorder [Accessed 3 December 2024]
- Stanford Medicine Children’s Health (n.d.). Separation Anxiety Disorder in Children. Available at: https://my.clevelandclinic.org/health/diseases/separation-anxiety-disorder. https://www.stanfordchildrens.org/en/topic/default?id=separation-anxiety-disorder-in-children-90-P02582 [Accessed 3 December 2024]
