Separation Anxiety Birth to Age 5

1. Separation Anxiety Birth to Age 5 Information from: Child Care Support Network By: Rebecca Chopp

2. How Separation Anxiety DevelopsSeparation anxiety is a normal part of child development • Separation anxiety varies widely from child to child • It may end when toddlers begin to understand that parents may be out of sight, but they will return later • Some children will undergo some degree of anxiety when placed in unfamiliar situations, especially when separated from parents.

3. Situations that can trigger stress and anxiety for young children include • New child care setting or teacher • New brother or sister • Moving to a new home • Tension at home (such as a divorce, death, or serious illness) • A parents service in the military • An extremely scary event that a child experiences personally (such as a nightmare or a bad storm) • A child who is naturally shy may experience anxiety more than other children

4. Anxiety at Different Ages • First few months- Babies can usually be calmed by any loving person, regardless of his or her relationship to the child • 7-14 months- By about 7 months, babies recognize there’s only one mom or dad, but they do not understand when they’ll come back. This phase is often called “stranger anxiety,” because even the happiest child becomes shy or fearful around everyone but the primary caregiver. This phase generally peaks before 18 months.

5. Anxiety at Different Ages, Continued…. • Toddler/preschool years- Children can become anxious and emotional when a parent or primary caregiver leaves, but they can be distracted by activities with the caregiver or other children. • Age 5- By this age, most children are secure enough to be dropped off at a child care center or school with out distress. Separation anxiety may be diagnosed as a disorder if symptoms persist longer than four weeks in a child older than age 5.

6. When feeling anxious about separation, young children display many different behaviors, including: • Crying or whining • Clinginess (holding hand or leg, wanting to be held, hiding behind parent) • Shyness • Silence (instead of constant talking or babbling) • Unwillingness to interact with others, even if they are familiar people

7. What are Anxiety Disorders? • Most children outgrow separation anxiety by about age 5. • Some children experience a continuation or reoccurrence of separation anxiety into their elementary school years. • About one in every 25 children experience SAD

8. Examples of Anxiety Disorders • Generalized Anxiety Disorder (GAD) • Separation Anxiety Disorder (SAD) • Obsessive Compulsive Disorder (OCD) • Post-Traumatic Stress Disorder (PTSD)

9. Red FlagsThe following symptoms are a problem if they interfere with a child’s functioning and last more than four weeks: • Nightmares about harm, danger, death, or separation • Excessive distress during routine separations from the parent or other family member • Repeated physical complaints (such as headaches or stomachaches) • Panics if parent or other family member is late for pick-ups-needs frequent reassurance of pick-up plan

10. Red Flags Continued…… • Reluctance to go to sleep without a significant adult nearby • Recurrent reluctance to go to school or other places because of fear of separation • Inability to attend birthday parties or field trips independently • In general, when anxiety is inappropriate or excessive, interferes with normal activities, and lasts for weeks rather than days, it is a good idea to have a psychiatrist evaluate the child.

11. Treatment • Addressing physical symptoms • Identifying anxious thoughts • Helping the child understand that the parent will return • Offering possible explanations for where the parent is • A good first step would be to have one parent leave for 15 minutes while the child stays with the other parent. This will build trust with both parents

12. Establish a Plan for Separation and ReunionDevelop Coping Strategies • Whenever possible, schedule separations after naps or feedings. • Develop a “goodbye” ritual • Establish consistency • Be calm, and when you say you’re leaving, go • Make new surroundings as familiar as possible

13. Promote trust and security about separation when a child is a little older: • Read stories and remind the child of success. Find a child’s story that incorporates the theme of separation anxiety. Talk to the child and remind them of times when he/she was brave or did something independently. • Honor all commitments to the child, especially time commitments. Pick up the child up at the specified time youtold him or her. This builds trust and security. • Recognize that unfamiliar surroundings can trigger anxiety. A child should see a new child care center at least once before left their alone.

14. Parental Recommendations in reducing separation anxiety • Change the subject. Distraction can work well with some children. • Be truthful. Sometimes simple reassurance works, such as telling a child, “Don’t cry. Mommy and Daddy always come back.” • Bring pleasant reminders of home. Items of the child, such as their box of crayons or a photo album.

15. Summary Separation anxiety is a normal stage of development. No one can prevent it, but it is possible to prepare children for absences and develop coping strategies.