Ten-month-old Anna is playing happily with her stacking toy -- until her mother steps out of the room to answer the phone. The second she leaves, Anna starts to cry. Soon after her mother returns, the crying stops.
Anna has separation anxiety, a normal developmental stage experienced by nearly all children starting when they're between 10 and 18 months old and usually lasting until age 2. The anxiety sometimes returns when the child is older, such as when she goes to preschool for the first time.
SIGNS & SYMPTOMS
Common symptoms include crying, clinging, and throwing tantrums when separated from primary caregivers. Crying at bedtime is also common. A child who is upset because of separation anxiety is not always easily comforted by another adult.
By age 10 months, children have developed a healthy attachment to their caregivers and may become anxious when separated from them. By age 2, the child is able to understand that although a parent may leave, she also comes back.
HELPING KIDS COPE
Rachel Busman, Psy.D., clinical psychologist at the Child Mind Institute's Anxiety and Mood Disorders Center in New York City, says having routines and having plans can help. Her advice:
- Play games. From a very early age, games like peekaboo and hide and seek can be helpful in teaching a child that separation is temporary, says Dr. Busman. You can also hide toys and help your child find them.
- Explain what's happening. Talk to your child in a calm, cheerful manner: "I'm going in another room now, but I'm coming back." "Remember when you had so much fun with Haley? You're going to see her today." "Daddy and I are going to dinner now, but we'll see you in the morning."
- Model resilience. "Even if you're feeling anxious yourself, you want to remain as calm as possible," Dr. Busman says. "You don't want to communicate to your child that she can't handle this." Try saying things like, "I know you might be upset and that's okay. But you're also going to have fun," "I know you want Mommy to stay, but I have to go now," or "You're going to go to school today. You'll have art and music, and then I'll see you later."
- Tell the truth. You want your child to trust what you say. So never tell her you're going to the bathroom if you're really leaving for a few hours. "Don't sneak out," advises Dr. Busman.
- Be quick. Prolonging the departure only makes it more stressful for both of you, and often the child calms down a few minutes after you leave. So be short, sweet, loving, and nurturing -- then go.
- Get rid of the guilt. "Your job is to be the parent but also to take care of you and your spouse or partner," says Dr. Busman. "You're allowed to go to work, go to dinner and a movie, or go upstairs and read a book. These things are not damaging to children, and you shouldn't feel bad about doing them."
WHEN TO WORRY
Most separation anxiety is perfectly normal and eases on its own. When it doesn't, it can develop into separation anxiety disorder, which affects between 4 percent and 5 percent of all children and adolescents. It may interfere with a child's ability to go to school, be part of a family, have fun, and make friends. Warning signs may include (but are not limited to):
- Refusal to attend school
- Problems sleeping alone
- Extreme distress when separations occur or are imminent
- Complaints of stomachaches or headaches
- Complaint of nightmares about separation
Not all of these signs need to be present in order for a child to have separation anxiety disorder, so if you notice any of them in a child older than 4 or 5, speak to your pediatrician or a child psychiatrist. "Once it's diagnosed, there are excellent treatments that can help a child face situations that involve separation," says Dr. Busman. "These treatments involve facing fears in a systematic way with lots of support, and they work really well." She stresses the importance of early intervention: "The earlier you get this under control, the better."
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