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Separation anxiety in children

It is normal for young children to be a bit 'clingy' at times, but if this behaviour continues, it may be a sign of separation anxiety disorder.

Separation anxiety disorder is a condition in which a child becomes fearful and nervous when away from home or separated from a parent, close relative, or other carer.

Some children also develop physical symptoms, such as headaches or stomach-aches, at the thought of being separated. The fear of separation causes great distress to the child and may interfere with the child's normal activities, such as going to school or playing with other children.

What are the symptoms of separation anxiety disorder?

The following are some of the most common warning signs that a child may have of separation anxiety disorder:

  • An unrealistic and lasting worry that something bad will happen to the parent or carer if the child leaves.
  • An unrealistic and lasting worry that something bad will happen to the child if he or she leaves the carer.
  • Refusal to go to school in order to stay with the carer.
  • Refusal to go to sleep without the caregiver being nearby or to sleep away from home.
  • Fear of being alone.
  • Nightmares about being separated.
  • Complaints of physical symptoms, such as headaches and stomach-aches, on school days.
  • Repeated temper tantrums or pleading.

What causes separation anxiety disorder?

Separation anxiety often develops after a significant stress or trauma in the child's life, such as a stay in the hospital, the death of a loved one or pet, or a change in environment (such as moving to another house or a change of schools). Children whose parents are over-protective may be more prone to separation anxiety. In fact, it may not necessarily be a disease of the child but can be a manifestation of parental separation anxiety as well - parent and child can feed the other's anxiety. In addition, the fact that children with separation anxiety often have family members with anxiety or other mental health disorders suggests that a vulnerability to the disorder may be inherited.

How common is separation anxiety disorder?

The charity Anxiety Care says research suggests that separation anxiety affects 4-9% of children at anyone time. It is less common in teenagers, and many studies have found it affects boys and girls equally. However, Anxiety Care says other surveys suggest that up to twice as many girls than boys are affected but the figure could be influenced by boys being less likely to discuss their problems.

How is separation anxiety disorder diagnosed?

As with adults, mental illness in children is diagnosed based on signs and symptoms that suggest a particular disorder. If symptoms are present, the GP will begin an evaluation by looking at the child’s medical history and will carry out a physical examination. Although there are no laboratory tests to specifically diagnose separation anxiety disorder, the GP may use various tests - such as X-rays and blood tests - to rule out physical illness or medication side effects as the cause of the symptoms.

If no physical illness is found, the child may be referred to a child and adolescent psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illness in children and teens. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a child for a mental illness. The doctor bases his or her diagnosis on reports of the child's symptoms and his or her observation of the child's attitude and behaviour.

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