How to Diagnose Separation Anxiety in Children

Three Parts:Observing Your Child’s BehaviorsNoticing the Child’s FearsObtaining a Diagnosis from a Professional

Separation anxiety is a type of anxiety disorder that most often occurs in children. While many children may experience sadness when separated from a parent, separation anxiety is more severe and greatly impacts the child’s ability to function. To receive a proper diagnosis and treatment, see a mental health professional.

Part 1
Observing Your Child’s Behaviors

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    Notice excessive distress when separated from the caregiver. While some children experience a mild level of distress when separated from a caregiver, the child with separation anxiety experiences an extreme level of of distress when separated. This distress interferes with the child’s ability to enjoy other activities or make friends. The child may become severely distressed at the thought of separation.[1]
    • For example, your child may cry, scream, kick, or shut down for long lengths of time after your leave.
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    Keep track of your child’s reluctance related to school and other activities. A child with separation anxiety may resist going to school or other activities where the parent is not present.[2] There may be complaints or excuses to avoid situations when the parent cannot come. The child may throw tantrums or make extreme complaints to avoid these situation.
    • Even if the activity is fun, like a sleepover or camp, the child may refuse or throw a tantrum to avoid going someplace without the parent.
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    Pay attention to your child’s bodily complaints. The child may complain about bodily discomfort before or during the separation. This can include headaches, stomach aches, or other problems.[3] The child may complain of feeling ill as a way to keep the caregiver around.
    • Do illnesses and other complaints seem to appear when the child is fearful of something?
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    Observe the child being clingy. The child may follow the parent around, or hold onto the parent’s arms or legs if the parent tries to leave.[4] This child may become the parent’s “shadow” in that he or she may go everywhere with the parent, even around the house. If the caregiver wants some alone time, the child may be reluctant to give it.
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    Recognize changes in sleep habits. A child may be fearful to go to sleep without the parent or caregiver nearby.[5] The child may sleep poorly due to fears of being alone or fears of having nightmares. Your child may experience distress around bedtime, falling asleep, or waking up at night.
    • Reflect on any changes to the child’s sleep patterns. Does the child complain about not sleeping well or fearing nightmares?

Part 2
Noticing the Child’s Fears

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    Identify common causes for separation anxiety. Typically, a child will develop separation anxiety if he or she feels unsafe in some way. If your child feels threatened or thrown off balance in some way, he or she may turn to the parent for support and safety. Some common factors affecting separation anxiety include a change in the environment (such as a move, or parents splitting up), stress (like starting a new school, loss of a loved one or pet), and an overprotective parent. Parents can influence the anxiety if the parent is overly anxious, as the child can pick up on the emotion.[6]
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    Check into the fear that something terrible may happen to a loved one. The most common fear children experience related to separation anxiety is that something awful may happen to a loved one. The child may fear the parent or caregiver may get sick or get hurt while separated from the child.[7]
    • The child may also fear that something terrible to happen to make the separation permanent, such as being kidnapped or the parent dying.
    • If a child has a fear, the child will often share the fear with you. If your child brings up a fear, ask him or her about it. Say, “Did you see that somewhere?” or, “What makes you feel scared?”
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    Pay attention when the child fears being hurt. The child may have fears about something happening to himself or herself while the parents or caregivers are away.[8] The child may fear that he or she may become ill, injured, or be involved in a scary situation without the help of the caregiver.
    • Reflect on your child’s fears and ask yourself if your child is fearful of something bad happening while separated.
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    Discuss the child’s nightmares.[9] Children may experience nightmares related to their fears of separation. They may have nightmares about something awful happening to a parent. Or, a child may have nightmares about something awful happening to the child while parents are not nearby.
    • If a child appears fearful in the morning, ask him or her about it. You can say, “Did you have bad dreams? Did something scare you?” Ask your child to tell you about the nightmare.
    • Think about the content of the child’s nightmares and if they may be related to experiencing separation anxiety.

Part 3
Obtaining a Diagnosis from a Professional

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    Know some facts of separation anxiety. Separation anxiety is most commonly diagnosed in children ages 7-9. About 4% of all children experience a clinical level of separation anxiety. It’s common for babies and young children to experience a small level of distress when parents leave while the child is at daycare or preschool. Typically, children will settle down once they are engaged in the new environment.[10] If not, the behaviors may be related to separation anxiety.
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    See a therapist. It’s important to treat separation anxiety as early as possible so that the anxiety does not continue to grow.[11] A diagnosis of separation anxiety can be obtained by seeing a therapist, such as a psychologist or social worker. For the first visit, the therapist may talk to parents and to the child separately. Symptoms of separation anxiety and examples of the anxiety will likely be discussed. The therapist may ask questions about what feelings and behaviors occur when the child is separated from the caregiver.
    • To obtain a thorough understanding, the therapist may want to hear from the daycare or school about the child’s behaviors when the parent or caretaker leaves.
    • If your child experiences separation anxiety as a result of trauma, talk about this with the therapist. You may wish to see a therapist specializing in trauma.[12]
    • Once diagnosed, a therapist will likely encourage the child and parents to engage in therapy. Talk therapy, play therapy, and family counseling ares recommended to treat separation anxiety, and can involve both the child and the parents.
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    Discuss the duration of the symptoms. To receive a diagnosis of separation anxiety, the symptoms must be present for 4 or more weeks.[13] Think about how long the symptoms have lasted and when they first started. Has the child always been a bit anxious, or did the symptoms start later? Talk about the symptoms and their duration with your therapist.
    • Was there an event that precipitated the anxiety, like a family move, starting a new school, or changes in the family structure?

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Categories: Stress Anxiety and Crisis Management