Causes
It is common and normal for a child to have a strong attachment to their parent or caregiver, a favorite stuffed animal, or the comfort of their own home. When that comfort is removed, it is normal for a child to feel some initial discomfort, but to eventually calm and soothe themselves and adapt to the new situation. However, for some children, removal of a comforting object, person, or environment can create reactions of complete devastation. The behavior of a child with Separation Anxiety Disorder is intense, prolonged, and cannot be easily remedied. The dysfunction persists even when there is no real separation other than in thoughts or dreams. It can be caused by external traumatic events, such as the loss of a family member or pet, the actions of an overprotective parent, or abuse that occurred while the child was away from the trusted person or place. This disorder begins in childhood, with early onset occurring before age 6, and can persist into adulthood.
Diagnosis
To be diagnosed with Separation Anxiety Disorder, a child must have had the symptoms of the disorder for at least 4 weeks and be under the age of 18. Signs that a child is dealing with this disorder will be very apparent to anyone familiar with the child. The child will not only become excessively emotional at times of separation but will constantly worry that separation is imminent. The child may believe that at any moment a comforting person will die or leave. They may ask excessively about plans for leaving, obsess with schedules in which the person must leave or is expected back, and will constantly inquire about possible separations. This will lead to nightmares of separation and possibly physical reactions such as nighttime urination, or vomiting on oneself. The child may require the comforting figure to stay in the room with them until they fall asleep or may demand to sleep in the bed with that person. They will show great reluctance in being left at school and may become inconsolable. In public places they may obsess about being kidnapped or lost and have a strong need to hold on to their parent. This disorder restricts independence and increases reliability on the outside world for comfort.
Treatment
Treatment for Separation Anxiety Disorder can sometimes be completed in the home if the parents become educated about the disorder, can stick with a long term plan, and have the time and patience to increase the child’s independence. The most important aspect of dealing with this disorder is to listen closely to the concerns of the child. Telling the child they are irrational or trying to get them to forget about it will only create the need for more comfort and increase anxiety. Listening to each of the child’s concerns and discussing them with honesty and caring will help the child gain some insight into his fears. Create a schedule so that the child knows when you will leave and return and try to stick to it. It may be helpful to give the child reminders by leaving a comforting note or calling them to check in after many hours away. When the child has an appropriate reaction to separation it is necessary to give praise. If is the child is having a difficult time you can then remind them that you have always returned in the past and point out successful times of separation. Encouraging the child to participate in group activities that are of interest to the child may also help Separation Anxiety Disorder. If the parents are not able to do this on their own, the next step is to get a family or school counselor involved to help the child and family work through the anxiety. In school, this can also help the teachers handle the behaviors in a manner which is consistent with the child’s treatment.
