Parents tend to think about separation anxiety in babies and toddlers, but older kids can grapple with it too. In fact, grade-schoolers and teenagers can have separation anxiety disorder, which is an extreme fear of being without a parent or caregiver that is out of proportion to the danger it actually poses. We asked Michelle Curtin, D.O., a developmental-behavioral pediatrician at Riley Hospital for Children at Indiana University Health, to explain the signs of separation anxiety disorder, why it may develop, and how parents can help their kids through it.
How can parents spot separation anxiety disorder?
“It can be hard to recognize an anxiety disorder. Kids who worry are often quietly worried,” says Dr. Curtin. But there are symptoms of separation anxiety disorder—which can vary depending on a child’s age:
- Your child resists going to school, camp, or play dates without you there.
- Your child has trouble falling asleep alone at night.
- Your child has a pattern of developing physical complaints such as stomachaches, headaches, or back pain—which are often seen in anxious and/or stressed children. (Note: Do not assume that these physical complaints are automatically signs of anxiety without discussing them with a doctor because these symptoms can also signal other significant medical conditions.)
- Your child has tantrums but is “too old” for typical tantrums. “A 5, 6, or 7-year-old having tantrums is a key sign that the child is experiencing a lot of distress and is unable to communicate it through words,” says Dr. Curtin.
If you notice any of these behaviors, talk with your pediatrician. “It’s important to sort out if there is a specific change, such as a bully that is causing problems, or if it’s anxiety that may be causing distress,” she adds.
What causes it?
“Both genetics and environment,” says Dr. Curtin. In other words, a child’s innate temperament may be a factor and the behaviors of the people in a child’s home play a role too. “Kids are very sensitive to how their parents feel,” notes Dr. Curtin. “We do know that having an immediate family member with anxiety or depression is considered a significant risk factor for anxiety disorders.”
What strategies help?
While specific tactics depend on a child’s developmental level, there are general strategies that parents can implement with children of various ages:
- Don’t remove the trigger. “With kids who are worriers, they tend to avoid things that make them worry. But if parents allow their kids to avoid everything that makes them anxious, they may be left with a very limited world—and they won’t learn how to move past their anxieties,” says Dr. Curtin.
- Help your child build up a tolerance to being away from you. For instance, go to a play date together and sit in another room. The next time, go to the play date and leave for a short period of time. Then leave for longer stretches until your child becomes comfortable even when you’re not there. Try the same tactic at bedtime.
- Instill confidence in your child. “Teach your child that this non-dangerous thing—even though it feels scary—is something they can conquer,” says Dr. Curtin. Let your child know she is strong and capable even without you. And do your best not to let any of your own worries about your child seep into her thoughts.
- Encourage your child to try—and show your support. “We want to help our kids be as independent as possible, so you can’t solve this for your child but you can help him get through it,” says Dr. Curtin. “I compare it to climbing a jungle gym: urge your child to try, and if he falls down, tell him he did a great job and help him get back up again.”
- Consider a transitional object. They’re not just for little kids. You might make a scrapbook of pictures for your child as she heads off to camp. Or maybe your child will want to wear a piece of your jewelry as a token of how you’re always with her in spirit.
- Make a plan for new situations. If your child is starting a new phase, such as a new school, visit ahead of time and help him imagine what he might expect by talking through his new routine. This can alleviate the fear of uncertainty that may arise when you’re not there.
- Practice positive reframing. Help your child think positively about situations. For instance, if your child is anxious about going to school, remind her that she will get to see her best friend or work on a project she loves—and that she can always ask her teacher for help if needed.
- Find an experienced therapist. “For kids younger than age 8, therapy may involve working with the parents and child to manage the child’s distress,” says Dr. Curtin. “With older children, parents are still important, but the direct parental participation decreases. Children learn how to shift how they think about their fears.”