Content originally published on July 5, 2017 and last updated Dec. 12, 2023
It’s normal for younger children to be clingy and cry when they must separate from their parent or caregiver at the door to daycare or preschool. But it’s also common for older children, adolescents and even adults to experience separation anxiety.
Separation anxiety disorder is an extreme fear of being without a parent or caregiver, or away from the home, in a way that is out of proportion to the danger it actually poses. Dr. Elesia Hines, a psychologist at Riley Children’s Health, says older children are often better able to express these concerns verbally than younger kids.
“Older kids can verbalize a fear that something bad will happen to their parents or their caregiver, and it’s important not to dismiss these fears. They may not say, ‘I don’t want to be away from you,’ but it may show up as, ‘I’m worried that if you go to work that something bad is going to happen to you on the way,’” Dr. Hines said. “That cognitive piece is important because it’s not just the behaviors we see in older kids, but actual thoughts that they can express.”
How can parents spot separation anxiety disorder?
As they learn how the world works, kids can worry about a lot of things, and these concerns can come and go over the years. However, an actual diagnosis for separation anxiety disorder occurs when a child has a persistent worry that’s impacting the child and their ability to carry on normally, like going to school or gymnastics.
“Separation anxiety disorder is an excessive and persistent fear that lasts for at least four weeks, and it causes family and caregivers stress because it begins to limit what they can do together as a family,” Dr. Hines said.
Symptoms of separation anxiety disorder can vary depending on a child’s age. They can include:
- Your child resists going to school, camp or play dates without you there.
- Your child has trouble falling asleep alone at night and/or has nightmares.
- Your child follows you around the house during the day.
- Your child has a pattern of developing physical complaints, such as stomachaches, headaches or back pain—which are often seen in anxious or stressed children. (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.)
- A school-aged child having tantrums signals distress that they are unable to communicate verbally.
If you notice any of these behaviors, talk with your pediatrician. It’s important to determine if there is a specific change, such as a bully that is causing problems, or if it’s anxiety that may be causing distress.
What causes separation anxiety?
There are several factors that can contribute to the development of separation anxiety in a child. A child’s innate temperament, genetics, the environment in which they live and parenting behaviors can play a role, such as parental over-protection or over-involvement.
“Separation anxiety can often develop after a life stressor – a divorce or a death in the family,” Dr. Hines said. “Sometimes it seems to develop out of nowhere, and sometimes it can be in response to something stressful happening or in reaction to living with someone who has anxiety.”
What strategies help?
While specific tactics depend on a child’s developmental level, general strategies parents can implement with children of various ages include:
- Don’t remove the trigger. Kids tend to avoid things that make them worry, but if parents allow their kids to avoid everything that makes them anxious, it can be very limiting. Plus, kids won’t learn how to move past their anxieties.
- 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. 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 influence her thoughts.
- Consider a transitional object. This could be 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 a therapist with experience in cognitive behavioral therapy (CBT). For kids younger than age eight, therapy may involve working with the parents and child to learn new coping skills and manage the child’s fears. For older children, parents are still important, but therapy involves children learning how to recognize anxious feelings, identify and modify their thoughts and develop coping skills to use in anxiety-provoking situations, such as separations.
- Communicate with your child’s teacher(s). Separation anxiety often becomes apparent in school settings. Parents and teachers can work together to help children cope with their anxiety while they are at school.
Dr. Hines says one of the best ways to support a child who experiences separation anxiety is through an open, honest and encouraging parent-child relationship that values conversation about these issues. She suggests choosing a calm time of day to talk to your child, hear their concerns and help them identify how they’re feeling. Ask them if they have any ideas for improving their anxiety while still following through on responsibilities like going to school.
“It’s important for the parent to acknowledge the child’s fears while remaining firm: ‘I hear that you feel nervous getting on the school bus in the morning. We have to go to school. What do you think could make that easier for you?’” Dr. Hines suggests. “Working with a therapist can help parents understand how they may be unintentionally reinforcing or increasing their child’s anxiety and how to help their child cope more effectively.”