Detecting separation anxiety disorder in children is not always easy. The child’s age, behavior patterns and the duration of the behavior must be considered.
There are stages in children’s early development where fear of strangers or separation from a parent is normal, appropriate and even expected. Stranger anxiety is one of the first “anxious” stages of development and typically occurs between ages 6 months and 15 months. This normal fear of separation is not part of separation anxiety disorder.
One way to recognize a problem is to gather information about what the child is thinking regarding anxiety-related behaviors. For example, a child may express fear about being abandoned by parents or be preoccupied by the thought of a reunion with a separated parent. It can be challenging to get younger children to put words to their fears and feelings. Similarly, while teen-agers might be able to recognize the irrational aspects of their fears, embarrassment might prevent them from freely discussing their anxiety. If this is the case, look for signs, such as that the teen is restricting his activities. Other problems commonly associated with separation anxiety disorder include misbehavior, poor academic performance, depression and an increase in physical complaints.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) published by the American Psychiatric Association defines the main feature of separation anxiety disorder as excessive and persistent anxiety about separation from home or from main caregivers (for example, parents) beyond the age where it may be developmentally normal.
Separation anxiety must significantly interfere with normal activities. Examples could include:
- refusal to go outside to play
- refusal to watch television in a room away from the main caretaker
- refusal to let parents leave to go shopping because of worry about parents dying in a car accident or some other frightening event occurring
- refusal to attend a friend’s party for fear of being kidnapped
- refusal to visit or sleep at a friend’s house
- refusal to go on errands
- difficulty falling asleep due to worry that parents may not be present upon the child’s awakening
- difficulty staying asleep due to nightmares or night terrors about being separated from parents
- trying to sleep in parent’s bed or outside the bedroom door
- inability to attend school due to physical complaints (for example, stomachaches, nausea, vomiting, headaches)
- clinging to parent when at home
Last reviewed: By John M. Grohol, Psy.D. on 27 Mar 2006
