The Parents Guide to Children and Separation Anxiety

separationanxietyguideAn infant or toddler screaming for mom when she walks out of the room is considered pretty normal. A 6-year-old doing the same thing is, well, a potential problem.

That problem could be a thing called separation anxiety.

The “normal” phase of separation anxiety typically lasts until a child is about 2 years old, at which time it can either subside or blossom into a mental health condition known as separation anxiety disorder. Psychology Today notes the official parameters of the disorder include symptoms that last at least 30 days, cause distress or affect your child’s academic or social functioning.

If your child is shy, typically anxious or used to only being around you, it may take a bit longer for the anxiety to wane. If it doesn’t wane at all, or if it worsens, it may be time to seek outside health.

Children suffering from separation anxiety can end up with a number of symptoms that include:

  • Panic attacks or signs of panic that include shortness of breath, nausea or vomiting
  • Trouble sleeping, loss of appetite, stomach aches or other unexplainable bodily aches, pains and complaints
  • Fear of sleeping by themselves of nightmares of being separated
  • Anxiety, worries and fears about being kidnapped, getting lost or traveling without mom or dad
  • Fear that mom, dad or the caregiver may be lost or harmed upon separation
  • School refusal or reluctance to go anywhere out of fear of being separated from parents

It’s also important to note when separation anxiety hits. If it only seems to happen when your child is set to go to one specific location, there may be something wrong at the location and not with your child’s anxiety levels. Bullying, unfriendly children or a creepy caregiver are just a few examples. Encourage your child to talk by prompting conversations, asking questions and always providing a listening ear.

How Children Conquer It

Snapping your fingers won’t bring a magical cure, although the most severe cases may be helped by medication, therapy or a combination of both. A less-severe case may eventually subside on its own, provided your child eventually begins to experience the three things needed to overcome it. The U.S. National Library and the National Institutes of Health say these three things are:

  • A child feeling safe and secure in his home surroundings
  • A child trusting people other than her parents
  • A child knowing or trusting his or her parents will come back

Even children who have seemed to have moved pass the separation anxiety stage can suffer from it when they are in unfamiliar or scary situations and under physical or mental stress. Leaving a child in the hospital with pain or an illness can be a prime environment for separation anxiety, as can being dropped off at a new school or any new activity for the first time.

Impact in Later Life

Children who do develop full-scale separation anxiety disorder may have a higher risk of being plagued by multiple anxiety issues in adulthood, according to a study in the American Journal of Psychiatry. The study looked at 252 adults with anxiety disorder diagnoses who also suffered from separation anxiety disorder in childhood.

The study found that those who had suffered from childhood separation anxiety disorder were highly likely to end up with two or more anxiety disorders as adults. Adults with only one anxiety disorder had overall lower prevalence rates of childhood separation anxiety disorder.

What Treatment Works?

A study published in the journal Psychotherapy and Psychosomatics not only showed that treatment specifically geared toward separation anxiety could be effective, but that it could be effective in younger kids.

The study looked at 43 children between the ages of 4 and 7 and found that 91 to 100 percent of them who took part in a 16-session treatment program with their parents showed marked improvement in their symptoms. The specific program coupled parent training with cognitive-behavioral therapy, or CBT.

The positive effects of the program held firm after a four-week follow-up, with the children not only having a decrease in separation anxiety symptoms but also improvements in their overall levels of distress and quality of life.

If your anxious child is pulling at your coat as you’re trying to leave the classroom, CBT isn’t always readily available in the next room. But chances are your child may have a chance to play, which can also alleviate the anxiety he or she feels when mommy or daddy have to go off to work.

Playtime as Treatment Time

A study published in the Journal of Consulting and Clinical Psychology found that separation-relevant play could help reduce separation anxiety and overall stress levels in children. Separation-relevant play refers to playing with dolls that can stand for mom, dad, the teacher or other adults that make the children feel safe, along with dollhouses and other items that are somehow associated with separation from family or caregivers.

Children ages 2 to 6 were divided into groups, some of which engaged in free play and others in directed or controlled play that set out to follow a given scenario. All of the children showed a decrease in anxiety following the series of play dates.

The type of separation-relevant play in which the children engaged was not a factor, although the quality of play was. The lowest anxiety levels in those who had the highest quality play of any sort. Being able to build a house out of block would be considered high-quality play while moving the blocks around randomly would not.

Engaging children in play where they can address their concerns, such as with the separation-relevant toys, appeared to greatly help reduce anxiety levels. 

The Worst Things You Can do for Separation Anxiety

Before we get into ways to help your child overcome separation anxiety, we must throw in a caveat by noting two of the worst things you can do:

Run back to your child at the slightest sign of discomfort. Not only will this make it nearly impossible to establish trust and move beyond the anxiety, it also teaches children that reacting in a negative manner can get them what they want.

Sneaking away when you think your child isn’t looking. This practice can backfire, according to, noting that experts say this is a surefire way to actually increase your child’s anxiety levels. Saying a brief but loving goodbye, followed by an equally loving reunion hello, can better establish a healthy pattern of parting and return.

The Best Things You Can do for Separation Anxiety

Making your goodbyes as painless as possible can help alleviate your child’s separation anxiety, and you can do so with several suggested tips from and Mayo Clinic: 

Practice being apart. Set up a few short-term separations, like going to the neighbor’s house for five minutes, and eventually elongate them until your child becomes more and more comfortable with separation.

Make a goodbye ritual. Create a little ritual for saying goodbye, perhaps with a key phrase or loving hug and mention of when you’ll be coming back. Don’t draw out your goodbyes into a three-act play. Keep them gentle but fairly short.

Pump up enthusiasm. Try to pick out at least one fun thing that your child will experience while you’re gone, giving him or her something to look forward to. Something like “Your new babysitter’s going to teach you how to jump rope,” might work, or “I can’t wait to hear the best thing you’re going to learn in school today.”

Leave a little reminder. Younger children may appreciate having a small toy, note or comforting object to hang onto while you’re gone.

Come back when you say you will. Breaking a promise to return at a given time can make your child’s anxiety levels go through the roof. If for some reason you are unable to return when you said you would, do your best to call or otherwise let your child know you’re running late.

Try to keep anxiety levels lower overall. Ensuring your child eats right, gets enough sleep and has time each day to unwind and do what he or she enjoys can help keep stress and overall anxiety at bay. Also try not to schedule departures or big separation-anxiety-inducing events when your child is overly tired, hungry or cranky.

Anything you can do to help your child build the confidence he or she needs to become more independent and less fearful of being without you can go a long way toward helping separation go a bit easier – and soothing the anxiety of both you and your child.


Study info:

  • Disorder-Specific Cognitive-Behavioral Therapy for Separation Anxiety Disorder in Young Children: A Randomized Waiting-List-Controlled Trial, Schneider S.; Blatter-Meunier J.; Herren C.; Adornetto C.; In-Albon T.; Lavallee K. Psychother Psychosom 2011;80:206–215 (DOI: 10.1159/000323444).
  • Effects of three play conditions on separation anxiety in young children. Milos, Mary E.; Reiss, Steven. Journal of Consulting and Clinical Psychology, Vol 50(3), Jun 1982, 389-395.
  • Childhood separation anxiety disorder in patients with adult anxiety disorders. Am J Psychiatry 1994;151:927-929.