Separation Anxiety in Children

What are the signs and symptoms of separation anxiety?

Children with separation anxiety may become homesick, not want to attend school or other activities, avoid visiting friends' houses or be unable to enter a room on their own. They may also have difficulty around bedtime and may insist that someone stay with them until they’re asleep.

Other common symptoms include stomach aches, headaches, nausea, emotional overwhelm and/or vomiting when separation occurs. 

Here are a few questions to ask yourself if you suspect your child might have separation anxiety:

• Does your child show excessive anxiety relating to their separation the night before it occurs? 
• Is your child constantly worried about something happening to a family member, such as an accident or illness?
• Does your child worry about getting lost or accidently separated at social events or supermarkets?
• Is your child excessively scared of school or participating in extracurricular curricular activities?
• Does your child refuse to go to sleep without being near a parent or carer? 
• Does your child have nightmares about separation?
• Does your child complain of physical symptoms before being separated from their home or significant family members?

What are the causes of separation anxiety?

While the exact causes of separation anxiety can be hard to pinpoint, there are several risk factors that can increase the likelihood of a child having separation anxiety (Essau & Petermann, 2002), including:

• Having a parent who has an anxiety disorder
• Exhibiting behavioural inhibition (crying/fretting, fearfulness, cautiousness and clinginess) as a young child
• Having had an adverse experience, such as a traumatic introduction to child care, parental illness or perceived threats of abandonment
• Having an overprotective or overly reassuring parent

How is separation anxiety prevented and treated?

According to Dr Kimberley, prevention is key during periods of transition if your child has exhibited signs of separation anxiety in the past.

Because starting a new school year is a common trigger for separation anxiety, here are some strategies to help prevent it before the first day. These same strategies can be applied to any new situation.

1. Get to know the school 

Whether your child is starting kindergarten or returning to school after the summer holidays, familiarising them with the school environment before the first day can help keep separation anxiety at bay.

“Do a couple of drive-bys to see what’s happening and check out the playground equipment,” says Dr Kimberley. “If you’re able to enter the school grounds and walk around to find some safe havens for your child, that’s even better. Children can feel more self-conscious when separation anxiety happens in a social context, so having a safe place to go - such as the computer lab or the library - can help.

Dr Kimberley also suggests attending any orientation or meet-the-teacher sessions that are offered before school starts. “The more opportunities you have to get comfortable with the school setting, the better,” she explains. “If you can’t meet the teacher, you can try to search for their photo online.”

2. Organise play dates with classmates

When you find out your child’s class placement, reach out to parents you know or introduce yourself via text message or email to other parents on your child’s class contact list to organise play dates before school starts. 

“It’s always helpful for your child to have a few familiar faces in the classroom on the first day of school,” says Dr Kimberley. “If you can meet up with classmates once or twice in the couple of weeks before school starts, your child will feel more secure.”

3. Create a social story 

Originally created by Carol Gray to help children with autism, social stories can also help ease separation anxiety. Social stories help to explain unfamiliar territory to children using visuals. Print out photos of various areas of the school and important staff members - the playground, oval, toilets, classroom, teacher, principal and so on - and place them in a folder or staple them together like a book. You can take your own photos at school, ask your child’s teacher to email some or download photos from your school’s website or Facebook page. 

Write a description under each photo, and then regularly read the social story with your child in the weeks leading up to the start of school. This may be as simple as “I put my uniform on before school”, “We park a few blocks away and walk to the school gate”, “I hug Mum or Dad goodbye and walk through the gate”, “I play on the equipment until the bell rings” and “At the end of the day, I play with friends until Mum or Dad collects me from inside the gate”. By the time school starts, your child will be familiar with the school environment and feel much more at ease. 

4. Use a graded exposure approach

When children experience intense separation anxiety or school refusal due to separation anxiety, a psychologist might recommend a graded exposure approach. Here is a sample graded exposure plan for parents to complete with the child experiencing anxiety:

1. Before school starts, drive past the school gate slowly but without stopping (over the course of three days).
2. Park outside school without leaving the car (over the course of three days for extended periods).
3. Walk past the school gate (after school hours on three occasions).
4. Arrange a phone call with your child’s teacher/school counsellor and check in on a daily basis for three days in a row.
5. Arrange a video call with your child’s teacher/school counsellor or an in-person meet-up in the school car park (while your child remains in the car).
6. Develop a structured plan for your child to briefly visit the school (outside student hours) with their parent.
7. Ask your child to walk by their school independently (during school hours).
8. Ask your child to hand deliver a note to the school office (outside student hours).
9. Ask your child to meet a peer from school in a structured context (outside school).
10. Ask your child to meet the same peer at the school office (inside school hours).
11. With the psychologist’s support, negotiate a gradual return to school in 10 to 15-minute increments and gradually extend the time with each success.

How Quirky Kid can help your child

The Quirky Kid Clinic is a unique place for children and adolescents aged 2-18 years. We work from the child’s perspective to help them find their own solutions. If you suspect your child may be experiencing symptoms of separation anxiety, you can:

Enrol your child in our award-winning Basecamp anxiety program.

Book an individual session with one of our experienced child psychologists.

Contact us for more information.