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The Informed Parent

Separation Anxiety Disorder

by Peter W. Welty, M.D., F.A.A.P.
Published on Oct. 15, 2007
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The beginning of the school year is a stressful time for everyone, with new responsibilities, demands and expectation. When a child’s anxiety begins to interfere with his or her usual normal activities at home, at school or with friends, further investigation is warranted.

Some children may become anxious about attending school and leaving their parents. Young children especially may worry about their parents, imagining that some harm could come to them while they are separated from them. This is known as separation anxiety disorder in which the child is fearful that some harm may come to the parent. The child worries that the parent may be the victim of an accident or other harm. As a result of this intense fear, the child may be afraid to be apart from his or her parent. This could become apparent at bedtime or before leaving for school. The child may develop stomachaches, headaches, or have nightmares. 

Generally the age of the child tends to determine what kind of symptoms he or she might have. The youngest children, ages 5-8 years, tend to be fearful of a calamitous accident befalling the parent. Older children, ages 9-12 years, tend to show intense distress at the time of separation. Teenagers may have somatic complaints such as stomachaches or headaches, and may refuse to attend school

Children with school refusal could have other concerns as well, such as depression, conduct disorder, or other issues. The thorough evaluation of an anxiety disorder requires input from all sources of the child’s life. Stressors such as illness or death of a family member, marital difficulties between the parents, or other school issues could significantly play a factor in the development of the child’s anxiety. It is important to obtain input from the school on the child’s academic and school functioning as well. Input from the child’s pediatrician regarding the interplay of a possible medical issue is also important.

Treatment for an anxiety disorder in children generally utilizes a short-term use of medication to eliminate the symptoms of anxiety. It is combined with therapeutic approaches to address the source of the anxiety. In this manner, the child feels better and is able to return to school. He learns to address his worries and fears in a constructive and useful way.

See your doctor if you have any further questions.




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