1. Symptoms, Causes, and Treatment

2. Separation Anxiety  What is separation Anxiety?  What age is this most common in?  About what percentage of all school children experience separation anxiety?

3. Separation Anxiety Separation anxiety disorder is a medical condition that is characterized by significant distress when a person is away from parents, another caregiver, or home. Separation anxiety is most common between the ages of 5-7 and 11-14 - when kids have to deal with new challenges in elementary and middle school. Separation anxiety occurs in about 10-15% of all school aged children at some time and some degree

4. Separation Anxiety Healthy separation anxiety is typically first seen around 8-10 months. Often called stranger anxiety Children also may become mildly anxious around 18-24 months when they are starting to explore the world more yet wanting the security of caregiver.

5. Separation Anxiety What are the symptoms of separation anxiety?

6. Separation Anxiety  Symptoms of separation anxiety include: Stomach aches Headaches Shakiness or trembling Rapid Heart rate Sweating Revved up respiration

7. Separation Anxiety  Symptoms of separation anxiety cont. Excessive worry that something bad will happen to their parents or themselves Diarrhea Vomiting Tantrums Clinging Refusing to be left alone

8. Separation Anxiety  At home other symptoms may be seen: Refusal or reluctance to participate in ordinary outings or activities Difficulty sleeping alone Scary dreams about being separated

9. Separation Anxiety  At school other symptoms may be seen: Avoidance of activities Low Self-esteem Difficulty concentrating Learning disorders and cognitive problems which are often overlooked Behavioral or cognitive effects from medication

10. Separation Anxiety Children may certainly not exhibit all of the symptoms. They will not complain about being anxious, but instead say “My stomach hurts” or “I have a headache.”

11. Separation Anxiety  First day jitters are normal.  Particular traits and temperaments make some children more prone to having separation anxiety. What might some of these traits and temperaments be?

12. Separation Anxiety What causes separation anxiety?

13. Separation Anxiety  Sensitive children are more prone to separation anxiety or anxiety in general  Parent in the household with anxiety increases child’s chances of developing separation anxiety

14. Separation Anxiety  First day of school – child is stressed  Stomach ache, headache occurs after being alone at school  Day two child remembers the feelings from the previous day and starts to anticipate the feelings happening again.  This results in anxiety forming around the act of going to school

15. Separation Anxiety How long does separation anxiety last?

16. Separation Anxiety  Most children do adjust eventually.  Depends on the child  Kids learn from parents  If parents are late …

17. Separation Anxiety  Rule of thumb: If the child is not adjusting within a month of starting school, seek help Assistance from teacher or guidance counselor to help team up and calm the child

18. Separation Anxiety  How do you treat separation anxiety??

19. Separation Anxiety  For Parents: Encourage independence early Learn to calm yourself Explain what is happening to the child Teach children how to calm themselves

20. Separation Anxiety  Psychological Interventions Counseling can help children and caregivers understand the cause of symptoms as opposed to being seen as having a flawed attitude or personality. Counseling can reduce the impact of symptoms on daily life. Help parents with specific needs for a child

21. Separation Anxiety  Individual psychotherapy Generally recommended as the first line of treatment Can help reduce symptoms and allow children to express feelings as well as to allow caregivers the chance to express feelings of self-blame Cognitive Behavior Therapy (CBT) Can teach young people new skills to reduce anxiety when separating from a caregiver In CBT the child is helped to become aware of and to describe negative thoughts, feelings or reactions. The clinician guides the child to think of new, more positive alternatives.

22. Separation Anxiety Parent Guidance Sessions Can help parents to manage their child’s illness, identify effective parenting skills, learn how to function as a family despite the illness, and to address feelings that arise when raising a child with the disorder. Group Psychotherapy Provides a safe place to talk with other kids who have the same issues School-based counseling Provides guidance on how to navigate the social, behavioral, and academic demands of the school setting

23. Separation Anxiety  Biological Interventions (Medication)  Antidepressants