Separation anxiety in children

Many children experience separation anxiety, which means being nervous or worried about being apart from loved ones. They may not want you to leave when you drop them off at school or day care. It can be difficult to know what to do when your child experiences this. Sara Loftin, LPC, RPT, Clinical Therapist at Children's Health℠, explains what fuels separation anxiety and how you can help your child feel better.

What is separation anxiety?

Separation anxiety is when children experience worries or nervousness when separating from loved ones. Children with more severe separation anxiety may refuse to leave home, have nightmares, or experience uncontrollable worries that a loved one will be harmed.

"Separation anxiety is a normal part of development for children. It typically starts around age 8 to 12 months and usually ends for toddlers around ages 2 or 3," Loftin says. "It's most common with babies and toddlers but can also be experienced by teenagers transitioning to high school or those leaving for college."

When children experience separation anxiety, they have difficulty being apart from their primary caregivers; they may even want to be in the same room. Being separated causes feelings of worry, fear and anxiety.

What are the signs of separation anxiety in children?

Signs of separation anxiety depend on your child’s age. In children under age 4, symptoms of separation anxiety may include:

• Clinging to parents
• Crying
• Nightmares
• Stomach aches
• Throwing tantrums

School-aged children and teens may show symptoms of separation anxiety, such as:

• Asking specific questions about how long a parent will be gone
• Changes in behavior, such as acting out
• Declining grades
• Extreme resistance to going to school, including crying or screaming
• Fear of a parent's death
• Headaches or stomach aches, even hours before the separation occurs
• Increased irritability and mood swings
• Losing interest in things they love
• Nightmares or sleep disturbances
• School-aged children may regress to younger behavior, such as wanting to sleep in their parents' bed or having toileting accidents
• Trouble concentrating

What triggers separation anxiety in kids?

Common triggers of separation anxiety include:

• Change in environment, such as moving to a new place or attending a new school
• Change in schedule or routine, such as starting school or going on vacation
• Changes in health, such as becoming ill or injured

How to ease separation anxiety in kids

The key to overcoming separation anxiety is helping your child feel safe. Talk to them about how you are staying safe and how the school is keeping them safe. You can also help ease your child’s separation anxiety by:

1. Allowing your child to ask questions, even if you don't have all the answers. And remember to be honest. Honesty builds trust.
2. Following through with what you say to your child. If you tell your child you'll be back in 10 minutes, make sure you are. If you are tempted to let your child stay home from school when they are upset, don't. Giving in may make the separation anxiety worse in the future.
3. Practicing separation. Try leaving for short periods – take a walk around the block. Practice routine separation and remain calm throughout. If you feel anxious, your child can tell and will also feel anxious.
4. Creating rituals and routines. Create separation rituals, such as a goodbye hug or giving them a separation item like a stuffed toy or sticker. Having this routine can help your child feel positive and safe about the separation. Sticking to routines throughout the day helps children predict what will happen.

"Children feel safe when there is a predictable and structured environment with limits," Loftin says.

Helping your child feel more independent may also help reduce their separation anxiety. Presenting children with simple choices, such as which cup to use or what outfit to wear, can help them feel more independent and empowered.

When should parents worry or visit a doctor due to separation anxiety?

Separation anxiety can be normal and may be temporary. If it begins to affect your child's ability to perform normal tasks, talk to your child's doctor.

"When anxiety is impacting your child's school attendance or your work attendance as a parent, that's a red flag," Loftin says.

Prolonged symptoms, especially symptoms like regressing to younger behaviors, difficulty sleeping or experiencing headaches and stomach aches, may also indicate that your child should see a physician.

"There are lots of different ways to help a child with separation anxiety," Loftin says. "Play therapy can be helpful for younger children, and Child-Parent Relationship Training can enhance the connection between child and parent to help them feel safe, too."

Learn more

Children's Health provides comprehensive services to support children's and teens' mental health. Learn more about our Pediatric Psychiatry and Psychology Programs.

You can also access emotional care and support from the comfort of your home with Virtual Visit Behavioral Health. With a behavioral health care appointment, you can speak to a board-certified psychiatrist or licensed therapist using video technology. Learn more about Virtual Visit Behavioral Health.