Between the ages of 8 months and 2 years, it's normal for a child to cry when its mother leaves the room or a stranger enters it. Neither overprotection nor constant punishment will change the situation. It's a natural stage that usually passes on its own. If, however, an older child continues to react to potential separations with unreasonable fear, professional help may be needed. If the problem isn't resolved, it can damage the child's self image, leading to teenage and adult emotional problems.

Separation anxiety disorder may run in families. It is most likely to affect shy, nervous children. The disorder is often triggered by a major change in the child's life, such as a death or hospitalization, the parents' separation or divorce, a new school, or a move.

Signs/Symptoms

Children with this disorder express their anxiety in a variety of ways:

• Screaming or temper tantrums when left with others

• Insistence on sleeping with parents in their room

• Difficulty going to sleep

• Fear of the dark

• Nightmares

• Fear of sleeping away from home

• Difficulty settling down

• Fear of meeting new people

• Clinging to parents at home

• Following parents from room to room

• Worrying about the family's safety in the home

• Fear of going to school

• Headaches, bellyaches, or body aches when a separation approaches

• Sadness

• Quietness

• Lack of concentration

This disorder poses the threat of a vicious circle in which the child's dependence and the parents' protectiveness reinforce and amplify each other. For that reason, both the parents and the child may need to see a counselor. If the youngster refuses to go to school, an immediate priority is to arrange a return as quickly as possible.

If this problem isn't successfully resolved, it can lead to greater emotional problems, such as depression, as the child grows older.

WHAT YOU SHOULD DO

• Try to prepare the child for a change such as a divorce or a move. Talk openly about such changes and encourage him to voice his worries. Give reassurance that everyone will be safe.

• Discuss the problem with the child's teachers. They may be able to give you tips for dealing with this disorder both at home and at school.

• Praise and reward the child for overcoming his fears.

Call Your Doctor If...

• The child can't sleep.

• You fear you will lose patience with the child.

Conditions and Treatments:

• AIDS/HIV

• Allergies

• Anxiety

• Arthritis

• Asthma

• Breast Cancer

• Cardiac Disease

• Cancer

• Cosmetic Surgery

• Depression

• Diabetes

• Digestive Problems

• Headaches

• Hepatitis

• High Blood Pressure

• High Cholesterol

• Impotence

• Infections

• Infertility

• Kidney Disease

• Liver Disease

• Migraines

• Respiratory

• Problems

• Sexually Transmitted Diseases

• Urological Conditions

• Separation Anxiety Disorder

SYMPTOMS

Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached, as evidenced by three (or more) of the following:

• recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated

• persistent and excessive worry about losing, or about possible harm befalling, major attachment figures

• persistent and excessive worry that an untoward event will lead to separation from a major attachment figure (e.g., getting lost or being kidnapped)

• persistent reluctance or refusal to go to school or elsewhere because of fear of separation

• persistently and excessively fearful or reluctant to be alone or without major attachment figures at home or without significant adults in other settings

• persistent reluctance or refusal to go to sleep without being near a near a major attachment figure or to sleep away from home

• repeated nightmares involving the theme of separation

• repeated complaints of physical symptoms (such as headaches, stomachaches, nausea, or vomiting) when separation from major attachment figures occurs or is anticipated

The duration of the disturbance is at least 4 weeks.

The onset is before age 18 years.

The disturbance causes clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning.

The disturbance does not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and, in adolescents and adults, is not better accounted for by Panic Disorder With Agoraphobia.