4 Separation Anxiety Stages in Kids
Child anxiously clutching a sweater up to their face.
Dealing with separation anxiety in children can be stressful. Every child goes through at least one stage of separation anxiety, but for some children, they continue to experience it past what child development experts would consider "typical." In this blog post, I'll explain the differences between developmentally appropriate separation anxiety and when it might become separation anxiety disorder. I'll also provide strategies on how to help your child when they are struggling with separation anxiety.
What is separation anxiety?
Everyone experiences worry sometimes, even very young children. To understand separation anxiety, it is important to understand attachment theory. Originally developed by psychiatrist John Bowlby after a series of observational experiments, attachment theory explains how humans relate to each other, starting with parents and children. Bowlby and his associates theorized that children naturally forge strong emotional bonds with specific individuals, typically parents and other significant caregivers, to help them survive. For children, caregivers provide food, shelter, and safety from threats. And until they develop more life skills, kids feel unsafe when caregivers are not around.
Early childhood experiences with caregivers lead to children establishing an attachment style. There are four types of attachment style that children can develop: secure, avoidant, resistant (also called anxious-ambivalent), and disorganized. Children who feel consistently supported by parents are more securely attached. They will cry when upset and be easily reassured by parents. Children who perceive parents as uncomfortable with "negative" emotions such as sadness and anger are likely to develop a more avoidant attachment style. Those with an avoidant attachment style tend to minimize their feelings and may even look calm when upset; they also might reject attempts to comfort and because they don't want others to know how upset they actually are. Children who are more anxious-ambivalent may experience parents responses as inconsistent and feel intense fear that their needs will not be responded to. They might exaggerate their emotional experience to seek comfort, but require a lot of reassurance and are difficult to actually soothe, so they can be labeled "dramatic." Children can also vary between their responses and appear disorganized, particularly if they have experienced trauma.
Children who are insecurely attached (i.e. children who have avoidant, anxious-ambivalent, and disorganized attachment styles) are more likely to have higher levels of separation anxiety, including separation anxiety disorder. Parents can help prevent separation anxiety disorder by fostering secure attachment.
However, even securely attached kids will still experience separation anxiety. For young children, they need adults to provide safety, and separation anxiety is a normal way that humans have developed to get their early life needs met. Thus, it's also important to understand the stages of developmentally appropriate separation anxiety to distinguish them from separation anxiety disorder.
Stages of separation anxiety
Separation anxiety looks different at different stages of development. While it is possible for separation anxiety to continue into the adult years, most research focuses on children and the following four stages of development. Separation anxiety develops as your child develops.
Infancy Stage
Babies develop very rapidly, and separation anxiety also changes throughout infancy. Newborns often do not display any signs of separation anxiety until they develop what's called "object permanence." Essentially, for very young babies, seeing is believing. If they can't see something clearly, it doesn't exist to them. That's what makes peek-a-boo so entertaining. To babies, you're literally making yourself disappear and reappear like magic!
Object permanence, or the ability to recognize that things still exist even if we can't see them, begins between 4 and 8 months of age. When this happens, so does separation anxiety in babies. At this time, most babies will begin to understand when you are and aren't there with them. They understand that adults, particularly their primary caregiver, are there to protect them because there isn't much they can do independently, and become worried when they are not there to help them. As this concept solidifies, your child might exhibit increased distress when separated from you. This is why more robust separation anxiety can occur around 9 to 10 months of age.
Toddler Stage
Children continue to develop rapidly even after infancy. Toddlers begin to walk without help, run, climb, draw, and talk in short sentences. While you might think this growing independence would lessen the anxiety your child would feel around separation, it often looks like the opposite.
While they aren't great at keeping track of it, toddlers are more aware of time. With this awareness, any amount of time apart can be noticed whether it is a few minutes or hours. Their awareness combined with their increased abilities makes it easier for toddlers to protest when parents leave. In an effort to avoid separation and the anxiety associated with it, your child might cling to you and cry between the ages of 1 and 3 years. There may be weeks where this happens all the time and weeks where they seem fine. Separation anxiety during toddlerhood often develops in phases.
Preschool Stage
Around the age of 3, children transition into the preschool years. Compared to toddlers, preschool age children are more able to balance, which is why they might want to skip or hop everywhere. Fine motor skill development also means that they are better at holding a pencil to draw and doing other tasks with their hands, such as getting dressed and starting to tie shoes. Most kids at this age use parents as a "safe base" to explore. While they might want to test their skills on the playground and run some distance away from caregivers, you will usually hear preschool age children asking adults to watch them and provide comfort if they get a scrape or a bruise. They can become very upset if they think that a caregiver is not paying close enough attention.
School Age Stage
School age children are typically considered to be between 6 and 10 years old. They are increasingly independent, though they still need a lot of support from adults to learn. Especially in the early school years, children may have trouble leaving their parents to go to class. It is common for children to protest for a few weeks and then begin to feel secure and trust that caregivers will come back for them.
While these are the most common stages, older children and teenagers can still display signs of separation anxiety, particularly in times of stress or following a traumatic event. If your child's separation anxiety has suddenly worsened, you may want to talk to a professional to determine if this is normal separation anxiety or a sign of separation anxiety disorder.
Common signs of separation anxiety disorder
Child covering their eyes with their hands.
So, when does developmentally normal separation anxiety become separation anxiety disorder? According to the American Psychiatric Association (APA), separation anxiety disorder occurs when a person is both persistently and excessively fearful or anxious about separation from attachment figures beyond what is appropriate for the person's age.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines persistent as lasting more than four weeks in children and adolescents and 6 months or more in adults.
Defining what is excessive is a little harder because it depends on the child's level of development. Anxiety is a normal part of life, even for children! Anxiety disorders, including separation anxiety disorder, occur when anxiety goes beyond what would be expected. This is why the stages I reviewed previously are important to consider. Each of the above are a normal stage of separation anxiety. Some signs that your child's separation anxiety is beyond what child experts consider developmentally appropriate include:
Physical symptoms
Many people do experience physical sensations alongside their emotions as part of the body's normal response. You might know the phrase "butterflies in your stomach" for when you're nervous about something. Your child might also have heard it, but that doesn't mean they understand it. Young children are very concrete and are still learning how to recognize and talk about what they feel. The closest experience children have to this sensation is usually a stomachache. That might be why according to one study, 70% of children with anxiety reported having stomachaches. In kids with separation anxiety, they might have frequent stomachaches before school or bed because they are anxious. In severe cases of separation anxiety disorder, children might be so anxious that they actually become physically ill. Other physical complaints that can be signs of anxiety in children include restlessness, fast heartbeat, muscle tension, trouble breathing, feeling dizzy, sweating, and trouble sleeping.
Fear and reluctance to be alone
Children with separation anxiety disorder can feel threatened during even brief periods of separation from trusted caregivers. In severe cases, this might even look like the child being reluctant to be in another room of their home by themself. They might closely follow a caretaker or sibling around the house and become extremely upset if prevented from doing so.
Worrying about something bad happening to them or others during separation
Some children with separation anxiety disorder do verbalize that they are afraid of something happening either to them or to others when they aren't together. Oftentimes this is the underlying fear even if children can't put words to what it is that they are afraid of. For many kids with separation anxiety disorder, the fear is that something bad will happen and prevent them from reuniting with caregivers, such as a car crash or natural disaster. Some children even express worries that they will be lost or kidnapped during even short separations.
Refusing to go to school or events (sports, sleepovers, etc.)
Even if there are plenty of other adults and children around, many children with separation anxiety disorder will experience excessive distress at just the idea of being separated. This can impact the child's ability to attend school or social events even if they really would like to go. The idea of being separated from caregivers even if parents are on the side of the soccer field might make it too stressful for a child with separation anxiety disorder to manage their worries.
Panic or emotional outbursts when separating from caregivers
Similar to refusing to go to events, those with separation anxiety disorder might display emotional outbursts when a separation is necessary. Your child might cling, cry, scream, or hit or kick when they are anticipating a separation. For a lot of parents, these behaviors can be distressing and frustrating, particularly at bedtime. While we as adults might not think of it this way, children often recognize going to bed as a significant separation from caregivers, especially if they have their own room.
Remember: These are potential signs that your child might be dealing with separation anxiety disorder. None of these symptoms are definitive, and if you are concerned that your child might have separation anxiety disorder, it is recommended to speak to your pediatrician or a child therapist.
Supporting your child through separation anxiety stages
Parent holding a smiling child and kissing them on the cheek.
There are things that you can do as a parent to help your child manage their worries
Introduce New Places
If you're leaving your child somewhere new, such as a relative's house, daycare, or school, try to spend time with your child at the new location before leaving. If they have time to explore and acclimate to their surroundings beforehand, kids can be calmer.
Provide Consistent Alternatives
Kids don't just form attachment relationships to parents, but any close caregivers. So if possible, try to keep a consistent babysitter for times when someone else needs to watch your child.
Use Comfort Objects
Let your child bring something from home with them to help them feel safer. Kids often have a favorite blanket or soft toy that can help remind them of home and make them feel more secure. Sometimes family pictures on their desk or attached to their backpack can also help.
Develop a Routine for Separations
Predictability can help ease worries. While it is important for your child to be flexible, developing a routine can help them prepare and reduce anxiety. This can be particularly important when getting ready for bed. Although your child will be asleep, they are still aware that they will be away from caregivers for several hours during the night, so having a bedtime routine can give your child time to prepare, such as with a soothing bath or warm drink. Developing a consistent sleep schedule where your child goes to bed and wakes up around the same time each day can also help with sleeping concerns associated with separation anxiety.
Therapy
If you've tried the above strategies and your child's separation anxiety is still unmanageable, particularly after around the age of 3-years-old, then therapy can be a helpful step. A child therapist can help you implement strategies to help manage your child's anxiety and provide a safe space for your child to work through underlying thoughts and feelings. Sometimes everyone, even children, need support, and your child is not alone in their experience. Anxiety disorders are the most common mental health condition in children. According to the DSM, the prevalence rate for separation anxiety disorder is approximately 4% in children and 1.6% in adolescents.
Get support navigating the stages of separation anxiety alongside your child.
You want to do everything you can to help your child, whatever that may be. No one gives you a manual when you have a child, and that can cause a lot of anxiety for parents! If you think your child might have separation anxiety disorder, it can be helpful to talk to a professional to get some guidance and reassurance. As Licensed Professional Counselor in the Dallas, Texas area that specializes in working with children and adolescents with anxiety, I would love to be that person for you and your family. With a dynamic, personalized approach to therapy, I can help you feel more confident in your skills as a parent and maybe help you add a few tools to your parenting toolbox. I can also help your child learn skills to effectively manage the common issues children and teens face today with confidence.
If you're interested in my child therapy services, you can learn more here or reach out to schedule a free 15 minute phone consultation to see if I am a good fit for your child's and your family's needs.
