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DEALING WITH SEPARATION ANXIETY IN YOUNG CHILDREN

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By: Dr. Tasaduq

When was the last time you played a game of peek-a-boo with an infant? Have you ever wondered why infants show so much surprise when you hide your face and then reappear within seconds? The answer lies in object permanence, a term first coined by Swiss psychologist Jean Piaget. According to Piaget, until the age of eight months, infants are not aware of objects outside of their sight. A classic case of out-of-sight out-of-mind. Between 8 and 12 months, object permanence—the understanding that an object still exists, even if you can’t see it—begins to develop. With this remarkable developmental milestone however, comes a firestorm of tears and tantrums. Children begin recognizing their primary attachment figures (usually the parents or the caregiver) and the minute they are out of sight, decide to start bawling.

Separation anxiety, as it is called, first hits around the age of eight months and as children continue to develop a stronger bond with the parent or caregiver, it peaks around toddler dom, and and is very noticeable when a child first enters preschool. At this stage, separation anxiety may present itself as:

➡Not wanting to go to school

➡Being clingy or shadowing one parent or caregiver all the time

➡Throwing a tantrum or feigning illness (headache, stomach ache, etc) when faced with separation.

The good news is that separation anxiety is a normal developmental stage and is very common in young children. It is usually a positive sign that the child recognizes and has formed healthy attachments with loved ones. The bad news is that you have to brace yourself for a tantrum-ridden goodbye every day. So if you are a parent feeling frazzled at the school gates every morning, here are six tips to ease separation anxiety:

➡Do not sneak away: As much as you are tempted to, sneaking away will only make your child feel abandoned. Have a clear parting routine. For the first few days, opt to stay for a short period of time instead of leaving abruptly. As the week progresses, say a proper goodbye and let your child know clearly when you will return (it might help to say things like after snack time, after play, and so on). Your child needs to know what to expect.

➡Get them engaged in an activity: It is important that you get the child engaged in an activity that draws their attention before you leave (for instance, building blocks, colouring, etc). Have a chat with the teacher about what helps distract your child the best. For example, some children are calmed by a specific storybook or song. Figure out what works best for your child and discuss it with the teacher.

➡Keep the conversation going at home: Before your children start preschool, take them on an informal visit and build up some excitement about the activities in store. Once school commences, learn the names of the teachers and bring them up in conversations with your children. Young children often use parents as a bridge when building relationships with another adult. By relating positively to your children’s teachers, you will help facilitate a great relationship. Involve your children in preparing for a school day; even very young children can help packing a snack box, laying out clothes, etc.

➡Do not model anxiety: Children are very skilled at picking up nonverbal cues from their parents. If you are an anxious parent, chances are your children will mirror your anxiety. If you can stay composed amidst all the high-decibel crying, that’s half the battle won.

➡Comfort object: Comfort objects are objects of emotional importance to children, such as a cuddly toy. These objects are reminders of the warmth and security of home, so allow anxious children to carry them to school. As children settle into the school, peer influence will set in and gradually the dependence on the comfort object will diminish.

➡Practice short separations: Leave your child for brief periods of time with another trusted adult whom your child enjoys being with, for instance, with a grandparent while you run an errand. As children begin to embrace the change, gradually extend the separation time.

WHEN SHOULD YOU HEAR ALARM BELLS ?

Separation anxiety usually eases by the time children are three years old. However if you notice symptoms of separation anxiety in a child aged 4.5–5 years and if the symptoms persist over a month, then it could be indicative of a deeper disorder known as Separation Anxiety Disorder (SAD). Persistent school refusal and excessive worrying are common in children with SAD. It reaches a stage where it interferes with the child’s everyday activities. SAD evaluations are carried out by clinical psychologists or psychiatrists using specially designed interviews and assessment tools. Treatment for SAD usually includes therapy, medication, or a combination of both. In younger children indirect therapies such as play therapy or art therapy work well, whereas Cognitive Behavioral Therapy (CBT), relaxation techniques and graded school exposure are effective in treating older children. Medication is usually used only in cases of severe anxiety .

The Writer is Resident Doctor at Acharya Shri Chander College of Medical Sciences and Hospital, Jammu.

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