Separation Anxiety

What is Separation Anxiety Disorder?

It is normal for young children to sometimes feel worried or upset when faced with routine separations from their parents or other important caregivers causing them to cry, cling, or refuse to part. Usually such separation anxiety fades as they grow up, begin school, and gain confidence. However, for some children their response to actual or anticipated separations is far more extreme than their peers, and/or continues well beyond the first 1-2 years of school. For these children it is likely that they may have separation anxiety disorder.

Separation anxiety disorder can really interfere with or limit a child or teen's normal activities. He or she can become isolated from peers, and have difficulty developing and maintaining friendships. It can also lead to missed opportunities to learn new things and engage in fun activities. School attendance and performance can drop. Many children and teens with separation anxiety disorder appear depressed, withdrawn, and apathetic.


  • Approximately 4% of youth will suffer from separation anxiety disorder during any given school year.
  • Separation anxiety disorder is the most common anxiety disorder in children under 12 years of age, with a gradual decrease in frequency as children mature into adolescence and adulthood. However, separation anxiety can continue well into adulthood, and even begin in adulthood.
  • Onset of separation anxiety peaks at several points of development including with entry into Kindergarten, between ages 7-9, and again with either entry into Middle or High School.
  • Boys and girls are equally affected by separation anxiety.

Signs & Symptoms

Thoughts (Note: very young children may be unable to identify specific fear thoughts):

  • What if something bad happens to mom or dad?
  • What if I get lost?
  • What if grandma doesn't pick me up after school?
  • What if I get kidnapped?
  • What if I get sick and mom isn't there to help me?

Physical feelings:

  • Stomachaches
  • Dizziness
  • Racing heart
  • General aches and pains
  • Headaches
  • Shortness of breath


  • Anxiety/worry/fear
  • Shame
  • Embarrassment
  • Helplessness
  • Sadness
  • Anger


  • School refusal
  • Avoiding participating in new activities or going places without a parent
  • Refusal to sleep alone
  • Nightmares
  • Asking a parent to be present or available
  • Crying or tantrumming
  • Cannot be alone in a room

Common Situations or Affected Areas

  • School absenteeism
  • Refusing to attend school field trips
  • Inability to make and maintain friendships due to fear of being away from parents
  • Lack of independence in a variety of domains (e.g. sleeping, playing, socializing, going away to college, etc.)
  • Increased dependence among family members

The following video provides valuable information about how separation anxiety affects children and youth, and four effective interventions that can offer relief not only for your child, but for the entire family.

How separation anxiety impacts the child at different ages

In the preschool and early childhood years, separation anxiety presents with more physical and observable signs such as complaints about stomachache or general ailments, as well as crying, clinging, refusal to part, and sometimes full-blown tantrums. Furthermore, these signs are often more common on Sunday nights and Monday mornings with the anticipation of a return to school, as well as following vacations and other extended periods of time off from school. Many parents are able to recognize that their child is struggling with separation anxiety within the first few weeks to months of witnessing a repeating pattern of these behaviours. In addition, teachers are often well equipped to notice and manage separation anxious kids as it is more expected in these early years.

However, as children mature into adolescence, most people expect that youth will move beyond childhood fears of separation from loved ones, and are capable of increased independence. Unfortunately, for some youth these fears either persist or emerge for the first time (sometimes occurring after a stressful event such as a divorce, loss of a loved one, or transition to a new school/community). Adolescents behave differently than younger children, no longer crying, clinging and tantrumming, but instead may decline invitations to hang out with peers, preferring to stay home on weekends, or cut school to return home, and even limiting their adult desires, such as planning to remain at home and attend a local community college rather than going away. As a result, it can be harder than in younger children to understand what is causing an adolescent to behave in this way. Like other disorders, a careful assessment from a trained mental health professional can determine what is going on. .

Click here for Home Management Strategies for Separation Anxiety Disorder


Allison’s Story
James’s Story
The Reynolds’ Story

Allison is a 7-year-old girl who lives with her parents and two younger siblings. Allison has missed numerous days of school since starting kindergarten, and is becoming increasingly upset about going to school. Monday mornings are often the worst, when Allison has temper tantrums and screams for her mom to allow her to stay home. Sometimes she lets Allison stay home to help with her baby sisters. On other days, Allison makes her mom stay in the school hallway for at least an hour before Allison “allows” her to leave. Allison’s mother must be exactly on time picking her up at the end of school; otherwise, Allison threatens not to go to school the next day. Allison also insists that her mom be present when she goes to birthday parties or on play dates, and she wants her mom to be in sight at all times if they go to the park. Allison has nightmares about monsters coming “to get her and take her away”. She also worries about her parents being harmed in an accident or being beaten up by burglars.


James is a 13-year-old boy whose parents have recently separated. James’s parents lovingly refer to James as Velcro-boy as he demands that he be in sight of his parents at all times when at home. When James was younger, he used to come into his parents' bedroom in the middle of the night to sleep with them. Although they allowed it for several years, since their separation they have begun insisting that James sleep in his own room all night. However, they often find him curled up outside their bedroom door many mornings. Lately, James complains of stomachaches and feeling ill, and has missed a few days of school this semester, spending the day with a parent at their work.  James prefers to do things with his parents than with his friends. He refuses sleepover invitations, and is very anxious about the end-of-year camping trip, which includes two nights sleeping away from home.


The Reynolds were in a partnership for over ten years before they decided to adopt an infant five years ago. Since that time, their daughter Serena has been a bright, happy and well-adjusted five year old, who has had an easy time in day care and preschool. However, Serena’s parents have become increasingly concerned about her over the past few months since she started Kindergarten, because several weeks after school began, Serena started complaining of stomachaches and feeling “bad”. In addition, she was having nightmares and refusing to sleep alone, and consequently was far more clingy than usual. As a result of her lack of sleep and being ill, Serena has missed quite a bit of school. The Reynolds have taken turns staying home from work 1-2 days a week to care for Serena and to get her to various medical appointments to determine what is going on. They recently met with their doctor; however, he reports that there is no medical explanation for what is going on, and has recommended the Reynolds see a counselor to determine if this might be psychological problem.  The Reynolds are feeling angry with his conclusion and think he is dismissing them. They are considering seeking a specialist to do a more complete diagnostic workup.