Separation anxiety is a normal developmental stage where children experience anxiety when apart from their primary caregiver, typically occurring from 8 to 14 months and usually resolving by age 2. Children may demonstrate excessive distress, nightmares, and reluctance to separate from their caregivers, particularly in unfamiliar or stressful environments. While no treatment is generally necessary for typical separation anxiety, supportive strategies from parents and caregivers can help alleviate distress and foster independence.

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Fitango Education
Health Topics
Separation Anxiety

2. 1
Overview
Separation anxiety is a developmental stage
during which the child experiences anxiety when
separated from the primary caregiver (usually the
mother).

3. 2
Overview
http://www.nlm.nih.gov/medlineplus/ency/article
/001542.htm

4. 3
Causes
As infants develop, they experience various
emotions, usually in a predictable order. Before 8
months, infants are so new
to the world that they have little knowledge of
what is ordinary and what may

5. 4
Causes
be dangerous, so new situations or experiences
seem usual, and not frightening.
In normal development, during this early
period the infant becomes familiar with the home
environment, and feels
comfortable when parents or other known
caretakers are present. After this

6. 5
Causes
time, lack of familiarity often produces fear
because the infant recognizes
that something unusual is going on.
From 8 - 14 months, children often become
frightened when they meet new people or visit
new places. They recognize their

7. 6
Causes
parents as familiar and safe. When separated from
their parents, particularly
when away from home, they feel threatened and
unsafe.
Separation anxiety is a normal
developmental stage. It helped keep our ancestors
alive and helps children

8. 7
Causes
learn how to master their environment.
It usually ends when the child is around 2
years old. At this age, toddlers begin to understand
that parents may be out of
sight now, but will return later. There is also a
normal desire to test their

9. 8
Causes
independence.
To get over separation anxiety, children
must:
-- Feel safe in their home environment
-- Trust people other than their parents

10. 9
Causes
-- Trust that their parents will return
Even after children have successfully
mastered this developmental stage, separation
anxiety may return during periods
of stress. Most children will experience some
degree of separation anxiety when

11. 10
Causes
in unfamiliar situations, especially when separated
from their parents.
When children are in situations (such as
hospitals) and are experiencing stress (such as
illness or pain), they seek the
safety, comfort, and protection of their parents.
When parents cannot be with

12. 11
Causes
their children in these situations, the children
experience distress.
This is why it is important to stay with
your child as much as is possible during any
medical procedures. Your presence
can actually reduce the amount of pain the child
experiences, as anxiety of any

13. 12
Causes
kind makes pain worse.
http://www.nlm.nih.gov/medlineplus/ency/article
/001542.htm

14. 13
Symptoms
-- Excessive distress when separated from the
primary caregiver
-- Nightmares
-- Reluctance to go to school or other places

15. 14
Symptoms
because of fear of separation
-- Reluctance to go to sleep without the
primary caregiver nearby
-- Repeated physical complaints
-- Worry about losing or harm coming to the

16. 15
Symptoms
primary caregiver
http://www.nlm.nih.gov/medlineplus/ency/article
/001542.htm

17. 16
Treatment
No treatment is necessary for ordinary
separation anxiety.
Parents can help their infant or toddler
learn to adjust to their absence by letting trusted
caregivers babysit the

18. 17
Treatment
child. This helps the child learn to trust and bond
with other adults and
understand that their parents will return.
If medical procedures are needed while a
child is in this stage, it is helpful for a parent to go
with the child

19. 18
Treatment
whenever possible. When a parent cannot come
with the child, exposing the child
to the situation beforehand is helpful; for example,
visiting the doctor's
office before a test. When this is not possible, the
child may display severe

20. 19
Treatment
anxiety by crying, resisting treatment, begging, and
screaming.
Some hospitals provide Child Life
specialists who can explain procedures and
medical conditions to children of
all ages. If your child is particularly anxious and
needs significant medical

21. 20
Treatment
care, it may help to ask your health care provider
about such services.
When separation from parents is necessary,
but exposing the child to it beforehand is not
possible (such as for surgical
treatment), many physicians will recommend the
child take mild sedating or

22. 21
Treatment
tranquilizing medications to help reduce the
trauma.
Explain the situation and experience to the
child and assure him or her that a parent is
waiting, and specifically, where
the parent is waiting.

23. 22
Treatment
For older children who have not outgrown
separation anxiety within the normal
developmental timetable or who have
regressed to it under stress, effective treatments
may include:
-- Anti-anxiety medications

24. 23
Treatment
-- Changes in parenting techniques
-- Counseling for the parents and child
-- Treatment for severe cases may include:
-- Family education
-- Family therapy

25. 24
Treatment
-- Individual psychotherapy
http://www.nlm.nih.gov/medlineplus/ency/article
/001542.htm