CLINICAL EDITOR’S COMMENTS: The COVID-19 pandemic has exacerbated separation anxiety in children and adolescents.
T
he author has
seen an increase
in children with separation anxiety in the last year. In that year, children
were informed that everything they knew to be safe (e.g., school, friends, etc.) was in fact unsafe. Protection measures imposed new requirements, such as masks, social distancing, and quarantines. With schools in the United States beginning to have in-person classes, children are leaving home to attend. For some, this will be the first time they have been around more than a few people in months. Students may feel anxious about COVID, a change in routine, large crowds, increased social interaction, and differing expectations regarding schoolwork. Ann and Robert H. Lurie Children’s Hospital of Chicago (2021) polled 1,000 caregivers has negatively impacted their children’s mental health. Loades et al. (2020) agreed children and adolescents may be more likely to experience depression and anxiety after required separation and social isolation secondary to the COVID-19 pandemic. In this article, the author explores separation anxiety, including symptoms, ways to assess for separation anxiety, and practical skills to reduce these symptoms.
What is Separation Anxiety?
Separation anxiety is a common developmental challenge among toddlers and babies and can often be a sign of a secure attachment (Berger, 2011). Separation anxiety generally begins around nine months of age as babies are able to experience and express fear (Berger, 2011). According to Schaefer and DiGeronimo (2000), Separation anxiety is not developmentally typical in older children; however, people all over the world are living in uncommon times. Jiao et al. (2020) identified a rise separation-related anxiety and began. As children are expected to leave their parents and attend school, many are likely to feel anxious to be away from their primary caregivers, causing separation-related anxiety.
As outlined in the Diagnostic and Statistical Manual of Mental Disorders 2013), separation anxiety becomes separation anxiety disorder when a child exhibits fear that is excessive or inappropriate for the
child’s developmental stage regarding separation from caregivers. of separation anxiety,
including a fear of being alone, fear of
abandonment, somatic complaints or a fear of physical illness, and worries regarding disastrous events. At school, children and adolescents often experience declining grades and concentration separation anxiety can lead to social isolation and poor academic performance as well as school refusal. Children and adolescents may exhibit psychosomatic symptoms, such as stomach aches and headaches when feeling anxious regarding the separation, which may manifest for hours prior to leaving home to attend school. A child’s symptoms, including anxiety or avoidance must last four weeks at minimum to warrant a diagnosis (APA, 2013).
Assessment and Treatment
Assessing for early experiences with strangers, new situations, daycares, level of shyness, and ability to sleep alone all support the development of a robust conceptualization of the client. Questions regarding family history, including attachment history, emotional disorders, and familial anxiety disorders could be beneficial. Adverse events, such as hospitalizations, deaths/losses, separation/divorce, and moving are all areas that are important to al. (2020) noted children who presented with anxiety symptoms prior to the pandemic may exhibit worsening symptoms during and after social distancing policies were implemented widely. Therefore, assessing how the child is coping regarding the COVID-19 pandemic is vital, by asking questions pertaining to the child’s response to virtual learning, mask mandates, and quarantines.
encouraged therapists to teach children coping skills, including relaxation techniques such as progressive muscle relaxation and diaphragmatic breathing and cognitive-based procedures, such as
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