Separation Anxiety in Toddlers
September 27, 2004, KidsHealth.org

You've always dropped off your 1-year-old child at day care without a problem - until today. She's anxious and distressed, she's clinging to you for dear life, and she's making it clear she doesn't want you to leave. She resists the teachers' attempts to calm her and seems to want nothing to do with the other kids. All she wants is you, and she screams and cries every time you try to walk out the door. Finally, you make one last attempt to comfort her and head to the car, feeling guilty, upset, and confused. And the same scenario plays out every day for the entire week.

Sound familiar? If so, then your toddler is experiencing separation anxiety, a normal phase of childhood development. But even though it's perfectly normal, it can be extremely unsettling for parents.

Understanding what your child is going through and having a few coping strategies in mind can go a long way toward helping both of you get through it.

What Is Separation Anxiety?
Separation anxiety is just one of the many different stages of behavioral growth your child will go through, and it affects most babies and toddlers at some point in their young lives. During this stage, a child does not want to be separated from her parent and she experiences intense distress whenever her mom or dad tries to leave her with someone else.

Separation anxiety usually begins between the ages of 8 months and 1 year and peaks between the ages of 1 and 2. However, the timing can vary widely from child to child. Some children may experience it later, around 3 or 4 years of age. Some may never experience it. And for others, there are certain life stresses that can trigger feelings of separation anxiety: a new child care situation or caregiver, a new sibling, moving to a new place, or tension at home.

How It Develops
When your baby was first born, you likely noticed that she adapted pretty well to other caregivers. This is typical for most infants. You probably felt more separation anxiety than she did when you first left her with a relative, babysitter, or a day care provider! As long as their needs are being met, babies younger than 8 months typically adjust well to other people.

Around 8 months to 1 year - sometimes sooner, sometimes later - this starts to change. Your baby may seem anxious around unfamiliar people and situations, and she may not want to let you out of her sight. This behavior is known as stranger anxiety. Actually this is a good sign, because your baby is starting to tell the difference between familiar and unfamiliar people.

Between 1 year and 2 years, your child is growing into a more independent toddler - yet she is even more uncertain about being separated from you. This is when separation anxiety typically develops, and your child may become agitated and upset whenever you try to leave her. Whether you need to go into the next room for just a few seconds, leave your child with a sitter for the evening, or drop her off at day care, you may find that she cries, clings to you, and resists attention from others.

Developmentally, your child is beginning to understand the concept of object permanence - that is, that there's only one of you, and when she can't see you, that means you've gone away. However, she doesn't yet understand the concept of time, and she doesn't know if or when you'll come back. So whether you're in the kitchen, in the next bedroom, or at the office, it's all the same to your toddler. You've disappeared. She'll do whatever she can to prevent this from happening.

And she does understand the effect her behavior has on you. If you come running back into the room every time she cries, and then stay with her longer or cancel your plans completely, she'll keep using this strategy to avoid separation.

What You May Be Feeling
During this stage, you're likely to experience a host of different emotions. You may feel flattered that your child doesn't want to leave you, especially if she's been adjusting well to other caregivers until now. It may be gratifying to feel that she is finally as attached to you as you are to her. At the same time, you're likely to feel guilty about taking time out for yourself, leaving her with a caregiver, or going to work. And you may start to feel overwhelmed by the amount of attention she seems to need from you.

Try to keep in mind that your child's unwillingness to leave you is a good sign that healthy attachments have developed between the two of you. Eventually she'll be able to remember that you always return after you leave, and these memories will be enough to comfort her while you are gone.

Making Good-Byes Easier
There are a number of strategies you can use to help ease your child (and yourself) through this difficult period. [list][*]Timing is everything. Try not to start day care or child care with an unfamiliar person between the ages of 8 months and 1 year, when separation anxiety is first likely to present itself. Also, try not to leave your child when she's likely to be tired, hungry, or restless. If at all possible, schedule your departures for after naps and mealtimes.[*]Practice being apart from each other, and introduce new people and places gradually. If you're planning to leave your child with a relative or a new babysitter, then invite that person over in advance so they can spend time together while you're in the room. If your child is starting at a new day care center or preschool, make a few visits there together before she starts a full-time schedule. Practice leaving her with a caregiver for short periods of time so that she'll get used to being away from you.[*]Be calm and consistent. Create a good-bye ritual during which you say a pleasant, loving, and firm good-bye. Stay calm and show confidence in your child. Reassure her that you'll be back - and explain how long it will be until you return using concepts she'll understand (such as after her lunch or after her nap) because she can't yet understand time. Give her your full attention when you say good-bye, and when you say you're leaving, mean it; coming back will only make things worse.[/list:u]It's Only Temporary
Try to keep sight of the fact that this phase, like many others, will pass. And every child is different. If your child has never been cared for by anyone but you, is naturally shy, or has other stresses, such as a new sibling or a health condition, then it may be worse than it is for other kids. Most kids eventually outgrow it.

At the same time, you should trust your instincts. If your child refuses to go to a certain babysitter or day care center or shows other signs of tensions, such as trouble sleeping or loss of appetite, then there could be a problem with the child care situation.

If intense separation anxiety lasts into preschool, elementary school, or beyond, then you should discuss this with your child's doctor. It may be a sign of a more severe form of anxiety known as Separation Anxiety Disorder (SAD). Children with this disorder fear being lost from their family members and are often convinced that something bad will happen when they're apart. Other symptoms of SAD include: [list][*]panic symptoms (such as nausea, vomiting, or shortness of breath) or panic attacks before a parent leaves [*]nightmares about separation [*]fear of sleeping alone [*]excessive worry about being lost or kidnapped or going places without parent[/list:u]Talk to your child's doctor if your child shows any of these symptoms.