Karen Wang
Parenting, Resources
10 Ways to remove separation anxiety from your special needs child
Sooner or later, almost all parents have to deal with a child’s separation anxiety. Separation anxiety is defined as a developmental stage in which a child suffers distress when apart from a primary caregiver, usually starting around 8 months of age when the child comprehends object permanence. For some parents of children with special needs, separation anxiety can be an emotionally intense experience that stretches over several years and limits a family’s activities. I know because I go through the whole process every day with my own children. It has been helpful to me to understand the differences between typical and atypical separation anxiety - and even more helpful to find ways to work through the anxiety not only without tears, but also with increased self-confidence and independence for my children. Here is a summary of three different types of separation anxiety:1. Typical Separation Anxiety:
In Caring for Your Baby and Young Child published by the American Academy of Pediatrics, the authors report that separation anxiety “usually peaks between ten and eighteen months and then fades during the last half of the second year.” Sometimes the child’s anxiety returns at different times in early childhood as the child balances between infancy and independence. The authors continue, “If your child has a strong, healthy attachment to you, her separation anxiety probably will occur earlier than in other babies, and she’ll pass through it more quickly. Instead of resenting her possessiveness during these months, maintain as much warmth and good humor as you can. Through your actions, you’re showing her how to express and return love. This is the emotional base she’ll rely on in years to come.”2. Separation Anxiety from birth:
Some children experience severe anxiety even as newborns, and it does not improve over time without intervention - in fact, it may worsen. These children are usually diagnosed later with a mood disorder or a neurological disorder such as autism, ADHD or brain injury. My husband and I knew immediately that our son was different from most other babies because of his severe anxiety. Although babies do not develop object permanence until they are 8 months old, they do recognize the scents, sounds and tactile sensations of their parents. Some babies like my son may become dependent on these sensations to remain calm.3. Separation Anxiety Disorder:
The Diagnostic and Statistical Manual (DSM-V) identifies Separation Anxiety Disorder as a “developmentally inappropriate and excessive fear or anxiety concerning separation” causing “clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning.” The symptoms include:- recurrent, excessive distress, nausea, vomiting, headaches or stomachaches when anticipating or experiencing separation from an attachment figure
- persistent and excessive worry about loss of attachment figures or possible harm to them, such as illness, injury, disasters, or death
- persistent reluctance or refusal to go out because of fear of separation
- persistent and excessive fear or reluctance about being alone or without major attachment figures at home or in other settings
- persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure
- nightmares on the theme of separation
Finding a Cure
The “cure” for separation anxiety is emotional security that is allowed to grow over an extended period of time. But emotional security may be elusive for a child with chronic, severe anxiety. In my son’s case, I learned how to teach him emotional security through habit, repetition and reinforcement. When he was 3 years old, he developed a phobia of schools and could not bear to see me leave his sight; but when he was 4 years old, he made a successful, happy transition to a specialized preschool program for 3.5 hours per weekday. How did he do that?1. Start with very brief or superficial separations
My son’s speech therapist worked out of her home office. For the first few sessions, I remained in the room with him, then I gradually removed myself for increasing periods of time. The office door was glass, so my son could see me during his therapy sessions. I made sure that I was always absorbed in reading something so that he could see me, but not engage me - I wanted him to engage his speech therapist instead. Similarly, when my son switched to a more supportive preschool, I attended the class with him for the first few minutes, then kissed him goodbye and stepped out of the room, where I stood on the other side of a glass door. On the first day, he remained in class for 5 minutes. His teacher and I gradually increased the length of time he spent in class until he remained for the entire 3.5 hour school day. I also stepped further and further away from the classroom every day, until I was at the school entrance for drop-off and pick-up. The total time for this transition was 6 weeks. At home, I would make sure my son was engrossed in a fun activity with my husband, then announce that I was going to the grocery store. I always gave an exact time for my return.2. Use positive language
One of the many reasons my son developed a phobia of schools was the negative language that his teacher used regarding separation. Whenever my son asked for me, the teacher would say, “Your mother is gone” or “She left.” These words were utterly devastating to my son. A positive way to discuss separation should always include the caregiver’s return time, such as, “Your dad will pick you up at 11:45” or “Your mother will be back right after story time.” Comfort during the caregiver’s absence should also be emphasized: “I will stay with you and we will have fun together until it’s time for you to go home.” It’s easy to include pick-up time on a picture schedule, too.3. Social story & photo story
Speaking of pictures, consider making a picture story that includes photos of the child with alternate caregivers and school classrooms. I try to arrange a visit for my son with his new teacher at the beginning of the summer vacation and again right before school starts. He can look at the photo of his new teacher and classroom all summer long, and he knows exactly what to expect on the first day of school. Social stories work best when illustrated, and these photos fit the job perfectly.4. Magic bracelet
Elizabeth Pantley, author of The No-Cry Separation Anxiety Solution, recommends that parents give a child a “magic bracelet” to whisk away anxiety. The bracelet can be made of materials that remind the child of his or her parents, or it may be something that belongs to the parents. The idea is to use the bracelet as an attachment object to transfer emotional security from the parent to the child.5. Say goodbye with a smile
When I separate from my children, I first make sure that they are engaged or about to be engaged in something positive, then I say goodbye. I often tell them briefly what I will be doing while we are apart, and I always give my return time. One kiss and then it’s done.6. Let the child walk away from the parent
Pantley writes, “Some children prefer to be the ones who walk away in a separation situation. They find it easier to leave than to watch you retreat and walk away from them.” My son was comfortable leaving me to go on errands with my husband, so we used that as a starting point for him to become accustomed to separation from me.7. Practice with games like hide and seek
For children with severe separation anxiety, this simple game draws out raw emotions. Keep it light by hiding in ridiculous places (I often hide behind a very skinny, small tree) and making lots of noise in your hiding place. Walk around the house and point out all the best hiding places before the game starts.8. Take field trips together to increase the child’s world knowledge
All of my friends know that field trips are my specialty as a mother. I’ve planned out field trips to reduce sensitivities and increase awareness of other people, ways of thinking and life experiences, which is essential for everyday coping skills.9. Cognitive-behavioral therapy
Cognitive-behavioral therapy is a systematic way to address behaviors and thought processes related to anxiety.10. Play Therapy
Play therapy builds on the natural way that child process their emotions. A play therapist directs the play to work through specific issues affecting the child. Here's an article that explains how to get started on play therapy at home. In my son’s case, crying through separation was unnecessary, counterproductive and even harmful because it diminished the level of trust between parent and child. By making my son an active, consenting partner in the process of separation, he was open to learning new life skills and increasing his awareness of the world around him. I think it’s important to consider these long-term goals when dealing with typical or atypical separation anxiety.
