Helping Kids Cope with Separation Anxiety

When children start attending day care or begin a new school year, drop-offs can be emotionally tricky. Saying goodbye each morning, toddlers can cling to their parents like burrs. Kindergarteners may become weepy, and middle school students might complain of stomachaches.

Pediatric psychologist Barbara Bentley, PsyD, herself a mom, understands how challenging these manifestations of separation anxiety feel for children and parents alike.

“Our brains associate ‘novel’ with ‘dangerous,’” said Dr. Bentley, a clinical associate professor of developmental and behavioral pediatrics at Stanford Medicine Children’s Health.

Separation anxiety happens when the fear of a new situation impairs a child’s ability to separate confidently from his or her parents, she said, adding that it’s one of several types of worry children may feel right now. “Thanks to the COVID-19 pandemic, many of us are experiencing multiple layers of anxiety, related not just to separation but also to social anxiety and fears of illness,” Dr. Bentley said.

By managing separation anxiety effectively, parents can build children’s confidence in their ability to move from their comfort zone toward new challenges and growth.

Techniques should be tailored to the child’s age, and parents should acknowledge the child’s feelings about new situations without adding to his or her fears, Dr. Bentley said. “It works better when a parent says to a child, ‘This is new and I know you can do it,’ rather than ‘Oh my gosh, this is really scary.’”

Age-appropriate techniques to lower worry

For toddlers and preschoolers, routine is key. Parents should work with their day care provider to establish a daily routine in which drop-off is quick. “The more you linger, the more it tells the child it’s not safe to separate,” Dr. Bentley said.

As part of the routine, the child should be able to bond with a specific caregiver, entering day care and going directly to that person, who should immediately direct the child’s attention to a favorite activity. At home, parents can talk about the steps of the routine with the child: “I’ll give you a hug. You get to see Miss Jennifer. You can play with the blocks.” As children build friendships, friends become another motivator to add to the conversation: “Your buddies Jasper, Willa, and Niko and will be there.”

For kindergarteners and other elementary school students, parents can build on the principles of conveying confidence, such as planning quick drop-offs and maintaining positive focus, while adding new strategies that accommodate the child’s greater sophistication and ability to think about the future.

“It’s really helpful to take advantage of kindergarten round-up or other opportunities to interact with the teacher before school starts, to tour or drive by the school or classroom, and to meet classmates ahead of time if possible,” Dr. Bentley said. Many elementary schools also have online materials that families can investigate before school begins. If the child’s teacher has posted information online about a daily routine, discussing this can help students feel prepared for school. “The more kids know in advance, the less anxious they will be,” said Dr. Bentley.

Parents can also encourage kindergarteners to bring a small object from home, such as a pocket-sized stuffy they can squeeze, as a reminder that they are loved and ready for school.

Allowing avoidance sends the wrong message

It’s important for parents to let children know that avoiding school is not an option. “If the parent accommodates the child’s anxiety by allowing them to avoid school, this communicates that the parent is not confident in the child’s ability to handle the situation,” Dr. Bentley said. “That defeats the purpose of helping your child develop a sense of competency.”

If a child continues struggling, parents can also recruit teachers and school counselors to plan strategies that support the child’s school participation, rather than letting them avoid situations that make them anxious.

For students starting middle school, junior high, or high school, orientation events such as campus tours and open houses are helpful. These events can help kids calm their anxieties about attending a larger school, navigating the expectations of multiple teachers, and meeting new classmates from different feeder schools.

Tweens and teens may feel social anxiety stemming from fear of not being accepted by peers.

Parents should recognize that tweens and teens may feel more complex anxieties, such as social anxiety stemming from fear of not being accepted by peers. Their anxieties also can manifest in less obvious ways. “For instance, students’ oppositional behaviors or complaints that school is ‘boring’ may be driven by underlying anxieties,” Dr. Bentley said.

Older students are also ready to have more nuanced discussions about these feelings. Parents can explain that the physical sensations of anxiety and excitement are similar: Just think about how you feel standing in line for the roller coaster, heart racing, breathing quickly.

Acknowledging a child’s internal experience—perhaps a mix of excitement and worry—while also conveying confidence in his or her ability to handle challenges remains key.

“Parents can say, ‘I know you feel unsure, but I’m confident you can handle this,’ and then look for ways to bring reminders of the familiar into the conversation,” Dr. Bentley said. For all of us, cognition drives behavior, so parents should think of themselves as filling up their child’s internal ‘thought bubble’ with messages of confidence. “That helps children move from their comfort zone to their growth zone.”

Contact your pediatrician for more information, or learn more about Developmental-Behavioral Pediatrics at Stanford Medicine Children’s Health.