Behavioral Problems in children

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BEHAVIORAL PROBLEMS IN CHILDREN SEPARATION
ANXIETY
CONTENTS
Sub-topic
What are Behavioral Problems in Children?
Causes of Behavior Problems
What is Separation Anxiety?
Symptoms of Separation Anxiety
Diagnosis and Management of Separation Anxiety
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WHAT ARE BEHAVIORAL PROBLEMS IN CHILDREN
SEPARATION ANXIETY
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CAUSES OF BEHAVIOR PROBLEMS
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WHAT IS SEPARATION ANXIETY

• Separation anxiety is a condition in which child
  becomes excessively anxious when separated from
  parents.
• It is normal for some older children,
  particularly those who are shy, to go through a
  phase of not wanting their parents to leave.
• Separation anxiety differs from normal
  clinginess. Children with the disorder cant
  think about anything but the present fear of
  separation. They may have nightmares or regular
  physical complaints.
• Dr. Ron Steingard, a psychiatrist at the Child
  Mind Institute, explains , At different stages
  of development it is normal to have problems
  around separation, because the world is not safe,
  and you havent learned how to master being away
  from the people who take care of you. As you
  develop, and as you begin to master situations
  and develop skills, it should get easier.
• Separation anxiety is common. More than 1 million
  cases per year in India.

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• The defining feature of Separation Anxiety
  Disorder is excessive fear or anxiety concerning
  the separation from home or attachment figures.
  This fear or anxiety exceeds what is to be
  expected of the individual given his/her
  developmental level.
• Children and adolescents with Separation Anxiety
  Disorder experience at least three of the
  following symptoms
• Recurrent excessive distress when anticipating
  or experiencing separation from home or
  attachment figures (parents or other caregivers)
• Persistent and excessive worry about losing an
  attachment figure or possible harm to them by
  illness, accident, disasters, or death

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• Symptoms of Separation Anxiety Disorder in
  children and adolescents last for at least four
  weeks and cause significant distress.
• School refusal is common with children and
  adolescents struggling with the disorder and can
  result in poor school attendance and poor
  academic functioning.
• Separation Anxiety Disorder can also impair
  social relationships and family relationships.
• Children with Separation Anxiety Disorder tend to
  shadow parents around the house, have difficulty
  playing or being alone, and have difficulty at
  bedtime.
• They often require a parent or caregiver to stay
  with them when they fall asleep and make their
  way into the parents bedroom when they wake
  during the night.

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• Some of the most common behaviours include
• clinging to parents
• extreme and severe crying
• refusal to do things that require separation
• physical illness, such as headaches or vomiting
• violent, emotional temper tantrums
• poor school performance
• failure to interact in a healthy manner with
  other children
• refusing to sleep alone

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DIAGNOSIS OF SEPARATION ANXIETY

• Diagnosis of separation anxiety disorder involves
  determining whether the child is going through a
  normal stage of development or the issue is
  actually a disorder.
• To help diagnose separation anxiety disorder,
  mental health professional will likely give the
  child a psychological evaluation, including a
  structured interview that involves discussing
  thoughts and feelings, as well as observing
  behavior.
• Separation anxiety disorder may occur along with
  other mental health problems.
• For diagnosis of SAD for children between 11-17
  years, a 10-item assessment is done which
  measure the severity of symptoms of SAD.
• Total score can range from 0 to 40, with higher
  scores indicating greater severity of separation
  anxiety disorder. The raw scores on the 10 items
  should be summed to obtain a total raw score.
  The average total score is calculated by dividing
  the raw total score by number of items in the
  measure.
• The formula to prorate the partial raw score to
  Total
• Raw Score is (Raw sum x 10) / Number of items
  that were actually answered

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During the past 7 days child .. Never Ocassion-ally Half of the time Most of the time All the time Total
felt moments of sudden terror, fear, or fright when separated 0 1 2 3 4
felt anxious, worried, or nervous about being separated 0 1 2 3 4
had thoughts of bad things happening to people important to me or bad things happening to me when separated from them 0 1 2 3 4
felt a racing heart, sweaty, trouble breathing, faint, or shaky when separated 0 1 2 3 4
felt tense muscles, felt on edge or restless, or had trouble relaxing or trouble sleeping when separated 0 1 2 3 4
had avoided going places where I would be separated 0 1 2 3 4
when separated, left places early to go home 0 1 2 3 4
spent a lot of time preparing for how to deal with separation 0 1 2 3 4
distracted himself to avoid thinking about being separated 0 1 2 3 4
needed help to cope with separation 0 1 2 3 4
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MANAGEMENT FOR SEPARATION ANXIETY

• Treatment of separation anxiety depends on the
  childs symptoms, age, and general health. It
  will also depend on how severe the condition is.
• Specialists can address physical symptoms,
  identify anxious thoughts, help your child
  develop coping strategies, and foster problem
  solving.
• Most mild cases of separation anxiety disorder
  dont need medical treatment.
• In more severe cases, or when the child refuses
  to go to school, treatment may be needed. The
  goals of treatment include reducing anxiety in
  the child, developing a sense of security in the
  child and the caregivers, and educating the
  child and family/caregivers about the need for
  natural separations. 
• There are several commonly used treatments for
  Separation Anxiety Disorder.
• With children and a dolescents, the sooner you
  intervene and seek
• professional help, the more likely your child
  will experience a positive
• treatment outcome.
• Finding a psychotherapist who specializes in
  children and adolescents
• is the first step toward helping your child
  cope.

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• There are different types of psychotherapy that
  can be effective in SAD.
• COGNITIVE BEHAVIORAL THERAPY (CBT)
• This is the primary type of psychotherapy
  recommended for treatment of Separation Anxiety
  Disorder. Through CBT, children learn how to
  recognize their anxious feelings and their
  physical responses to anxious thoughts. They
  learn to identify their triggers and the thought
  patterns that contribute to their anxious
  feelings. Through a variety of techniques,
  children learn strategies to manage their
  anxious thoughts and feelings and cope with
  their emotions.
• PLAY THERAPY
• Younger children can have difficulty connecting
  the dots between thoughts, feelings, and
  actions. For these children, play therapy can
  help them demonstrate and process their emotions
  and learn to cope with them.
• MEDICATION  
• Antidepressants or other anti-anxiety
  medication may be used to treat severe
• cases of separation anxiety disorder.
•  SCHOOL INTERVENTION  
• Mental health practitioners at your childs
  school can offer therapy to help
• them manage SAD symptoms.
• RELAXATION TRAINING
• It is essential for children struggling with
  Separation Anxiety Disorder. Deep breathing,
  guided relaxation, and progressive muscle
  relaxation can also help children and
  adolescents learn to self-soothe during anxious
  times.

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THANK YOU!