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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
BEHAVIORAL PROBLEMS ?
 There is no exact definition of behavioral problems but we can say it as the behaviors of the child
which create or which are likely to create difficulties in the learning activities of the child
Or
 The behaviors that contradict to some specific age(infancy, childhood, adolescence), social norms
and values etc.
 A child may show one or more than one behavior problem during his/her period of development.
Some behavior problems may occur at a specific stage of development while some behavior problems
occur at different stages.
 Example- (1) Revolt against parents , teachers and others is characteristics feature of adolescence.
(2) Stranger anxiety is a problem of infancy.
(3) Lack of interest in studies or negligence of duties may occur at any stage of
development.
WHAT ARE BEHAVIORAL PROBLEMS IN CHILDREN:
SEPARATION ANXIETY
In 1995 M. Dash conducted a study on behavior problems of children
in which he observed the following behavior problems occurring at
the different stages of development i.e.
 INFANCY
Crying, Bed-wetting, Lack of appetite, Separation anxiety,
Stranger anxiety, Sibling rivalry.
 EARLY CHILDHOOD
Excessive shyness, Unhappiness, Temper tantrums, Laziness, Cheating, Bullying and teasing, Jealousy,
Bed-wetting, Obstinacy
 LATE CHILDHOOD
Excessive shyness, Defiance, Daydreaming, Vulgarity, Getting nervous and feeling disappointed over
petty matters, Truancy, Telling a lie, Bullying, Stealing
 ADOLESCENCE
Rebellion against teachers, parents and authority, Unhappiness, Excessively thoughtful, Objectionable
behaviour towards girls, Excessive carelessness, Vulgarity, Truancy, Defiance and disobedience,
Laziness, Cheating, Excessively moody etc.
CAUSES OF BEHAVIOR PROBLEMS
 Behavioral problems are not hereditary in nature.
 Problems are caused by social and psychological environment of the child.
 There are many reasons for the cause of behavioral problems. Here I will explain the
environment factors.
 The environment which causes behavior problem may be the-
FAMILY/HOME ENVIRONMENT
 In some homes, parent exert authority over their
children and considered as useless by their parents
which in result show behavioral problems at later
point of time.
 In some homes, children are discouraged by their
parents for performing various activities. Such
children fail to co-operate in various school programs.
A child who has been discouraged in his home does
not understand the significance of co-operative
behavior in school. Rather, he demonstrates
“attention-getting mechanism” to draw other’s
attention towards him.
SCHOOL ENVIRONMENT
 Physical and cultural features of the school can also
cause the child to acquire negative, problem
behaviors.
 The school policy, the social, moral and psychological
climate of the school, teacher’s behavior and attitude
towards the problem child, and inter-personal
relationship among children in the school, etc. lead to
the behavior problem or aggravate the behavior
problem of children.
 Different class such as low, middle, high class
children behaviors in the school can also be a cause
for problems in some children.
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 can’t 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 haven’t 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.
Symptoms Of Separation
Anxiety.
 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
 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.
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
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
DIAGNOSIS OF SEPARATION ANXIETY
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
Treatment of separation anxiety depends on the child’s 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 don’t 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 adolescent’s, 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.
MANAGEMENT FOR SEPARATION ANXIETY
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 child’s 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.
THANK YOU!

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Behavioral Problems in children.pptx

  • 1. 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
  • 2. BEHAVIORAL PROBLEMS ?  There is no exact definition of behavioral problems but we can say it as the behaviors of the child which create or which are likely to create difficulties in the learning activities of the child Or  The behaviors that contradict to some specific age(infancy, childhood, adolescence), social norms and values etc.  A child may show one or more than one behavior problem during his/her period of development. Some behavior problems may occur at a specific stage of development while some behavior problems occur at different stages.  Example- (1) Revolt against parents , teachers and others is characteristics feature of adolescence. (2) Stranger anxiety is a problem of infancy. (3) Lack of interest in studies or negligence of duties may occur at any stage of development. WHAT ARE BEHAVIORAL PROBLEMS IN CHILDREN: SEPARATION ANXIETY
  • 3. In 1995 M. Dash conducted a study on behavior problems of children in which he observed the following behavior problems occurring at the different stages of development i.e.  INFANCY Crying, Bed-wetting, Lack of appetite, Separation anxiety, Stranger anxiety, Sibling rivalry.  EARLY CHILDHOOD Excessive shyness, Unhappiness, Temper tantrums, Laziness, Cheating, Bullying and teasing, Jealousy, Bed-wetting, Obstinacy  LATE CHILDHOOD Excessive shyness, Defiance, Daydreaming, Vulgarity, Getting nervous and feeling disappointed over petty matters, Truancy, Telling a lie, Bullying, Stealing  ADOLESCENCE Rebellion against teachers, parents and authority, Unhappiness, Excessively thoughtful, Objectionable behaviour towards girls, Excessive carelessness, Vulgarity, Truancy, Defiance and disobedience, Laziness, Cheating, Excessively moody etc.
  • 4. CAUSES OF BEHAVIOR PROBLEMS  Behavioral problems are not hereditary in nature.  Problems are caused by social and psychological environment of the child.  There are many reasons for the cause of behavioral problems. Here I will explain the environment factors.  The environment which causes behavior problem may be the- FAMILY/HOME ENVIRONMENT  In some homes, parent exert authority over their children and considered as useless by their parents which in result show behavioral problems at later point of time.  In some homes, children are discouraged by their parents for performing various activities. Such children fail to co-operate in various school programs. A child who has been discouraged in his home does not understand the significance of co-operative behavior in school. Rather, he demonstrates “attention-getting mechanism” to draw other’s attention towards him. SCHOOL ENVIRONMENT  Physical and cultural features of the school can also cause the child to acquire negative, problem behaviors.  The school policy, the social, moral and psychological climate of the school, teacher’s behavior and attitude towards the problem child, and inter-personal relationship among children in the school, etc. lead to the behavior problem or aggravate the behavior problem of children.  Different class such as low, middle, high class children behaviors in the school can also be a cause for problems in some children.
  • 5. 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 can’t 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 haven’t 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.
  • 6. Symptoms Of Separation Anxiety.  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
  • 7.  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.
  • 8. 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
  • 9. 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 DIAGNOSIS OF SEPARATION ANXIETY
  • 10. 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
  • 11. Treatment of separation anxiety depends on the child’s 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 don’t 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 adolescent’s, 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. MANAGEMENT FOR SEPARATION ANXIETY
  • 12. 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 child’s 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.