Separation Anxiety in a 21-Month-Old Toddler: Is This Normal?

Question:

My 21-month old gets upset if I leave the room even for a minute. I’m having trouble getting ready for work in the morning, because Ethan panics if I’m not in direct contact with him, even if my husband is there with him. Otherwise, he’s an active and curious little boy who enjoys playing with other kids, and loves learning of all kinds. He sleeps well, has a good appetite, and seems happy to see his nanny and the other child the nanny takes care of. However, I’m starting to worry he has a fear of abandonment because of me going to work every day. 

Answer:

If you google ‘separation anxiety,’ you’ll see how very normal this behaviour is at this age. It is usually abates by 2½, but it can last until the age of 4. From what you write here, there’s no reason to think you’re dealing with a separation anxiety disorder. The main reason I say this is that Ethan is thriving while you’re at work, and able to enjoy the nanny and other children. He’s eating and sleeping well, and playing, learning, and participating in a variety of activities.

Although many children start showing signs of separation anxiety before their first birthday, Ethan is not unusual in going through it now. The duration of separation anxiety is also highly variable. It depends on the child’s temperament (more sensitive kids are more likely to experience), and what’s happening in his environment, including how his parents respond to it (you’ll see some suggestions below for coping well). After Ethan has successfully mastered his separation anxiety, it might return during periods of stress, including unfamiliar situations, especially when he’s not with you or his father.

Ethan’s separation anxiety is a sign that he’s developed a healthy attachment to you, and that’s a good thing. Eventually, he will learn that you always return when you say you will, and that will be enough to comfort him while you’re away. In the meantime, your separations are opportunities for him to develop coping skills and independence.

Ten Tips for Coping with a Toddler’s Separation Anxiety:

1. Ensure Ethan’s childcare circumstance is a good one. (It sounds like it is.)
2. Minimize the number and duration of separations until he’s able to handle them more easily.
3. Monitor your own stress levels. An anxious or overprotective parent can induce anxiety in a child. You might find that good sleep, exercise, nutrition, and relaxation practices for you can help reduce Ethan’s anxiety.
4. Establish dependable routines. Provide stability and predictability in as many dimensions of his life as possible.
5. Explain where you’re going and how long you’ll be. Don’t try to sneak away.
6. Create an exit ritual during which you say a calm, relaxed, loving, and firm goodbye. Explain how long you’ll be gone using concepts he understands (such as after lunch, after his nap, and after playtime). Give him your full attention for the exit ritual, and when you say you’re leaving, mean it. Coming back will only make things worse.
7. Exude a calm confidence that he’ll be able to handle the separation, and that you’re confident you’re leaving him in a safe and happy situation.
8. If he has a ‘transitional object’—a stuffed animal, a blanket, a special toy—leave that with him while you’re gone.
9. Make time for a happy reunion when you return.
10. If Ethan’s separation anxiety symptoms start interfering with his eating, sleeping, playing, or learning, consider consulting an expert. You might start with your paediatrician or primary care physician.

For more info about seperation anxiety:

http://kidshealth.org/parent/emotions/feelings/sep_anxiety.html

http://www.helpguide.org/mental/separation_anxiety_causes_prevention_treatment.htm

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002509/

http://www.nlm.nih.gov/medlineplus/ency/article/001542.htm