HomeHealth & BehaviorSocial Skills

Ask the Experts

My Fourth-Grader Has Separation Anxiety

By Dr. Stacie Bunning, clinical psychologist


My child is in fourth grade and we are again going through separation anxiety. No changes have occurred in the home or our morning routine. But when she is expected to exit from the car drop-off area and go into the school, she freezes and immediately begins to cry. What am I supposed to do?


You didn't mention how your daughter explains her distress when it's time to get out of the car. Is she worried about something or someone at school? She may be having difficulty with a particular subject or a teacher, she may have an upcoming test or project, she may be being bullied, or she may have had a break with a favorite peer. Or, is she worried about something or someone at home? If she or someone else was recently ill or injured, or there has been conflict among family members, she may be worried about that.

Anxiety is a standard part of development; we all experience these feelings, and a small amount can even be productive. However, when worry becomes excessive, persistent and developmentally inappropriate, there may be an emerging anxiety disorder. Separation anxiety disorder is defined as unwarranted worry and fear about being apart from family members or individuals to whom a child is attached. Other symptoms can include the following:

  • Reluctance to sleep without being near a parent or caregivers
  • Nightmares with a theme of separation
  • Excessive distress, panic or temper tantrums when separation from home or family occurs or is anticipated
  • Excessive worry about the safety of a family member or the self
  • Excessive worry about getting lost from family
  • Frequent stomach aches, headaches, nausea or other physical complaints
  • "Clinginess," even when at home

Symptoms from family members must last for a period of at least four weeks to be considered separation anxiety disorder. This disorder can be successfully treated, and intervention should begin with a comprehensive evaluation of the child and family by a qualified mental health professional. Treatment recommendations may include therapy for the child, with a focus on helping her learn skills to manage her anxiety. Some children may also need treatment with anti-depressant or anti-anxiety medication to help them feel calmer. Parents are a critical part of treatment, and consultation with the child's school will be important.

Dr. Stacie Bunning is a licensed clinical psychologist in the St. Louis area. She has worked with children, adolescents, and their families in a variety of clinical settings for 20 years. Bunning also teaches courses in child psychology, adolescent psychology, and human development at Maryville University in St. Louis.

Advice from our experts is not a substitute for professional diagnosis or treatment from a health-care provider or learning expert familiar with your unique situation. We recommend consulting a qualified professional if you have concerns about your child's condition.

Comments from readers

"This sounds a lot like what my daughter is going through, having 5 of the 7 symptoms. I have mentioned it to her kindergarten teacher, who told me to talk with the school counselor. However, I have been afraid to do so, because I worry that the counselor may want to put my daughter on medication, which both my husband and I are against."
"what if you child and the teacher don't get along?"