Behavioral Problems in children

1. BEHAVIORAL PROBLEMS IN CHILDREN : SEPARATION ANXIETY CONTENTS

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. 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- CAUSES OF BEHAVIOR PROBLEMS • 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. • 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.

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. • Childrenand 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 • 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

11. MANAGEMENT FOR SEPARATION ANXIETY • 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 a dolescent’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.

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.

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