Gerald, a 5-year-old kindergartner, is reluctant to go to sleep without his parents nearby.He clings to his parents each morning when being dropped off at school and spends the first 30 minutes in tears, even after the second month of school.What do these symptoms represent?

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Separation anxiety disorder is characterized by extreme anxiety when anticipating separation from or separating from home or a parent.It is a disorder experienced by about 4% of children.Children and adolescents with this disorder may experience extreme distress traveling away from home or may refuse to go to school or visit or sleep over at a friend's home.The diagnostic criteria includes repeated nightmares involving the theme of separation, reluctance or refusal to sleep without a significant person nearby, and persistent worrying about separation or harm to major attachment figures (e.g., mother or father).Separation or the anticipation of separation may trigger physical (somatic) symptoms that include headaches, dizziness, palpitation, stomachache, nausea, and vomiting.Typically there are exacerbations and remissions with this disorder.Children with separation anxiety disorder exhibit delayed social development, refusal to attend school, and anxiety while at school, all of which result in poor academic performance.Separation anxiety disorder will usually resolve or decrease in severity with time, but it may also be a precursor to other conditions such as panic disorder.

Gerald, a 5-Year-Old Kindergartner, Is Reluctant to Go to Sleep