Joanna Fortune: My 12-year-old daughter refuses to go to school due to separation anxiety 

This anxiety is not rooted in reality but the experience is very real for the child. Picture: iStock 

Joanna Fortune

CHILD PSYCHOTHERAPIST

My 12-year-old experiences separation anxiety to such an extent she will not go to school. Also, she wants me to stand outside the bathroom when she uses it. She has sensory differences and may be neurodiverse — we are waiting on an ADHD assessment. Can you advise me on how to enable her to go back to school?

Separation anxiety can be defined as a lingering worry or anxiety that something bad will happen to the child (or they believe something bad will happen to their mum or dad) if they leave their parent.

This anxiety is not rooted in reality but the experience is very real for the child.

It is not unusual for children with separation anxiety to refuse to go to school or sleep in their room or, in your child’s case, to even go to the bathroom without their caregiver nearby.

Some young people experience it as a fear of being alone or apart from their caregiver in any context.

It is good to hear you are getting a broader assessment done. While the outcome of that assessment might explain your daughter’s separation anxiety — separation anxiety can be part of an ADHD presentation, for example) — you will both still need some strategies to manage it.

• Help your child to gradually build up a tolerance to being apart from you. At home, play Marco Polo by you going to a different room, even upstairs, as you practice this and every time she calls ‘Marco’, you will reply ‘Polo’.

The intention is that as she builds up tolerance, she will not need to call ‘Marco’ as frequently.

Gradually practice in other settings, such as visiting a familiar friend/family member and sitting in a different room. Tell her ahead of time that you will do this and see how long she can manage it.

You can do it while she is in the bathroom too — she goes in and closes the door and you are close enough to hear her call out but not right outside the door.

• Explore using a transitional object. She can take and hold this while apart from you that conjures you up in her mind. It might be a piece of your scarf or a T-shirt you sleep in that has your scent as our olfactory sense is strongly associated with memory.

Equally, you can get a photo of you and her hugging and put it into a keyring she can attach to her school bag. With older children, consider using an ink pad to make a thumbprint onto a piece of paper and putting this into the keyring as some children are self-conscious of peers seeing them holding a photo of their parent.

• Always plan for new situations. Drive by any new venue; if it is somewhere with a website, look at photos of it online together.

Role-play the situation at home between yourselves or by using little doll’s house characters to act out the new scenario. Do this about five times before she goes to a new setup, and always play it out as you want it to unfold, not including her distress in the play.

It can be exhausting to be the parent managing a child’s separation anxiety and the associated behaviours, so please ensure you activate your own support network.

• If you have a question for child psychotherapist Joanna Fortune, please send it to [e-mail]