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Answer 'Yes' if your child is younger than 18 and has experienced they symptom for at least 4 weeks? (The word 'you' in the following questions could also refer to either parent or another caregiver.) |
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1. |
Does your child seem anxious about leaving home or being separated from you (or another caregiver)? |
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2. |
Does your child often worry about you being hurt or dying? |
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3. |
Does your child often worry about being kidnapped or lost? |
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4. |
Does your child resist leaving you, even to go to school? |
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5. |
Is your child afraid of being left anywhere, including home, without you? |
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6. |
Does your child refuse to go to sleep without you nearby or does he/she get anxious about sleeping away from home? |
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7. |
Does your child have frequent nightmares about being separated from you? |
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8. |
Does your child have physical symptoms (dizziness, nausea, headaches, heart palpitations) before or during a period of separation? |
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9. |
Do your child's symptoms interfere with his/her daily activities (school, social situations, etc.)? |
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Total 'Yes' |
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0 |
(out of 9 possible) |
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Interpretation |
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Your child has no symptoms of separation anxiety disorder. See your child's pediatrician if you are still concerned your child may have any kind of anxiety disorder. |