pediatrics
Separation Anxiety and Stranger Anxiety
Stranger anxiety
Stranger anxiety is manifested by crying when an unfamiliar person approaches. It is normal when it starts at about 8 to 9 months and usually abates by age 2 years. Stranger anxiety is linked with the infant’s developmental task of distinguishing the familiar from the unfamiliar. Both the duration and intensity of the anxiety vary greatly among children. Some infants and young children show a strong preference for one parent over another at a given age, and grandparents may suddenly be viewed as strangers. Anticipating these occurrences during Health Supervision of the Well Child helps prevent misinterpretation of the behavior. Comforting the child and avoiding overreaction to the behavior are usually the only therapy needed. Common sense should dictate management. If a new sitter is coming, having that person spend some time with the family before the actual day makes sense. When the event arrives, having parents spend some time with the child and sitter before they leave is prudent. If grandparents are coming to watch the child for a few days while parents go away, they should arrive a day or two early. Similar techniques can be used in anticipation of hospitalization. Stranger anxiety of pronounced intensity or extended duration may be a sign of more Generalized Anxiety Disorder in Children and Adolescents and should prompt evaluation of the family situation, parenting techniques, and the child’s overall emotional state. 