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    Suggest treatment for separation anxiety and fear of strangers in a child

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Posted on Fri, 14 Jul 2017 in General Health
Question: My daughter is 2 years and 9 months old. She has a problem of stranger anxiety since she was 6 months old. We realized this when we travelled with her when she was 6 months old from XXXXXXX to our native place, XXXXXXX She cried continuously for 2 hours in the flight and refused to calm down. During her stay in XXXXXXX she refused to go to any unknown person and her interaction was limited to few family members only. As she grew up, she was very scary of strangers and refused to mix up with people. We took her regularly to the children’s park, playgrounds and residence of some friends. Initially she refused to play in the park. Even today, if she goes to the park, she prefers to play a lot but alone. She would not play in sand and or walk on any surface with mud / sand. She is comfortable only if the ground is cemented or tiled. We do our maximum to take her to crowded places and markets. She is very comfortable in such places but would not venture out on her own anywhere. She would stay close to parents. Now, we have put her in playschool so that she can increase her initial socializing. It has been 7 days in school but she has not settled down at all. She insists on her mother sitting throughout the playgroup time of 1-2 hours and does not let her go. At times when the playgroup people ask her mother to leave, she cries a lot and does not let anyone else touch her or calm her.
As a child, she is bright and learns and remembers things quickly. She has interest in books and when at home, she would open books and glance through them. She would also remember incidents as old as 1 year and learns anything told to her almost. She remembers rhymes and stories told her once or twice. She also makes stories on her own and tells us. Individually she is very good, but the resistance to get involved in a group is worrying us.
At the same time, I would admit that both me and my wife are also not great extroverts and limited in our social interactions. However, I would like to know if there is any medical issue with my daughter. It is not possible to even take her to a doctor as she would not allow the doctor to touch her or evaluate her.
Please help.
doctor
Answered by Dr. Sumanth Amperayani 1 hour later
Brief Answer:
Suggestions On Stranger anxiety and separation anxiety

Detailed Answer:
Hi.... I understand your concern. By what you say I feel that your kid is having both stranger anxiety and separation anxiety. But I am very happy because by what you describe your child's IQ is very good and her understanding of the situation is also quite intelligent. But at the same time she is too much attached to you and your wife as you might have been overprotective in your earlier days and the basic psychology of the parents also might be reflecting on the child has both of you are not too great extroverts.

I suggest you can wait and gradually detach yourself from the kid in school and gradually increase the detachment time.

This is the best way out.

But as she's intelligent she will cope up with it eventually.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sumanth Amperayani 13 hours later
Thank you doctor. I hope this will not require any specific medical treatment or medication. I do not want to force her into things to avoid resistance from her to go to school. At least now she is happy going there but retracts into a shell once she reaches school and clings on to her mother. Also, she will be completing 3 years in September and there is a concern on delay in starting her education. She weighs 12 kgs now, so please advise if her growth is ok as per required milestones.
doctor
Answered by Dr. Sumanth Amperayani 3 hours later
Brief Answer:
Please get back to me with DOB and other details

Detailed Answer:
Hi...I am confident that she will do excellently well academically keeping in mind her intelligent behavior.

Please answer the following questions for me to guide you better for your queries about her growth.

Questions -

1. What is her date of birth (DOB)?
2. What is the birth weight and current exact weight?
3. What is her current exact height?
4. Is there any family history of developmental delay?
5. Whether you or your spouse were underweight as kids?
6. When did the baby attain social smile?
7. When did the baby roll over (at what age)?
8. At what age did the baby sit without support?
9. At what age did the baby stand without support?
10. When did the baby start saying mama - dada?

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani 21 hours later
Dear Dr.,
Please find below the answers to your queries:
1. What is her date of birth (DOB)? - 17th September 2014
2. What is the birth weight and current exact weight? - Birth Weight was 4.2 Kgs and Current Weight is 12 kgs.
3. What is her current exact height? - 87 cms
4. Is there any family history of developmental delay? - No
5. Whether you or your spouse were underweight as kids? - No
6. When did the baby attain social smile? - 2.5 months
7. When did the baby roll over (at what age)? - 3.5 months
8. At what age did the baby sit without support? - 7.5 months
9. At what age did the baby stand without support? - 1 year
10. When did the baby start saying mama - dada? - 1 year 2 months

Please advise on what we can do to decrease her dependency on her mother so that she can stay without her mother for some time. She is still attached to breast feeding which we have been trying to stop but she insists on it at times.
doctor
Answered by Dr. Sumanth Amperayani 3 hours later
Brief Answer:
Suggestions on stranger anxiety and separation anxiety

Detailed Answer:
Hi...thank you for the information.

I have calculated her height and weight centiles based on date of birth. She is doing well.

The weight centile is between 10-15th centile and height centile is between 5-10th centile.

Coming to centiles - any value between 5-95 is normal. As your kid is falling in-between these, I don't think you should worry.

Her development too is normal.

Coming to the query about separation anxiety and stranger anxiety - The change should be gradually and it can start from home - leaving the kid for gradually increasing time alone in a room at home (leaving her to play by herself).

Keep telling her constantly that she has to mix up at school and if she does do a positive reinforcement and applaud her.

Negative reinforcement and reprimanding will not help and will only increase the problem.

Talk to the teachers about her problem and ask them to be patient and understanding with her at school.

You can try giving a baby doll or XXXXXXX bear for the time being temporarily and decrease the dependency on the mother.

Breast feeding after 2 years in non-nutritious and is not appropriate. I suggest you stop it suddenly and not in steps. This way the dependency on the mother can be tackled.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8243 Questions

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