As each situation is dealt with masterfully, the child advances to the next phase of intensity. This pattern continues until the child is able to handle being away from their parent in a developmentally typical way that causes them and their caregiver(s) minimal amounts of stress. While there is some controversy about using exposure therapy with children, it is generally agreed upon that exposure therapy in the context of SAD is acceptable as it may be the most effective form of therapy in treating this disorder and there is minimal risk associated with the intervention in this context. Contingency management
Contingency management is a form of treatment found to be effective for younger children with SAD. Contingency management revolves around a reward system with verbal or tangible reinforcement requiring parental involvement. A contingency contract is written up between the parent and the child, which entails a written agreement about specific goals that the child will try to achieve and the specific reward the parent will provide once the task is accomplished. When the child undergoing contingency management shows signs of independence or achieves their treatment goals, they are praised or given their reward. This facilitates a new positive experience with what used to be filled with fear and anxiety. Children in preschool who show symptoms of SAD do not have the communicative ability to express their emotions or the self-control ability to cope with their separation anxiety on their own, so parental involvement is crucial in younger cases of SAD.
"Heritability was estimated at 73% in a community sample of 6-year-old twins, with higher rates in girls. "A childs temperament can also impact the development of SAD. Timid and shy behaviors may be referred to as "behaviorally inhibited temperaments" in which the child may experience anxiety when they are not familiar with a particular location or person. Mechanism
Preliminary evidence shows that heightened activity of the amygdala may be associated with symptoms of separation anxiety disorder. Defects in the ventrolateral and dorsomedial areas of the prefrontal cortex are also correlated to anxiety disorders in children. Diagnosis
Separation anxiety occurs in many infants and young children as they are becoming acclimated with their surroundings. This anxiety is viewed as a normal developmental phase between the months of early infancy until age two. Separation anxiety is normal in young children, until they age 3–4 years, when children are left in a daycare or preschool, away from their parent or primary caregiver. Other sources note that a definite diagnosis of SAD should not be presented until after the age of three.Some studies have shown that hormonal influences during pregnancy can result in lower cortisol levels later in life, which can later lead to psychological disorders, such as SAD. It is also important to note significant life changes experienced by the child either previous to or present at the onset of the disorder.