Health and Wellness Home - Anxiety, Depression, ADHD and more  
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Child Separation Anxiety Self Test
The following self test has been developed to assist you in helping to determine if your child may be experiencing symptoms related to separation anxiety. This is only a preliminary questionaire and should not be used to diagnose or treat any condition, disorder or disease.
 
 
1. Does your child display excessive distress whenever leaving home or being separated from you or another person to whom they feel attached?
 Yes
 No
 
 
2. Do they express excessive fear about harm being done to people to whom they are attached?
 Yes
 No
 
 
3. Do they have problems going to sleep without your presence or the presence of another person to whom they are attached, or do they have a fear of sleeping away from home?
 Yes
 No
 
 
4. If separation is anticipated, does your child complain of physical ailments such as stomachaches or headaches?
 Yes
 No
 
 
5. Do they have nightmares about losing you or a figure of attachment, causing them distress and night terrors?
 Yes
 No
 
 
6. Do they refuse to go to school or daycare because of fear over separation?
 Yes
 No
 
 
7. Does your child express an excessive fear that something bad will befall them if they are separated from you or another figure of attachment, such as getting kidnapped or lost?
 Yes
 No
 
 
8. Do they express a fear that a figure of attachment will get lost or not return if they are separated from them?
 Yes
 No
 
 
9. Has your child been having problems with separation from you or a figure of attachment that causes extreme distress to the point of impairing their social or academic functioning?
 Yes
 No
 
 
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