Separation Anxiety Disorder
Most children of between 18 months and three years old become anxious when a parent leaves the room or goes out of sight, and this is normal. Crying on the first day in daycare or pre-school is also normal and subsides when the child becomes distracted by their surroundings.
If a four year old is unable to leave his/her parents, the problem could be Separation Anxiety Disorder, which affects about 4% of children. The child experiences unreasonable anxiety when taken away from home or family, and the desire to be in contact with the missing people is excessive, and usually includes extreme homesickness and misery. While separated, these children are often anxious about the health and safety of their parents.
Separation Anxiety Disorder may cause a child to attempt to avoid going anywhere alone, refuse to go to school or camp, be unwilling or refuse to go on sleepovers, demand that someone stay with them at bedtime, follow a parent around, or go into their parent’s bedroom during the night or have nightmares about being separated from their family. Separation Anxiety Disorder can start at anytime during childhood, but it is most often found in children between the ages of seven and nine.
Selective Mutism is when a child fails to respond verbally to normal stimuli that should bring about a vocal reaction. When their reluctance or failure to do so interferes with school and social interactions, they may have Selective Mutism, considered to be an extreme form of Social Anxiety Disorder. Selective Mutism most often starts before five years of age, but it usually becomes a problem when the child enters school. Diagnosis usually occurs between 4-8 years old, but these children were probably extremely shy from an early age. The behaviour must persist for at least one month before Selective Mutism can be diagnosed. These children can be perfectly normal and talkative, even boisterous at home or in a familiar place.