Separation anxiety disorder (SAD) is an anxiety condition in which a person has extreme anxiety when they are separated from their home and/or from persons with whom they have a deep emotional bond. SAD is defined by the American Psychiatric Association (APA) as an overabundance of dread and anguish when confronted with circumstances that demand separation from home and/or from a specific authority figure (American Psychiatric Association, n.d.). It is most frequent in infants and toddlers, but it can also affect older children, teenagers, and adults. Separation anxiety is a normal element of childhood development.
Strategies for the Different Stages of Development
Toddler
At such a young age it is crucial to establish rules of behavior to make a child accustomed to separating from their parents. A good strategy is to create specific good-bye rituals, which has to be quick. Otherwise a toddler will start thinking it’s a game and would not want to separate. Taking longer time for goodbyes will make the transition process take longer and as a result anxiety will increase as well. However, if established properly, a goodbye tradition will prepare the child that it is time to say goodbye and accustom them to being without parents at this age.
Preschool
Consistency is particularly essential at this age. Whenever possible, try to conduct the same drop-off with the same ritual at the same time each day to prevent unexpected elements. A routine can help to ease the pain and enable a child to develop trust in both their independence and parents. Parents must also emphasize the need of “positive goodbyes” and explain the advantages of being apart from Parents or Siblings, such as spending time with friends at preschool.
School aged
For a school-aged youngster, the start of school is frequently the source of separation anxiety. In such instances, a parent should begin discussing what is about to occur before it occurs. It is necessary to begin talking about it a week in advance, including details concerning pick-up at the conclusion of the day. Furthermore, parents should discuss each future day with their children night before, and assist them in preparation. The less surprises there are, the better. Before kids have to go off on their own, it would be beneficial to show them their educational environment and meet the teachers.
Adolescent
A teen’s reluctance to attend or stay at school is frequently due to separation anxiety. Counseling can help anxious kids get back in gear, whether it is caused to by a nervous disposition, life stress, or the pandemic. It’s immensely gratifying to see teens overcome their separation anxiety with cognitive behavioral therapy. Such tactics assist the adolescent in examining their fear, anticipating situations where it is likely to emerge, and comprehending its consequences. When kids feel empowered and given the correct tools, the process can be surprisingly swift.
Post Operational Care a Child Requires After Abdominal/Bowel Surgery
The goal of post-surgical treatment is for a child’s intestine to restore function so that it can operate by itself. A newborn will have a lot of watery bowel movements just after the operation, leading them to lose a lot of critical fluids and minerals. To compensate for these losses, the infant will pee in order to get nourishment and fluids via an intravenous (IV) line. Parents must ensure that their children sleep when they are weary, but also take them for a walk every day. Getting adequate sleep can help you recover faster. Following surgery, a child’s appetite may be affected. However, it is critical that they consume a nutritious diet.
Assessments for a Postop Pediatric Patient
Postoperative patients must be constantly monitored and checked for any signs of worsening, and the appropriate postoperative care plan or pathway must be followed. If a child is in pain when they wake up after surgery, it’s critical to diagnose and treat it as quickly as possible. Inadequately handled pain will simply add to the child’s worry and anxiety during his or her hospital stay. Because self-reporting is the only direct measure of pain, it is frequently regarded the best technique. However, there are a variety of situations in which youngsters find it difficult or impossible to express their own discomfort levels. A proxy measure must be employed in children who are cognitively challenged, extremely ill, or too young to talk.
Pain Scales Used in Pediatrics
In order to assess pain in newborns and young children, age-appropriate scales must be used. CRIES (Crying, Oxygen Requirement, Increased Vital Signs, Facial Expression, and Sleep) is the first tool. Based on changes from baseline, an observer assigns a score of 0-2 to each parameter. The Neonatal/Newborns Pain Scale (NIPS) has been utilized mostly in infants under the age of one year. Before, during, and after an operation, a numeric value is given to each of the following: facial expression, cry, breathing pattern, arms, legs, and state of arousal. A score of more than 3 indicates that the person is in agony.
From 2 months to 7 years, the FLACC (Face, Legs, Activity, Crying, Consolability) measure has been validated. The scoring system is based on a scale of 0 to 10. The CHEOPS scale (Children’s Hospital of Eastern Ontario Scale) is for children aged 1 to 7. Examines the child’s cry, facial expression, verbalization, torso movement, whether the youngster touches the affected area, and leg posture. A pain score of more than 4 indicates that the person is in pain. Children aged 3 and above can use self reporting to rank their pain. Wong-Baker 6 cartoon expressions with varying degrees of distress on a scale of one to six. Face 0 means “no pain,” while face 5 means “worst pain you can conceive.” At the time of the assessment, the kid selects the face that best portrays pain.
References
American Psychiatric Association. (n.d.). Separation Anxiety. APA Dictionary of Psychology. Web.