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Seperation Anxiety Disorder Or Environment?

Question:

I have a friend, we will call Pam. Most of this will be referencing Pam because she is the one that I really know, but the father is a part of all this, and does pretty much what I write that Pam does. Her daughter June is 8.5 years old. She has been having some “focus” problems at school, has been for all types of extra help. The teachers and guidance counselors have told Pam that June has some separation anxiety disorder. Also, they suggested a mild medication that June would take (maybe a patch?) for school hours to help keep her focused. One of the counselors had done the same thing for her own child. Let me point out that Pam is a very good mother, loves her children to death. Now here are some other facts that I think Pam has trouble admitting fully, and that these counselors/teachers are unaware of. Pam owns a business, which June can be there with her when necessary, but Pam works many hours everyday. However, as I mentioned, she does get to spend time with June, even if at the business. June, who is in 2nd grade, never does her homework on her own, never had since day one. Pam always sits and does every single piece of homework with her, and much of the time leads her into the right answers or occasionally just tells her the right answer, not to do her work but to show her the answer though not realizing that it is not the best way. Pam will occasionally make comments that the homework is too much or too hard right in front of June, and does not let her start her work without someone else there if she cannot be there. June can be demanding, and usually gets what she wants, or is promised it, with enough badgering and carrying on. Most people around June are guilty of this, including grandparents, aunts, parents, etc. June does not sleep alone, never has. She sleeps with her parents, and basically no effort is made to change that, it is just said by Pam that it needs to change. June usually doesn’t go to sleep unless someone is there with her, again though, she never has been taught to. That is more on the part of laziness by those involved. She asks questions over and over and over, to the point of annoyance, usually when something is not going her way and she is looking for the person who will give her what she wants. June still will throw tantrums (not that often) and can act irrational like a 2 year old rather than an 8 year old. Now, when June is by my house, she does none of this. She sleeps alone, or in my son’s room and goes to bed when told, sleeps through the night, wakes up happy in the morning. Eats whatever I make, despite that she claims to hate cheese or whatever, she eats it happily by me. She is a perfect angel at my house, and I have never spanked her (she does not fear me I mean), and rarely punish her because she is always so well behaved with me. But I do not cater to her, and she knows there are rules that stand with me no matter what (it is how I am with my own kids, so she must follow along.) Same goes for my other friend who has June over many times as well. She will figure things out for herself if I do not help her with something that she should know. No problems. My point in all of this is, if she had a disorder, would she be able to just turn it off when she is with me? That is what makes me against the medication because I don’t think the basic issues have even been dealt with at home, such as having no strong routines, no consistent discipline, and no opportunity to be independent. I can clearly see that she gets tons of attention at home and at school when something is “wrong” with her, so it’s beneficial to her in the way children can think. At my house, she gets no attention for these “problems” but gets treated like my other kids and gets better results doing the right things. I am worried for her because Pam can become defensive about this, so she is hard to talk to. I feel like nobody wants to deal with the real problems, which aren’t even that major, they just take a little effort and consistency to fix. It is easier for all involved to say she has a disorder, let’s medicate her. I know medication can be very necessary, I just don’t see that as the first option in this case. It may never be necessary and it is the first resort after a poor effort to change anything else. Any advice?

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Answer:

There are a number of important issues that you have been good enough to bring forward in you E. Mail question.

First, I would be very skeptical about any teachers or guidance counselors diagnosing a child much less recommending medication for them. June needs a complete evaluation by a Psychologist who will give her a full battery of tests to determine what, if anything, is wrong. If it is found that something is wrong she might need to be further evaluated by a Psychiatrist. Only a Psychiatrist can determine whether or not a medication is needed for June or for any child. Psychiatrists are medical doctors and are legally permitted to write prescriptions for children or adults. Also, it is not likely that anyone would ask for medication to be provided for separation anxiety.

Second, some of the information you have provided suggests that June may have Attention Deficit Hyperactivity Disorder (ADHD). A child can have ADHD with or without the hyperactivity. It is very difficult to determine, based on this information, whether or not June is hyperactive. However, her inability to focus her attention does strongly hint at ADD. Only a child a psychiatrist can make the final diagnosis about what is bothering June. If she is found to have ADD or ADHD she will need a combination of medication and specific types of therapy to help her learn how to focus and control her impulses. Talk of a patch further indicates that the school staff believes that June has ADD.

Third, it is possible that June is attempting to cope with problems at home. All children do better with structure and rules and that is why your approach to June is correct, whether she has ADHD or not. The fact that she can control herself at your house indicates that she is not hyperactive. However, she could still have Attention Deficit Disorder.

Yes, environment can be an important factor in causing children to have difficulties at home and in school. The lack of attention from her mother, adults submitting to her temper tantrums and other types of factors do affect how children feel and behave. However, in this case, it still sounds a lot like there is an ADD factor at work. In any case, when ADD or any other childhood problem is treated, parents are asked to be part of the treatment process.

The bottom line is that June needs to be evaluated and the entire family brought in to learn how to help her. If the staff at the school is calling for medication it is most likely that they have been in touch with her mother and attempting to get June and her parents some help.

Lastly, helping June with her homework is something that I do not see as a problem. It is recommended that parents be there, with their children, helping and encouraging with homework. Homework is fairly anxiety provoking for children and the help provided by parents can reduce the anxiety and provide a way for children to learn how to go about doing homework.

Thank you for this E. Mail and I hope you send this information along to June’s parents.

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