A child with SAD will persistently and excessively demonstrate at least three of the following for a period of a month or longer:
- Distress when anticipating or experiencing separation from home or attachment figure(s)
- Worry about losing attachment figure(s) or about possible harm coming to them (for example, from illness, disasters, or death)
- Worry about experiencing a negative life event that would separate the child from attachment figure(s) (such as being kidnapped or becoming lost)
- Reluctance to leave the home (including to attend school) because of fears of separation
- Reluctance to be alone, including at home
- Reluctance to sleep away from home, or to sleep at home without an attachment figure close by
- Nightmares involving themes of separation
- Physical symptoms such as headaches or gastrointestinal symptoms when separated from attachment figures
Children with SAD may express separation fears by "clinging" to attachment figures, including following them from room to room around the house, or requiring an attachment figure to follow the child when he or she moves to a new room. Children with SAD may refuse to fall asleep alone and may routinely move to a parent or sibling's bed in the night.