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AAP Clinical Report Details How to Help Children Through Divorce, Separation

​Pediatricians can support children whose parents are going through a divorce or separation by identifying the need for intervention and maintaining positive, neutral relationships with both parents, according to a new clinical report released by the American Academy of Pediatrics.

More than 1 million American children annually are affected by their parents’ break-up and may suffer emotional trauma that requires extra support, according to the report, “Helping Children and Families Deal with Divorce and Separation.” The report, to be published in the December 2016 Pediatrics (online Nov. 28), observes that the separation of unmarried heterosexual partners is more common than divorce yet may result in psychological effects that are just as significant. These children need pediatric support, just as couples who formally go through divorce, according to the recommendations.

“The pediatrician can help parents understand their children’s reactions to divorce or separation,” said one of the lead authors, Carol C. Weitzman, MD, FAAP, chairperson of the AAP Section on Developmental and Behavioral Pediatrics.

“Those reactions will vary, depending on age and stage of development,” she said. “Parents should be encouraged to answer their children’s questions honestly, and allow them to express their own feelings.”

Many children show behavior changes in the first year of parent separation. While most adjustment problems resolve in two to three years after separation, the child’s sense of loss may last for years and be exacerbated on holidays, birthdays or special events, according to the report.

Children’s reactions will also vary according to their temperament and their parents’ ability to focus on their needs and feelings, as well as how parents and children related to each other before and after the separation, the report states.

As children develop and mature, their emotions, behaviors and needs concerning the impact of divorce are likely to change, the report states. Changes in custody arrangements, the introduction of stepfamilies and parents’ dating and sexual activities may also pose adjustment challenges for the child.

“Children’s routines -- such as school, extracurricular activities and their contact with friends and family --- should remain as normal and unchanged as possible,” said Michael Yogman, MD, FAAP, chairperson of the Committee on Psychosocial Aspects of Child and Family Health. “Children need to understand that they did not cause the divorce, and have their questions answered honestly, at their level of understanding.”

The clinical report advises pediatricians to refer families to mental health and child-oriented resources with expertise in divorce, if necessary.

11/28/2016 12:15 AM
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