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Helping Children Cope with Stress
Karen DeBord, Ph.D.

While some stress is normal and even healthy, children today seem to encounter many stressful life events at earlier ages. Stress shows itself in children by complaints about stomachaches, being nervous, trouble sleeping, anger flares, and infections.

Stress is a life event or situation that causes imbalance in an individual's life. An unhealthy response to stress occurs when the demands of the stressor exceed an individual's coping ability. Often stress results from something that is beyond our control. Control has a great deal to do with levels of stress.

Some stress is normal. Daily and life challenges can be expected. For example, most children will attend school and will have to go through many transitions. Most adolescents will have to grapple with their sense of identity to determine where they "fit." Being afraid of the dark and feeling peer pressure are predictable stressors. Other stressors are not as predictable. Disruptions to what is considered normal for the child cause problems with stress. Small amounts of stress, as experienced before a test or when meeting new people, are necessary to present challenges for greater learning. Simple stress experienced when learning a new skill or playing an exciting game raise a person's level of excitement or pressure above the normal level.


WHEN IS STRESS DISTRESS?
Problems begin when ordinary stress becomes too much stress or distress. There are a variety of reasons for children to feel stress. Death, divorce, remarriage, moving, long illness, abuse, family or community violence, natural disaster, fear of failure, and cultural conflict may each heighten stress. Under stress, the heart rate and breathing are at a higher speed and muscles are tense. Multiple stressors worsen the stress level and the length of the stress. Our bodies need relief from stress to reestablish balance.

CHILDREN'S REACTIONS
Reactions to stress vary with the child's stage of development, ability to cope, the length of time the stressor continues, intensity of the stressor, and the degree of support from family, friends, and community. The two most frequent indicators that children are stressed are change in behaviors and regression of behaviors. Children under stress change their behavior and react by doing things that are not in keeping with their usual style. Behaviors seen in earlier phases of development, such as thumb sucking and regression in toileting, may reappear.

SOME OF THE TYPICAL SIGNS AND SYMPTOMS OF STRESS FOR CHILDREN

Preschoolers:
Typically, preschoolers lack self-control, have no sense of time, act independently, are curious, may wet the bed, have changes in eating habits, have difficulty with sleep or speech, and cannot tell adults how they are feeling.

Preschoolers under stress each react differently. Some behaviors may include irritability, anxiety, uncontrollable crying, trembling with fright, eating or sleep problems. Toddlers may regress to infant behaviors, feel angry and not understand their feelings, fear being alone or without their parent, withdraw, bite, or be sensitive to sudden or loud noises. Feelings of sadness or anger may build inside of them. They may become angry or aggressive, have nightmares, or be accident prone.

Elementary-age Children:
Typical elementary-age children can whine when things don't go their way, be aggressive, question adults, try out new behaviors, complain about school, have fears and nightmares, and lose concentration.

Reactions to stress may include withdrawal, feelings of being unloved, being distrustful, not attending to school or friendships, and having difficulty naming their feelings. Under stress, they may worry about the future, complain of head or stomachaches, have trouble sleeping, have a loss of appetite, or need to urinate frequently.

Preteens and Adolescents:
Adolescents typically are rebellious, have "growing" pains and skin problems, may have sleep disturbances, may go off by themselves, be agitated, and act irresponsibly.

Adolescents and teens under stress may feel angry longer, feel disillusioned, lack self-esteem, and have a general distrust of the world. Sometimes adolescents will show extreme behaviors ranging from doing everything they are asked, to rebelling and breaking all of the rules and taking part in high-risk behaviors (drugs, shoplifting, skipping school). Depression and suicidal tendencies are concerns.


BUILDING SAFETY NETS FOR STRESS
Just as children's reactions are each different, so are their coping strategies. Children can cope through tears or tantrums or by retreating from unpleasant situations. They could be masterful at considering options, finding compromising solutions, or finding substitute comfort. Usually a child's thinking is not developed fully enough to think of options or think about the results of possible actions. Children who live in supportive environments and develop a range of coping strategies become more resilient. Resiliency is the ability to bounce back from stress and crisis. For many children, a supportive environment is not present and many children do not learn a set of positive coping strategies.

Factors that support children and create a safety net for them during stressful times include:

A healthy relationship with at least one parent or close adult.
Well-developed social skills.
Well-developed problem-solving skills.
Ability to act independently.
A sense of purpose and future.
At least one coping strategy.
A sense of positive self-esteem and personal responsibility.
Religious commitment.
Ability to focus attention.
Special interests and hobbies.
Families can provide further protection by:

-developing trust, particularly during the first year of life.
-being supportive family and friends.
-showing caring and warmth.
-having high, clear expectations without being overly rigid.
-providing ways for children to contribute to the family in meaningful ways.
-being sensitive to family cultural belief systems.
-building on family strengths.

Children who live in supportive environments and develop a range of coping strategies become more resilient.

COPING STRATEGIES
It is not necessary to be a therapist to help children cope with stress. One key element in reducing stress is a stress-free environment. A stress-free environment is based on social support, having the ability to find hope by thinking through solutions, and being able to anticipate stress and learn ways to avoid it.

SOCIAL SUPPORT
Social support means having people to lean on during difficult times. Parents who listen, friends to talk to, hugs, and help in thinking through solutions are ways children feel support.

Specifically:

Notice them. Well-developed observation skills are essential. Observe for more quarrels with playmates, poor concentration, or bed-wetting.

Praise children. Encourage children and show you care. Be positive.

Acknowledge feelings. Let children know it is okay to feel angry, alone, scared, or lonely. Give children the names for their feelings and words to express how they are feeling.

Have children view the situation more positively. Some stressors make the child feel ashamed. Shaming truly affects self-esteem.

Structure activities for cooperation, not competition. This allows individuals to go at their own pace and increases the learning of social skills.

Involve parents, family members, and friends. They can read books together, encouraging openness and listening. They also can ensure good nutrition and proper rest.

Host regular, safe talks. Members of the family or classroom group who feel comfortable can share experiences, fears, and feelings. Adults can recognize the steps a child uses to cope and help others learn from these experiences. Hold regular family conferences or classroom meetings to plan activities or to suggest solutions.


THINKING IT THROUGH CLEARLY
Children must learn to think through a problem. Some specific strategies include self-talk, writing about the problem, and making a plan. Thinking positively and thinking up real solutions is important.

Adults can:

Show how they can cope in a healthy way. Keep calm, control anger, think through a plan, and share the plan with the family.

Be proactive. Plan plenty of playtime, inform children about changes, and plan activities where children can play out their feelings. Books, art, puppetry, play, and writing help children think through and name their feelings.

Develop thinking skills. Help children think through the consequences of actions. Pose situations (friendship, stealing, emergencies) and think through actions. Ask open-ended questions about what the solutions to problems could include, such as "What could we do about this?"

Help children tell reality from fantasy. A child's behavior, for example, did not cause his or her parents' separation.

As an adult, focus on the stressor. Model how thinking through options for dealing with difficult people, situations, or problems helps you find solutions.

Find individual talk time. Talk about stressful events and everyday events.

Use stories and books. Stories can help the child identify with the feelings of the character and tap their own feelings to ease them out for discussion and to discuss coping strategies.

Use art for expressing feelings. Paint, clay, sand, and water all allow for active expression.

Encourage children to act out coping skills. Playing with dolls, boxes, toy telephones, puppets, blocks, cars, and similar items provides another avenue to bring feelings out for discussion.

Give the child some degree of control. Children should be allowed to choose within the framework of what is expected. Allow them to make some manageable decisions, such as how to arrange their room, to voice their opinion in some family decisions, which activity to complete.


FORESEE STRESSFUL SITUATIONS AND AVOID THEM
If we can foresee an event, we can often block it as a stressor. Ignoring problems, changing the subject, not worrying about it, or changing an action can be coping strategies.

Identify what could cause stress and plan ways to avoid it or how to deal with it.

Encourage children to be proud of themselves in some way. Developing a special interest or skill can serve as a source of pride and self-esteem.

Use gentle humor or read a silly book to create laughter and to reframe negative thoughts into opportunities.

Offer personal space. Modify the environment. Quiet space and alone time should be allowed. (Adjust noise levels and check the traffic pattern.)

Teach relaxation and deep breathing techniques. Ask children to close their eyes and imagine a quiet and or happy place (the beach with waves, a birthday party, a warm cup of cocoa).

Teach conflict-resolution strategies. Teach children to think through alternatives ways to solve problems. Who else can help solve given problems? What additional information do they need?

As adults, we can make sure we don't add to children's stress by expecting them to act in adult ways. We can praise, be positive, seek positive solutions, help children name their feelings, teach fairness, help children learn to like themselves, be patient, teach honesty, and give lots of love and encouragement, particularly during difficult times.


REFERENCES
Elkind, D. (1988). The Hurried Child. Reading, MA: Addison-Wesley.

Hart, A. D. (1992). Stress and your child. Word publishing: Dallas.

Honig, A. S. (1986). Stress and Coping in Children. In J. McCracken's Reducing Stress in Children's Lives. pp. 142-167.

Brenner, A. (1984). Helping Children Cope with Stress. Lexington Books: Lexington, MA.

National Network for Family Resiliency (1995). Family Resiliency: Building strengths to meet life's challenges. Ames: Iowa State University Extension.

Karen DeBord, Ph.D. is a Child Development Specialist at the North Carolina Cooperative Extension Service. Reprinted with permission from the National Network for Child Care - NNCC. DeBord, K. (1996). *Helping children cope with stress*. Raleigh, NC: North Carolina Cooperative Extension Service.

The information presented on this site is intended solely as a general educational aid, and is neither medical nor healthcare advice for any individual problem, nor a substitute for medical or other professional advice and services from a qualified healthcare provider familiar with your unique circumstances. Always seek the advice of your physician or other qualified healthcare professional regarding any medical condition and before starting any new treatment.

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