February 12, 2010

Four ways to treat a stressed-out child

Myles Williams was a happy-go-lucky kindergartner who started coming home each day with a soggy shirt collar.

His parents were mystified until his teacher called to report that Myles, 5, was chewing on his shirt and acting anxious. She asked if anything unusual was going on at home that might be stressing him out.

"My husband and I didn't even know a child (his age) could even be stressed," said his mother, Patrice Williams, a management consultant in northern California.

In fact, stress is an all-too-common part of childhood. Children older than 8 feel overwhelmed by school and relationships, according to the American Psychological Association's "Stress in America 2009" report. For younger children, stressors can range from new experiences such as using the toilet to tree branches that scrape the window.

Signs can also mirror behavior that's often considered age-appropriate, such as tantrums, power struggles, nail-biting or thumb-sucking, said Laura Markham, a child psychologist in California. "Kids who are not stressed are cheerful, cooperative and able to handle normal developmental challenges," Markham said.

Stressed kids usually have one thing in common: behavioral changes. They're more irritable, suddenly can't sleep or take comfort objects such as a blankie to places they didn't need them before. They may have headaches, stomachaches, night terrors or wet the bed.

But signs of stress can be subtle, particularly in quiet children. They may pull or twist hair, ask a lot of "what if" questions ("What if I get lost?") or need to see you at all times within the home.

Parents often underestimate how much stress their kids are feeling, according to the APA report. And it's easy to miss signs. Myles, for example, showed no obvious signs of stress at home. When his teacher learned he was spending more than an hour each night working with spelling and math flashcards, she asked his parents to limit drills to 15 minutes. Two days after they backed off, Myles (now 7) returned to his old self at school.

To identify stress, learn your child's unique signals, and figure out if anxiety is at the root of unusual behavior. A cluster of symptoms might be more worrisome than a single one, said Dr. Rahil Briggs, director of the Healthy Steps program at Montefiore Medical Center in New York.

If you can't identify and remove the stressor, you may need to seek professional help.

But never discount a child's fear, warned child psychologist Charlotte Reznick, former UCLA Associate Clinical Professor of Psychology.

"It's real for them," she said. "Fear comes from emotion, not intellect, so logic doesn't help."

Four ways to 'treat' stress

Promote play. "If a child is well fed and not sick, but not playing, it's a signal that something is wrong," said Stuart Brown, founder of the National Institute for Play. "Play is voluntary, it can be interrupted and there's no need to accomplish a goal."

Give them fighting words. Dr. Rahil Briggs, of Montefiore Medical Center in New York, tells of a boy who wouldn't use the toilet at night because tree branches made noises on the bathroom window. She taught him to repeat, "I'm safe," "That's just a tree," and "There's nothing to be afraid of" to himself while in the bathroom.

Increase sleep. It helps lower the body's levels of cortisol, a stress hormone.

Try scaffolding. Take a child a tiny bit above his comfort level and let him get comfortable at that new level, said Briggs. Gradually inch toward the desired goal, teaching coping skills along the way.