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Chandra Ghosh Ippen, Ph.D.
National Child Trauma Stress Network |
All children experience some stress. Stress is part of normal development and learning to deal with stress is a key part of development.
Unfortunately many more children than we would hope or expect experience severe stress (trauma) – stress that overwhelms their developmental capabilities. For example, the latest study suggests that 15.5 million American children live in families with partner violence, annually 3.6 million children receive a Child Protective Services investigation, and studies of Head Start children suggest that in some populations, over 75% have witnessed or been victim to at least one incident of violence.
Different Levels of Stress
Most children experience normal stresses associated with development and normal developmental transitions. In early childhood, examples of normal stress include separating from caregivers for brief periods, learning to deal with frustration when you can’t do something or are denied something, the birth of a sibling, and going to a new school.
Significant but tolerable stressors form another category of stressors. These stressors occur but they do not overwhelm the child’s ability to cope with them. When we think about how children cope with stress, we have to think about how in early childhood coping is a process involving both child and caregiver. The same stressor (such as an earthquake, parental divorce, parental illness) may be tolerable to some kids and overwhelming to others.
Then there is traumatic or toxic stress. There are acute stressors that may momentarily disrupt the child’s life in a significant way such as a fire, car accident, or serious natural disaster and there are chronic stressors such as living in poverty and chronic community violence. Other traumatic stressors that may be acute or chronic include physical abuse, sexual abuse, exposure to domestic violence, and the death of a caregiver.
Effects of Stress
We are learning a lot about how stress, particularly chronic stress affects the stress response system, which is still developing in early childhood. What does this mean? Basically, when we sense danger, changes occur inside our body at a chemical/physiological level that prepare our bodies to deal with the stressor. We call this system our fight or flight system. Our bodies literally get ready to go. Our heart may beat faster, changes in hormone levels such as cortisol result in increased adrenaline in our system, which would help us get the energy to move.
Usually after a while, the system down regulates. It decides it’s time to turn off our response. The problem arises when the system is constantly aroused because, especially in the case of chronic trauma, there is constant danger. So what we are seeing in children who have experienced trauma are irregular patterns in their stress response system particularly in their cortisol levels. Some studies have also found elevated blood pressure in young children.
Indicators of Stress
There is considerable overlap in the symptoms that infants, toddlers, preschoolers, and young school-aged children may exhibit in response to stress. In young children common symptoms of stress include sleep and feeding problems, temper tantrums and other aggressive behaviors, clinginess, separation anxiety, and fearful behavior. We also commonly see developmental delays or loss of developmental skills the child had previously acquired (for example a child who had been toilet trained suddenly begins having accidents).
With more serious traumatic stressors the child may show symptoms of re-experiencing of traumatic events including posttraumatic play, which includes play that is often highly repetitive and focused on some aspect of the traumatic experience. The child may also exhibit social withdrawal. For example, the child may not engage with others, may show little range of feelings and seem flat in their affect, and/or may seem to play less than others of their same age. The child may also seem to be more easily aroused. The child may startle in response to sounds, may appear to be hypervigilant – worried about possible danger. Often children exposed to stressors seem irritable and may act aggressively. They may seem hyperactive because they may be distractible and have difficulty concentrating.
Alleviating Stress
The first step is to identify and then try to reduce or eliminate the stressor, particularly if it is a traumatic stressor. The next step is us to understand that one way that stress affects children is because it affects the adults who care for them. Across multiple studies we have seen that the best predictor of how a child does following a stressor is how the caregiver does. To alleviate stress in the children we need to alleviate stress in the adults who care for them.
Creating a Safe Environment
Adults can help enhance children’s development and learning by providing a safe environment. This should be a given but unfortunately as we go into the schools we see this is often not true. Young children develop in the context of relationships. If relationships continually change, safety is affected and so is development and learning.
Provide an environment with well-trained caregivers and good staff-to-child ratios. Create an environment that focuses on the whole child – not just academic functioning, but also social, emotional, and physical development and well-being.
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Maria Segura
Grandmother of a 3-year-old |
My son and daughter-in-law are currently separated, and my son is staying with us. My four-year-old grandson currently spends weekends with us. Sometimes when he comes to our house he’s in a bad mood. He doesn’t want to talk. He doesn’t give us a hug or a kiss and goes straight to his room. When that happens we leave him alone and give him some space, or we will try to make jokes and make him laugh so we can cheer him up. But we have to be careful, too, because sometimes if we try to cheer him up it backfires and we make things worse.
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