Children

Some Type A researchers believe that the problem begins at an early age.  Type A heart attack patients consistently reveal feelings that one or both parents never loved them when carefully interviewed.  Typical aggression and low anger thresholds can be detected even in preschoolers.  In one study, Type A behavior was evaluated in some 150 boys and girls between the ages of 3 ½ and 6 ½ who were enrolled in three preschools.  Type A behavior was evaluated in terms of tendency to interrupt others or to be very competitive in play activities.  The children were then taught a relaxation as well as memory game during which blood pressures were measured repeatedly with an automatic device.  After the relaxation game the children were “stressed” with the memory test.  Those children scoring high as Type A’s displayed no significant difference in blood pressure from others when they were in a relaxed state.  However, there was a significant rise in systolic blood pressure in type A’s during the memory game.  The researchers will now continue their study to determine whether or not this behavior persists or intensifies as Type A children get older and if it is predictive of a higher incidence of cardiovascular disease later in life.  More importantly, this prospective study will measure whether attempts to reduce Type A behavior can successfully prevent adverse cardiovascular consequences.

Some Schools Press So Hard Kids Become Stressed and Fearful” was the title of a past Wall Street Journal article.  In kindergartens playtime is increasingly being replaced by reading, arithmetic, and computers. It’s even possible to flunk kindergarten in Minneapolis and Georgia and many pediatricians and psychologists are concerned about an associated increase in stress-related problems in children. Fast paced competition has been blamed for symptoms of “burnout” in kids as young as age 10 or 11. Factors contributing to this trend are an increased reliance on daycare centers by working mothers which emphasize so-called “enrichment programs.” As one nursery head noted, “We have a lot of parents wanting us to be teaching reading to two- and three-year-olds.  They say, “We’re not paying $2,000 for play. We want to see product.”   Text book publishers also see preschoolers as a growth market, pointing out the accomplishments of the Japanese in this regard. There has been some backlash and, in Chicago, one institute has created a business out of teaching parents and children how to play again.  The National Association for the Education of Young Children has called for an end to kindergarten admission tests and indeed any standardized testing before the third grade. Some parents are even keeping their kids out of kindergarten an extra year to keep them in play-oriented nurseries. One of the hotbeds of controversy is the growing use of a preschool readiness test developed by the Gesell Institute for Human Development which is used by almost 207″ of the nation’s school districts.  Orders for Gesell test materials jumped 67% between 1984 and 1987 despite a federally commissioned study.  And several test reviewers who feel it is unreliable.  In one New York school last year, almost two out of every three prospective kindergarten applicants were judged not to be ready and assigned to developmental kindergarten. Parents of one child filed a complaint with the state department of education and the school capitulated and agreed to put her in the regular kindergarten. Despite a widespread belief to the contrary, there is no good evidence that delayed entry to school results in better scholastic performance down the line. The move towards “let kids be kids” seems to be growing and parents are urging “blocks not books . . . more song and less software.”

Emotional distress can play a significant role in precipitating asthma attacks and increasing their severity as well as frequency. This is especially common in children and one study reported in Thorax found that asthmatic kids faced quadruple the risk of an attack after experiencing a stressful event that involved family relationships such as divorce, separation, deaths, births or having to move. Researchers studied 60 children between the ages of 6 and 13 who had suffered from asthma for at least three years and had them keep daily records of acute attacks noting their duration and severity. They also periodically interviewed them as well as their parents and family members to obtain information about stressful life events over the 18-month study period. An analysis of the data revealed that the participants were four times as likely to experience a sudden worsening of symptoms within two days of a stressful event and that they had double the risk of a recurrence of this about six weeks later. It was suggested that this could be due to disturbed immune system function as well as neuroendocrine influences. In a more recent study, Canadian researchers followed 40 asthmatic children and healthy controls for six months and recorded the frequency and severity of stressful events. Blood levels of glucocorticoid and beta-2 adrenergic receptors were measured periodically. They reported that these two indicators of adrenal cortical function were diminished following stressful events in asthmatic children and an opposite trend was seen in healthy controls. The attenuated expression of both these receptors could lead to airway inflammation and constriction following exposure to allergic triggers and also reduce the effect of asthma medications that frequently include cortisone-like steroids.

References

Sandberg S, Järvenpää S et al. Asthma exacerbations in children immediately following stressful life events. Thorax, Dec 2004; 59: 1046 – 1051.

Gregory E. Miller GE, Chen E. Life stress and diminished expression of genes encoding glucocorticoid receptor and 2-adrenergic receptor in children with asthma. Proceedings of the National Academy of Sciences, April 2006; 103: 5496-5501.