Transforming stress through awareness, education and collaboration.


Stress in Children

Type A Toddlers

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.

Are Schools Causing Tense Tots?

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.”

Talking To Your Kids About Your Terminal Illness

When a parent is diagnosed with a terminal illness, this new situation will affect the entire family, especially the children. In these cases one of the main concerns is how, when and if this news should be shared with the children. It is normal for parents to want to protect their child, but hiding the terminal illness can oftentimes make matters worse. Withholding information can cause children to feel confused, angry and, many times, guilty.

How to Have the Conversation with Your Children

According to the American Society of Cancer, it is a good thing to tell your children about the terminal illness, but this news should be shared in stages and in a language that a child will be able to understand. Never give a child more information than they will be able to absorb and understand.

If you have a partner, it is best to share this news together; but if you are a single parent then you should tell them alone. A single parent’s greatest concern is to find a reliable person who will take care of their children after they are gone.

But when is the best time to tell your children about your terminal illness? You should talk to your child as soon as the diagnosis is definite. Children know more than parents may think, and they do understand when something is happening in their family, even if you think that you are good at hiding it. Be honest with your children and try to prepare them as much as you can for the future. Keeping your child away from the truth will just make them feel lonely, afraid and guilty.

Preparing Your Child for Loss

In many cases, families have been dealing with the disease for months or even years before it is known that the condition is terminal. In just a few cases, the disease is diagnosed in an advanced stage. This period will help you and your children prepare for the worst. No matter how long you have been dealing with the illness, dealing with it in it’s terminal stage will never be easy.

Children have an abstract understanding of life. Young children especially will have difficulties understanding what death is, and the fact that their parent will be gone forever. Usually after the age of 10, children do understand the meaning of death. Using the right words is very important. Be sure to explain to your child what death really means, and that once you are gone, you will not be back. Don’t give hope to your child. Instead, explain to them that once someone has died, they will be physically gone and that the child will no longer see the loved person. In some cases this conversation might need to be repeated a couple of times, because children will usually have questions. Try to answer these as much as you can. For most children it is very hard to cope throughout the process of losing a parent, especially if they are very young. But in time, the child will accept the reality.

In one way, telling your child the truth can help distract parents from dwelling on the illness. The more they know about the situation, the less fear they will feel. If you are hospitalized, try to get in touch with your children as much as you can. Reassure your children that you love them and that the illness has no effect on your love for them. Let your child visit you while hospitalized only after you, your partner, a friend or a family member prepares them for this situation. It is not easy for children to see their parent in a terminal condition.

Remember, when a parent suffers from an illness, children will notice that something is going on. Being overprotective of them will just make the situation worse, so be honest. It is normal for you as a parent to not know all the answers, as well as to be unsure of what to say and how to explain the illness to your children. Seek help when necessary from a family member, friend or a professional.


Stress and Asthma in Children

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.


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.