Stress is a common part of every child’s life. Children worry about their appearance, about tests and school projects, being accepted by friends, being separated from family, as well as many other concerns. Most children are able to keep stress in control as they have positive and successful life experiences. A certain amount of stress is normal, but too much stress can be unhealthy. Disturbing events in the news or in the home can increase a child’s stress and make them feel unsafe. When a child is ill or in the hospital, it can be an especially stressful time for the child and family.
Parents and other caregivers often ask what they can do to reassure children and help them to feel safe. Here are some tips for supporting children during stressful times:
- Encourage family members to pay special attention to one another. Children of all ages need extra hugs in stressful times.
- Pay attention to the child’s environment. Be aware of what children are hearing and seeing. Even very young children can be upset by news images of disasters and destruction. It may be wise to limit TV viewing and talk with children about what they are seeing.
- Help children and teens release tension. Encourage physical exercise, play and other diversions that help them relax and “unwind.” Help older children and teens direct their energies into positive and helpful activities like volunteering.
- Continue with your family’s daily routines and schedules as much as possible. Structure and familiar rituals help children feel safe.
- Pay special attention to see that children’s needs for nutrition, sleep and exercise are met.
- Help children in the hospital by bringing familiar and comforting belongings from home. Discuss your normal routines with health care team members so they can better support your family-centered care needs.
How to Talk with Children
- Be honest, calm and factual. Answer children’s questions, but don’t overwhelm them with too much information. (See What Children Think at Certain Ages on page 2.)
- Offer hope. Let children know they are not alone.
- Assure children you are there for them and “we’ll get through this together.”
- Help children and teens to express their worries and fears. Younger children may share their feelings in play and drawings; older children may want to write about their feelings. Toddlers and preschoolers may feel guilty when bad things happen; reassure them that they did not cause what happened.
What Children Think (and Fear) at Certain Ages
Things that are stressful for children may be different from things that are stressful for adults. A child’s age affects responses to situations that are stressful. Children at most ages worry about separation from their parents or friends. While children develop at different rates, these are common concerns at certain ages:
|Not fully able to separate fantasy from reality (fear of a tragic event may be same as fear of monsters under the bed).|
|May feel guilty when bad things happen and may worry they did something to cause a bad situation.|
|Pick up on parents' fears and anxieties without anyone having to say a word.|
|Imagine of fires, smoke and hurt people are seen as very big, powerful and very bad.|
|Concerned about their own safety and security and that of their family and friends.|
|Fears can cause emotional problems because they understand reality of a situation, but can't understand the reasons for violence, death or other tragedy.|
|Likely to understand many facts but have trouble accepting the disruption in their lives the event has caused.|
Signs of Stress
It’s normal for children to have a wide range of feelings and some behavior changes during and following stressful events. Talk with your child about what behaviors you are seeing and share your concern. For example, “You seem to be having trouble getting to sleep at night.” Listen to their response. Offer reassurance and helpful thoughts. For example, “You are safe in your room and won’t be left alone. Would you feel better if you had a night light or some relaxing music?”
The following behaviors are often seen during stressful times:
|Toddlers and Preschoolers||Older Children and Teens|
|Depression (restless, fidgety, hyperactive, whiny, clinging and demanding behavior)||Depression (sad or withdrawn; trouble eating or sleeping; talking about feeling hopeless)|
|Unusually angry||Emotional outbursts|
|Tummy aches||Violet themes in artwork or unusual interest in weapons|
|Difficulty sleeping||Abdominal pain, headaches, chest pain|
|Regression (doing things they did when they were younger); for example, a toddler who has been potty trained has "accidents" again||Regression (doing things they did when they were younger) such as sucking their thumbs, bedwetting or clinging to parents|
Too Much Stress
Children who experience continual stress may show ongoing signs of emotional and physical problems if their stress level gets too high. If you see behavior changes that last longer than a few weeks, prevent children from taking part in usual activities or continue to get worse, please talk with a member of your child’s health care team.
HH-IV-81 10/01 Copyright 2001, Nationwide Children’s Hospital