Recognizing Stress in Children
A disaster is frightening to everyone. Several factors play an important part in a
child's reaction to the event. Children will be affected by the amount of direct exposure
they have had to the disaster. If a friend or family member has been killed or seriously
injured and/or the child's school, home or neighborhood has been destroyed or severely
damaged, there is a greater chance that the child will experience difficulties. Adults can
help children grieve by patiently listening and being able to tolerate feelings. This is a
major factor in a child's perception of adults' reactions to the disaster. Children are
very aware of adults' worries most of the time but they are particularly sensitive during
the period of a disaster. Acknowledging your concerns to the children is important, as is
your ability to cope with stress. Another factor that affects a child's response is
his/her developmental age. Talking about the disaster together using words children can
understand is important, as is being sensitive to their different responses.
Preschool children will cling to parents and teachers and will worry about their
parents' whereabouts. School-age children whose homes have been damaged by a fire may
express the fear that life isn't safe or fair, whereas adolescents may minimize their
concerns but fight more with parents and spend more time with their friends. It is
important to listen to children's individual concerns and to be alert to signs of
difficulty.
Children are the most vulnerable population. Times of disaster and trauma increase
their vulnerability. Recognizing children's symptoms of stress is not easy. Some stress
reactions may include the following:
Sleep disorders
Persistent thoughts of trauma
Belief that another bad event will occur
Conduct disturbances
Hyperalertness
Avoidance of stimulus or similar vents, i.e., boating, swimming, baths, traveling
Moving
Regression, thumb sucking
Dependent behaviors
Time distortion
Obsession about the event
Feeling vulnerable
Excessive attachment behaviors
Extension professionals, parents and caregivers can work with child care providers to
help them understand that parents who are under stress may not be able to provide enough
love and affection for their children. Some of this lack of affection can be supplemented
in child care settings.
There are multiple factors that determine how to negotiate stress with children.
Child's developmental level
Elementary school children in the developmental stage of accomplishing and feeling
competent may not progress well in school. This is an interference in development.
Research indicates that the stage of identity development (usually in adolescent and teen
years) can be hampered if fear is pronounced.
Latent reactions observed in children experiencing the Buffalo Creek flood in New York
was depression, powerlessness, vulnerability, difficulty distinguishing fact from fantasy,
fear of separation, and chronic anxiety.
Child's perceptions of family reactions
Sometimes, anxiety in children can be attributed to anxiety in parents. Children who
realize that their parents are powerless (the inevitability of flood waters for example)
are fearful. Erikson suggests a loss in the belief of adults' power results in the
questioning of adult authority in other instances and may manifest itself in juvenile
misconduct.
Collaboration between parents, care givers, social workers has worked in the past.
Meaningful adaptations in children's environments will aid in their feelings of security.
Expected Reactions of Children and Adolescents to Disasters
Refusal to return to school or child care. This may emerge up to several months after
the disaster.
Fears related to the disaster (i.e. the sound of wind, rain, thunder, sirens, etc.)
Sleep disturbances persisting several months after the disaster, manifested by
nightmares and bed wetting.
Misconduct and disobedience related to the disaster reflecting anxieties and losses that
the child may not be talking about may appear weeks or months later.
Physical complaints (stomach aches, fevers, headaches, dizziness) for which no immediate
physical cause is apparent.
Withdrawal from family and friends, listlessness, decreased activity, preoccupations
with the events of the disaster. Many children may be confused or upset by their normal
grief reaction. Children have reported that they do not feel enough support from adults
during a disaster.
Loss of concentration, irritability.
Increased susceptibility to infection and physical problems related to the disaster.
The most common psychological disturbances found among children who have lived through
a disaster include: anxiety disorders, sleep-disturbances, phobias, depression and
post-traumatic stress disorder.
Children proceed through a variety of stages following a trauma. The following stages
have been identified as stages one might expect following a disaster.
Terror - Exhibits for children through crying, vomiting or bodily discharge,
becoming mute, loss of temper, or running away.
Rage, anger - Adrenaline release, tense muscles, heart rate increases.
Denial - Adults may exhibit denial differently than children. Some behaviors
include feeling numb, blocking off pain and emotion, dreaming, feeling removed from
experiences, or no feelings at all. Children may withdraw into uncustomary behavior
patterns. One study reported avoidance and resistance to participating in art therapy by
not drawing anything related to the actual disaster (Newman, 1976). Behaviors may appear
non-responsive and be overlooked.
Unresolved grief - Unresolved grief could move into deep depression or major
character changes to adjust to unresolved demands of grief and trauma. A child may stay
sad or angry, be passive or resistant.
Shame and guilt - Children do not believe in randomness and may even feel at
fault after a disaster. Shame is one's public exposure of vulnerabilities. Guilt is
private. There is a need to resolve these feelings, regain a sense of control, gain a new
sense of independence and feel capable.
The effects of trauma in childhood can be found both immediately and after a long
period of time. Trauma changes those involved. Knowing what to look for in children can
lead caring adults to seek professional assistance.
Behavioral Signals
Generally the world for small children is predictable and stable served by dependable
people. Any disruption in stability causes stress. The two most frequent indicators that
children are stressed are CHANGE in behaviors and REGRESSION of behaviors. Children can
change their behavior and react by doing things that are not in keeping with their usual
style. Behaviors seen in earlier phases of development such as thumb sucking and
regression in toileting may reappear. Age groups differ in reactions. For example, loss of
prized possessions, especially pets, hold greater meaning during middle childhood. Of
concern to adolescents during/after a major disaster is the fear related to own body
(intactness), disruption of peer relationships and school life. Adolescents feel their
growing independence from parents and family is threatened. At this time, it feels
different since the family needs to pull together during this time and less independence
is allowed.
There will be a difference between age groups:
Normal Behavior/Stressed Behavior
Preschool (1-5) |
Normal Development |
Possible Stressful reactions |
Consider referral for professional assistance |
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thumb sucking, bedwetting |
uncontrollable crying |
excessive withdrawal |
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lacking self-control; no sense of time; wanting to exhibit independence (2+) |
trembling with fright, immobile |
does not respond to special attention |
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fear of the dark or animals, night terror |
running aimlessly |
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clinging to parents |
excessive clinging, fear of being left alone |
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curious, explorative |
regressive behavior |
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loss of bladder/bowel control |
marked sensitivity to loud noises, weather |
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speech difficulties |
confusion, irritability |
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changes in appetite |
eating problems |
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Middle Childhood (5-11) |
Normal Development |
Possible Stressful reactions |
Consider referral for professional assistance |
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irritability |
marked regressive behaviors |
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whining |
sleep problems |
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clinging |
weather fears |
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aggression question authority try new behaviors for 'fit' |
headache, nausea, visual or hearing problems |
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overt competition with siblings for parents' attention |
irrational fears |
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school avoidance |
refusal to go to school, distractability, fighting |
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nightmares, fear of dark |
poor performance |
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withdrawal from peers |
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loss of interest/ concentration in school |
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Early Adolescence (11-14) |
Normal Development |
Possible Stressful reactions |
Consider referral for professional assistance |
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sleep disturbance |
withdrawal, isolation |
disoriented, has memory gaps |
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appetite disturbance |
depression, sadness suicidal ideation |
severely depressed, withdrawn |
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rebellion in the home/refusal to do chores |
aggressive behaviors |
substances abuser |
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physical problems (skin, bowel, aches and pains) |
depression |
unable to care for self (eat, drink, bathe) |
Adolescence (14-18) |
Normal Development |
Possible Stressful reactions |
Consider referral for professional assistance |
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psychosomatic problems (rash, bowel, asthma) |
confusion |
much the same as middle childhood |
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headache/ tension hypochondriases |
withdrawal, isolation |
hallucinates, afraid will kill self or others |
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appetite and sleep disturbance |
antisocial behavior, i.e., stealing, aggression, acting out |
cannot make simple decisions |
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-begin to identify with peers -have a need for alone time -may isolate self from
family on occasion |
withdrawal into heavy sleep OR night frights |
excessively preoccupied with one thought |
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agitation, apathy |
depression |
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irresponsible behavior |
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poor concentration |
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Continue on to next the section >
This material adapted by Dr. Karen DeBord, Child Development Specialist with North Carolina Cooperative Extension Service. The material came from the Stress and Coping with Disaster manual from University Extension in Columbia, Missouri developed during the Flood of 1993.
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Special Thanks to Dr. Karen DeBord, the North Carolina Cooperative Extension Service and North Carolina State
University  
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