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How to Keep Children’s Stress From Turning Into Trauma

From the New York Times

Parents can help children use the stress of coronavirus shutdowns as an opportunity for growth, experts say.


By Stacey Steinberg, May 7, 2020

Children may be processing the disruptions in their lives right now in ways the adults around them do not expect: acting out, regressing, retreating or even seeming surprisingly content. Parents need to know that all of this is normal, experts say, and there are some things we can do to help.


“Our natural response to scary things is biologically to release stress hormones,” said Dr. Nadine Burke Harris, a pediatrician and surgeon general of the state of California, and the author of “The Deepest Well: Healing the Long-Term Effects of Childhood Adversity.” The release of stress hormones activates our fight or flight response. Our bodies, in responding with the release of stress hormones, are doing exactly what they should be doing.


But in some cases, exposure to stressful events — which right now might include the absence of routines, a parent’s job loss and economic hardship, or the serious illness or death of someone a child cares about — can leave children feeling traumatized.


Dr. Burke Harris said the Covid-19 pandemic is a “perfect storm” for this stress to negatively impact children’s mental and physical health and behavior. But at a time when there are so many unknowns, tools are available to help mitigate the harms that children experience. Instead of fearing stress, she said, we need to tune in to our kids, assess their needs and help them turn stressful situations into opportunities for growth.


Here are some ways that parents can help kids work through stress without it becoming toxic to their emotional and physical well-being.


Watch your kids closely.

When we see a child acting in a manner that we think is inappropriate, we need to consider that the child is outside her window of tolerance for stress, explained Corinne Edwards, a therapist in private practice with over 15 years of experience working with children with histories of trauma. “Children’s brains are wired for survival, and given this, it’s important to look at their behaviors from the lens of considering what need the behavior is attempting to meet during this difficult time.”


For some children, temper tantrums and bed-wetting — stages they had seemed to outgrow months or years ago — might be the only sign that they are facing an internal struggle.


“Reactions that seem unwarranted for a given circumstance, or different than a child’s typical demeanor, can be cues of underlying distress,” said Joy Gabrielli, a psychologist and assistant professor in the University of Florida’s Department of Clinical and Health Psychology.


If you are not sure whether the stress response you’re seeing is normal, you may want to seek counseling for your child. Often, your child’s regular health care provider can point you toward mental health resources that may be accessed through telemedicine while you are under stay-at-home orders.


Understand the effects of adversity on children.

While many kids are experiencing a stressful situation right now, those who have been exposed to other adverse events in childhood are at an increased risk of struggling during and after this crisis.


A tally of adverse childhood experiences, known as an ACE score, can be used as an indicator of a person’s risk for later health problems, so having a high ACE score is like a warning light. ACEs include “aspects of the child’s environment that can undermine their sense of safety, stability and bonding” — traumatic events like experiencing violence, abuse, neglect or substance abuse in the home. Covid-19 presents unique challenges to kids who have experienced a significant number of adverse events, said Dr. Burke Harris.


“An ACE score is not the be-all and end-all,” Dr. Burke Harris said. Instead, she compares it to a thermometer. You can be sick and not have a fever. But if you have a fever, it is an indicator to everyone that you are sick, and that we need to pay close attention.


“When we can predict, hopefully we can prevent,” Dr. Burke Harris said. By knowing who is most at risk to suffer toxic stress from Covid-19, policymakers can deliver community resources to those who are expected to need them most.


Yo Jackson, a psychology professor at Pennsylvania State University, who also serves as the associate director of the Child Maltreatment Solutions Network, stressed that it would be overly simplistic to say that children from homes with greater risk factors are suffering more right now. “Dose matters,” she said, “but it is much more nuanced than that. We can’t just ‘check the boxes’ to decide how Covid-19 will affect a particular child.”


Dr. Burke Harris agreed. “The same stressor won’t elicit the same response in everyone,” she said. Kids who were not at risk before Covid-19 may face new risks because the safety nets parents relied on in the past have disappeared, and those who relied on support networks in the past may be overwhelmed with the lack of resources currently available.


Avoid making assumptions.

Adults must recognize that for some kids, the newfound solitude brought on by Covid-19 feels like a gift. While we may be struggling with schools being closed, kids could be rejoicing in it. We might assume our kids miss their friends, but they may appreciate having more time with us. And some who were dealing with bullying or social challenges at school may be relieved not to have to see other kids.


Find “stress busters” that work for your family.

When we think of adversity in childhood, the key, Dr. Burke Harris said, is to think about what kids can do, and what we are able to offer, in the face of that stress.


“While dose matters, buffering matters, too,” she said. Buffers help us deal with stress and allow us to process it in healthier ways. Along with positive relationships, Dr. Burke Harris explained that sleep, exercise and nutrition also can help kids keep stress under control.


Dr. Burke Harris recommends that parents help kids avoid the harmful effects of stress by first talking with them about the pandemic. She advises parents to help kids understand that there are things they can do to help others — like staying home whenever possible and wearing a mask when they go out. Kids feel good when they know they are helping solve a problem.


Dr. Burke Harris also encourages parents to keep kids connected with friends and family, which can be done through video chats, phone calls and letter writing. Lastly, she recommends families create and stick to a routine that gives kids structure, making time for play, hygiene and when able to be done safely, physical activity.


Some children will struggle more than others during the pandemic, and these kids may need even greater support in the months to come.


“As difficult as it is to see children in distress, we want to interact with them from a place of support,” Ms. Edwards said. These moments are opportunities for connection, and we can help kids grow by helping them learn how to process their strong feelings and reminding them that they are not alone.


Other Articles: Silent Signs Your Child is Stressed

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