By Gina Shaw
WebMD Health News
Reviewed by Hansa D. Bhargava, MD
Aug. 27, 2015 -- When Valaree Busse neared the end of eighth grade in St. Paul, NE, the school guidance counselor called her and the rest of her classmates in for something called "career cruising." At ages 13 and 14, the kids were asked to plan all of their coursework for the next 4 years of high school.
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"There's a track for kids who don't plan to attend college, one if you're going to a 2-year college, and one if you're going to a 4-year college," says her mother, Janet. "They're planning as entering freshmen for the end of their high school career. Valaree doesn't know what she wants to do yet! A year ago, she was going to major in dance. Now, she wants to go to vet school, but she's not sure if she wants to be a vet tech or a veterinarian. But they're telling them that if they don't start planning now, as a freshman, they're going to be behind."
Valaree's social life only added to the pressure. "When you see pictures on Facebook and Instagram of your friends all out with a bunch of other people and you're not included, it's painful," her mother says. "Before all the social media, you didn't see pictures of everything people were doing without you."
All this brewed up a perfect storm of stress that left the once happy-go-lucky Valaree frequently in tears. "Once she cried almost nonstop for 3 days. She just said over and over, 'I just feel so much pressure! I can't be myself because I have to act mature.' She won't sleep at night because she's worried about what someone will think of how she acted, and if it will wind up on Facebook. And she wants to be a kid, but she has to think about what she's doing 4 years from now."
A national WebMD survey found that parents rate school and friends as the biggest sources of stress in their kids' lives. The survey also found that 72% of children have negative behaviors linked to stress, and 62% have physical symptoms linked to it, such as headaches and stomachaches.
The survey comes at a time when the American Psychological Association's Stress in America survey finds that high school students say they have stress levels that top those of adults.
What drives all this tension? Research and kids' health experts cite a number of things. These include:
Faster child development. Kindergarten, many parents and teachers say, is the new first grade. Thirty years ago, kindergarten was for finger painting and blocks. Today, kindergartners average 25 minutes of homework a day, while first and second graders have three times the amount recommended by the National Education Association, according to a new study from Boston University School of Medicine. Another report from the University of Virginia found that time spent on early literacy in kindergarten has increased by 25% since 1998, while time spent on art, music, and physical education has dropped dramatically.
Academic pressures and high-stakes testing. "Our obsession with testing kids puts an enormous amount of pressure on children," says Marian Earls, MD, a developmental and behavioral pediatrician in North Carolina. "I've seen third-graders coming in for help because their parents are noticing sleep problems, tearfulness, and reluctance to go to school because of all the hype on performance and testing."
Over-stuffed schedules. "I would say the level of activity kids have today is nothing like it used to be," says Todd Bentsen, a divorced father of two in Washington, DC. "I was not scheduled the way I have to schedule my kids. After-school care, sports activities, speech therapy -- I feel like I spend about half my time making sure everybody's where they need to be when they need to be there, in reasonably good condition."
Activities like sports or art or music should help relieve stress, not add to it. "You have to understand your child and watch for their cues," says Sandra Hassink, MD, president of the American Academy of Pediatrics. "We all know children who are free spirits who do best with unstructured time. And we all know children who really like to have a schedule. They like to know what's coming next. There's no one answer."
Take your cues from your child. If your child starts a new sport or music lesson and starts becoming overwhelmed and stressed, it may be too much.
Fewer healthy outlets for stress. Remember recess? Your kids might not. The National Association for the Education of Young Children reports that 7% of first-graders and 8% of third-graders never have recess. Since 2008, 20% of school systems have shortened recess time by an average of 50 minutes per week. Physical education has also been slashed. Most kids have PE twice a week or less.
Media saturation and viewing adult content. Thanks to the 24-hour news cycle and constant connectivity, kids are exposed at a much younger age to terrifying news stories. And today's young people see more than their share of violence and adult sexuality packaged as entertainment, often without their parents present, thanks to smartphones and tablets. And the use of electronic devices is skyrocketing.
Parents need to filter this information flow, Hassink says. "Look at the content your child's watching. Put it in context for them. Parents need to be present and be more aware of what their children are taking in."
Bullying and teasing. Before the Internet, if you weren't invited to a birthday party, you heard about it, but you didn't have to see pictures of the fun you missed on Instagram and Facebook. Yesterday's nasty notes passed from hand to hand are today's bullying texts, gone viral with one click.
All of this has a long shelf life. "Kids are using apps like Yik Yak and Snapchat to put up comments and images they think are going to go away, but of course nothing ever really goes away once it's on the Internet," says Valaree Busse's mom, Janet.
Not enough sleep. School pressures and the lure of social media whittle away at an all-important stress remedy: shut-eye. According to the National Sleep Foundation, about one-third of parents say homework and after-school activities get in the way of their child's sleep. And nearly 3 in 4 children ages 6 to 17 have at least one electronic device in the bedroom, which can cut a night's sleep down by almost an hour. Research shows that even slight sleep loss affects memory, judgment, and mood.
Chronic illness. These ongoing illnesses in children more than doubled between 1994 and 2006, from 12.8% to 26.6%, with asthma, obesity, and behavioral and learning problems topping the list. About 6.4 million children in the U.S. have been diagnosed with ADHD; that's about 2 million more than just a decade ago. Plus, many conditions that once killed children, like HIV and Down syndrome, are now chronic, manageable illnesses. Missing school and play activities for doctor's appointments, side effects from treatment, and not being able to do some things that other children do can be very stressful.
Family disruption. "Family issues like parental illness, deployment, or divorce can really stress out kids," Earls says. The divorce rate has remained fairly stable over the past decade or so, with about 1.5 million children each year living through their parents' divorce.
But few children of the 1980s and 1990s endured the anxiety of prolonged and frequent parental deployments. Today, more than 2 million American children have had a parent deploy to Iraq or Afghanistan, and studies show that children from military families of all ages have more stress and anxiety than other children do.
Parental stress. The family is a child's stress buffer. But when a family struggles and can't play that role, a child feels even more tension. "Just like we're asking parents to pay attention to the kids, parents also need to pay attention to themselves," Hassink says. "We all know as parents you get in a zone where it's just, 'I need to do the next 20 things.' By simply spending some unstructured time with your children, you can decrease stress and find energy for the next task."
Like many parents, Busse and her husband realized that the stress their daughter was under required more help than they could give. Using the employee assistance program offered by her husband's company, the Busses found Valaree a counselor whom she saw for several months. "She helped her sort out what's important and what isn't important," Busse says. "She also got her started journaling, and I think being able to write things down has helped her a lot. She gave her the tools she needed to be able to cope with the pressures she faces, and she's gotten better about telling us what she needs."
Spotting Stress: Signs to Watch Out For
How can you tell if your child struggles with stress? You may think you'd know, but that's not always the case, says Carrie Bashoff Spindel, PhD, clinical assistant professor of child and adolescent psychiatry at NYU Langone Medical Center in New York. "Stress and anxiety in children often goes unrecognized because it's a quiet disorder. Kids go inwards -- they don't act out in school, so they don't get noticed because they're not disruptive."
Watch for these signs:
- Acting unusually irritable or moody
- Unexplained changes in school performance
- Withdrawing from friends
- Not participating in activities that he or she used to enjoy
- Unexplained physical symptoms, like frequent stomachaches or headaches, and trips to the school nurse
- Sleeping much more or much less than usual
- Eating much more or less than usual
"Everyone experiences stress and anxiety. It's common, especially in childhood," Spindel says. "But is the stress causing disruption in your child's life? Is it lasting? ... If your child has a stressful week, and the anxiety goes away once things have calmed down, that's normal. But if the stress is significant and frequent or doesn't go away, that's when it's time to seek help."
Dissing Stress: How to Help Your Child
If you do spot the signs that stress is doing a number on your child, how can you make things better? Here are a few tips from Spindel:
- Keep connected. The greatest way to increase resilience in kids is to stay connected with them. Make sure you have time every day when you put your phones and your devices away, and you're talking to your kids and your kids are talking to you.
- Take it easy. Families are always running from one thing to another. Make sure your kids get regular, unstructured time at home when they can play, rest, read, or do whatever they feel like doing. It's space where they can pick and choose, and it's soothing, fun, and stress free. All kids need breaks.
- Name stress and normalize it. With little kids, Spindel calls it the "worry bully" or "Mr. Worry." Stress can make a child feel like their body is out of control. Explain to them that this is the body's response when we're expecting something scary to happen. And when they learn to recognize those signs, they can do things like deep breathing to slow the body's stress reaction down.
- Stick to healthy routines, like good nutrition and regular bedtimes.
- Ask your pediatrician for guidance or a referral for counseling if your child's stress seems to be persistent and overwhelming.
- Take care of you. Get yourself in check emotionally before you take care of your kids. When you ease your own stress, you boost your connection to your children.
SOURCES: American College Health Association: "Annual Survey 2014." American Psychological Association: "Stress and Sleep," "Stress in America: Are Teens Adopting Adults' Stress Habits?" Bassok, D. Is Kindergarten the new first grade? EdPolicyWorks Working Paper Series, No. 20. Updated May 2015. Janet Busse, parent, St. Paul, NE. Todd Bentsen, parent, Washington, DC. Chartrand, M. Archives of Pediatric and Adolescent Medicine, Nov 3, 2008. Marian Earls, MD, pediatrician, Guilford Child Health, Greensboro, NC. Sandra Hassink, MD, president, American Academy of Pediatrics. Pressman, R. The American Journal of Family Therapy, July 15, 2015. Carrie Bashoff Spindel, PhD, clinical assistant professor of child and adolescent psychiatry, NYU Langone Medical Center, New York. Nader, P. Archives of Pediatric and Adolescent Medicine, February 2003. National Association for the Education of Young Children: "Recess: It's Indispensable!"Tartari, M. International Economic Review, May 2015. Van Cleave, J. Journal of the American Medical Association, Feb. 7, 2010. Visser, S. Journal of the American Academy of Child and Adolescent Psychiatry, January 2014.
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