GOOD HEALTH MAGAZINE : Psychology : A LESSON PLAN FOR KID STRESS : TODAY’S YOUNGSTERS MUST LEARN TO COPE WITH PRESSURE. THOSE WHO SUCCEED DO BETTER AT SCHOOL, HAVE FEWER PROBLEMS IN ADOLESCENCE AND GROW UP TO BE HAPPIER, HEALTHIER ADULTS.

Stress. That single word encompasses a good deal of what makes modern adult life less than perfect. Stress on the job, on the highway, while shopping. Stress from trying to have children, from having children, from balancing the demands of work and family. It’s enough to make you long for the carefree days of childhood.

Before wishing too hard, though, you might consider today’s children. They, too, are under an increasing amount of stress--pressured more than ever to get better grades, to participate in more group activities, to engage in more organized after-school play, to fit into their parents ever-more-complicated schedules.

A growing number of children have to cope with the stresses of living in a family torn by divorce, or with only one parent, or in poverty. More children are having sex today and at younger ages than ever. And according to a survey conducted by Weekly Reader, a magazine for school children, children as young as 9 years old are feeling pressure to experiment with alcohol and other drugs.

Children, it seems, simply aren’t getting the chance to be children.

All these stresses, says David Elkind, professor of child study at Tufts University, add up to one chilling fact: “Children are less healthy today --physically and mentally--than they were 25 years ago, or even 10 years ago, and the evidence shows that incidence of psychological stress has grown dramatically over that time. Certainly, childhood is more stressful today than at any time in the near past.”

Recent studies by the National Institute of Mental Health and the Institute of Medicine found that 35% of American children under the age of 14 suffer stress-related problems at some point in their young lives.

Some of the problems are physical: recurring headaches and stomach aches. Others affect behavior, including lack of concentration, loss of self-confidence, temper tantrums, forgetfulness, crying and yelling, avoiding friends, depression, even attempting suicide. Whatever the symptom, children, like adults, experience stress and suffer when they do not cope well with it.

Also like adults, there are some children who do fine under stress, even such severe stress as divorce, death of a parent, physical or psychological abuse, or extreme poverty. Psychologists call this resilience, and the study of resilient children has provided many clues as to why some deal with stress better than others. “We’ve been trying to find the protective factors that enable some children to handle high levels of stress while others can’t,” says Ann S. Masten, assistant professor of child development at the University of Minnesota and a leader in the study of resilience. “We see a lot of variability in kids’ responses to stress. We see kids raised in very stressful situations who end up in terrible shape, but we find a large number of kids who turn out very competent.”

Several studies have found that lifelong patterns for coping with stress are developed during childhood. “The evidence suggests that children who do not learn to deal with stress in a positive way grow up to become adults who also deal poorly with stress,” says Nancy M. Ryan-Wegner, assistant professor of life-span processes in Ohio State University’s School of Nursing. She adds, though, that the reverse is also true: “Children who learn to cope effectively with stress seem to be more stress-resistant as adults.”

Psychologists such as Masten and Ryan-Wegner are developing a good understanding of how children deal with stress and how adults can help children become better at that essential life skill. “There is a lot that parents, teachers and other adults can do to help reduce stress in a child’s life and to (help him or her) cope better with stresses that are unavoidable,” says Lee Salk, professor of psychology, psychiatry and pediatrics at the New York Hospital-Cornell Medical Center. According to Salk and others, this knowledge comes none too soon.

The first thing to understand about stress is that it is not what you think it is. Stress is not hard work. It is not tough assignments at school or difficult chores. It is not being disciplined for bad behavior. Says Salk: “Stress is being in a situation where the options have been diminished substantially or taken away entirely.” In other words, the child feels that his or her life is totally out of his or her control.

And because a child is simply that--a child--there are more things that they will not be able to control. Says Ryan-Wegner: “Kids probably have more stresses in their lives that they can’t control than adults do.”

To a child, stress is having every waking moment scheduled--school, dance class, karate lessons, soccer practice--without having any say in the matter. Stress is endless boredom in school and after school, or constant pressure to learn more, to do better, be smarter, get higher grades. It is also relentless pressure from peers to do something against the child’s better judgment. Stress is not knowing whether a parent will be too busy to spend some time chatting before your bedtime, or what behavior will result in seemingly capricious punishment.

In today’s world, various factors have conspired to put more children under more stress than ever before. According to a recent study by the National Assn. of State Boards of Education, much of the blame for this increased stress results from, “two-income and single-parent families, changes in society and a lack of neighborhood cohesiveness that have left many children on their own and more isolated from adults.” Children need guidance from adults to learn to cope with the rigors of the modern world, according to the report.

Others say that adults increasingly are placing too many demands on children to engage in too many organized activities. A child’s job, these experts say, is to play, and playing needs to be done without an adult’s rules being imposed. Says Salk: “What adults think of play and what children think of play are not the same thing. When parents impose their notion of play upon their children, it can become stressful.”

But stresses in a child’s life also include worries about being smaller or fatter than others or not being popular with a certain clique. Children also feel stress when they don’t get their homework done or if they feel as though they aren’t as good in sports as some of their friends.

Surprisingly, children begin in elementary school to make conscious decisions about the ways in which they will cope with stress. Until recently, the dogma has been that children did that without knowing it, but Ryan-Wegner discovered that 8-year-olds were able to identify how they dealt with stress and how effective each method was. “Previous research has been based on observing adults help children cope with stress, and interventions were based on how adults, not kids, perceived the way children coped with stress,” says Ryan-Wegner. “I looked at it from a child’s point of view.”

Ryan-Wegner interviewed 103 children ages 8 to 12, who collectively said they used more than 500 different methods to try to reduce stress. She grouped these methods into 13 general categories and rated their effectiveness, again based on the children’s own assessments.

Not surprisingly, boys and girls generally used different methods to cope with stress. Boys turned to more aggressive and physical behaviors, while girls relied more heavily on emotional behaviors and social support. Both sexes, however, agreed on the three most effective ways to relieve stress: social support--talking to a parent, hugging a friend or asking for help; cognitive behaviors--thinking about it, reading, writing, talking to oneself, working on a model, planning what to do, thinking positively; and avoidance behaviors--running away, ignoring it, changing the subject, not worrying about it. The children also agreed that the least effective behaviors were: aggressive--yelling, screaming, swearing, tattling, talking back, insulting people; emotional--crying, pouting, moping, panicking, getting angry, feeling sorry, having a fit; and habitual behaviors--cracking knuckles, twisting hair, biting nails, chewing gum, eating.

What was most striking in her study, says Ryan-Wegner, was that children she interviewed cope by doing things adults would not normally think of as ways of reducing stress. “Children actually think about what is causing the stress, plan about how to deal with it, and then take some action.”

Another way to look at how children effectively diffuse stress is to study resilient children, those who develop normally despite growing up in unusually stressful situations. Masten, at Minnesota, leads one such study, called Project Competence, that was started in the 1970s by Normal Garmezy, emeritus professor of psychology and child development at Minnesota.

Masten and Garmezy looked at the development of several groups of children, but their most detailed study, still in progress, involves 205 children from a working-class neighborhood in Minneapolis. This was a heterogeneous sample: 91 boys and 114 girls; 28% were minority children, 45% were from intact families, 38% had single parents. The children have been followed since they were in third and fourth grade, more than a decade ago.

One trait Masten examined was the role of humor in coping with stress. Sigmund Freud described humor as a way of gaining control of a situation that you don’t really have control over. (Think of how many times you’ve cracked a joke during a tense, i.e., stressful, situation.) To see if humor also helped children cope, Masten recruited the help of Ziggy cartoon creator Tom Wilson. Children rated Ziggy cartoons for funniness, and interviewers noted how hard they laughed; Wilson also drew some unfunny cartoons as controls. Then children were asked to think of their own captions for cartoons drawn without them.

The results showed that children who laughed and smiled a lot when rating the cartoons, especially those who could create funny captions, were generally more popular with their classmates and they appeared to do better in school even when there was a great deal of stress in their lives. Says Masten: “A lot of what makes humor funny is intelligence and a good social awareness. So perhaps we’ve measured another aspect of how good children are at relating to their world, which you might expect would correlate well with an ability to deal with stress in that world.”

Project Competence and other similarly ambitious studies of children from diverse backgrounds and social settings are finding that certain internal traits as well as environmental factors seem to work together to make some kids seemingly stress-resistant. Such internal traits include high IQ, sense of humor, social awareness, good-natured disposition, problem-solving skills, an ability to talk about problems, and high self-esteem; environmental factors can include caring parents and other relatives, a concerned teacher or a close best friend.

The longest ongoing study of children and their stress-coping abilities is being conducted by Emmy E. Werner, now a professor of human development at UC Davis. In 1955, Werner headed a team of pediatricians, psychologists and social workers that set out to follow the physical and emotional development of all children born that year on the then-rural island of Kauai, at the northeast end of the Hawaiian island chain. Of the nearly 700 children in the study, 72 were classified as resilient. “These children had a lot of stress in their lives,” says Werner, “but they could draw on a number of ameliorative factors in themselves and in their care-giving environment that tilted the balance from ‘undergoing’ to ‘doing’--they took charge of their lives--that led to successful developmental outcomes.”

After following the group for 20 years, Werner was able to develop a list of protective factors, which she published in her 1982 book, “Vulnerable but Invincible: A Study of Resilient Children.” Resilient children, Werner concurred, have both good things in their environments and the internal traits that enable them to see that those good situations exist and to get the most from them.

The internal protective factors that Werner identified include: affectionate nature, responsiveness to people, being firstborn, positive social orientation, autonomy, ability to focus attention and control of impulses, positive self-concept, and special interests and hobbies. Among the environmental factors: receiving lots of attention during the first year of life, positive relationship between parent and child in early childhood, additional caretakers besides the mother, structure and rules in household, close peer friends and required responsibility.

Despite compiling this extensive list, Werner is quick to point out that stress-resistance is not merely a matter of having a lot of positive factors in a child’s life. “It’s a balance between risk factors, stressful life events and protective factors within the child and protective factors in his care-giving environment.”

Werner likens the resilient child to a piece of bamboo: “Every piece of bamboo can be broken. It’s very flexible and you can bend it quite a bit. You can put it under a fair amount of stress and it will still snap back. Bend it far enough, though, and it will eventually break. The same is true of the resilient child. You can bend that child so much and then the child, too, will break.”

Werner believes that her studies point out a number of recommendations for helping children become more resistant to stress in their lives. Parents should allow their children experiences that challenge but do not overwhelm them. Children should be encouraged to develop a special interest or hobby that can provide gratification, especially during times of stress. Werner says that parents should give children tasks that convey a sense of responsibility and caring and then reward them emotionally for a job well done.

What that does is to help children develop a sense of self-esteem, a factor that almost every study identifies as a key in helping a child deal effectively with stress. “The thing that I advocate when I talk to parents is to give children options,” says Salk, who has written and lectured extensively on good parenting skills. “You want to make children feel that they have an impact on their environment. When you read to your children, let them pick the books you read to them. When it comes to deciding what to have for dinner, ask your children what they would like to have.

“Involving them in those kinds of decisions gives them a feeling of significance in the life of someone else, and that really helps a child deal with stress.”

A parent can start fostering self-esteem when a child is very young, Salk says. “When infants try reaching for a spoon, for example, don’t hand it to them. Let them pick it up themselves; or if it’s out of reach, place it so that the child can reach for it successfully. Then praise the child for the accomplishment. In that way, the child begins to learn the rewards of handling challenges.”

Using that same example, some parents will actually move the spoon farther from the child, frustrating the latter’s efforts. “That is the dog-eat-dog world of parenting,” Salk says, “showing the child early that one has to struggle constantly to get anywhere. All that does is make the child feel helpless.” Contrary to many parents’ beliefs, children who receive praise for the good things they accomplish do not grow up soft. Instead, they grow up confident in their abilities to tackle tough situations.

Another way to increase children’s self-esteem is simply to let them play on their own or with friends. “Play is a child’s work,” Salk says. “It’s what children do to develop mastery over the things in their world, and they need to do it on their own. Letting children invent games or create imaginary situations with their toys is a way of letting them have control over some of the things in their lives.”

To cope well with stress, children need to have what psychologists call internalized controls--a good sense of correct and incorrect behavior. Says Salk: “If a child--or adult--has good internalized controls, then that person tends to get along in less structured situations. That, in turn, enables the person to cope well with more stressful situations.”

Internalized controls develop as a child learns right from wrong. As such, effective discipline is important, though physical punishment does little to foster this stage of development. The key here is to be consistent, enabling a child to learn quickly the rules for behavior.

Blind obedience to authority is not what you are aiming for, however. “Every parent should teach his child to challenge authority, but in a polite and respectful way,” Salk says. Again, this shows children that though they have to live within the bounds of society, that there is room to control one’s own destiny, at least to some degree.

“This skill is particularly helpful to a child who needs to resist peer pressure,” Salk adds.

Parents who instill a good sense of internal controls early in life will find that they will need to be less restrictive with their children when the latter reach adolescence. This, says Elkind, helps reduce the stresses of adolescence, for it once again gives well-prepared teen-agers a sense of control over their lives.

There will be times, of course, when a parent is stressed and unable to provide all the support a child needs. Going through a divorce or losing a job can be stressful for both child and parent. What is important in this situation is to provide some sense of order and stability.

Judith Wallerstein, executive director of the Center for the Family in Transition in Corte Madera, Calif., has studied the effects of divorce on children and found that a parent who somehow manages to preserve some of the family routines helps reduce the stress in children’s lives. Other studies confirm this. “In times of stress, routine can really help a child cope,” Wallerstein says.

Perhaps the most important thing a parent can do to help their children cope with stress is to communicate with them. Talk to them. Find out what’s bothering them and then ask them how they might handle the situation. Then offer advice, working through the problem; don’t merely tell your child how to deal with the stressful situation.

A good time to do this is when you put your child to bed. And after you work though the problem, end your conversation on an up beat. Tell your child something that you like about him or her. Talk about something that you are looking forward to tomorrow, and get your child to tell you the same thing.

Finally, tell your children you love them. After all the studies, those timeless words may still be the best way to reduce childhood stress.