NC State Extension Publications


When we think of stress, we usually think of the negatives. “This is SO STRESSFUL!” sentiments come to mind. Stress is a life event or situation that causes imbalance in an individual’s life. An unhealthy response to stress occurs when the demands of the stressor exceed an individual’s coping ability. Often stress results from something that is beyond our control. Control has a great deal to do with levels of stress.

Some stress is positive—it gives us the oomph we need to get up and get our days going. Too much stress, chronic stress, or stress without the support of loved ones, is considered toxic. Toxic stress makes us sick and unhappy.

For children, stress can impact behavior, feelings, and development. Stress shows itself in children in a number of ways, including complaints about stomachaches, feeling nervous, trouble sleeping, anger flares, and even infections or illness. Stress in children can also be seen in behavioral changes such as acting out, regression of previously mastered skills, and clinging or distant behaviors.

Typical Stress in Children

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Most children will experience stressors related to friendships, family arguments, and school-related issues. Adolescents will have to grapple with their sense of identity to determine where they “fit.” Small amounts of stress, as experienced before a test or when meeting new people, are necessary to present challenges for greater learning. Simple stress experienced when learning a new skill or playing an exciting game raises a person’s level of excitement or pressure above the normal level. We call that positive stress.

When Is Stress Distress?

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Problems begin when ordinary stress becomes too much stress—or distress. These more intense stressors are not as predictable or helpful and can cause harmful impacts on children. Known as adverse childhood experiences (ACEs), traumatic events in childhood where children do not feel supported can have long-lasting negative impacts on children. Big stressors such as death, divorce, remarriage, moving, long illness, abuse, family or community violence, natural disaster, fear of failure, and cultural conflict may each heighten stress. Under extreme or chronic stress, the heart rate and breathing increase and muscles tense. Multiple stressors worsen the stress level and the duration of the stress. Our bodies need relief from stress to reestablish balance.

ACEs are connected to mood disorders, anxiety, and impulse control, which sometimes look like bad behaviors in children. In reality, those behaviors are just a communication that the child is experiencing stress. It is the role of the adults and caregivers to support the child with loving and nurturing responses. Positive interactions with adults help the child build resilience.

Children's Reactions

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Reactions to stress vary with the child’s stage of development, ability to cope, length of time the stressor continues, intensity of the stressor, and degree of support from family, friends, and community. The two most frequent indicators that children are stressed are changes in behaviors and regression of behaviors. Children under stress 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. With older children, these reactions might look like disrespectful attitudes, acting out, participating in risky behaviors, and withdrawal, feelings of sadness, anxiety, or depression.

Some of the Typical Signs and Symptoms of Stress in Children

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Just as children’s reactions are each different, so are their coping strategies. Children can cope through tears or tantrums or by retreating from unpleasant situations. They could be masterful at considering options, finding compromise, or finding substitute comfort. Usually a child’s thinking is not developed fully enough to think of options or consider the implications of possible actions. Here are developmentally normal responses to stress. It is important to note that children who live in supportive environments often develop a range of coping strategies and become more resilient.


Typically, preschoolers lack self-control, have a limited understanding of time, act independently, are curious, may wet the bed, have changes in eating habits, have difficulty with sleep or speech, and cannot always tell adults how they are feeling.

Preschoolers under stress each react differently. Some behaviors may include irritability, anxiety, uncontrollable crying, trembling with fright, and eating or sleeping problems. Toddlers may regress to infant behaviors, feel angry and not understand their feelings, fear being alone or without their parent or caregiver, withdraw, bite, or be sensitive to sudden or loud noises. Feelings of sadness or anger may build inside of them. They may become angry or aggressive, have nightmares, or be accident prone.

Elementary-age Children

Typical elementary-age children may whine when things don’t go their way, be aggressive, question adults, try out new behaviors, complain about school, have fears and nightmares, and lose concentration.

Reactions to distress may include withdrawal, feelings of being unloved, being distrustful, feeling unwell, lack of interest or excessive interest in attending school, fighting with or ignoring friends, and having difficulty naming their feelings. Under stress, they may worry about the future, complain of headaches or stomachaches, have trouble sleeping, be disrespectful, act out, have a loss of appetite, or need to urinate frequently.

Preteens and Adolescents

Adolescents typically are rebellious, have “growing pains” and skin problems, and may have sleep disturbances, go off by themselves, be agitated, or act irresponsibly.

Adolescents and teens under distress may feel angry longer, feel disillusioned, lack self-esteem, and have a general distrust of the world. Sometimes adolescents will show extreme behaviors ranging from doing everything they are asked, to rebelling and breaking rules and taking part in high-risk behaviors (for example, drug use, shoplifting, and skipping school). Depression, anxiety, and suicidal tendencies are additional distress responses.

Protective Factors and Resiliency

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Resiliency is the ability to bounce back from stress and crisis. For many children, a supportive environment is the key to overcoming ACEs in a positive way. There are many protective factors or ways adults can support children to enhance resilience.

  • Social and Emotional Competence. Parents and caregivers who build positive relationships and nurture their children are a protective factor for children. These positive relationships buffer the negative impact of stress on children.
  • Knowledge of Caregiving Skills and Child Development. When parents understand positive child development behaviors and respond appropriately, such as with good communication, consistency, affection, and respect, children are more likely to develop positive coping strategies.
  • Concrete Support in Time of Need. Families that can meet the basic needs of food, housing, transportation, and clothing are better able to meet the safety and well-being needs of children. Providing such support is protective for children.
  • Social Connections. It takes a village, so having a team of emotionally supportive friends and family members to help with a child’s development is a key component of building resiliency.
  • Caregiver Resilience. When parents and caregivers have the skills to cope well with stress, they are teaching resilience. Modeling positive coping helps children learn to bounce back.

Families can provide further protection by

  • developing trust, particularly during the first year of life,
  • showing caring and warmth,
  • having high, clear expectations without being overly rigid,
  • providing ways for children to contribute to the family in meaningful ways,
  • being sensitive to family cultural belief systems, and
  • building on family strengths.

Coping Strategies

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It is not necessary to be a therapist to help children cope with stress. One key element in reducing stress is creating a low stress environment. It may be easier said than done, but ensuring that there are more positive than negative interactions with children helps them build resilience and feel happy. It also helps to anticipate stress and learn ways to avoid it. Start by practicing HALT: ensuring that your child is not Hungry, Angry, Lonely, or Tired. Once those physical factors are settled, you can work with your child to learn other coping strategies for stress, such as taking deep breaths or finding a calm space when they feel stressed.

It is also good practice to encourage social support for your child and yourself as a parent. Social support means having people to lean on during difficult times. Having parents who listen, friends to talk to, hugs, and help in thinking through solutions are ways children feel support.

Coping Strategies

  • Notice children’s behavior. Well-developed observation skills can tell you if your child is experiencing distress. Observe for more quarrels with playmates, poor concentration, or bedwetting. See these behaviors as a communication.
  • Be positive. Encourage children and show you care by pointing out what they are doing right.
  • Acknowledge feelings. Let children know it is OK to feel angry, alone, scared, or lonely. Give children the names for their feelings and words to express how they are feeling.
  • Avoid shaming. Some stressors make children feel ashamed. Shaming truly affects self-esteem.
  • Structure activities for cooperation, not competition. This allows children to go at their own pace and enhances the learning of social skills.
  • Involve parents, family members, and friends. They can read books together, encouraging openness and listening. They also can ensure good nutrition and proper rest.
  • Host regular, safe talks.

Practice Positive Discipline and Avoiding Stressful Situations

Positive discipline is an approach that puts the emphasis on ignoring unwanted behavior, while focusing on positive behavior. This includes tactics such as changing the subject, redirecting a child, and just watching for children to make a good choice and celebrating that moment.

  • Identify what could cause stress and plan ways to avoid it or learn how to deal with it.
  • Encourage children to be proud of themselves in some way. Developing a special interest or skill can serve as a source of pride and self-esteem.
  • Use gentle humor or read a silly book to encourage laughter and have fun.
  • Offer personal space. Modify the environment. Allow quiet space and alone time.
  • Teach relaxation and deep breathing techniques. Ask children to close their eyes and imagine a quiet or happy place (for example, the beach with waves, a birthday party, a warm cup of cocoa).
  • Teach conflict-resolution strategies. Teach children to think through alternative ways to solve problems. Turn it into a teachable moment and have children identify resources or strategies to solve a problem. You can ask what steps they take next. Who do they need to help them? What additional information do they need to create a better option?

As adults, we can make sure we don’t add to children’s stress by expecting them to act in adult ways. We can praise, be positive, seek positive solutions, help children name their feelings, teach fairness, help children learn to like themselves, be patient, teach honesty, and give lots of love and encouragement, particularly during difficult times.


Skip to References

Center on the Developing Child. n.d. ACEs and Toxic Stress: Frequently Asked Questions. Accessed June 2020.

Felitti, V.J., R.F. Anda, D. Nordenberg, D.F. Williamson, A.M. Spitz, V. Edwards, M.P. Koss, and J.S. Marks. “Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: the Adverse Childhood Experiences (ACE) Study.” American Journal of Preventive Medicine 14 (1998): 245–258.

National Child Traumatic Stress Network. n.d. What is Child Trauma? Accessed June 2020.

Shonkoff, J.P., A.S. Garner, and Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care and Section on Developmental and Behavioral Pediatrics. “The Lifelong Effects of Early Childhood Adversity and Toxic Stress.” Pediatrics 129, no. 1 (2012): e232–e246.


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This is an adaptation of a publication originally written by Karen DeBord, Professor Emeritus, Agricultural and Human Sciences.


Extension Specialist and Associate Professor
Agricultural & Human Sciences

Find more information at the following NC State Extension websites:

Publication date: June 25, 2020

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