For healthy development, children need a sense of stability and security.

Children are resilient by nature, and cope well with stress. However, some children may experience multiple stressful events, more than they could deal with.

The following events are recognised as stressful: Parent abusing alcohol and drugs.

Mother experiencing abuse by her partner (maternal abuse).

Child experiencing abuse.

Parents in the process of separating/divorcing.

Illness of parent or caregiver.

Loss of parents by death, divorce or placement in foster care.

Loss of parents employment.

Loss of home.

Child experiencing a serious or chronic illness, hospitalisation.

Relocating, moving house, leaving familiar environment.

Starting day care, new school, college.

Arrival of new baby.

Experiencing teasing or bullying at school.

Pressure to succeed.

Puberty, issues related to peer pressure, substance abuse, sexual activity and pregnancy.

Some symptoms of stress in children are as follows: Infants and young children may show changes in sleep patterns or appetite. They may become "clingy'', and regress in development and "become a baby again'', e.g. A child who has given up the feeding bottle to a cup may insist on the bottle again, or a potty trained toddler may go back to needing diapers.

This is the child's way of coping with a stressful event, e.g. arrival of a new baby, or a recent hospital stay. Regression is usually temporary.

School aged children under stress may complain of vague aches and pains, with many visits to the doctor, who finds nothing wrong.

Falling grades in a previously good student should alert adults to the possibility of serious medical or psychological problems. Stealing, lying, aggressive behaviour (fighting excessively) teasing other children, being disruptive in class, withdrawing from friends, starting to wet the bed, may all indicate stress.

So, how can we help minimise the impact of stress in children? A conscious effort should be made to avoid unnecessary changes. Think carefully before you plan your major decisions in life, and try to space them out. For example, if you are going through a separation, try not to change your child's school at the same time, leave a few months for the child to get used to one change in his or her life.

There are many young children who spend their time divided between two or even three homes, e.g., with mother during the week, with father or grandparents during the weekend.

Babies aged six to 18 months have a fear of strangers, which is normal.

Special efforts should be made by all concerned to avoid unplanned or prolonged separations, during this developmental stage.

If a child must stay with other care givers, make sure you tell the child, rather than sneak out. Make sure the child's important medical details are given to the caregiver. Make sure you can check on your child. Don't forget to pack a favourite toy or comforter.

If there is a serious illness or death in the family, open and honest family discussions should be encouraged. Professionals should try to maintain contact with a child's parent who is ill. Breaking bad news could be difficult, so seek help from a mediator if necessary.

Recreational activities such as sports and music help children cope with stress, and must be made available to such children, but they should not be pressured to participate.

Safe areas such as supervised after school programmes provide refuge for children, and prevent them turning to undesirable activities to cope with stress.

Adolescents need privacy and must be provided with a quiet area of the house, e.g., a room or at least a partitioned area where they can be alone.

Caring relatives, foster parents, neighbours and other professionals provide a valuable support network. To help a child, the support should be long-term rather than temporary or merely "crisis intervention'', if the youngster is to feel a sense of security.

Do seek help early, so you and your child will become better equipped to survive a stressful experience.

DR. L. ANANDAGODA Medical Officer .