Children who suffer from stress disorders often have lived for so long with their stress symptoms and behaviors that they do not realize that they are different from other children. They take their extreme level of stress and resulting behaviors as a fact of life. One step in treating stress behaviors in children is to help them to become self-aware of their stress, how the stress is cued and triggered, and the levels of their stress.

The first step, of course, is for the adult caregivers to be able to make a list of the stress behaviors that are seen regularly in the child. If you do have a clear idea of what “stress signs in children” looks like, you can read the companion article to this one entitled: “Stress Cluster Descriptions”. You should also consult with your treatment specialist to help you make the list.

Once the signs and behaviors have been identified, caregivers can gently make observations to the child about the behaviors once the child has clamed down from the stress episode (upset, or acting out). These observation might be something like: “I notice you seem to get very upset when you are told that you cannot have a food treat…your face gets red, and then you begin to yell and say that I am unfair…”

Children in foster care who have stress disorders often have an increase in stress and stress related behaviors before and after contact with biological family members. When signs are seen prior to a visit, a caregiver can comment on this to the child, once again, very gently: “You seem to be a little bit nervous or worried, I see you pacing around and you can’t seem to stay still…I wonder if I am right, are you worried?”

The phrase: “I wonder…”, followed by a reflection of what the caregiver thinks the child might be feeling, thinking, or what the cause of the behavior is a very useful phrase. By saying “I wonder…”, you are not making a definitive statement or accusation, but leave room for the child to correct you if you are wrong. If you are right, you have just helped the child to recognize their stress source and level, and if you are wrong, the child will likely correct you, and then still become self aware of their stress.

For many children with stress disorders, there are many, many things, people, and situations that may trigger stressful memories of the traumas in their past. When a caregiver gets a clue that something, someone, or a particular kind of situation is triggering to a child, they should ask the child directly about it: “After you saw that big dog, you seemed to get very anxious…I wonder why?” It is important not to lead the child by saying something like: “I wonder if it because something bad happened to you that involved a big dog?” If a child is led in this way, you could very well get a false agreement by the child, because children want to please adults.

Another way you can help a child become aware of their stress is by modeling: talk about your own stress and stressors (when appropriate), and describe how the stress feels to you, such as where in your body you feel the stress, the level of stress, etc. You then can in turn ask the child how and where they feel their stress.

Once it has been established with the child that they have stress problems, a caregiver and child can make a creative chart that will help both the child and caregiver to graphically symbolize the stress level. This could be a big poster of thermometer, with a sliding red line to indicate how high the child feels their stress level is. Finally, children can be taught healthy self-comforting and stress reducing techniques. When the child experiences genuine relaxation, safety, and security, they are better able to come to a better self awareness of their debilitating stress and stress behaviors.


All children go through problems with sleep. Children who have mental health disorders or are in foster care often have more problems in this area. Sleeping in a strange bed and strange home contributes to this, but in many cases, a child in foster care who has sleep problems may be having intrusive or bad dreams. Or, they have had a pattern of bad dreams in the past, and they resist and fear going to sleep. In some cases, their medication may be interfering with sleep. If you suspect this, check with the child’s doctor. While there are medications available to help children to sleep, but even these are not always 100% effective.

In most cases, the child’s sleep difficulties are behaviorally based. The child has gotten into a successful habit of avoiding going to bed, or getting up in the middle of the night to play. As such, the child needs to have a strong adult who can be self-disciplined in using a set sleep protocol with the child. Caregivers need to work hard at helping children with sleep disorders to get to sleep and stay asleep. The key, of course, is consistency. I’m not talking just the usual consistency, but super consistency, 99.9% consistency and adherence in following the sleep protocol.

  • Be ready to use this protocol for at least one year, or until the child has had a positive sleep pattern for three months before easing any of the steps.
  • Establish the bedtime and always, always keep the bedtime the same. This means NO changes, even for “special events” or summertime. Due to summer daylight issues, set the time at whatever nightfall is in the summertime. Really. Same bedtime every night.
  • Establish a set bedtime routine: bath, snack, quiet time, potty time, story, prayer, and tuck in.
  • Be sure to have a nightlight on in the child’s room.
  • NO TV! GET THE TV OUT OF THE ROOM. Ditto for music players.
  • After following the bedtime routine, LEAVE the room. If the child comes out of the room, take their hand, walk them back to bed, and say this (and only this) in a calm voice: “It is time for you to go to sleep.” Turn and leave the room as you did the first time. DO THIS THE EXACT SAME WAY EVERY TIME THE CHILD COMES OUT OF THEIR ROOM. (Yes, it might be well over 300 times.) Over time, you will have to do this less and less. You might track how many times you do this nightly in order to get encouragement in seeing the progress.
  • With older children, you can have them go to their room at bedtime and have 30 minutes of lights on quiet activity before lights out. You can also tell an older child that if they do not cooperate with staying in their room and going to sleep, bedtime will be 30 minutes later for each infraction tomorrow night.
  • If you hear the child awake, or up playing in their room, don’t intrude. Only act if they come out of the room.
  • Limit the toys in the child’s bedroom, especially the more complex and interesting toys. One or two cuddle toys, or a few story books are o.k., but put the construction toys, battery operated toys, and action figures in some other place.
  • DO NOT allow the child to sleep in any bed other than their own, unless you are not really serious about curing their sleep problem. While some families have a tradition of children sleeping in the same bed, or children sleeping with adults in the ‘family bed’, this is bad practice for foster children, due to liability issues, health issues, and from a behavioral standpoint. It creates secondary behavior problems unnecessarily.

Do not be discouraged by the child’s resistance. The child may cry, scream, tantrum, or have a stress episode. Other than a stress episode, all else is manipulation to get you to give in and alter the routine. If you do, even in a little way, and just once, you will have to start all over again. I hate to sound smug, but if this is not working, it’s because YOU are not following the protocol EXACTLY as you see here.


Since life is so busy, we all take short cuts. We may not even notice how many short cuts we take each day, especially those we take while raising children. How often do we do a chore that was supposed to be done by a child, just because it will be quicker (not to mention easier) than getting the child to do it? Or we dress a small child because they are slower than we want them to be?

We take other short cuts in raising our children, too. We do quite a bit of thinking for them, instead of making them think for themselves. Parents will eventually notice when their children seem to be asking them annoying questions that the parent knows that the child has the answer to, like “Mom, where is the peanut butter?” We also let them off the hook in thinking through situations: have you ever been on the phone with an important call, and your child is interrupting you with some question or need?

When children enter into confrontations with each other, parents tend to sometimes step in too soon to solve the children’s disagreement by simply separating them, or handing out a consequence and forcing the children to apologize to each other. The only thing the children have learned is that adults will solve their problems, to avoid fights in front of adults, and that all you have to do to “make up” is say “sorry”.

When children who are very needy for consistent and close guidance are in our care, we may tend to “over guide” them out of our concern that if we do not, they will quickly ‘get out of line’. Children with mental health disorders who have a high level of distractibility and poor focus often do need very close guidance and clear, simple directives. But if we do not help them to expand their opportunities to make good decisions, we are not allowing the child to progress in their development. To be sure, it is a very difficult task for an adult to determine just how much “leash” to allow with children who have behavioral problems. Try starting these children out with simple challenges to force them to think. (see ‘What To Say To Make Them Think’)

By making a child’s decisions for them, solving all of their conflicts for them, or guiding their every behavioral movement in a day, we are also depriving the child of age appropriate responsibilities. When a parent does this over a long period of time, they will become trapped by a teen (or older) child who is extremely dependent upon them to function. As a former Boy Scout Leader, I have seen many, many, new boys to the Troop that clearly have had too many decisions made for them by parents. Like the Tenderfoot who has had his mother pack his backpack for the camping trip!

There is nothing wrong with taking short cuts, but not all the time when it comes to raising children! When we constantly solve all of the child’s problems and make all of their decisions for them, we are depriving them of valuable learning experiences that they need to mature.

Learning how to stop thinking for your child all the time is not hard to do, it just takes practice and learning some new techniques. It also takes a general idea of what is ‘age normal’ for any particular child, teaching the child how, and then standing back to let them do it themselves.