Children and families representing all types of demographics and socioeconomic backgrounds will experience stress. It is, unfortunately, a fact of life. We are beginning to understand now that there are different types of stress, based on objective reactions to it: positive, tolerable, and toxic. (Center on the Developing Child, Harvard University, 2012) With each type, the critical factor that determines if a child (and family) can move through the event successfully or not is resilience.
What is resilience?
Resilience is the process by which the child moves through a traumatic event, utilizing various protective factors for support, and returning to “baseline” in terms of an emotional and physiologic response to the stressor. More can be found on the physiologic stress response in the AAP technical report on toxic stress.
Why is resilience important?
Resilience is critical to a child’s ability to navigate through stressful events – even those that are traumatic – successfully. Resilience provides a buffer between the child and the traumatic event, mitigating the negative effects that could result, such as physical, emotional, and behavioral health issues that can last even into adulthood.
How to increase resilience in children
As stated above, resilience is actually the process of utilizing one’s protective factors to navigate successfully through a stressful situation. For example, a child may go through the loss of a grandparent, which is very painful. With the support of caregivers (ideally, parents) and other social connections (friends), the child can grieve appropriately and will return emotionally and physiologically to a place of stability, after a period of time. The critical piece here, obviously, is the presence of protective factors. Life will certainly provide the “opportunities” to walk through stressful circumstances, but parents and other support systems – including pediatricians – must ensure that the child has the protective factors in place to prevent long-term negative outcomes. These protective factors include parental resilience, social connections, concrete/tangible help in times of need, parent knowledge of child development, and social and emotional competence of the child. (Strengthening Families)
The role of the pediatrician
Pediatricians have an incredible opportunity to impact the lives of their patients and families – even before the child is born – to help increase protective factors and build resiliency. Educating parents on the vital role they play in helping raise their children to be resilient is incredibly important. Pediatricians are seen as a trusted source of information by parents. Explaining to them the role that resiliency will play in helping ensure their child remains healthy can have a tremendous, positive impact. Expect that families will experience stress – and ask them about it proactively. They may not initially consider their pediatrician as a source of support for these types of issues; reassure them otherwise, being prepared to provide resources for additional support, as necessary. Finally, as a stable, caring adult in the child’s life, you are part of the protective factor package and can continue providing that support throughout their time as your patient. For more information, check out the resource Promoting Children's Health and Resiliency: A Strengthening Families Approach developed by the AAP and the Center for the Study of Social Policy.
Center on the Developing Child, Harvard University. (2012). Toxic Stress: The Facts. Retrieved March 18, 2013, from Center on the Developing Child Web site: http://developingchild.harvard.edu/topics/science_of_early_childhood/toxic_stress_response/
Strengthening Families. (n.d.). Protective Factors Framework. Retrieved March 18, 2013, from Center for the Study of Social Policy’s Strengthening Families: http://www.cssp.org/reform/strengthening-families/basic-one-pagers/Strengthening-Families-Protective-Factors.pdf