How to recognize signs of distress in children

Common reactions to stress in children

UNICEF Myanmar
©UNICEF Myanmar/2018/Nyan Zay Htet
09 May 2022

Children have different reactions to adverse events in their environment. Culture influences the ways in which we express emotions. In some cultures, for example, it is not appropriate to show strong emotions like crying loudly, while in others it is widely accepted. 

Some signs of distress may not be so obvious. Here are some of the signs of distress at different ages. Different children will show different signs of distress.

Did you know? During times of stress and crisis, children will observe adults’ behaviours and emotions for cues on how to manage their own.

Common reactions to stress in children

Many of these reactions only last for a short time, and are normal reactions to stressful events. If these reactions last for a prolonged period of time, the child may need specialist support.


Age Reaction
0-3 years
  • Clinging to their caregivers more than normal
  • Regressing to former (younger) behaviours
  • Changes in sleeping and eating patterns
  • Higher irritability
  • Increased hyperactivity
  • More afraid of things
  • More demanding
  • More frequent crying
4-6 years
  • Clinging to adults
  • Regressing to former (younger) behaviours
  • Changes in sleeping and eating patterns
  • Higher irritability
  • Poorer concentration
  • Becoming more Inactive or more hyperactive
  • Stop playing
  • Take on adult roles
  • Stop talking
  • More anxious or worried
7-12 years
  • Becoming withdrawn
  • Frequent concern about others affected
  • Changes in sleeping and eating patterns
  • Increasingly fearful
  • Higher irritability
  • Frequent aggression
  • Restlessness
  • Poor memory and concentration
  • Physical symptoms/ psychosomatic
  • Frequently talks about the event or repetitive play
  • Feels guilty or blames themselves
13-17 years (teens)
  • Intense grief
  • Shows excessive concern for others
  • Feelings of guilt and shame
  • Increasingly defiant of authority
  • Increased risk taking
  • Aggression
  • Self-destructive
  • Feeling hopeless

All age groups - physical reactions

These may also be signs of physical illness, so please take your child to see a doctor to rule out any physical condition.

  • Tiredness
  • Tight chest
  • Shortness of breath
  • Dry mouth
  • Muscle weakness
  • Stomachache
  • Dizziness
  • Shaking
  • Headaches
  • General aches

Very serious distress reactions in children if they occur most of the time

Children who demonstrate these signs over a prolonged period of time will need specialist support.

  • Withdrawn or very quiet with little or no movement
  • Hides or shies away from other people
  • Does not respond to others, does not speak
  • Extreme and constant worry
  • Physical symptoms of not feeling well; shaking, headaches, loss of appetite, aches, and pain
  • Aggressive, trying to hurt others
  • Confused or disoriented

Emotional check-ins

The COVID-19 pandemic has been an emotionally difficult time for everyone and many children have been greatly affected. You should check in regularly on how your child is feeling. To check-in emotionally is to ask children “how they are” in a direct or indirect way. One check-in method is to ask your child to draw or paint a picture. Ask them to tell you more about the picture, what they have drawn, or why they used a specific colour, for example. This may help some children talk about how they feel, whereas other children may be happy to show the picture without discussion, let the child decide.

Activities to reduce stress and support your child’s well-being

These activities can be done with your child to help reduce stress and provide them with positive coping strategies that support their well-being. These activities are also beneficial for you and can be done with your child together. 

Belly breathing

Often when we are stressed our breathing becomes shallow, high in our chests, and we forget to breathe deeply into our bellies, or abdomens. Abdominal breathing is very calming and helps us to draw oxygen deep into our lungs.

How to do it:

  • Place your hand on your stomach
  • Take 5 deep breaths, spend 5 seconds breathing in and 5 seconds breathing out, breathing in through your nose and out through your mouth
  • Explain that when your child inhales, they are blowing up their tummy softly like a balloon, and when they exhale the air is going slowly out of the balloon again.


My special place

Sometimes the world around us can feel overwhelming. By taking a moment to imagine being somewhere calm without stress, children can feel less stressed. Here’s an activity to help your child imagine such a place.

How to do it: 

  • Sit or lie down in a comfortable position, close your eyes, and relax
  • Take several deep slow breaths through your nose and into your belly. Breathe out through your mouth
  • Keep breathing slowly and softly. Gentle long inhales then gentle long exhales
  • Listen and follow the story in your mind. Imagine being in the story:

Letter writing

If your child hasn’t been able to see some friends or family members during the pandemic, writing a letter can help them celebrate the relationship with that person even if they are not present.

How to do it:

  • Ask your child to write a letter or draw a picture for a loved one who they have not seen in a long time
  • What would you like to say to them if they were sitting with you today?
  • What do you love about them?
  • What memories about them make you smile?