ATHABASCA UNIVERSITY

UNIVERSITY OF CALGARY

UNIVERSITY OF LETHBRIDGE

MY TOES FEEL LIKE SPAGHETTI: AN EXPLORATION OF RELAXATION

STRATEGIES FOR PRESCHOOL CHILDREN

BY

LEONA C. CORNIERE

A final project submitted to the

Campus Alberta Applied Psychology: Counselling Initiative in partial fulfillment

Of the requirements for the degree of

MASTER OF COUNSELLING

Alberta

September, 2004

i

ii

iii

ABSTRACT

Preschool children are vulnerable to experiencing stress as a result of their perceptions of,

and responses to, individual circumstances, busy schedules, family dynamics, and societal

pressures. These interweaving experiences often overtax children’s coping abilities,

increasing the number of potential demands and earlier stress related symptoms. Providing

young children with skills and strategies to cope enhances their abilities to respond and adapt

effectively to a variety of situations. Relaxation techniques that have been successfully taught

to adults and school age students appear to be beneficial for preschool children when adapted

appropriately. This study documents the experiences of eight early intervention workers and

how they adapted, and then implemented the relaxation procedures of breathing, progressive

muscle relaxation, and yoga with 3, 4, and 5-year old children. Appropriate teaching

strategies, along with skill development and competency building, allowed both the children

and workers to benefit from the relaxation procedures.

iv

TABLE OF CONTENTS

CHAPTER I - INTRODUCTION ............................................................................................ 1

General Introduction ....................................................................................................... 1

Problem Statement .......................................................................................................... 2

Rationale.......................................................................................................................... 3

The Current Study ........................................................................................................... 3

Overview ......................................................................................................................... 4

CHAPTER II - LITERATURE REVIEW ................................................................................ 6

Theoretical Foundations of Stress ................................................................................... 6

A Contemporary Examination of Childhood Stress .............................................. 7

How Children Experience Stress ........................................................................... 9

Stress and Coping.......................................................................................................... 13

Relaxation Strategies for Young Children........................................................... 14

Preventative Relaxation Strategies for Preschool Children................................. 18

Summary ....................................................................................................................... 19

Conclusion..................................................................................................................... 20

CHAPTER III - METHODOLOGY....................................................................................... 22

Participants .................................................................................................................... 22

Data Source ................................................................................................................... 22

Procedure....................................................................................................................... 23

CHAPTER IV - RESULTS .................................................................................................... 26

Research Question One ................................................................................................. 26

v

Research Question Two ................................................................................................ 29

Research Question Three .............................................................................................. 33

CHAPTER V - DISCUSSIONS AND CONCLUSIONS....................................................... 37

Implications................................................................................................................... 37

Strengths and Limitations.............................................................................................. 40

Future Research Directions ........................................................................................... 42

Discussion and Conclusions.......................................................................................... 44

REFERENCES ....................................................................................................................... 46

APPENDIX A......................................................................................................................... 56

APPENDIX B ......................................................................................................................... 57

APPENDIX C ......................................................................................................................... 58

APPENDIX D......................................................................................................................... 61

APPENDIX E ......................................................................................................................... 62

APPENDIX F.......................................................................................................................... 63

1

CHAPTER I

Introduction

General Introduction

The early childhood years are often viewed as a time during which children are

carefree and removed from daily hassles, societal pressures, and systemic influences. Parents

and caregivers tend to perceive preschool children as being immune to experiencing stress

(Thompson & Rudolph, 2000). However, research demonstrates that young children do

experience stress (Omizo, Omizo, & D’Andrea, 1992). Early child development encompasses

tasks such as acquiring independence, forming attachments, developing individuality,

learning to relate to peers, mastering new skills, and establishing values (Landy, 2002).

Additional circumstances such as parental relationships, socioeconomic status, family

dynamics, and health status influence children’s lives. Furthermore, changes in social,

cultural, and technological systems constantly alter and redefine family interactions and

lifestyles (Elkind, 1988). These interweaving experiences often overtax children’s coping

abilities, increasing the number of potential demands, and leading to earlier reports of stress

related symptoms such as gastrointestinal problems, skin disorders, headaches, and

respiratory ailments (Grey, 1993). For instance, the research indicates that up to 75 % of

medical-related problems are directly influenced by the presence of stress in people’s lives

(Allen & Klein, 1996).

Educators, counsellors, and parents are currently advocating for prevention programs

to address these findings.

The main conceptual argument is that if prevention programs can provide young

children with skills and competencies that enhance their ability to cope, and help them

2

develop a sense of efficacy that becomes an active part of their future adaptive

repertoires, they have much to offer in the life-span sense. (Cowen, Hightower,

Pedro-Carroll, & Work, 1990, p. 154)

Research has shown that relaxation strategies are an effective way of dealing with

stress, anxiety, and tension in adults and school-age children (Allen & Klein, 1996; Chang &

Hiebert, 1989). Allen and Klein suggest that progressive muscle relaxation, imagery, and

music are the most effective strategies to implement with children due to their simple

administration, low economic costs, high interest, and evidence-based practices. The current

movement towards early intervention and quality early childhood education (Guralnick,

1993) provides an opportunity for the promotion of relaxation strategies with preschool

children. Considering that the rate of human learning and development is most rapid in the

preschool years (Landy, 2002), incorporating relaxation strategies into curriculum and

intervention programs for preschool children could help to promote wellness at an early age.

Problem Statement

Preschool children experience stress in their lives that often is not recognized or

addressed by parents and caregivers; stress is associated with children’s quality of health,

self-esteem, and well-being. Preschool children could potentially learn how to cope with

stressful events and circumstances through effective relaxation training conducted by early

intervention workers. However, more information is needed on how existing relaxation

procedures need to be adapted for use with younger children. Information is needed also on

the degree to which early intervention workers, who typically do not have extensive training

in relaxation, can use these procedures effectively with children.

3

Rationale

Stress commonly occurs in the daily routines of preschool children. An increase in

societal problems and the subsequent influences on young children have elevated levels of

stress (Hiebert, 2002; Romano, 1996). Heightened levels of stress, once associated with

adolescence, are now observed to be present in the lives of young children (Thompson &

Thompson, 2000). Habitual stress occurs when children experience intense, challenging

circumstances for extended time periods, taxing their coping mechanisms.

Much of the current literature cites the need for the development of strategies and

programs to increase children’s ability to deal with stress (Henderson, 1992; Romano, 1996).

“Research suggests that learning how to cope successfully is a key determiner of the long-

term psychological, emotional, and physiological effects of stress” (Henderson, 1992, p.

125). There are numerous programs for children that have been developed to help them

control stress (Allen & Klein, 1996; Rickard, 1992; Stroebel, Stroebel, & Holland, 1980).

The focus and content of these programs is predominantly oriented towards school-age

children. Few intervention strategies have been specifically developed for the preschool

population, in particular 3 to 5-year-old children. Knowing the influence of stress in

children’s lives, it seems logical that stress management programs and strategies should

begin during early childhood. Furthermore, strategies taught to young children could likely

function as primary prevention interventions and result in effective coping strategies that will

be useful throughout their lifespan.

The Current Study

This research project examined the use of relaxation strategies with preschool

children using a qualitative approach. The project focused on early intervention workers’

4

abilities to adapt relaxation procedures to preschool children. Workers with considerable

education and work experience with this age group participated in a workshop on relaxation

strategies oriented towards adults and school age children. Following this training, the task of

the workers was to use their acquired knowledge and experience to adapt the relaxation

strategies for use with preschool children. The workers took part in regularly scheduled

interviews to share their observations, ideas, and conclusions about the effectiveness of the

relaxation strategies. The goal of the interviews was to determine the extent to which they

used relaxation procedures with children, the effects of using these procedures on the

children, and the effects on the workers themselves, as a result of using these types of

procedures with their clients.

Overview

To date, the literature on relaxation strategies for preschool children is minimal. The

intent of this research project was to document the experiences of early intervention workers

developing and adapting relaxation procedures geared towards the needs and abilities of

preschool children. The stories and accounts of the workers’ experiences provide important

insight to further potential work in this area.

Chapter one provided a context for the project. Chapter two contains a review of the

theoretical foundations of stress, including an examination of the contemporary literature on

childhood stress, and a synopsis of how children experience stress. This is followed by a

brief overview of stress and coping, including the use of relaxation strategies used with

children, as well as the benefits of this type of an approach. Chapter three provides an outline

of the methodology used in the project. Chapter four presents the research findings according

5

to the three main research questions. Finally, chapter five provides a discussion of the

implications, strengths and weaknesses of the study, and possible future research directions.

6

CHAPTER II

Literature Review

Theoretical Foundations of Stress

The definition of stress has evolved over time. Stress has been conceptualized as a

bodily reaction to a specific situation that exceeds an individual’s coping ability, as an

individual-environment interaction that overburdens personal resources, and as a

psychological state that reflects personal tension or daily disturbances (Lazarus & Folkman,

1984; Rutter, 1983). Malec et al. (2000) offer a contemporary view of stress, stating, “Stress

is a complex reaction that affects our physiology, behaviour, thinking, and emotions. It arises

in situations where people believe that they cannot handle the demands they face as well as

they would like to” (p. 23). This definition contains several important elements: the nature of

the stress response, the nature of the stressor, the individual’s repertoire of skills and

resources to deal with the stressor, and the individual’s perception of the stressor, resources,

and stress response. Perception is a critical factor in this perspective. “The key is peoples’

perception of the adequacy with which they are handling the demand characteristics of the

situation” (Hiebert, 1988, p. 227). The greater part of the current literature on stress adopts

this interactive perspective (Hiebert, 2002). Therefore, the definition from Malec et al. was

chosen as the foundation for this project.

There are numerous theoretical models that describe stress, however none specifically

address childhood stress (Fallin, Wallinga, & Coleman, 2001). Lazarus introduced a

comprehensive theory, describing stress in relation to the interactions between individuals

and their environment (Lazarus & Folkman, 1984):

7

All stimulus-response approaches are circular and beg the crucial questions of what it

is about the stimulus that produces a particular stress response, and what it is about

the response that indicates a particular stressor. It is the observed stimulus-response

relationship, not stimulus or response that defines stress. (p. 15)

This approach regards the impact of a stressor as being mediated by people’s

appraisal of the stressor with respect to potential personal risks, as well as their perceived

coping abilities. Many of the studies that focus on children and stress have adopted Lazarus’

theory of stress (Atkins, 1991; Muir-Ryan, 1989), likely because of the central role played by

perception in people’s experience of stress. Thus, for children, it is the child’s perception and

appraisal of the total situation that impacts the child’s experience of stress.

Researchers are gradually becoming more attentive to childhood stress, recognizing

the significance of the problem (Dombrowski, 1999; Omizo, Omizo, & D’Andrea, 1992;

Romano, 1996). Kagan (1983) suggests that it is during the childhood years that lifetime

patterns and habits are developed. Muir-Ryan (1989) recognizes that both adaptive and

maladaptive coping strategies are acquired during this time, providing the opportune situation

for effective learning, as well as adaptation, modification, and elimination of ineffective

behaviours.

A contemporary examination of childhood stress. Heightened levels of stress are

observed to be present in the lives of young children (Thompson & Rudolph, 2000).

Variables such as hectic daily routines, systemic changes, overextended parental roles,

enrollment in low quality early childhood programs, and increased academic expectations

have been associated with these elevated levels of stress (Hart, 1992; Omizo, Omizo, &

Suzuki, 1988). Children’s perception of these potential stressors, and their respective

8

capacity to respond adaptively to them, determines the magnitude of the child’s stress

response.

Systemic trends and family lifestyles are progressively more hectic, placing increased

demands and pressures on children (Miller & McCormick, 1991). The post modern,

permeable family is pluralistic, complex, fluid, and vulnerable to contemporary lifestyles

(Scherer, 1996). “The contemporary parent dwells in a pressure-cooker of competing

demands, transitions, role changes, personal and professional uncertainties, over which he or

she exerts slight direction” (Elkind, 1988, p. 3). Furthermore, technological progress,

economic changes, political influences, mobility opportunities, and scientific advances

continue to alter lifestyles and affect individual family members’ psychological,

physiological, and social well-being (Fthenakis, 1998).

The daily routines of preschool children have changed during the past several

decades. Prior to the 1960’s, less than 50 % of children participated in any type of early

childhood program before entering kindergarten (Sang, 1994). Today, 85 % of preschool

children participate in some sort of structured group experience prior to entering the school

system. While regulated early childhood programs exist in Canada, fewer than one in three

preschoolers and one in four infants are in programs that stimulate the child’s social,

language, and thinking skills (Goelman, Doherty, Lero, LaGrange, & Tougas, 2000).

Research shows that while high quality early childhood programs positively influence

children's development and learning, poor quality programs have negative influences that

children may find stressful (Doherty, 1995). Therefore, it is important to have high quality

early childhood programs that are tailored to the child’s situation.

9

Children’s increased participation in early childhood programs has also led to higher

expectations in preschool, kindergarten, and first grade, particularly with respect to literacy

and numeracy skills (Scherer, 1996). Inappropriate curriculum content often becomes

embedded in programs, a situation that can result in higher stress levels for many children

(Burts et al., 1992), for example, children who do not meet these standards are frequently

held back, identified as needing extra supports, or placed in transition classes. All these types

of experiences can add to the demands children face and create additional pressures for them

to deal with.

Considering the magnitude of family and societal changes, and the impact on young

children, it is not surprising that the increased levels of stress experienced by children

challenges their well-being (Romano, 1996). The stress experienced by preschool children

supports the need for stress prevention programs. “It is imperative that at a young age

children learn about stress and stressors and develop healthy strategies to cope with the

inevitable stressors of life” (Romano, 1992, p. 199). The literature suggests that parents,

teachers, counsellors, and other related adults, possess the potential to help preschool

children proactively learn and develop the knowledge and skills necessary to face these daily

challenges (Honig, 1986b).

How children experience stress. Currently, excessive stimulation, challenge, choice,

and opportunity are common components in the lives of young children (Hart, 1992). These

components are implicated in the increasing number of stressful demands in preschool

children (Dombrowski, 1999). Two types of stressful experiences, acute life events and

chronic situations, have been identified in the literature (Honig, 1986a). Acute life events are

viewed as being intense, although relatively brief (Jewett & Peterson, 2002). Examples of

10

acute life events for children might include the temporary illness of a parent or a child’s

initial entry into an early childhood program. These experiences may evoke feelings of fear,

helplessness, or anxiety. Chronic situations are described as continuous and ongoing.

Although not necessarily as severe as acute events, chronic stressors have the most

significant and detrimental effects on children, including brain chemistry, brain function, and

lowering resistance to disease (Gunnar & Barr, 1998). Examples of chronic situations that

children might experience, include the loss of a parent through death, ongoing socio-

economic deprivation, or continuing parental discord that often results in cumulative negative

effects and long-term consequences for children (Honig, 1986a). In many of these situations

the parents have limited time, energy, or motivation to provide the necessary supports that

are needed by the children (Van Nguyen & Caspi, 1985). The emotions and attitudes

expressed by parents or other significant adults may also have significant impacts on the

experiences of the children (Arnold, 1990). Furthermore, multiple stressors and coping

inadequacies may become intertwined within children’s lives, with possible detrimental

cumulative effects (Brenner, 1984; Jewett, 1997). Blom, Cheney, and Snoddy (1986) provide

a compelling observation:

It is inspiring to observe that there are children who bear up well under such multiple

adversities. More typically, of course, children endure such circumstances without

collapsing but without reaching their full potential either. Sadly, there are few who

fail even to defend themselves against these multiple stress events. (p. 34)

Common signs indicative of childhood stress include changes in behaviours or

regression of behaviours (DeBord, 1996). For example, children may display behaviours that

are not characteristic of their usual conduct or behaviours that are associated with earlier

11

phases of development. Some of the typical signs of stress displayed by preschool children

include irritability, anxiety, anger, withdrawal, uncontrollable crying, appetite or sleep

problems, and feelings of sadness (DeBord, 1996). Other symptoms suggesting that children

may be experiencing stress are aggressive outbursts, defensive behaviours, rocking or self-

comforting actions, fidgeting, physical complaints such as headaches or upset stomach, hair

twirling, biting of skin or fingernails, and regression of acquired toileting skills (Fallin et al.,

2001; Stansbury & Harris, 2000). The literature also indicates that children experiencing

chronic stress may demonstrate depression, avoidance, excessive shyness, extreme alertness,

constant nervousness, minimal social interactions, obsessive tendencies, and constant

clinging to an adult (Dacey & Fiore, 2000). Honig (1986b) outlines a comprehensive list of

common symptoms associated with childhood stress (See Appendix A).

Children’s perceptions of potential stressors and subsequent responses may vary

according to factors such as developmental level, temperament, gender, age, and previous life

experience (Honig, 1986a). Developmental competence and coping skills are important

components in children’s ability to manage stress (Jewett & Peterson, 2003). Preschool and

kindergarten children demonstrate limitations in their abilities to think about the totality of an

incident, thoughtfully choose from a realm of potential responses when confronted with a

demanding situation, understand an event apart from their own emotions, and alter physical

reactions as a result of a variation in stimuli (Allen & Marotz, 2003).

Temperament is another factor that influences children’s experience of stress (Arnold,

1990; Dunn & Kendrick, 1980). Block and Block’s (1980) examination of temperament and

stress suggested that ego-resilient children are more confident and creative in their responses

to demands, adapting more readily to the requirements of a particular situation, while ego

12

unresilient and slow-to-warm-up children are more insecure and unimaginative in their

responses to challenging situations. In a similar vein, Smith and Carlson (1997) contend that

resiliency is influenced by additional variables such as social support systems and parenting

style that also regulate the effects of stress.

Boys and girls may vary in their responses to particular stressors (Burts et al., 1992).

In a study conducted by Hetherington, Cox, and Cox (1978), a comparison of 48 preschool

boys and girls, all from middle-class families of divorced parents, concluded that boys

demonstrated a significantly higher rate of negative behaviours. A 2-year follow-up

confirmed that the boys continued to experience coping difficulties in dealing with the

changes in their new life situations. Age also appears to influence children’s ability to cope

with demands (Band & Weisz, 1988). Further, the birth of a sibling or hospitalization of a

child seems to impact the preschool child quite differently than an older child (Arnold, 1990).

“Stress is difficult to research, partly because of the wide variety of stimuli that are

potentially stressful, their differential intensity, duration, and the interactions of different

stressors in a child’s life” (Honig, 1986a, p. 51). Nevertheless, the research that does exist

demonstrates that stress is more prominent in children under the age of 10, are male, possess

slow-to-warm-up or difficult temperaments, are born prematurely or have traumatic birth

deliveries, exhibit cognitive limitations, live in poverty or violent settings, and have lower

thresholds for external and internal stimuli (Jewett & Peterson, 2003; McLoyd, 1998). Thus,

the awareness of these variables allows for further promotion of coping strategies for young

children.

13

Stress and Coping

Stress and coping are frequently cited in the literature as going hand in hand (Atkins,

1991). “While stress and coping have been recognized as interrelated, the definition of

coping has eluded science even more than the definition of stress” (Sorensen, 1993, p. 12).

Research related to child and adolescent coping has been conducted without a precise

definition, resulting in varying measurement approaches, struggles with the comparison of

study outcomes, and barriers in the examination of related variables such as age, gender, and

other individual characteristics (Compas, Connor-Smith, Saltzman, Thomsen, & Wadsworth,

2001).

The most common definition of coping used in the research with children and

adolescents is that of Lazarus and Folkman (Compas et al., 2001). Lazarus and Folkman

(1984) contend that coping is a process that involves continuously changing cognitive and

behavioural efforts to manage specific internal and external demands. Thus, coping is viewed

as a goal-driven process in which the individual’s thoughts and behaviours work towards

addressing the demands of a situation, as well as dealing with the emotional and physical

responses associated with the situation (Lazarus, 1993). Coping in this sense is neutral; it is

simply an attempt to deal with either the demand or the person’s response to the demand,

which may be either effective or ineffective. Future research on coping and young children

requires attention to the conceptualization of coping in childhood, the need for more reliable

and valid measurement tools, the need for more thought concerning developmental

implications and social context, and the need for linking coping with physical health, well-

being, and intervention research (Atkins, 1993; Ayers, Sandler, & Twohey, 1998; Brodzinsky

14

et al., 1992; Causey & Dubow, 1992; Compas et al, 2001; Dise-Lewis, 1988; Ryan-Wenger,

1992).

Spivak, Platt, and Shure (1976) examined coping responses in young children and

found that the ability to generate multiple solutions to interpersonal problems emerges as

early as 4 to 5 years and that more complex means-ends thinking appears between 6 and 8-

years. However, there is still a tendency for young children to revert to simple, behavioural

coping strategies; for example, a 5-year old faced with chronic demands may regress to

infantile behaviours such as thumb sucking. The coping strategies for children that have been

identified in the literature include distraction, redefinition, direct action, catharsis,

acceptance, social support, and relaxation (Altshuler & Ruble, 1989; Honig, 1986b). A study

conducted by Dickey and Henderson (1989) involving kindergarten, first, and third grade

children, revealed that only 3.7% of the participants surveyed identified the use of relaxation

as a coping strategy. They suggested more purposeful teaching of relaxation techniques for

young children.

Relaxation strategies for young children. Learning successful coping strategies helps

to enhance children’s quality of health, self-esteem, and well-being (Henderson, 1992).

Relaxation training with children is an example of a potentially successful coping strategy

that children could use in their day-to-day routines (Allen & Klein, 1996). Humphrey (1984)

describes relaxation as “A neuromuscular accomplishment that results in a reduction, or

possible complete absence of muscle tone in a part of the body or in the entire body” (p.

301). Relaxation techniques are effective, self-regulatory intervention strategies that allow

children to develop self-control and independence. Research addressing relaxation training

with children is gradually becoming more prominent (Lowenstein, 1991), although the

15

majority of the studies appear to focus on school age children. Common relaxation strategies

used with young children include diaphragmatic breathing, progressive relaxation, imagery,

creative movement, and yoga (Cormier & Nurius, 2003; Gerler & Danielson, 1984; Rickard,

1994; Romano, 1992; Seiler & Renshaw, 1978). Some of the key research findings pertaining

to relaxation and children are outlined below.

Zaichkowsky and Zaichkowsky (1984) implemented a 6-week relaxation program

with 24 healthy fourth grade students. The relaxation program consisted of 18 training

sessions encompassing progressive muscle relaxation, mental imagery, and breathing

exercises. The results revealed that children showed considerable progress in their capacity to

control physiological arousal, as well as reported lower levels of anxiety following the

training. The authors noted, “Like any other learned skill it is important that the children

receive quality instruction, appropriate feedback, and practice time in order that they learn to

master the skills of tension control” (p. 84). This study examined only the short-term effects

of relaxation training; the researchers recognized the need for assessing whether these results

were sustained over longer periods of time.

Chang and Hiebert (1989) reviewed 72 studies involving biofeedback and

nonmachine-mediated relaxation training conducted with children. Nonmachine-mediated

techniques included progressive relaxation, meditation, autogenic, and Quieting Response

training. Positive, consistent results were apparent, documenting diminished general anxiety

and enhanced school performance. However, Chang and Hiebert noted:

A general statement on the efficacy of relaxation training with children is difficult to

make because most studies do not report how closely the children adhere to the

16

training procedures and the home practice regimen, or the degree to which subjects

receiving training actually acquired the ability to relax. (p. 171)

The authors offered numerous suggestions for implementing relaxation training with children

including the importance of using techniques to deal with relevant problems, as well as the

need for guided instruction, supportive practice, and age-appropriate content.

Richter (1984) reviewed an array of research articles to assess the efficacy of

relaxation programs to address a range of learning, behavioural, and physiological difficulties

in school age children. The main findings suggested that relaxation training was equally

successful when used alone over a sufficient amount of time, or paired with other treatment

modalities. Relaxation techniques have also been used to address various concerns such as

high activity level, attention control, impulsivity, and disruptive behaviours (Dunn & Howell,

1982; Matthews, 1986; McBrien, 1978; Oldfield & Petosa, 1986). In addition, relaxation

techniques have been used successfully with children with a variety of disabilities (Zipkin,

1995). Omizo, Loffredo, and Hammett (1982) found that children with learning disabilities in

the first and second grades were able to achieve increased attention control following the

implementation of a progressive muscle relaxation program. Overall, the findings suggest

that relaxation most often is accompanied by some positive influences, especially when

paired with other interventions.

The use of imagery has been successful in teaching relaxation to children (Cautela &

Groden, 1978). McBrien (1978) suggested that children use imagery to facilitate relaxation;

for example, ‘let your toes relax as if they were spaghetti.’ Humphrey (1984) encouraged

children to imagine they could ‘float like a feather’ to create a serene image and promote a

relaxed state.

17

A related relaxation approach for children is Kiddie QR (Quieting Reflex) (Stroebel

et al., 1980). The Kiddie QR program is based on cognitive behavioural theory and is adapted

from adult QR training used to manage stress. Ragan and Hiebert (1987) described QR

training as “a form of cue-controlled relaxation that consists of practice to increase

discrimination of arousal cues and faulty muscle bracing, easy abdominal breathing, elements

of progressive relaxation training, and autogenic training” (p. 274). Mental imagery is the

means employed in Kiddie QR to enhance student proficiency at discerning tension status

and substituting them with calm feelings. The Kiddie QR program incorporates a collection

of body friends to help children identify common body tension areas, as well as substitute

relaxed states for tension areas. For instance, the body friend TMJ (temperomandibular joint)

helps children be aware of tension in their jaw, whereas, the body friend magic draw string (a

string attached to the child’s chin; the string is pulled down causing the jaw to droop), is used

to encourage relaxation of the jaw muscle.

Minimal research has been completed to evaluate the effectiveness of the Kiddie QR

program. Ragan and Hiebert (1987) looked at the influence of Kiddie QR training on

children’s stress levels. The intent of their study was to address the stress that young children

in elementary school grades are experiencing, as well as potential intervention strategies. In

general, the results of the study were not conclusive. The authors noted that the outcome may

have been influenced by the students’ low initial stress levels. Consequently, a floor effect

may have resulted in minimal room for reduction in the post-test findings. Despite the lack of

reliable statistical findings in this study, important anecdotal information was generated to

document the benefits most children derived from the training. For example, numerous

children indicated that they had transferred the skills they had learned to other areas of their

18

lives (e.g., helping them to sleep at night or managing personal anger related to peer

interactions).

Hiebert, Kirby, and Jaknavorian (1989) promote relaxation opportunities for children

to decrease anxiety levels and preclude additional stress-induced problems. Furthermore,

Hiebert (2002) observes that relaxation strategies taught to young children function as

primary prevention interventions that instill effective coping strategies for dealing with

physiological and emotional reactions. Children are capable of becoming cognizant of when

their bodies feel tense. Although more research on school age stress management strategies is

beginning to emerge in the literature, there remains a paucity of data pertaining to preschool

children.

Other proactive approaches incorporating relaxation techniques that have been

developed for young children include Thinking of Something Quiet (Cherry, 1981),

Relaxation for Children (Rickard, 1992), Relax (O’Neill, 1993), and Ready, Set, R.E.L.A.X.

(Allen & Klein, 1996). Most of these approaches are oriented towards school age children

and remain experimental in nature. Although professionals working with young children rate

programs such as these as being advantageous, minimal empirical support exists to document

the benefits (Blom et al., 1986).

Preventative relaxation strategies for preschool children. Early childhood

experiences are associated with later emotional, behavioural, and hormonal stress activity.

Stress hormones, and their respective regulatory processes, play a critical role in early

development. “Knowing that chronic stimulation of the stress response can influence disease

states, it seems logical that stress management programs should begin during childhood, a

time when lifelong behaviors are developed” (Dombrowski, 1999, p. 126). Intervention

19

during childhood works towards relieving stress, providing tools to deal with future

situations, and preventing possible implications later in life (Wolff, 1973).

Many of the relaxation techniques developed for treatment programs can be

incorporated into preventative strategies (Arnold, 1990; McManus, 1984). Zaichkowsky and

Zaichowsky (1984) suggest, “It seems that any preventive program should focus on the

young child rather than waiting for individuals to assimilate attitudinal and behavioral

patterns which will virtually guarantee their becoming high-risk adults” (p. 81). The

promotion of wellness through preventative approaches is apparent in the paradigm shift

within the field of medicine, away from disease and illness, and towards an emphasis on

well-being and health (Malec et al., 2000; Myers, Sweeney, & Witmer, 2000). “Wellness

typically includes the provision of nutritional information, services designed to improve

value clarification and self-understanding, stress management, physical fitness, and self-care”

(Omizo et al., 1992, p. 194). Based on these findings, researchers, counsellors, and educators

are more readily advocating for, and adopting, primary prevention interventions to provide

preschool children with skills and strategies that enhance their abilities to cope with demands

and establish a sense of resourcefulness and competency that extends into life-long practices

(Dubow, Schmidt, McBride, Edwards, & Merk, 1993).

Summary

Stress is a natural part of children’s lives, although the events or situations that may

be perceived as stressful to them are often different from those of adults. Stress is

experienced as an integrated, multifaceted reaction encompassing physical, cognitive, and

behavioural components. It is children’s perception of the demands, and their respective

capacity to respond adaptively, that determines the magnitude of their stress response. Stress

20

can be associated with acute life events or chronic situations that can result in disequilibrium

for children.

Researchers and professionals working with children are becoming more attentive to

the subject of stress in children. There is some empirical support for using stress management

strategies with school age children, although further research has been deemed necessary to

provide longitudinal data and ensure reliable outcomes. Relaxation techniques for young

children such as Kiddie QR have been shown to be effective, though further studies showing

statistically reliable findings are needed. There is minimal literature on using age appropriate

relaxation techniques with the preschool population. The literature advocates teaching

relaxation strategies to preschool children, although professionals report inadequate training

and lack of curriculum resources in this area.

Conclusion

Many preschool children are impacted by, and ill equipped to deal with stressful

experiences in their daily lives. Professionals interacting with children have opportunities to

intervene in a manner that enhances children’s understanding and ability to cope with these

situations. Ideally, the introduction of proactive, developmentally appropriate interventions

will assist preschool children in dealing with potentially stressful situations, promoting

personal autonomy and self-esteem.

In light of the above information, the following research questions are addressed in

this project:

1. To what extent can early intervention workers use relaxation procedures with

children?

2. What are some of the effects of using those procedures with children?

21

3. What are the effects on the early intervention workers themselves, when they

use these types of procedures with the children?

22

CHAPTER III

Methodology

Participants

The participants who volunteered for this study were eight female workers employed

in the field of early childhood education and therapy. Seven of the individuals were

employed at an early intervention centre and one at a counselling program for children. The

workers had clinical and educational backgrounds in the areas of education, social work,

occupational therapy, physiotherapy, and speech-language pathology. The participants

worked with preschoolers who were progressing typically in their development, as well as

children with a variety of special needs. The participant’s experience working with preschool

children ranged from 2 to 15 years. The participants worked with children individually and in

groups.

Data Source

A qualitative approach was used to explore the workers’ experiences developing and

adapting relaxation strategies for preschool children. An interview guide consisting of seven

questions was used as a framework for data collection that addressed the three main research

questions:

1. To what extent have you been able to use relaxation procedures with the

children?

2. How have you adapted or changed the relaxation procedures?

3. In what kinds of situations have you used these procedures?

4. How many children have you used these procedures with?

5. What effects have you noticed on the children?

23

6. What effects have you noticed for yourself in using these types of procedures

with the children?

7. Are there any other observations, comments, or anecdotal information you

would like to share?

The interview guide used open-ended questions that elicited participant responses

framed in their own words. Individual’s ideas, thoughts, and feelings depicted salient

observations and themes that were captured in rich testimonies that exemplified the

participant’s experiences. The questions were organized in a logical sequence beginning with

information about the use and adaptation of the relaxation strategies, progressing to the

effects on the children, and finally, the implications for the workers themselves. The final

question provided participants the opportunity to expand on their comments or provide

additional information. Analysis of the interview data was completed to identify existing

themes that coincided with the three research questions and explore potential implications of

these findings.

Procedure

A 2-day workshop on relaxation techniques oriented to adults and school age children

was organized for 14 early intervention workers in Whitehorse, Yukon. An instructor with

extensive education and experience in relaxation strategies conducted the workshop.

Following the training, a recruitment letter (See Appendix B) was sent to potential

participants, inviting them to take part in this project. The role of the participants was to

revise and incorporate relaxation techniques into their daily scheduled work with preschool

children, record the findings (e.g., case reports, pre and post recordings of specific

behaviours, anecdotal notes, parent feedback), and meet regularly with the examiner to

24

complete a standard interview. Eight workers volunteered to be part of the study. A consent

form (See Appendix C) was completed with each volunteer and pre-interviews (See

Appendix D) were conducted to determine how each worker anticipated using relaxation

strategies with preschool children, as well as how they intended to document their findings

(See Appendix E).

The number of interviews within the 4-month period of the study varied for each

worker, depending upon the worker’s assignment with an individual child or group of

children, as well as work schedules (See Appendix F). A total of 45 interviews were

completed, each taking approximately 30 minutes. Participants were given a copy of the

interview guide at the start of the project. The examiner recorded the participants’ responses

for each interview, transcribed the notes, and returned the transcript to the participant within

the same day to review for accuracy. This process enhanced the credibility and validity of the

data.

A content analysis of the interviews was completed to identify themes that related to

the three research questions. As well, an examination of the implications of these findings

was made. Coding and data analysis occurred simultaneously to solidify existing themes and

concepts, and work towards an overall description of the experiences of the workers. As

noted by Rubin and Rubin (1995), “Data analysis is the final stage of listening to hear the

meaning of what is said” (p. 226).

Coding involved a phrase-by-phrase examination of the data. Colour coding and notes

recorded on the right hand side of the transcripts were completed to identify salient points

and reoccurring themes. Strauss and Corbin (1990) refer to this as taking apart an

observation, a sentence, a paragraph, and giving each idea or event a name that represents a

25

phenomenon. This process resulted in patterns of meaning, as well as consistencies and

differences. Consistencies between codes were used to identify categories in the analysis.

Categories, and the concepts pertaining to them, were then written as memos. The use of

memos was a way of getting ideas down on paper, as well as engaging the researcher in

personal reflection and systematic insight (Maxwell, 1996); memos provided a way to

explore the data, clarify ideas, and examine the experiences of the eight workers.

To ensure credibility, checks were also conducted with four of the participants to test

the overall report before presenting it in final form (Mills, 2000). Overall, this process

allowed for insightful contextual learning and the promotion of new understanding about

implementing relaxation strategies with preschool children.

26

CHAPTER IV

Results

This chapter consolidates the information collected from the workers throughout the

interview process. Themes and categories that emerged from within the data analysis, as well

as the stories and testimonies of the workers, are presented here.

Research Question One

To what extent can early intervention workers use relaxation procedures with

children? All eight participants incorporated relaxation procedures in their work with

preschool children. The relaxation techniques that were the main focus of this work included

breathing exercises, progressive muscle relaxation, and yoga. Individual work with children

incorporated techniques at the beginning, middle, and closing parts of the sessions. In group

work, techniques were integrated into routines including playtime, circle time, art activities,

story time, gym, and transitions between activities. Initially, the workers reported planning

the techniques as separate activities. During the latter part of the project, many of the workers

noted the techniques had become an integral part of their programs. For example, after 2

months of using the techniques on a regular basis with a group of children, one worker noted,

“We seem to be incorporating some aspect of the techniques in almost all activities and

transitions now.” Many of the workers became more spontaneous in their use of activities as

their skill level, repertoire of activities, and confidence increased over time. This helped them

to integrate these relaxation procedures more readily into the daily routines.

The workers reported five teaching strategies that were important for the successful

implementation of relaxation techniques with preschool children. First, simple instructions

and directions were necessary. Instructions needed to parallel the language and cognitive

27

development of the children. This was apparent in the varying degrees of intervention

required for the 3, 4, and 5-year olds. For example, one worker noted, “With the 3-year olds,

we need to present information in a simple, precise manner, for instance, only focus on two

things at one time like breathing and the story versus breathing, stretching, and the story.”

Second, the use of repetition with young children was reported by several workers

to be key to the learning experience. Repeating the same activity many times over a period of

several weeks was important for children to understand the idea and directions of the

exercise, as well as provide opportunities for regular practice. Repetition was reported to be

particularly important for 3-year olds, as well as children with special needs. The workers

noted that some children would simply observe the techniques the first few times and then

gradually join in the activities as their understanding and confidence level increased. One

worker commented, “None of the children have complained about the repetitive use of the

relaxation activities; when other activities are repeated this sometimes happens.”

Furthermore, two workers noted that several children often requested the relaxation activities

during circle or story time.

The third teaching technique incorporated by all the workers was the use of

concrete, tangible instructional aids. Examples of concrete teaching aids included the use of

chiffon scarves and feathers to blow in the air to introduce the idea of deep breathing, the use

of mirrors to demonstrate the idea of exhalation, hard and soft objects to present the idea of

tense and relaxed muscle states, pictures, puppets, and numerous story props. The use of

concrete, visual items to teach relaxation strategies provided multi-sensory learning

opportunities, especially for the 3 and 4-year olds. The workers suggested that the use of

visual aids assisted in promoting attending skills, motivation, and understanding the

28

respective techniques. Furthermore, one worker observed that these aids often acted as a cue

for the children. For example, now when the worker takes out the bumble bee puppet used in

circle time each day for a breathing activity, the children often begin engaging in the

breathing exercise before she instructs them to begin.

Fourth, the workers integrated the use of imagery into their instructions, songs,

finger plays, stories, and activities to assist the children with comprehending the techniques

and maintaining their focus to the task. For example, while introducing progressive muscle

relaxation, one worker had the children pretend to be tin soldiers and Raggedy Ann dolls to

practice tensing and relaxing different body parts. Other examples included the Finger

Family Relaxing song that portrayed the children’s fingers as a family being tucked into bed

(make a tight fist) and then waking up and dancing softly on the floor (fingers loosely

swinging); the Melt the Ice activity involved the children pretending to be an ice cube

(tensing various different body parts) and slowly progressing to a puddle of water on the

floor (relaxing body parts); and the Gluing Hands Together game where the children brushed

pretend glue on their hands, rubbed it in, pushed their hands together firmly, and then washed

the glue off and gently swayed them in the air to dry. The workers reported that the children

were very motivated to engage in these tasks, drawn into the pretend aspect of the activities.

The final teaching strategy, mentioned by four workers, was the adult’s voice and

tone level while carrying out the activities. One worker suggested that voice level and tone is

critical. She noted the adult’s voice level and tone could change the dynamics of the group.

For instance, when she would speak softly and quietly to the group of children while

engaging in a relaxation activity, the children would also become quiet to hear what she was

29

saying, and subsequently speak more quietly. The quiet voices created a calm, comforting

setting that promoted relaxation.

Purposeful teaching strategies appeared to play an important role in the planning

and delivery of successful relaxation procedures with preschool children. Simple instructions,

repetition, tangible teaching aids, the use of imagery, and the worker’s voice and tone level

all contributed to the learning process and outcomes for young children.

Research Question Two

What are some of the effects of using relaxation procedures with children? There

were three main observations reported by the participants in this project. First, the workers

observed the children to be calmer after engaging in breathing exercises, progressive muscle

relaxation, and yoga activities. The children’s calm demeanour was particularly noticeable at

the end of the activities, as well as during transitions within individual sessions and group

settings. Transitioning from one activity to another or from one place to another is often

difficult for preschool children. The workers discovered that completing relaxation

techniques prior to transitioning resulted in the children being calmer and more relaxed. One

worker noted:

Completing the Finger Family song at the end of the day resulted in improved

behaviour while dressing to leave preschool. I was able to focus more on specific

children rather than constantly managing the group, giving directions, and

reminders. It was a nice way to end the day, everyone leaving on a positive, calm

note. When the Finger Family song was not done, the hectic routine returned.

Following the inclusion of this relaxation exercise at the closing circle each day, the same

worker reported that the bus driver, who was unaware of the implementation of relaxation

30

procedures with the children, commented on the children’s improved behaviour and calmness

on the bus.

Another participant, who was working with a small group of 4-year olds and their

teacher at a local childcare program, noticed a change in the children’s behaviour before and

after sessions while working on relaxation techniques. For instance, she recalled arriving at

the centre on one particular day and the teacher telling her that “she had her work cut out for

her” because the children were extremely active. After completing a 45-minute session of

breathing exercises, progressive muscle relaxation, and yoga poses, she noted that the

children and teacher were considerably more calm and relaxed. The ongoing results

convinced the teacher to incorporate the techniques into her daily schedule and were soon

being copied by other teachers at the centre.

Four workers also relayed stories of how individual children learned to calm

themselves, based on the regular use of the relaxation techniques. For instance, one worker

who routinely used a variety of yoga poses with the children taught one pose called the

mouse position, an adaptation of the child’s pose. One day, she noticed that a child beginning

to engage in a temper tantrum positioned herself in the mouse position and calmed down

quickly, compared to previous tantrum episodes. The worker described this experience as the

child’s initial steps to transferring the relaxation techniques and engaging in self-regulating

behaviour. Other evidence indicating the transfer of skills was based upon the parent’s

comments about the children’s use of the techniques at home. The children’s initiative to use

these skills at home appeared to create an increased level of interest from the parents,

resulting in requests for information and copies of the songs and stories to try at home. The

parent’s interest in, and support for, the relaxation procedures appeared to further reinforce

31

the participant’s work. For example, one worker noted during a case conference with a child

psychiatrist, that the parent reported improvement in her child’s behaviour partly due to the

relaxation techniques taught by the teacher. This feedback motivated the worker to continue

practising and expanding these techniques.

A second effect, noted by seven of the workers, was the children’s ability to focus

on and attend to an activity following the relaxation procedures. The workers found that

beginning an activity such as circle or art time with a short relaxation exercise resulted in the

children being more attentive to the activity. As described by one worker:

During our bumblebee name game at the beginning of circle each day, the

bumblebee [a puppet with soft silk wings] invites the children to blow gently on her

wings; each child takes a deep breath and blows gently on her wings and then at the

end of the activity they all do this together as a group. This is a great transition into

circle time, helping the children become calm and focused; a teacher who was

subbing this week commented on this activity and how quickly the children were

able to become calm and then attend to the circle time activities.

Another participant working with an individual child during weekly play-oriented

sessions described the child’s initial behaviour as unfocused, moving quickly from one

activity to another every few minutes. After several sessions that involved the inclusion of

relaxation activities, the worker noted the child’s increased attentiveness and ability to stay

with one activity for longer periods of time.

The third behaviour noted by the workers was the quietness of the children

following the relaxation activities. The workers further described this quietness as promoting

self-control, cooperativeness, and positive interactions. For example, one worker noted while

32

doing yoga poses with the children, she would purposefully progress from more active,

motoric positions, to calmer, quiet poses. She ended the activity with the turtle pose that

would often result in total silence in the room for a brief period of time. She described this as

a special time of the day for both her and the children. Another participant shared a similar

story with respect to using the turtle pose during yoga sessions.

This quiet demeanour described by the workers also appeared to assist with

transitions and general behaviour management. One worker observed, “The relaxation

activities help them focus, they become quiet and are able to move into and participate in the

next activity more successfully.” Another participant shared the following experience:

During playtime one day, it was particularly busy, hectic, and noisy in the room so I

invited the children to listen to the Quiet Farm Story [incorporates breathing

exercises]. The noise level in the room substantially decreased, the children became

more focused, and the children’s behaviour and attention control was noticeably

better during the next activity.

One final observation, noted by two workers, was that girls appeared to be more

receptive to participating in the relaxation activities than boys. These workers found they

often had to find motivating activities to encourage the boys to participate in the exercises.

For instance, one worker used the story of a dragon to teach breathing exercises to one 4-year

old boy who refused to take part in the activities. This approach immediately caught his

attention and motivated him to participate in other exercises. The worker noted the challenge

in this circumstance was to use a character such as a dragon, but still promote and maintain

the focus of the task within the realm of a quiet, calm exercise.

33

The workers’ observations about the effects of using relaxation procedures with

preschool children suggest calm, focused, and quiet responses to the techniques. Feedback

from parents, childcare workers, and other individuals reinforced these observations and

encouraged continued use by the workers.

Research Question Three

What are the effects on the early intervention workers themselves, when they use

these types of procedures with the children? Interestingly, the workers described similar

benefits for themselves as those that they observed for the children following the

implementation of relaxation procedures. Five of the workers reported feeling calmer after

they gained the skill and confidence level to lead the activities and engage the children. One

worker noted, “My voice level has gone down, it is not so high pitched and I am aware of my

tone.” Another participant observed, “Overall, I am more calm, my voice is more calm, and

my movements calmer.” Similarly, another worker commented, “Using these procedures

reduces my own stress level at transition times.”

Five workers reported becoming more focused and aware of the children and

techniques after establishing regular relaxation activities within routines. One worker stated,

“I participate in the activities too which gives me time to collect my thoughts and get ready

to move into the next activity.” Other workers noted being more aware of themselves and the

children with respect to feelings, reactions, activity level, and relaxation levels. This idea of

being more aware and attentive to the children also appeared to be related to managing and

guiding the children’s behaviour. One worker explained, “Having a calmer child and having

tools [relaxation procedures] to deal with her behaviour makes me more confident, it allows

me to do the treatment work and focus on her goals.” A second participant explained that she

34

has gained tools to promote self-control strategies for the children, empowering them to

develop ways to control or redirect their own behaviours. A third worker elaborated:

When children get wound up, I know I have techniques to deal with the situation;

this lowers my stress level. Previously, in similar situations, we often had to take

children outside of the classroom environment to assist them to calm down – now

by using relaxation techniques, we can deal with these situations in the preschool.

Six of the workers talked about the quieter environment that proceeded the

relaxation activities and promoted a more relaxed personal state. One participant explained,

“It is a breather, sometimes we miss these moments and pauses are helpful for keeping the

pace manageable.”

There were numerous other observations noted by the workers in the interviews

regarding personal effects. Developing skills to implement relaxation strategies and time to

build self-confidence appeared to be a significant factor. One worker talked about the

importance of finding the appropriate approaches for teaching relaxation techniques to fit

personal and unique teaching styles. She noted:

You have to choose activities and techniques that are comfortable for the person, for

example, I am not a storyteller so that approach does not work for me. It is not

something you just pick up and do - I develop, adapt, and implement techniques that

fit for me as a person.

Another factor that seemed to influence the outcomes of the procedures used by the workers

was the availability or access to resources, as well as interactions with other workers who

were developing and implementing similar techniques. Several of the workers would have

liked more ideas for preschool children to assist and guide them with the implementation of

35

relaxation procedures. Due to the limited resources specifically for this age group, the

workers reported the need to be creative and inventive in their approaches. One worker spoke

about the time investment this required and how she wasn’t always able to develop and

prepare activities to the extent she would have liked to for the sessions. Another worker

noted that sharing and exchanging ideas and resources with colleagues was very motivating

and helpful.

Several of the participants also talked about the relaxation procedures as being a

preventative tool to use with both individual and groups of children. They described

preventative in the context of being able to calm, redirect, focus, and support children. As the

project progressed, the workers talked more about the benefits of using relaxation strategies

as a preventative measure, rather than a reactionary approach. Throughout this process they

became more attentive to children’s cues (e.g., noise level, activity level, unfocused

behaviour), and were able to intervene more purposefully and readily to address the response

or situation. For example, one worker discovered that giving feathers to the children to gently

rub against their cheeks had a very calming effect. As a preventative tool, she kept a basket

of feathers in the preschool for the children to take themselves or would strategically use

them during transition times.

All the workers talked about future uses of relaxation procedures and how they

might be elaborated on or improved over time. Engaging in this initial process of developing

and implementing relaxation techniques appeared to stimulate progressive thinking and

planning in this area. Relevant comments by two workers included, “I have an increased

awareness of the kinds of things that can help children relax. There is the awareness now to

make these opportunities available to children” and “Next year I plan to start using relaxation

36

strategies with the children on day one. Considering what we have done in 4-months, a full

year will open all sorts of possibilities.”

Finally, as professionals from other agencies heard about the work of the

participants, several of the workers received requests from these individuals for information

about the activities, permission to visit their programs, and invitations to do presentations

about their experiences.

Overall, the workers successfully implemented the relaxation procedures of

breathing exercises, progressive muscle relaxation, and yoga with preschool children. Pre and

post behaviour observations and feedback from parents and childcare workers revealed

effective, age appropriate teaching strategies that encouraged participation and learning of

the relaxation techniques. The worker’s skill development, confidence level, and access to

resources all promoted preventative, progressive interventions.

The results of this project demonstrate that the workers were able to use the

relaxation procedures with preschool age children in both individual and group settings.

When the workers presented the procedures using simple instruction, repetition, concrete

teaching aids, imagery, and calm voice levels, they observed relaxed, focused, and quiet

behaviours that promoted self-regulation and cooperation from the children. Furthermore, the

successful use of these procedures by the workers produced personal effects that included

calmness, attentiveness, and a quieter, productive learning environment.

37

CHAPTER V

Discussion and Conclusions

This project involved eight early intervention workers using relaxation strategies

with preschool children. The results of the study are summarized below, followed by the

implications for practice arising from the study. A critique of the project is then offered,

followed by suggestions for future research, as well as some concluding observations.

Implications

Relaxation strategies to date have been predominantly designed for and implemented

with school age children and adults. The findings of this project, suggest that it is beneficial

to implement relaxation procedures with preschool children and that when doing so several

considerations need to be taken into account. The workers reported the need to be attentive to

developmental considerations when using relaxation procedures with young children. In

particular, the developmental status of a child is salient to comprehending a particular event

and the child’s capacity to respond to it (Kagan, 1983). Humphrey (1988) contends that

teaching children how to relax needs to commence with a thorough comprehension of child

development and emotions. Furthermore, he suggests when considering relaxation strategies

for young children, it is important to consider the whole child, including physical, social,

emotional, and intellectual aspects; all components are interrelated and interdependent and

important to well-being.

Piaget’s work with children further supports the successful teaching strategies

identified by the workers in this study. Pre-conceptual thought, the inability to make abstract

generalizations or systematically categorize data, is associated with 2 to 4-year olds (Piaget,

1960). The thought processes of children at this age are characterized by thinking that is

38

closely tied to physical properties of objects or events, and egocentrism, the inclination to see

an event from the perspective of its meaning to the self. Eventually, 4 and 5-year olds begin

to make more casual and conceptual associations, but their reasoning is intuitive, susceptible

to errors, and egocentric. Similarly, concept development (e.g., qualitative, quantitative,

temporal) progresses during the preschool years from simple to more complex schemes.

Many of the concepts that are embedded within the existing relaxation programs are not

within appropriate developmental expectations of preschool children. For example, the

Kiddie QR relaxation program (Stroebel et al., 1980) that is aimed at children between the

ages of 3 and 8-years, uses the concepts of left and right to frequently talk about the QR

friends. The concept of left and right is typically acquired between the ages of 6 and 7 years

(Brigance, 1991), thus children at the lower end of the suggested age range may have

difficulty following the instructions. Ensuring appropriate conceptual content in the

application of relaxation techniques for preschool children is an important consideration in

the design and implementation of programs (Sandler, Miller, Short, & Wolchik, 1989), and

evident in the findings of this project.

It is important also to be mindful of the preschooler’s memory capacity. “In memory,

young children have a tendency to confuse plan with action retrospectively, and this tendency

appears to increase if the plan was formulated and inhibited under stress” (Arnold, 1990, p.

8). Current relaxation training strategies are not always attentive to the amount of

information that is given at any one time, the need for repetition, and the pairing of visual

and auditory cues to assist with the learning process for young children. The workers

identified these factors (small bits of information, repetition, visual-auditory pairing) as being

critical to the learning process for preschool children.

39

The worker’s ability to incorporate relaxation techniques into individual play-based

sessions, as well as group programs, coincides with the idea of play as a central theme in

children’s lives (Allen & Marotz, 2003). Creative play provides children with an outlet to

relieve stress, solve problems, learn social cooperation, and work through stressful situations

(Scherer, 1996). Barten and Zeanah (1990) propose that play serves two important functions

for children in respect to the issue of stress. First, it provides a retreat or reprieve for children

away from stressful realities for a period of time. Second, play provides a forum for children

to act out a stressful event in an attempt to better understand the situation and work towards

some affective reconciliation. In this project, play-oriented relaxation activities were

motivating and fun for the children. All the workers incorporated play-based philosophies

that lent themselves to the inclusion of preventative teaching around stress and relaxation.

The workers in this study were motivated to use relaxation procedures, but

commented on the lack of resources specifically designed for preschool children. The

literature reports teachers and professionals working with young children frequently identify

a lack of training, curriculum resources, and skills with which to implement interventions

(Omizo, et al., 1992). Blom et al. (1986) note, “Teachers have regular extensive and intensive

contact with the child over an extended period of time, giving them the opportunity to

observe and interact with the child and to observe and have an effect upon changes in

behavior over this extended period” (p. 11). Providing early childhood professionals with

knowledge and tools to allow for relaxation training with preschool children needs to become

a more common theme with the emergence of early intervention practices and the evidence-

based practices that exist for school-age children (Allen & Klein, 1996; Rickard, 1992).

40

The findings of this study have positive implications for both children and early

intervention workers. Successful implementation of relaxation procedures generally resulted

in calm, focused, quiet behaviours that promoted positive, cooperative interactions. These

results further influenced the workers calm demeanour that allowed for a more relaxed,

productive learning experience. The combination of the children’s and workers’ relaxed

behaviours created an overall calm, quiet environment that promotes positive, constructive,

and cooperative interactions.

Strengths and Limitations

Numerous strengths and limitations were identified in the process of completing this

study. Three strengths and three limitations particularly stand out.

First, one strength of this project was the qualitative approach, which allowed for the

exploration of phenomena in natural early intervention settings. As noted by Anderson

(2001), “A fundamental assumption of the qualitative research paradigm is that a profound

understanding of the world can be gained through conversation and observation in natural

settings rather than through experimental manipulation under artificial conditions” (p. 119).

In this study, the workers’ abilities to use the relaxation procedures with preschool children

was explored in their natural working environments, that helped to make sense of and

interpret these phenomena with reference to the meanings individuals brought to them.

Personal experiences, observations, and the development of relaxation activities collectively

described successful and problematic moments. In addition to gaining information about

specific children, this approach provided insight into the more global influences on

classroom behaviours that would not have been captured with more traditional methods.

41

A second strength stems from the workers’ experiences working with preschool

children. The workers understanding of early child development from a variety of

perspectives (e.g., education, physiotherapy, social work, speech and language pathology), as

well as their vast work experiences with this age group, allowed them to develop, adjust, and

adapt relaxation strategies in a developmentally appropriate manner that was meaningful and

fun for the children. Comprehending child development is critical to effective program

delivery and success (Landy, 2002).

Third, the workers’ interests in, and motivation for, using relaxation procedures with

the children was evident throughout this project. This interest and motivation helped to

maintain the worker’s adherence to the ongoing development and use of strategies over the

span of this study. Implementing relaxation strategies on a consistent basis has been cited in

previous research as being critical to the success of relaxation programs (Ragan & Hiebert,

1987). The benefits of consistently implementing relaxation strategies became evident in

several workers’ conclusions and subsequent intentions to incorporate these techniques into

their daily and yearly program plans, as well as classroom set up. Incorporating relaxation

strategies into overall programs, rather than separate lessons or activities, proved to be more

effective and rewarding for the children.

Three limitations are also identified here. First, three workers were able to only

work with groups of preschool children for short periods of time, ranging from 6 to 10 weeks

that involved only one or two contacts per week. All of these workers reported insufficient

time to adequately develop and implement relaxation strategies that could be integrated into

the groups in a meaningful, routine manner. Ample time to teach and practice the procedures

appears to be an important component of using relaxation techniques with this age group.

42

Although these workers were able to see benefits of the techniques within a short period of

time, they were unable to integrate them on a regular basis.

A second limitation pertains to the homogeneity of the sample. All participants in

this project worked at an early intervention agency with the exception of one worker who

was part of a separate counselling program for children. A more diverse sample of workers

from a variety of agencies may have provided further insight into the use of relaxation

procedures with this age group.

A third limitation is that other factors may have been operating while teaching the

relaxation procedures that had an influence on the results and these potential other factors

were not tracked nor were they mentioned by the workers. This makes it difficult to

determine the relative contribution of relaxation techniques to the overall results versus other

contributing factors such as children’s increased comfort levels with the child care programs

and program staff or other curriculum or therapy interventions. More explicit attention to

other potential variables that may be impacting the results would be warranted in future

research.

Overall, this project was able to examine the experiences of qualified, motivated

workers in their efforts to teach relaxation procedures to preschool children within their

natural work settings. Duration of program intervention, diversity of sample, and possible

confounding variables are all factors for consideration in future research.

Future Research Directions

The findings of this study suggest continued exploration of the use of relaxation

procedures with preschool children would be useful. Further qualitative and quantitative

research in this area would assist in examining the use of relaxation strategies with this age

43

group, as well as the effects on the workers using the procedures. For example, a study with

pre and post measures would assist in quantifying specific behavioural changes. Furthermore,

the use of relaxation procedures with parents and children would be beneficial to address the

growing demands and coping abilities within family systems, and allow for a carry over of

the techniques from early childhood programs to home environments. For instance, a parent

survey could help to identify parent’s interest in this area, as well as potential time

commitments and relaxation strategies that might be conducive to the home environment.

The parent’s interest and request for information in this study underlie the utility of these

needs.

Further research examining worker characteristics and attitudes may be helpful to

identify important factors necessary to successfully implement and maintain relaxation

procedures within early intervention programs. For example, in this study the worker’s

acknowledgement of children’s stress, understanding of child development, and motivation

to take part in the project were evident in their creativity, developmentally appropriate

practices, progression towards preventative approaches, and abilities to adapt the procedures

to become an integral part of the children’s day. Identifying and examining these

characteristics and attitudes through interviews with workers who are actively involved in

implementing relaxation procedures with young children, may help to promote and expand

successful program planning, delivery, and evaluation.

Additional research to explore workers’ training needs and opportunities, as well as

availability and access to resources is warranted. This information could potentially enhance

post secondary and graduate curriculum development, professional development training

opportunities, promotion and expansion of resources, and multidisciplinary work with young

44

children. For instance, surveying post-graduate students and employees in the field of early

intervention would assist in identifying current educational opportunities present in this area,

as well as ascertain specific needs in order to provide focus and direction to educators,

employers, and policy makers.

Finally, future research on relaxation procedures with the preschool population will

help to acknowledge and reinforce the importance of including preschool children within the

realm of relaxation training. To date, preschool children have not always been seen as

experiencing stress and therefore minimal attention has been given to the development of

coping strategies for this age group. Increasing empirical evidence serves to acknowledge the

needs and vulnerabilities of young children and encourages future work and commitment in

this area.

Discussion and Conclusions

Overall, the results of this study support the use of relaxation procedures with

preschool children. The eight early intervention workers who participated in the project were

able to use relaxation techniques with 3, 4, and 5-year old children. Combining knowledge

acquired during the training session on relaxation procedures with previous work experience

allowed the participants to develop, revise, and adapt breathing, progressive muscle

relaxation, and yoga strategies to meet the developmental needs of these children.

The findings suggest appropriate teaching techniques, along with worker

commitment and motivation, can produce positive influences for both the children and the

workers. Simple instructions, repetition, concrete teaching aids, imagery, and calm voice

levels are all factors that contributed to the success of the children learning the relaxation

procedures. The children’s subsequent calm demeanour, focused attention, and quiet nature

45

led to constructive learning environments and cooperative interactions following the

relaxation activities. As a result, the workers themselves were more calm and attentive to the

children and activities, allowing for more positive interactions and teaching opportunities.

The workers’ stories and testimonies of the development and implementation of successful

relaxation procedures were evident in their personal observations, as well as those of parents

and other related professionals. The workers’ abilities to make the activities meaningful and

fun for the children were critical to their accomplishments.

Providing children with skills and competencies to enhance their coping abilities at

a young age promotes life-long practices of independence, wellness, and self-care. For

example, the children’s eagerness to tense their toes like Popsicle sticks and then relax them

like spaghetti is the beginning foundation for preschoolers to acquire relaxation strategies

that will allow them to respond to future stressful experiences in an effective, healthy

manner.

46

REFERENCES

Allen, J., & Klein, R. (1996). Ready…set…R.E.L.A.X.: A research based program of

relaxation, learning, and self-esteem for children. Watertown, WI: Inner Coaching.

Allen, K., & Marotz, L. (2003). Developmental profiles: Pre-birth through twelve (4th ed.).

New York: Delmar Learning.

Altshuler, J., & Ruble, D. (1989). Developmental changes in children’s awareness of

strategies for coping with uncontrollable stress. Child Development, 60, 1373-1391.

Anderson, G. (2001). Fundamentals of educational research. London: Routledge Falmer.

Arnold, L. (1990). Stress in children and adolescents: Introduction and summary. In L.

Arnold (Ed.), Childhood stress (pp. 1-19). New York: John Wiley & Sons.

Atkins, F. (1991). Children’s perspective of stress and coping: An integrative review. Issues

in Mental Health Nursing, 12, 171-178.

Atkins, F. (1993). Stress and coping among Missouri rural and urban children. Journal of

Rural Health, 9, 149-156.

Ayers, T., Sandler, I., & Twohey, J. (1998). Conceptualization and measurement of coping in

children and adolescents. Advances in Clinical Child Psychology, 20, 243-301.

Band, E., & Weisz, J. (1988). How to feel better when it feels bad: Children’s perspectives

on coping with everyday stress. Developmental Psychology, 24, 247-253.

Barten, M., & Zeanah, C. (1990). Stress in the preschool years. In L. Arnold (Ed.),

Childhood stress (pp. 193-221). New York: John Wiley & Sons.

Block, J.H., & Block, J. (1980). The role of ego-control and ego-resiliency in the

organization of behavior. In W. Collins (Ed.), Development of cognition, affect, and

social relations (pp. 39-102). Hillsdale, NJ: Lawrence Erlbaum.

47

Blom, G., Cheney, B., & Snoddy, J. (1986). Stress in childhood: An intervention model for

teachers and other professionals. New York: Teachers College Press.

Brenner, A. (1984). Helping children cope with stress. Lexington, MA: D.C. Heath.

Brigance, A. (1991). Revised Brigance diagnostic inventory of early development. North

Billerica, MA: Curriculum Associates.

Brodzinsky, D., Elias, M., Steiger, C., Simon, J., Gill, M., & Hitt, J. (1992). Coping scale for

children and youth: Scale development and validation. Journal of Applied

Developmental Psychology, 13, 195-214.

Burts, D., Hart, C., Charlesworth, R., Fleege, P., Mosley, J., & Thomasson, R. (1992).

Observed activities and stress behaviors of children in developmentally appropriate

and inappropriate kindergarten classrooms. Early Childhood Research Quarterly, 7,

297-318.

Causey, D., & Dubow, E. (1992). Development of a self-report coping measure for

elementary school children. Journal of Clinical Child Psychology, 21(1), 47-59.

Cautela, J., & Groden, J. (1978). Relaxation: A comprehensive manual for adults, children,

and children with special needs. Champaign, IL: Research Press.

Chang, J., & Hiebert, B. (1989). Relaxation procedures with children: A review. Medical

Psychotherapy, 2, 163-176.

Cherry, C. (1981). Thinking of something quiet: A guide for achieving serenity in early

childhood classrooms. Belmont, CA: Pitman Learning.

Compas, B., Connor-Smith, J., Saltzman, H., Thomsen, A., & Wadsworth, M. (2001).

Coping with stress during childhood and adolescence: Problems, progress, and

potential in theory and research. Psychological Bulletin, 127, 87-127.

48

Cormier, S., & Nurius, P. (2003). Interviewing and change strategies for helpers:

Fundamental skills and cognitive-behavioural interventions (5th ed.). Pacific Grove,

CA: Brooks/Cole.

Cowen, E., Hightower, A., Pedro-Carroll, J., & Work, W. (1990). School-based models for

primary prevention programming with children. In R. Lorin (Ed.), Protecting the

children: Strategies for optimizing emotional and behavioral development (pp. 133-

160). New York: Haworth.

Dacey, J., & Fiore, L. (2000). Your anxious child: How parents and teachers can relieve

anxiety in children. San Francisco: Jossey-Bass.

DeBord, K. (1996). Helping children cope with stress. Raleigh, NC: Cooperative Extension

Service.

Dickey, J., & Henderson, P. (1989). What young children say about stress and coping in

school. Health Education, 20(1), 14-17.

Dise-Lewis, J. (1988). The life events and coping inventory: An assessment of stress in

children. Psychosomatic Medicine, 50, 484-499.

Doherty, G. (1995). Quality matters: Excellence in early childhood programs. Don Mills,

ON: Addison-Wesley.

Dombrowski, M. (1999). Preventing disease with stress management in elementary schools.

Journal of School Health, 69, 126-227.

Dubow, E., Schmidt, D., McBride, J., Edwards, S., & Merk, F. (1993). Teaching children to

cope with stressful experiences: Initial implementation and evaluation of a primary

prevention program. Journal of Clinical Child Psychology, 4, 428-440.

49

Dunn, J., & Kendrick, C. (1980). Studying temperament and parent-child interaction:

Comparison of interview and direct observation. Developmental Medicine and Child

Neurology, 22, 484-496.

Dunn, F., & Howell, R. (1982). Relaxation training and its relationship to hyperactivity in

boys. Journal of Clinical Psychology, 38(1), 92-100.

Elkind, D. (1988). The hurried child (Rev. ed.). Menlo Park, CA: Addison-Wesley.

Fallin, K., Wallinga, C., & Coleman, M. (2001). Helping children cope with stress in the

classroom setting. Childhood Education, 78(1), 17-24.

Fthenakis, W. (1998). Family transitions and quality early childhood education. European

Early Childhood Education Research Journal, 6(1), 5-17.

Gerler, E., & Danielson, H. (1984). The quieting reflex and success imagery. Elementary

School Guidance & Couseling, 19(2), 152-155.

Goelman, H., Doherty, G., Lero, D., LaGrange, A., & Tougas, J. (2000). You bet I care:

Quality in child care across Canada. Guelph, ON: Centre for Families and Well-

Being.

Grey, M. (1993). Stressors and children’s health. Journal of Pediatric Nursing, 8, 85-91.

Gunnar, M., & Barr, R. (1998). Stress, early brain development and behavior. Infants and

Young Children, 11(1), 1-14.

Guralnick, M. (1993). Second generation research on the effectiveness of early intervention.

Early Education and Development, 4, 366-378.

Hart, A. (1992). Stress and your child: Know the signs and prevent the harm. New York:

Word.

50

Henderson, P. (1992). Effects of a stress-control program on children’s locus of control, self-

concept, and coping. School Counselor, 40, 125-131.

Hetherington, E., Cox, M., & Cox, R. (1978). The aftermath of divorce. In J. Stevens & M.

Matthews, (Eds.), Mother/child, father/child relationships. Washington, DC:

NAEYC.

Hiebert, B. (1988). Controlling stress: A conceptual update. Canadian Journal of

Counselling, 22(4), 226-241.

Hiebert, B. (1991). Nature and treatment of stress-related problems in schools. In R. H.

Short, L. Stewin, & S. McCann (Eds.), Educational psychology in Canada (pp. 210-

232). Toronto, ON: MacMillan.

Hiebert, B. (2002). Relaxation in the classroom: A win-win life skill. Guidance &

Counselling, 17, 73-80.

Hiebert, B., Kirby, B., & Jaknavorian, A. (1989). School-based relaxation: Attempting

primary prevention. Canadian Journal of Counselling, 23, 273-287.

Honig, A. (1986a). Stress and coping in children (part 1). Young Children, 41(4), 50-63.

Honig, A. (1986b). Stress and coping in children (part 2): Interpersonal family relationships.

Young Children, 41(5), 47-59.

Humphrey, J. (1984). Creative relaxation: A stress reduction technique for children. In J. H.

Humphrey (Ed.), Stress in childhood, (pp. 301-324). New York: AMS Press.

Humphrey, J. (1988). Teaching children to relax. Springfield, IL: Charles C. Thomas.

Jewett, J. (1997). Childhood stress. Childhood Education, 73, 172-173.

Jewett, J., & Peterson, K. (2002). Stress and young children. Retrieved October 21, 2003

from http://www.ericfacility.net/databases/ERIC_Digests/ed471911.html

51

Kagan, J. (1983). Stress and coping in early development. In N. Garmezy & M. Rutter (Eds.),

Stress, coping, and development in children (pp. 1-41). New York: McGraw-Hill.

Kuczen, B. (1982). Childhood stress: Don’t let your child be a victim. New York: Delacorte

Press.

Landy, S. (2002). Pathways to competence: Encouraging healthy social and emotional

development in young children. Baltimore, MD: Paul Brooks.

Lazarus, R. (1993). Coping theory and research: Past, present and future. Psychosomatic

Medicine, 55, 234-247.

Lazarus, R., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.

Lowenstein, J. (1991). A is for apple, p is for pressure: Preschool stress management.

Journal of Physical Education, Recreation & Dance, 62, 55-58.

Malec, C., Hiebert, B., Young, L., Rose, J., Blackshaw, K., Felesky-Hunt, S., & Lea, S.

(2000). Bridging self-care with health care. Calgary, AB: Lifelong Wellness Research

Institute.

Matthews, D. (1986). Discipline: Can it be improved with relaxation training? Elementary

School Guidance & Counseling, 20(3), 194-200.

Maxwell, J. (1996). Qualitative Research Design: An Integrative Approach. Thousand Oaks,

CA: Sage.

McBrien, R. (1978). Using relaxation methods with first-grade boys. Elementary School

Guidance and Counseling, 12, 146-152.

McLoyd, V. (1998). Socioeconomic disadvantage and child development. American

Psychologist, 53, 185-204.

52

McManus, J. (1984, April). Overview of stress effects on body and stress prevention

techniques. Paper presented at the Annual Convention of the National Association of

School Psychologists, Philadelphia.

Miller, S., & McCormick, J. (1991). Stress: Teaching children to cope. Journal of Physical

Education, Recreation & Dance, 62, 53-54.

Mills, G. (2000). Action research: A guide for the teacher researcher. Upper Saddle River,

NJ: Prentice Hall.

Muir-Ryan, N. (1989). Stress-coping strategies identified from school age children’s

perspective. Research in Nursing and Health, 12, 111-122.

Myers, J., Sweeney, T., & Witmer, J. (2000). The wheel of wellness counseling for wellness:

A holistic model for treatment planning. Journal of Counseling & Development, 78,

251-266.

Oldfield, D., & Petosa, R. (1986). Increasing student ‘on task’ behaviors through relaxation

strategies. Elementary School Guidance & Counseling, 20, 180-186.

Omizo, M., Loffredo, D., & Hammett, V. (1982). Relaxation exercises for the LD and

family. Academic Therapy, 17, 603-608.

Omizo, M., Omizo, S., & D’Andrea, M. (1992). Promoting wellness among elementary

school children. Journal of Counseling & Development, 71, 194-198.

Omizo, M., Omizo, S., & Suzuki, L. (1988). Children and stress: An exploratory study of

stressors and symptoms. The School Counselor, 4, 267-274.

O’Neill, C. (1993). Relax. Toronto, ON: Child’s Play International.

Orlick, T. (1998). Feeling great: Teaching children to excel at living. Carp, ON: Creative

Bound.

53

Piaget, J. (1960). The child’s conception of the world. London: Routledge & Kegan Paul.

Ragan, L., & Hiebert, B. (1987). Kiddie QR (Quieting Reflex): Field testing a relaxation

program for young children. The School Counselor, 34, 273-281.

Richter, N. (1984). The efficacy of relaxation training with children. Journal of Abnormal

Child Psychology, 12, 319-344.

Rickard, J. (1992). Relaxation for children. Melbourne, Aus: The Council for Educational

Research.

Romano, J. (1992). Psychoeducational interventions for stress management and well-being.

Journal of Counselling & Development, 71, 199-202.

Romano, J. (1996). Stress and well-being in the elementary school: A classroom curriculum.

School Counselor, 43, 268-277.

Rubin, H., & Rubin I. (1995). Qualitative interviewing: The art of hearing data. Thousand

Oaks, CA: Sage.

Rutter, M. (1983). Stress, coping, and development: Some issues and some questions. In N.

Garmezy & M. Rutter (Eds.), Stress, coping, and development in children (pp. 1-41).

New York: McGraw-Hill.

Ryan-Wenger, N. (1992). A taxonomy of children’s coping strategies: A step toward theory

development. American Journal of Orthopsychiatry, 62, 256-263.

Sandler, I., Miller, P., Short, J., & Wolchik, S. (1989). Studying children’s social networks

and social supports. In D. Belle (Ed.), Childern’s social networks and social supports,

(pp. 277-307). New York: John Wiley & Sons.

Sang, D. (1994). The worry teacher comes on Thursdays: Clinical consultation in a

kindergarten class. Young Children, 49(2), 24-31.

54

Scherer, M. (1996). Our changing family values: A conversation with David Elkind.

Educational Leadership, 53(7), 4-9.

Seiler, G., & Renshaw, K. (1987). Yoga for kids. Elementary School Guidance and

Counseling, 12, 229-238.

Smith, C., & Carlson, B. (1997). Stress, coping, and resilience in children and youth. Social

Service Review, 71, 231-256.

Sorensen, E. (1993). Children’s stress and coping: A family perspective. New York: The

Guilford Press.

Spivack, G., Platt, J., & Shure, M. (1976). The problem-solving approach to adjustment. San

Francisco: Jossey-Bass.

Stansbury, K., & Harris, M. (2000). Individual differences in stress reactions during a peer

entry episode: Effects of age, temperament, approach behavior, and self-perceived

peer competence. Journal of Experimental Psychology, 76, 50-63.

Strauss, A., & Corbin, J. (1990). Basics of qualitative research; Grounded theory procedures

and techniques. Newbury Park, CA: Sage.

Stroebel, E., Stroebel, C.F., & Holland, M. (1980). Kiddie QR: A choice for children.

Hartford, CT: QR Institute.

Thompson, C., & Rudolph, L. (2000). Counselling children (5th ed.). Belmont, CA:

Brooks/Cole Thomson.

Van Nguyen, T., & Caspi, A. (1985). Linking family hardship to children’s lives. Child

Development, 56, 361-375.

Wolff, S. (1973). Children under stress. Middlesex, ENG: Penguin.

55

Zaichkowsky, L.B., & Zaichkowsky, L.D. (1984). The effects of a school-based relaxation

training program on fourth grade children. Journal of Clinical Child Psychology, 13,

81-85.

Zipkin, D. (1995). Relaxation techniques for handicapped children: A review of literature.

The Journal of Special Education, 19, 283-290.

56

APPENDIX A

Common Symptoms Associated with Childhood Stress(Honig, 1986b)

• Doesn’t respond to friendly adult overtures• Daydreams frequently• Has grave, solemn face; rarely smiles or laughs• Has frequent prolonged temper tantrums• Cries a great deal for months after entry into a child care program (even though

caregivers have been gentle and responsive)• Acts sullen, defiant (says “I don’t care’ frequently when adult explains how

misbehaviour has hurt another)• Punishes self through slapping, head banging, or calling self bad names (e.g., bad

boy)• Is overly sensitive to mild criticism• Flinches if adult approaches with caressing or reassuring gesture of outstretched arm• Reports proudly to adult that he or she has hurt another child• Is overly vigilant about others’ misdeeds, tattles, or jeers• Is highly demanding of adults although usually fairly self-sufficient• Bullies or scapegoats and may get other children to join in• Carries out repetitive, stereotyped play that may have destructive aspects• Clings to, shadows caregiver• Is unable to carry out sustained play with preschool peers• Has constant need to sleep although physically well• Is preoccupied with frightening images of monsters or other threatening figures• Has dull, vacant expressions, as if trying to ward off thinking about stressful event, or

tries to deny stressful feelings• Is hyperactive or restless, wanders around room, touches and disturbs things, cannot

settle into constructive play• Displays disturbed bodily functions, has trouble with feeding, constipation or

dairrhea; soils self frequently, months after toilet training is completed• Has trembling hands or facial twitches although apparently well• Talks compulsively about physical dangers and threats• Grinds teeth• Has rigid facial expressions from taut muscles• Displays loss of perceptual acuity• Displays reduced attention control and capacity• Stimulates self constantly (e.g., thumb sucking, masturbation, rocking, or such

behaviours), which children normally do occasionally for self-comfort• Stutters, uses disfluent speech, or refuses to talk in a group (older preschooler)• Is clumsy on easy manual tasks due to muscular tension• Frequently acts aggressive against others, even adults• Has nightmares

57

APPENDIX B

Recruitment Letter

Date

To the Early Intervention Workers,

Following your participation in the workshop “Relaxation Techniques for Children,” you areinvited to participate in the research project I am conducting as part of the requirements formy enrolment in the Campus Alberta Master’s of Counselling Psychology Program. Theresearch project will examine approaches to relaxation training for preschool children toassist them to learn how to cope with stressful circumstances in a healthy, constructivemanner.

Workers participating in this research project will adapt and incorporate relaxationtechniques into their scheduled work with preschool children. Documentation will berequired, as well as bi-weekly interviews.

Participation is voluntary and all information will be kept confidential. If you are interestedin finding out more information or if you are interested in participating, please contact me at456-8180. My faculty advisor for this project is Dr. Bryan Hiebert and he can be reached at403 220-5651 for any questions about the research.

Sincerely,

Leona CorniereGraduate Student

58

APPENDIX C

Cover Letter and Consent Form

Date

To the Early Intervention Workers,

As part of the requirements for my enrolment in the Campus Alberta Master’s of CounsellingPsychology Program, I am completing a research project on early intervention workers use ofrelaxation training with preschool children. The purpose of this research project is to examinethe ways in which early intervention workers use relaxation training for preschool childrenand the effects associated with that use. The research questions that will be addressedinclude:

• To what extent can early intervention workers learn and use relaxation procedureswith children?

• What are some of the effects of using those procedures with children?• What are the effects on the early intervention workers in using these types of

procedures with the children?

Workers who volunteer to participate in the research project will adapt and incorporateexisting relaxation techniques oriented towards school age children into their regularscheduled work with preschool children. Documentation will be required, as well as bi-weekly interviews. Participation is voluntary and all information will be kept confidential.

The purpose of the attached written consent form is to provide you with adequate informationto enable you to make a rational, informed decision as to whether you wish to participate inthe research study, or not. We will take the time to review the consent form together toensure that all the information, as well as any questions or concerns you may have areaddressed thoroughly.

Sincerely,

Leona CorniereGraduate Student

59

Consent Form

Research Project Title:My Toes Feel like Spaghetti: An Exploration of Relaxation Strategies for Preschool Children

Investigator:Leona C. CorniereGraduate Student, Campus Alberta Master’s in Counselling Psychology Program

This consent form, a copy of which has been given to you, is only part of the process ofinformed consent. It should give you the basic idea of what the research is about and whatyour participation will involve. If you would like more detail about something mentionedhere, or information not included here, you should feel free to ask. Please take the time toread this carefully and to understand any accompanying information.

Preschool children experience stress in their lives that often is not recognized or addressed byparents and caregivers. Stress is associated with children’s quality of health, self-esteem, andwell-being. The purpose of this research project is to examine the ways in which earlyintervention workers use relaxation training for preschool children and the effects associatedwith that use.

The participants of this research project will include workers from the Child DevelopmentCentre in Whitehorse, Yukon who would like to volunteer to be part of this study.

Workers participating in this research project will adapt and incorporate relaxationtechniques into their scheduled work with preschool children at the centre. Documentation ofthe ways the procedures will be used will be required, as well as bi-weekly interviews.

Anonymity of the participants will be maintained. The data will be accessible only to theinvestigator and her supervisor. The data will be kept in a locked filing cabinet inside theinvestigator’s office that is locked during her absence. The data will be retained for 5 yearsand then shredded. The investigator will supply the participants with any new or updatedinformation through a written format during the course of the research project.

Your signature on this form indicates that you have understood to your satisfaction theinformation regarding participation in the research project and agree to participate as asubject. In no way does this waive your legal rights nor release the investigators, sponsors,or involved institutions from their legal and professional responsibilities. You are free towithdraw from the study at any time. Your continued participation should be as informed as

60

your initial consent, so you should feel free to ask for clarification or new informationthroughout your participation. If you have further questions concerning matters related tothis research, please contact:

Leona Corniere, Graduate Student Dr. Bryan Hiebert, Supervisor867 456-8180 403 220-5651

If you have any issues or concerns about this project that are not related to the specifics of theresearch, you may also contact the Research Services Office at 220-3782 and ask for Mrs.Patricia Evans.

Participant’s Signature Date

Investigator’s Signature Date

Witness’ Signature Date

A copy of this consent form has been given to you to keep for your records and reference.

61

APPENDIX D

Participant Pre-Interview

1. What is your target population/setting for implementing relaxation procedures?

2. How many children do you anticipate working with?

3. How frequently do you anticipate using relaxation procedures with the children?

4. What specific relaxation procedures do you plan to use?

5. What other resources do you have to assist you in planning intervention strategies?

6. What evidence (or documentation) will you use to provide a record of how well theprogram is working?

7. Do you have any questions or comments before beginning the interviews?

62

APPENDIX E

Information from Pre-Interviews

Participants Target Population Anticipated Strategies Type of Documentation

1 Integrated preschoolprogram for 3 to 5-year old children

Breathing exercises,progressive musclerelaxation, yoga, imagery

Case notes, anecdotalobservations, record of preand post behaviours,parent feedback

2 Integrated preschoolprogram for 3 to 5-year old children

Breathing exercises,progressive musclerelaxation, yoga, imagery

Case notes, anecdotalobservations, record of preand post behaviours,parent feedback

3 Preschool group for 4to 5-year old children

Breathing exercises,progressive musclerelaxation, yoga

Daily record log, pre andpost behaviourobservations, feedbackfrom parents

4 Work with smallgroup of 4-year oldchildren at a childcare centre

Breathing exercises,progressive musclerelaxation, yoga

Case notes, pre and postbehaviour observations,parent and child careworker feedback

5 Individual work witha 4-year old child

Breathing exercises,progressive musclerelaxation, yoga,

Case notes, pre and postbehaviour observations,feedback from parents andchild care workers

6 Preschool group for 4and 5-year oldchildren

Breathing exercises,progressive musclerelaxation

Case notes, pre and postbehaviour observations,parent feedback

7 Integrated preschoolprogram for 3 to 5-year old children

Breathing exercises,progressive musclerelaxation, sensoryactivities

Case notes, pre and postbehaviour observations

8 Integrated preschoolprogram for 3 to 5-year old children

Breathing exercises,progressive musclerelaxation, sensoryactivities

Case notes, pre and postbehaviour observations

63

APPENDIX F

Number of Participant Interviews

Participant Number of Interviews1 9

2 9

3 3

4 7

5 7

6 3

7 3

8 4