How to help an ‘orchid child’ blossom

Supportive early environments can have powerful effects on the health of children who are more sensitive to their surroundings. Professor of pediatrics and psychiatry Thomas Boyce explains why some children seem to need more nurturing than others in order to thrive.

Juanita Bawagan: Your 2019 book is called The Orchid and the Dandelion: Why Some Children Struggle and How All Can Thrive. Can you explain the idea of an ‘orchid child’ and a ‘dandelion child’?

Thomas Boyce: I began studying childhood stress and adversity in the 1970s. Back then, the idea that something psychological would influence a child’s physical health was a really radical idea. Over the course of four decades of research, my colleagues and I have now shown some children are highly sensitive to stress — we call them orchid children — and depending on their environment, they either have the best or worst health outcomes.

When nurtured, orchid children have the potential to grow up to be healthier than average. However, if they are neglected and exposed to a lot of hardship, they ‘wither’ and are more likely to get sick. In contrast, so-called dandelion children seem to be able to grow almost anywhere. They are more resilient and respond less to stress in their surroundings.

JB: Do genes also play a role in whether a child might develop into an orchid or a dandelion?

TB: Yes, it’s not just the environment that affects the development of these characteristics. There is no single ‘orchid or dandelion gene’ but rather a network of genes that can predispose a child to develop orchid or dandelion-like characteristics. We think that the interactions between genes and environment control how these genes are expressed.

“Some children are highly sensitive to stress — we call them orchid children — and depending on their environment, they either have the best or worst health outcomes.”

JB: How did you come to understand the differences between children?

TB: One way we researched this was by asking children to carry out a series of mildly stressful tasks, like watching an emotional video or repeating a series of numbers back to an examiner whom they had never met. While they were doing these tasks, we monitored the two principle stress response systems in the brain: the autonomic nervous system, which controls the fight-or-flight response and the adrenocortical system which is responsible for the secretion of cortisol, an anti-inflammatory stress hormone. There was this amazing degree of variation in children’s stress response systems. Some kids were relatively unfazed by the challenging tasks while others had much greater reactions.

To see the bigger picture, we compared lab results with children’s health in the real world. We looked at both mental and physical health, ranging from respiratory illnesses to behavioural issues. When the children who were most responsive to stress experienced a lot of adversity, they had health problems that were off the charts. But when these kids were in very predictable and supportive environments, they were actually healthier than average.

“Orchid children do well in families and classrooms that have lots of rituals and routines.”

JB: What can caregivers do to help these very sensitive children?

TB: During our clinical research, we took note of orchid children who were thriving, and interviewed their parents. From this research we identified six strategies that seemed to be effective, and to help caregivers, I developed a mnemonic to remember them that spells out ORCHID: expressing One’s own true self, Routines, caritas (Latin for ‘steadfast love’), Human differences, Imaginative play, and Danger.

JB: Can you share a couple of examples?

TB: The ‘R’ stands for routines and sameness. We found that orchid children do well in families and classrooms that have lots of rituals and routines – a bedtime story every night, eating dinner together or setting weekly activities. These kinds of routines seem to be reassuring and helpful to very sensitive kids.

The ‘D’ stands for danger and it’s one of the toughest for parents of orchid children. The example I often refer to is that of a child invited to a birthday party with a bunch of kids they don’t know, and so don’t really want to go to. The parent is faced with a dilemma: Do I let them withdraw or do I nudge the child? There is no right or wrong answer but sometimes confronting this ‘danger’ can be important for a child to learn that they can handle themselves in social situations that may at first seem scary.

“In these unprecedented times, creating safe and supportive environments in the midst of all the turbulence is that much more important for all children.”

JB: Why is creating supportive environments for children even more important during the COVID-19 pandemic?

TB: The COVID-19 pandemic is not only a physical threat to the wellbeing of children, but a psychological one. We’ve seen the disparities among children growing up in ‘normal times’ and this period of global adversity could magnify the stresses on children and their families; research is necessary to address and understand these consequences.

The pandemic is unfortunately disrupting the very routines and relationships that should be helping kids cope. In these unprecedented times, creating safe and supportive environments in the midst of all the turbulence is that much more important for all children.