Dr Stuart Slavin, a paediatrician and professor at the St Louis University School of Medicine, knows something about the impact of stress. After uncovering alarming rates of anxiety and depression among his medical students, Dr Slavin and his colleagues remade the programme: implementing pass or fail grading in introductory classes, instituting a half-day off every other week, and creating small learning groups to strengthen connections among students. Over the course of six years, the students' rates of depression and anxiety dropped considerably.
But even Dr Slavin seemed unprepared for the results of tests he did in cooperation with Irvington High School in Fremont, California, a once-working-class city that is increasingly in Silicon Valley's orbit. He had anonymously surveyed two-thirds of Irvington's 2,100 students last spring; using two standard measures, the Centre for Epidemiologic Studies Depression Scale and the State-Trait Anxiety Inventory. The results were stunning: 54 per cent of students showed moderate to severe symptoms of depression. More alarming, 80 per cent suffered moderate to severe symptoms of anxiety.
"This is so far beyond what you would typically see in an adolescent population," he told the school's faculty at a meeting just before the autumn semester began. "It's unprecedented." Worse, those alarming figures were probably an underestimation; some students had missed the survey while taking Advanced Placement exams.
What Dr Slavin saw at Irvington is a microcosm of a nationwide epidemic of school-related stress. We think of this as a problem only of the urban and suburban elite, but in travelling the country to report on this issue, this writer has seen that this stress has a powerful effect on children across the socioeconomic spectrum.
Expectations surrounding education have spun out of control.
On top of a seven-hour school day, our kids march through hours of nightly homework, daily sports practices, band rehearsals and weekend-consuming assignments and tournaments. Each activity is seen as a step on the ladder to a top college, an enviable job and a successful life.
Children living in poverty who aspire to college face the same daunting college admission arms race, as well as the burden of competing for scholarships, with less support than their privileged peers. Even those not bound for college are ground down by the constant measurement in schools and are under pressure to push through mountains of rote as early as pre-school. Yet instead of empowering them to thrive, this drive for success is eroding children's health and undermining their potential. Modern education is actually making them sick.
Nearly one in three teenagers told the American Psychological Association that stress drove them to sadness or depression - and their single biggest source of stress was school. According to the Centres for Disease Control and Prevention (CDC), a vast majority of American teenagers get at least two hours less sleep each night than recommended - and research shows the more homework they do, the fewer hours they sleep.
Working together, parents, educators and students can make small but important changes: instituting everyday homework limits and weekend and holiday homework bans, adding advisory periods for student support and providing students opportunities to show their growth in creative ways beyond conventional tests.
At the university level, 94 per cent of college counselling directors in a survey from last year said they were seeing rising numbers of students with severe psychological problems.
At the other end of the age spectrum, doctors increasingly see children in early elementary school suffering from migraine headaches and ulcers. Many physicians see a clear connection to performance pressure. "I'm talking about five-, six-, seven-year-olds who are coming in with these conditions. We never used to see that," said Dr Lawrence Rosen, a New Jersey paediatrician who works with paediatric associations nationally. "I'm hearing this from my colleagues everywhere."
What sets Irvington apart in a nation of unhealthy schools is that educators, parents and students there have chosen to start making a change. Teachers are re-examining their homework demands, in some cases reviving the school district's forgotten homework guideline - no more than 20 minutes per class per night, and none on weekends.
In fact, research supports limits on homework. Students have started a task force to promote healthy habits and balanced schedules. And for the past two years, school counsellors have met one on one with every student at registration time to guide them towards a manageable course load.
"We are sitting on a ticking time bomb," said one Irvington teacher, who has seen the problem worsen over her 16 years on the job.
A growing body of medical evidence suggests that long-term childhood stress is linked not only with a higher risk of adult depression and anxiety, but with poor physical health outcomes, as well. The ACE (Adverse Childhood Experiences) Study, a continuing project of the CDC and Kaiser Permanente, an insurance firm, shows that children who experience multiple traumas - including violence, abuse or a parent's struggle with mental illness - are more likely than others to suffer heart disease, lung disease, cancer and shortened life spans as adults. Those are extreme hardships, but a survey of the existing science in the 2013 Annual Review Of Public Health suggested that the persistence of less severe stressors could similarly act as a prescription for sickness.
"Many of the health effects are apparent now, but many more will echo through the lives of our children," said Mr Richard Scheffler, a health economist at the University of California, Berkeley. "We will all pay the cost of treating them and suffer the loss of their productive contributions."
Paradoxically, the pressure cooker is hurting, not helping, our kids' prospects for success.
Many college students struggle with critical thinking, a fact that has not escaped their professors, only 14 per cent of whom believe that their students are prepared for college work, according to a 2015 report. Just 29 per cent of employers in the same study reported that graduates were equipped to succeed in today's workplace. Both of those numbers have plummeted since 2004.
Contrary to a commonly voiced fear that easing pressure will lead to poorer performance, St Louis medical school students' scores on the medical boards' exams have actually gone up since the stress-reduction strategy was put in place.
At Irvington, it is too early to gauge the impact of new reforms, but educators see promising signs. Calls to school counsellors to help students having emotional episodes in class have dropped from routine to nearly non-existent. The Advanced Placement class failure rate has dropped by half and Irvington students continue to be accepted at respected colleges.
There are lessons to be learnt from Irvington's lead. Working together, parents, educators and students can make small but important changes: instituting everyday homework limits and weekend and holiday homework bans, adding advisory periods for student support and providing students opportunities to show their growth in creative ways beyond conventional tests.
Communities across the country - such as Gaithersburg, Maryland, Cadiz, Kentucky, and New York City - are taking some of these steps. In place of the race for credentials, local teams are working to cultivate deep learning, integrity, purpose and personal connection. In place of high-stakes childhoods, they are choosing health.
NEW YORK TIMES
- The writer is the author of Beyond Measure: Rescuing An Overscheduled, Overtested, Underestimated Generation and director and producer of the documentaries Race To Nowhere and Beyond Measure.