Thank goodness, a bunch of rowdy teenagers rush by at just the right moment, knocking him back down from the ledge accidentally.

In real life, there may not be the coincidental saving moment.

In June last year, 10-year-old Lysher Loh died after jumping from a block of flats in Bedok Reservoir Road where she lived.

The top pupil from Bedok West Primary School was disappointed with her mid-year examination grades and had also complained about having too much homework.

Hers is an isolated case, and an extreme example.

But as extreme as both reel and real examples are, they highlight how childhood emotional distress - or what doctors term 'bad' stress - can take tragic turns.

Is your child under stress?

SIGNS Under the Singapore Children Emotional Distress Scale, your child may be cracking under stress if he has displayed some of these symptoms in the past week. Appears worried about many things Appears miserable, unhappy, tearful or depressed Shows little enjoyment in things Sheds tears over doing some things Has been irritable and quarrelsome Has been complaining of aches and pains Has been withdrawn and quiet Appears forgetful and shows poor concentration WHAT TO DO Consultant psychiatrist Daniel Fung of the Institute of Mental Health offers some tips to parents on dealing with stress in their child. Recognise the symptoms Children find it more difficult than adults to express their feelings of being stressed out, so it is up to you to look for the symptoms. Modify the child's environment Take a hard look at his life. Does he have too much homework, too many tuition or extra-curricular classes? If he cannot cope, help lessen the burden. Help him develop coping skills Teach him how to organise his time. Make sure he has time for play, rest and nourishment too. Help him lead an all-rounded lifestyle. If your child's symptoms persist despite your intervention or interfere with his ability to function day to day, you might want to speak to a doctor, teacher, counsellor or a psychiatrist.

This is especially since the symptoms of emotional distress can be elusive, ignored or misunderstood, psychiatrists say.

A stressed-out child may manifest his distress in a variety of ways, says Dr Daniel Fung, 35, a consultant psychiatrist with the department of child and adolescent psychology in the Institute of Mental Health.

A quiet child may be seen as 'good', a quarrelsome one as 'naughty' and one who cannot concentrate as 'stupid'.

Yet, all three could be showing symptoms of childhood distress, he says.

The good news is that a new screening tool might help parents identify kids in need of help.

The Singapore Children Emotional Distress Scale is a simplified version of other internationally-used scales that detect childhood stress, such as the Achenbach Child Behaviour Checklist.

That checklist, which is used to identify children with behaviour problems that warrant clinical intervention, was developed in 1981 by Dr T. Achenbach of the University of Vermont.

But unlike the formidable 118 questions in the Achenbach checklist, parents answer just eight questions in the Singapore scale.

These include whether a child has appeared worried, quiet, unhappy and tearful of late and whether he complains of aches and pains.

'It gives you a broad idea of whether a child may be under emotional distress, and if he might need help,' says Dr Fung.

The scale was devised by Dr Cai Yiming, the chief of the department of child and adolescent psychology of the Institute of Mental Health.

It was created for another study on examination stress in Singapore and then further developed to be used on its own.

Tests were done in 1999 and 2000 on nearly 2,000 Primary 5 and 6 students here and the scale was published in the internationally-recognised Journal of Child Psychology and Psychiatry and Allied Disciplines last year.

The scale is now issued to parents who take their children to the department's Child Guidance Clinic, and is being fine-tuned.

Dr Fung says a final product is expected at the end of the year.

GOOD AND BAD STRESS

There is no such thing as a stress-free life and doctors say some stress is actually useful and positive, whether in children or in adults.

According to the Yerkes-Dodson law about stress, which dates back to 1908 and was developed by Doctors R. M. Yerkes and J. D. Dodson in the United States, an optimal level of stress is needed to improve performance in whatever task one does.

Increasing stress up to that level can prompt a person to perform better. But beyond that optimal level, raising stress levels further could cause performance to deteriorate. The person may even have a breakdown.

That is when what is termed 'eustress', or good stress, becomes distress. Everyone has a different breaking point.

'Imagine the strings of a violin or guitar. If they are too loose, you can't play. You have to tighten it to make music.

'But if you tighten it too much, the strings will snap. That is how everyone responds to stress,' Dr Fung explains.

'Most children are quite resilient, but some are more prone to emotional distress. They need to be identified and given some leeway to develop at their own pace,' he adds.

The issue of stress among Singapore children has become a talking point since I Not Stupid.

As of Monday, the movie, which was released in February, has grossed $3.68 million.

The story about three friends from a 'slower' academic stream, EM3, and the pressures they face from their peers, teachers and families has struck a chord in a society that places an inordinately high premium on straight As.

Mr Norman Mohd Yusof, 38, a form teacher of an EM3 class in a school in the north, took his entire class of students to watch the movie. Some cried.

'This is their reality,' he says. 'They could relate to it. I could relate to it. Some of their parents expect so much, but they don't realise their children can't cope.'

Furniture importer Michael Teo, 52, who watched the movie on Sunday with his wife and two sons, Nicholas, 13, and Benjamin, 15, says: 'I kept looking at my wife during the movie because there were so many phrases in there that we used to say to our own children.'

His children were both in EM2. Both are now in the Express stream in Maris Stella High School.

The issue of stress in school cuts across all streams, says Dr Brian Yeo, 41, a child psychiatrist in private practice.

'Stress in all children here always seems to relate to academic workload and expectations. Take that away and a huge stress load falls off,' he says (See other story.)

SILENT KILLER

But that stress seems to be here to stay.

Parent and child psychiatrists agree that Singapore's education system works well to pick out the cream of the crop.

The rest are forced to accept stress as part of life and they try to keep up with the Tans with the help of private tuition, assessment books and dollops of pressure.

An under-performing student wanting to end his life in I Not Stupid (above) may be an isolated and extreme example, but in real life, it highlights how childhood emotional distress can turn tragic.

Even the brightest may find themselves having to cope with enrichment courses and activities like ballet and swimming, in which they are also expected to excel.

Parents sometimes make things worse.

One voluntary child counsellor, who declines to give her name, says: 'Parents also sometimes put their kids on a guilt trip about how their lack of performance shames the family and about how the child doesn't seem to be performing despite the love he gets.'

Some kids may buckle under and be forced to seek help, others may have attentive parents or teachers who pick up on the signs.

But they are probably only the 'tip of the stress iceberg', says Dr Fung.

Last year, about 14,000 children were seen by psychiatrists at the Institute of Mental Health, of which about 2,233 were new cases and the rest follow-ups.

These figures have stayed relatively consistent over the last five years.

But studies have shown that 5 per cent to 25 per cent of children have some mental health issues.

The rate of incidence goes up in developed cities like Singapore and Japan.

'Even if you take an average of, say, 10 per cent, that works out to about 90,000 children that have problems here, which means only a small percentage seek help,' he says.

BE A FRIEND

Parents should look out for a child's 'distress signals', says Dr Fung.

For example, a child who might be fine on weekends but who develops stomach aches, headaches and other ailments on Monday mornings might be afraid about going to school.

He may also have trouble sleeping or eating or even start wetting his bed.

Older children may react with anger, frustration or defiance.

Sometimes, attentive teachers and parents do pick up on the symptoms.

Mr Norman often finds himself playing teacher, pastoral care adviser and psychologist to his EM3 students.

'You have to look out for signs, like if they are very quiet and down, or staying away from their friends, throwing tantrums or causing fights,' the father of three says.

'And sometimes, you have to be a friend. If all you do is demand homework and push too hard, they might just give up.

'And when that happens, it's hard to get them back.'

It takes a lot of 'patience', he adds.

His 13-year-old daughter, who is from the Express stream, was from EM1. His youngest daughter, 10, and son, 11, are both in EM2.

Parents should tap into teachers, their child's 'surrogate parents' during most of the day, for feedback.

Dr Fung says: 'Even if you don't want to see a psychiatrist, you should go to your family doctor, a counsellor at a family service centre or teacher if your child is very distressed.'

Only when you recognise and admit that your child may have a problem will you be able to solve it.

This involves finding out what level of stress he can handle and dealing with situations that are placing too much of a burden.

But it does not mean letting up on your child entirely.

'Part of living in Singapore involves stress,' says Dr Fung. 'You have to help your child become more resilient so he can cope with it better.'