Children's hair cortisol as a biomarker of stress at school entry
Related Experiment Video
Updated: May 10, 2026

Extraction and Analysis of Cortisol from Human and Monkey Hair
Published on: January 24, 2014
Marleen G Groeneveld1, Harriet J Vermeer, Mariëlle Linting
1Centre for Child and Family Studies, Leiden University , Leiden , the Netherlands and.
Insights
Starting elementary school increases stress hormone levels in young children, as measured by hair cortisol concentrations (HCC). Fearful children showed particularly elevated stress markers after school entry.
Area of Science:
- Pediatric endocrinology
- Stress physiology
- Developmental psychology
Background:
- Cortisol in scalp hair offers a method for assessing long-term stress levels.
- Hair cortisol concentration (HCC) is a potential biomarker for chronic stress.
- The transition to elementary school represents a significant life event for young children.
Purpose of the Study:
- To quantify hair cortisol concentrations (HCC) in children at the beginning of elementary school.
- To investigate changes in HCC before and after school entry.
- To explore the influence of fear and prior daycare experience on HCC.
Main Methods:
- Hair samples (≥5 cm) were collected from 42 children (mean age 4.2 years) two months after school entry.
- Two 2-cm segments of hair were analyzed: one near the scalp (first 2 months of school) and one prior.
- Hair cortisol concentrations (HCC) were measured using laboratory analysis.
Main Results:
- Hair cortisol concentrations (HCC) were significantly higher after school entry compared to the period before.
- Elevated HCC post-entry was particularly pronounced in children identified as fearful.
- Prior group daycare experience did not significantly alter the observed changes in HCC.
Conclusions:
- Starting elementary school is associated with increased physiological stress in young children.
- Hair cortisol concentration (HCC) serves as a valid indicator of stress during this transition.
- Fearful children may be more susceptible to the stress associated with school entry.
Abstract:
Quantification of cortisol in scalp hair seems a promising measurement for long-term cortisol levels, and thereby a biomarker for stress. We examined hair cortisol concentrations (HCC) in children when first entering elementary school. Participants were 42 children (45% boys) with a mean age of 4.2 years (SD = 0.42 months). Hair samples (≥5 cm) were collected 2 months after school entry. Hair analysis was conducted using two 2-cm long segments, reflecting the first 2 months of school attendance (the scalp-near segment) and 2 months prior to school entry. HCC were higher after school entry than before, especially for fearful children. Alterations in HCC were not moderated by experience in group daycare before school entry. Thus, HCC suggest that starting elementary school is accompanied by increased stress hormone levels in young (in particular fearful) children.
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