Alisa is 4 1/2, and has mild salt losing CAH. I have never increased her dose for emotional physical stress, however, I will from now on, I was not sure wether it was necessary, however when Alisa started a new play group Last November and then a new school just after Christmas, she ended up in hospital with adrenal crisis both times, the first time, I did not make the connection, the second time I realised what it was, I spoke to the endocrinology nurse who thinks I should stress dose her as she is obviously affected by emotional stress, so exams, new school, accisents even if not injured badly would require stress dosing, but I agree all children are different and some would need stress dosing and others would not.