Recently I wrote about the effects of toxic stress in children focusing on the experience of immigrant children. I reviewed some of the effects of such stress. The scientific consensus is that ongoing stress during early childhood can harm childrens' brains and other body systems. Such stressors can include severe poverty, neglect, sudden traumatic separation from parents, parents' substance abuse and/or mental illness, and familial dysfunction. Scientific findings have shown that the brain and disease-fighting immune system are not fully formed at birth and can be damaged by childhood adversity. The first three years are thought to be the most critical, and children lacking nurturing parents or other close relatives to help them cope with adversity are most at risk.. As we know, high levels of stress can trigger hormones that can have lasting negative effects on development and the immune system. There also are research findings consistent with the conclusion that chronic and severe stress in childhood can lead to some of the major causes of death and disease in adulthood, including stroke, heart attacks, cancer, diabetes, Alzheimer’s disease, and drug use.
In a recent article in the Los Angeles Times on March 17, 2019, titled “Toxic stress in children is a top issue, state official says”, author Melody Gutierrez highlighted the efforts of California’s first surgeon general, Dr. Nadine Burke Harris. Dr. Burke Harris seeks to expand screenings for abuse and extreme stress in children as part of regular physical screenings. As noted in the article, too often mental trauma is considered unrelated to medical care. Dr. Burke Harris, a pediatrician by training, seeks to change that priority. California is in the forefront of development of screening tools. With the new tools, screening for toxic stress in children asks a parent to count how many of the following ten issues a child has encountered: physical, sexual or emotional abuse, physical or emotional neglect, a parent’s mental illness, substance dependence, a parent’s incarceration, parental separation or divorce, and domestic violence. Of course, sensitivity and skill will be needed to validly access such information. Each affirmative answer adds a point, which physicians use to obtain a score and assess risk.
Many providers are increasingly adopting what is called "trauma-informed" care. The approach starts with the premise that extreme stress or trauma can cause brain changes that may interfere with learning, explain troubling behavior, and endanger health. The goal, such as in the efforts noted above in California, is to identify affected children and families and provide services to treat or prevent continued stress. These services can include stress reduction for children such as breathing exercises, parenting classes, addiction treatment for parents, school and police-based programs, and psychotherapy.
It is important to keep in mind that we are discussing toxic levels of stress during childhood. Under normal stress situations (for a young child that could be getting a shot or hearing a loud thunderstorm), the stress response is initiated resulting in brief rises in heart rate and elevated cortisol levels and other stress hormones. When the stress subsides or stops, the child's heart rate and cortisol levels return to a more normal level. However, when stress is severe and chronic, those levels may remain elevated, putting children in a persistent "fight or flight" mode.
As is true for much of science, there is some disagreement among scientists about whether this phenomenon really exists for children given the state of research. However, given that such findings occur for adults as well, it is reasonable to conclude that exposure to chronic/severe stress during childhood might have such negative health consequences.Much of the recent interest stems from landmark U.S. government-led research published in 1998 called the Adverse Childhood Experiences study. It found that adults exposed to neglect, poverty, violence, substance abuse, parents' mental illness and other domestic dysfunction were more likely than others to have heart problems, diabetes, depression and asthma. In other words, they had experienced more stress. In fact, the American Academy of Pediatrics supports the theory and in 2012 issued recommendations urging pediatricians to educate parents and the public about the long-term consequences of toxic stress and to push for new policies and treatments to prevent it or reduce its effects. It is good to see that California is taking a lead and I support Dr. Burke Harris’ efforts to expand such screenings.
It is long overdue to focus on screening and intervention in children at risk for the negative consequences of toxic stress. If you want more information on stress and its effects on your life and that of your family, you can acquire our book on this topic (I Can't Take it Anymore: How to Manage Stress so It Doesn't Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., P.H.N.), available through Amazon at https://www.amazon.com/dp/1542458056. If you want more information about the authors and the book, please see our website at www.manageyourhealthandstress.com.
Best wishes on your journey.
Dr. Paul Longobardi
For information on these and related topics, please see my website at www.successandmindset.com.