Preventing Toxic Stress in Children

Cambridge – What if political leaders around the world could improve school achievement and job readiness, reduce crime, and extend healthy life expectancy – but the results would not be seen until after they left public office? Would they have the political courage to act now in the best long-term interest of their people? Or would they become mired in ineffective, poorly-funded attempts to obtain quick results, and then say it couldn’t be done? Thanks to a remarkable convergence of new scientific knowledge about the developing brain, the human genome, and the effects of early experiences on later learning, behavior, and health, these are not hypothetical questions. We have the knowledge to secure our future by improving the life prospects of all our young children. What is needed now is political vision and leadership. Scientists can now credibly say that the early childhood years – from birth to age 5 – lay the foundation for later economic productivity, responsible citizenship, and a lifetime of sound physical and mental health. Conversely, deep poverty, abuse, neglect, and exposure to violence in early childhood can all lead to toxic stress. In contrast to normal or tolerable stress, which can build resilience and properly calibrate a child’s stress-response system, toxic stress is caused by extreme, prolonged adversity in the absence of a supportive network of adults to help the child adapt. When it occurs, toxic stress can actually damage the architecture of the developing brain, leading to disrupted circuits and a weakened foundation for future learning and health. The lasting, neurobiological effect on young children who experience toxic stress leads to a far greater likelihood of anti-social behavior, lower achievement in school and at work, and poor physical and mental health – all of which society addresses at great cost. Deep poverty is but one risk factor for toxic stress and its long-term consequences. The greatest harm comes from the cumulative burden of multiple risk factors, including neglect, abuse, parental substance abuse or mental illness, and exposure to violence. With each additional risk factor, the odds of long-term damage to brain architecture increase. Neuroscience and the biology of stress help us to begin to understand how poverty and other adversities are literally built into our bodies. Prolonged activation of the body’s stress system during early development can damage the formation of the neural connections that comprise our brain architecture and set our stress-response system at a hair-trigger level. We can thus comprehend why children born into such circumstances have more problems in school, are more likely to commit crimes, and are more prone to heart disease, diabetes, and a host of other physical and mental illnesses later in life. By addressing the circumstances that can produce toxic stress – always asking, “How can we best protect our children?” – local, national, and global leaders would improve not only the life prospects of their youngest citizens, but also outcomes for their societies. A wide range of policies and practices that support positive relationships and quality learning experiences – at home, in early care and education programs, and through targeted interventions – can have a positive impact if based on solid evidence and matched to the specific needs they are expected to address. Beyond their short-term benefits to individuals, extensive economic analysis also has demonstrated significant financial benefits to society for years to come. Science points to three things that we can do to level the playing field: • Make basic medical services and early care and education available to all young children; • Provide greater financial support and rich learning experiences for young children living in poverty; and • Offer specialized services for young children experiencing toxic stress from difficult life circumstances. The scientific principles of early childhood development do not vary by family income, program type, or funding source. In advanced countries, programs that screen for adversity and respond to the specific health and developmental needs of individual children and families can yield benefits that far exceed their costs. In developing countries, shifting the focus of international investments from an exclusive focus on child survival to an integrated approach to early childhood health and development offers greater promise than addressing either domain alone. Children burdened by significant economic insecurity, discrimination, or maltreatment benefit most from effective interventions. Neuroscience, child development, and the economics of human capital formation all point to the same conclusion: creating the right conditions for early childhood development is far more effective than trying to fix problems later. Finally, leadership is about more than smart economic decisions. It is also about moral responsibility, wisdom, judgment and courage – and about leveraging knowledge to promote positive social change. The negative consequences of poverty and other forms of adversity are not inevitable. The gap between what we know and what we do is growing and increasingly unconscionable. The time for leadership on behalf of vulnerable children is now. Jack P. Shonkoff is Professor of Child Health and Development and Director of the Center on the Developing Child at Harvard University. Copyright: Project Syndicate, 2009.www.project-syndicate.org

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Preventing Toxic Stress in Children