Children and Toxic Stress

November 2, 2016


Our stress response system is set up to protect us from harm when our well-being is threatened. Many of us have been in situations when we felt unsafe, which resulted in a rush of adrenaline. This may have caused our heart rate to increase and our awareness of surroundings to heighten. We were prepared to run or fight in order to ensure our safety.

Children have the same response system that activates when they feel unsafe or anxious. Their bodies go on high alert. When activated frequently, this high alert results in increased chemicals within the body that can become dangerous or “toxic.” This toxicity can lead to potential disruption in how the brain and other organ systems develop. This is of particular concernin utero and in early life when toxic stress can impact children’s physical, cognitive, social and emotional well-being for years to come.

This impact is the focus of research being conducted at Cincinnati Children’s. As more and more of Cincinnati’s young children experience adversity or stress there is greater potential of it becoming toxic.

So what do we mean by adversity? Adverse childhood experiences (ACEs) are incidences where children feel unsafe or that their wellbeing is at risk. Adverse experiences can include loss or incarceration of a parent, exposure to family or neighborhood violence, living in poverty or within a family where there is mental illness or substance abuse, divorce or neglect. In Greater Cincinnati, one out of three children experience at least two of these incidences before the age of five and 60 percent experience at least one of these incidences by the age of 17, which is above the national average of 48 percent.

When do these adverse experiences lead to toxic stress? Responses to stress vary and are often influenced by the children and families internal and external support systems. Children raised in families that are well supported and whose caregivers are resilient are better able to effectively cope with stress or adversity. However, building on the widely used definition of toxic stress from the Harvard Center for the Developing Child, having prolonged exposure to stress and adversity in the family or community can have a cumulative toxic stress effect on children. In other words, the over-activation of the stress response system leaves a lasting impact on the brain and physical development.

Research shows that safe, stable, nurturing relationships and communities can help protect young children from experiencing toxic stress responses when faced with significant adversity. Here are some things each of us as parents, caregivers and community members can do to help prevent and respond to toxic stress:

  • Promote resilience. Children can sense the worry and anxiety in parents or caregivers. Parents who approach adversity with creativity and flexibility tend to remain hopeful and likewise teach their children to be resilient. Some tips for promoting resilience are to consider all possible options, seek or give encouragement and change messages of hopelessness (“Nothing I do makes a difference.”) into positive beliefs (“It will get bette.” or “We’ll figure it out.)
  • Connect to social supports. Isolation during times of stress can intensify the experience. Families who have others they can count on for emotional and physical support tend to better manage worries or anxieties. Children need to know they are not alone. Emotional attachment with consistent caregivers can greatly impact children’s responses to stress. Being soothed, comforted and attended to by consistent caring adults decreases toxic stress.
  • Create positive experiences. Often children’s feelings are overlooked or minimized. Children may not be able to verbally name or express feelings, but those feelings exist and can be as intense as those of adults. It is helpful for caregivers to recognize that changes in behavior (not sleeping well, being clingier or more frustrated) are often expressions of children’s feelings. Listen to what children are saying and showing and provide empathy and reassurance.
  • Provide concrete supports in times of need. Concrete supports for families are connections to community resources that address specific needs. For young children, concrete supports may come in the form of consistency and routines. Reliable routines (the steps that take place each night before bedtime) and expectations (the rules in the home) help children feel safe, especially during times of stress.
  • Reduce potential sources of toxic stress in the lives of families. A key for our community is to address issues like poverty and violence that contribute to the adversity in the lives of families with young children. Getting involved in community initiatives or helping a neighbor in need can truly combat toxic stress. It is important to note that all families are at risk for experiencing adversity and toxic stress—but having access to reliable supports can lessen the impact. Forces for Children is a collaborative of over 30 partner organizations in Greater Cincinnati that have come together under to leadership of the Mayerson Center for Safe and Healthy Children to develop some community responses to this growing need.

This article was written for the November 2016 edition of Parent Source.