Early Toxic Stress Report Encourages Pediatricians to Link Health Care and Community Services

The American Academy of Pediatrics released a report, The Lifelong Effects of Early Childhood Adversity and Toxic Stress, which not only examines the effects of early childhood toxic stress, but encourages pediatricians to become  leaders in integrating health treatment and community services for children in order to prevent harmful effects later in life.

According to the authors, the report provides a new framework, called EBD (ecobioevelopmental framework) for addressing the problems of today’s children, such as increasingly complex mental health issues; increased TV viewing; new technologies; the obesity epidemic; and, “persistent economic, racial and ethnic disparities in health status.” The authors apply the EBD framework to analyzing the interactive effects of toxic stress, brain architecture and poor physical and mental health.

It is proposed that new advances in science are more clearly making the case that repeated exposure to stress, especially “in the absence of a supportive, adult relationship,” impairs learning and behavior and negatively affects physical and mental health into adulthood.

Child welfare and maternal depression are the two areas designated as being particularly ripe for a “new way of thinking” that includes more targeted early identification and intervention. Use of evidence- based interventions is strongly encouraged:

“The growing availability of evidence-based interventions that have been shown to improve outcomes for children in the child welfare system underscores the compelling need to transform ‘child protection’ from its traditional concern with physical safety to a broader focus on the emotional, social, and cognitive costs of maltreatment.”

The authors note that past barriers have included poor communication and collaboration among pediatricians and community service providers. They also acknowledge a lack of available services, particularly in rural areas.

Despite barriers, the authors seek to galvanize the medical community to recreate the current landscape of pediatric care:

“No other profession brings a comparable level of scientific expertise, professional stature and public trust-and nothing short of transformational thinking beyond hospital and office settings is likely to create the magnitude of breakthroughs in health promotion that are needed to match the dramatic advances that are currently emerging in the treatment of disease.”