How severe, ongoing stress can affect a child's brain

Research suggests persistent stress in young children can become toxic, causing brain changes that can interfere with learning and lead to disease in adulthood.

It's unknown how many children and adults have been harmed by toxic stress but data show that many live in circumstances that experts say put them at risk.

• Treating poverty works like medicine, doctors say
   
• Caregivers key to countering early poverty stress

Some examples:

• More than 1 in 4 U.S. kids experience a serious traumatic event by the age of 16, including abuse, neglect and household or neighbourhood violence, according to the National Center for Child Traumatic Stress.
• More than 1 in 5 children have experienced at least two of these traumas and are more likely than others to have school difficulties, along with health and behavioural problems, a 2014 study found.
• Nearly half of U.S. children younger than 18 live in families at or near the poverty level, U.S. Census data show.
• The number of U.S. children in foster care climbed steadily after 2011, reaching nearly 430,000 in 2015, the most recent government data show. Neglect was the reason in nearly two-thirds of cases, with most of the rest due to drug abuse, according to a 2016 government report. Authorities believe the opioid epidemic has contributed to the trend.

'Severe as damage from meningitis'

It's no secret that growing up in tough circumstances can be hard on kids and lead to behaviour and learning problems.

But researchers are discovering something different. Many believe that ongoing stress during early childhood — from grinding poverty, neglect, parents' substance abuse and other adversity — can smolder beneath the skin, harming kids' brains and other body systems. And research suggests that can lead to some of the major causes of death and disease in adulthood, including heart attacks and diabetes.
 
 "The damage that happens to kids from the infectious disease of toxic stress is as severe as the damage from meningitis or polio or pertussis," says Dr. Tina Hahn, a pediatrician in rural Caro, Michigan. She says her No. 1 goal as a physician is to prevent toxic stress. Hahn routinely questions families about stresses at home, educates them about the risks and helps them find ways to manage.
 
Mounting research on potential biological dangers of toxic stress is prompting a new public health approach to identifying and treating the effects of poverty, neglect, abuse and other adversity. While some in the medical community dispute that research, pediatricians, mental health specialists, educators and community leaders 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 is to identify affected children and families and provide services to treat or prevent continued stress. This can include parenting classes, addiction treatment for parents, school and police-based programs and psychotherapy.
 
Many preschoolers who mental health specialist Laura Martin works with at the Verner Center have been in and out of foster homes or they live with parents struggling to make ends meet or dealing with drug and alcohol problems, depression or domestic violence.
 
They come to school in "fight or flight" mode, unfocused and withdrawn or aggressive, sometimes kicking and screaming at their classmates. Instead of adding to that stress with aggressive discipline, the goal is to take stress away.                  
 
"We know that if they don't feel safe then they can't learn," Martin said. By creating a safe space, one goal of programs like Verner's is to make kids' bodies more resilient to biological damage from toxic stress, she said.