AAP addresses adverse effects of toxic stress on kids’ health

Leaders in pediatrics and others called for deepened emphasis on preventing toxic stress in children at an American Academy of Pediatrics (AAP) June symposium in Washington, DC, saying biological sciences are now confirming the heavy toll that early adverse experiences take on physical and mental health.

“We know so much about the fact that the antecedents of adult chronic disease really begin in many ways in childhood," said AAP president James M. Perrin, MD, FAAP, adding that toxic stress plays a substantial role in that process.

Emphasizing that healthcare alone cannot ameliorate the problem, Perrin said government, educators, medical professionals, not-for-profits, and industry all need to “come together to create better environments for our children.”

Robert W. Block, MD, FAAP, immediate past president of the AAP, indicated the symposium was held for AAP leaders to listen and learn in advance of the opening of the organization’s new Center on Healthy, Resilient Children. The center, he indicated, will incorporate the science of toxic stress and adversities, providing information about epigenetics and advising how to apply the information to healthcare. The focus will be on early childhood but will continue with older children, he noted.

He said pediatricians have an opportunity to expand their role from more traditional things into working with families to find support from community agencies.

Toxic stress affects children's brains

In an interview, Block said that biological sciences are showing that exposure to toxic stress can change the brain’s structure and functions, and it can change the functions of an individual’s genetic code, creating an inability to cope that can carry over to future generations.

Block pointed out that the Adverse Childhood Experiences (ACE) study, begun in the 1990s, is getting new attention as biological sciences confirm what it had suggested. The study had looked at 17,000 Kaiser Permanente patients and found connections between childhood adverse experiences and health problems in adulthood. The ACE study, Block indicated, made a finding but did not know the cause. Now science is beginning to understand the cause.

Jack P. Shonkoff, MD, FAAP, director of the Harvard University Center on the Developing Child, Cambridge, Massachusetts, said of the current revolution in biology, “Pretty much everything that we have known is being superseded by an unbelievable level of insight into health and illness,” and genetically customized treatment is not far off.

That knowledge base is waiting to be used to address problems such as toxic stress across a wide area of policy, he asserted.

Shonkoff urged that one key element to help children in adversity is adding a component to early childhood education for active coaching and modeling with parents to help them with the children’s development, rather than just providing parenting education. Research shows, he said, that an active component can double the impact on reading and math scores and significantly increase cognitive skills.

Block said the new center will have staff at AAP headquarters and in Washington, DC, with a presence on the AAP website in coming months. The initiative is an attempt to bring to light the fact that toxic stress is a health issue for both the brain and other organ systems, he said.

The symposium’s presentations and webcast are available at http://ow.ly/yhaaN.

Ms Foxhall is a freelance writer in the Washington, DC, area. She has nothing to disclose in regard to affiliations with or financial interests in any organizations that might have an interest in any part of this article.