“I’m so stressed out,” is, perhaps, the top complaint for many Americans these days. But it turns out many people are feeling stressed even before they’re old enough to complain about it. The American Academy of Pediatrics is now recommending that pediatricians screen toddlers for signs of “toxic stress,” as part of routine examinations. But what does that mean, exactly, for parents for kids, and for doctors?
I’d never heard that term before, but on the website for Harvard’s Center on the Developing Child, it’s defined as “prolonged activation of stress response systems in the absence of protective relationships.” The site continues:
When we are threatened, our bodies prepare us to respond by increasing our heart rate, blood pressure, and stress hormones, such as cortisol. When a young child’s stress response systems are activated within an environment of supportive relationships with adults, these physiological effects are buffered and brought back down to baseline. The result is the development of healthy stress response systems. However, if the stress response is extreme and long-lasting, and buffering relationships are unavailable to the child, the result can be damaged, weakened systems and brain architecture, with lifelong repercussions.
Situations when toxic stress can form include when a child is exposed to abuse, violence, or neglect or lack of access to food. According to a Southern California Public Radio report, continued stress can cause the baby’s “brain architecture” to form in an unhealthy way, where stress systems are always set on high alert.
But how can doctors look for signs of toxic stress in babies? And what can parents do about it? SCPR continues:
The recommendations will include simple strategies for pediatricians to talk to parents about ensuring healthy brain development in infants. [Pat] Levitt [a neurologist with the University of Southern California] calls it “attuned parenting” and uses a tennis metaphor to illustrate how simple it is to ensure “health brain architecture.”
“Children grow up in an environment of relationships,” said Levitt. An infant will do something and will have an “expectation of getting a response from whoever is in their environment. And that’s ‘serve and return’.”
Levitt adds there is no set of exercises parents should do to help an infant regulate stress. Attuned parenting, he said, comes naturally to most parents and simply involves “being close and warm and nurturing and looking directly into your child’s eyes.” Responding to a baby’s vocalizations or facial gestures is “fantastic for the developing brain,” said Levitt.
Doing the basics of what we think of as “good parenting,” it seems, will help prevent a toxic stress response from happening. And on the flip side of that coin, things that we think of as traumatic childhood experiences, like moving from one foster home to the next or enduring a natural disaster, can cause a toxic stress response when there’s no caregiver providing comfort and support.
It sounds like a complicated issue. How do you ask pediatricians to determine whether or not parents are doing a good enough job comforting their kids based on an office visit? And aren’t many of the situations more related to economics (or even weather problems) than any decision people make about parenting style? Sadly it seems that the parents who most need help making sure their kids are not experiencing toxic stress are the ones who probably are dealing with the most stress personally: over bills, over their own health issues, over their personal lives.