“…He wanted to find out what kind of speech and what manner of speech children would have when they grew up if they spoke to no one beforehand. So he bade foster mothers and nurses to suckle the children, to bathe and wash them, but in no way to prattle with them or to speak to them, for he wanted to learn whether they would speak the Hebrew language… or Greek, or Latin, or Arabic, or perhaps the language of their parents, of whom they had been born…. But he labored in vain because the children all died. For they could not live without the petting and joyful faces and loving words of their foster mothers.” — Salimbene di Adam (13th Century Franciscan)
Childhood adversity has lifelong consequences. Significant adversity in childhood is strongly associated with unhealthy lifestyles and poor health decades later (ACE Study).
Toxic stress is long lasting, frequent and of strong intensity.
Salimbene illustrated how insufficient social-emotional interactions can have catastrophic results. Other extreme precipitants of childhood toxic stress include household dysfunction; physical, sexual and emotional abuse; as well as physical and emotional neglect.
Potentially permanent changes and the long-term effects of toxic stress can include how the genetic program is turned on or off (epigenetics); changes to brain development as well as connectivity; and the development of maladaptive or unhealthy coping skills.
Early experiences lead to alterations in brain architecture and functioning.
Therefore, psychosocial stressors and other salient features of the environment/ experience are every bit as biological as nutrition or lead.
There are ways to treat, mitigate and/ or immunize against the effects of toxic stress. Ninety-five percent of the trillions of dollars that we spend on health is on treatment and not prevention. Over 70 percent of early deaths are preventable with the majority due to behavioral patterns that lead to chronic disease.
Perhaps these maladaptive behavioral patterns and unhealthy coping skills are due to toxic stress. It is estimated that by 2030 close to 90 percent of the morbidity in high-income countries will be due to non-communicable diseases (NCDs).
NCDs are related to unhealthy behaviors (overeating/inactivity, smoking, alcohol, and substance abuse).
Do we continue to treat disease, the unhealthy lifestyles that lead to disease, or the toxic stress that leads to the adoption of unhealthy lifestyles?
There needs to be advocacy to minimize childhood adversity (efforts to address food scarcity, abuse/neglect, poverty, domestic violence, parental substance abuse). The rising child poverty rate is an indictment of America. To have 22 percent of children living in poverty is unacceptable.
There needs to be improvement in the caregiver/community capacity to prevent or minimize toxic stress, to promote wellness, and to support families in need. Significant cuts ($8.6 billion over 10 years) in the food stamp program recently occurred. Neglected health care in America is not rare, and if access to health care and health insurance is a basic need in the United States today, 8.7 million (11.7 percent) children experience this form of neglect yearly.
Neglected dental care is widespread. A study of preschoolers found that 49 percent of 4-year-olds had cavities and fewer than 10 percent were treated.
Another study found that 8.6 percent of kindergarteners needed urgent dental care.
“It is easier to build strong children than to repair broken men.” — Frederick Douglass
Pat Bruno, M.D., of Selinsgrove, specializes in recognition of child abuse.