When a child suffers trauma or has negative experiences it does not dictate their future. Children can survive and even thrive despite trauma in their lives.
The Adverse Childhood Experiences (ACE) study showed an association between adverse childhood experiences and diseases and conditions affecting adult health. Adverse childhood experiences in categories of abuse, household challenges and neglect are not only associated with worse mental health outcomes, but also with chronic health conditions such as diabetes, heart disease, chronic obstructive pulmonary disease, liver disease, and cancer (among many other adult health conditions).
However, there are children with high ACE scores who do remarkably well. For these children, adverse experiences are counterbalanced with protective factors. Adverse events and protective factors experienced together have the potential to foster resilience. Resiliency is the ability to overcome hardship.
Resiliency can be defined as being resourceful in moments of stress and crisis. Resilience builds throughout life and close relationships are an important factor. Having a grandparent who loves you, a teacher who spends extra time with you, a neighbor or coach who understands and believes in you or a trusted friend you can confide in may off-set the long-term effects of early trauma. Increased social support is associated with higher positive emotions, a sense of personal control and predictability, self-esteem and motivation. Building a child’s connection with people who care will help strengthen them. A simple affirmative phrase of “I told Grandpa how brave you were. He’s so proud of you.” can go a long way. It can also be beneficial for families to cultivate a sense of faith, hope and family and/or cultural traditions.
It’s important for parents and caregivers to know that resilience is made of ordinary rather than extraordinary occurrences. One of the most important ways a parent or caregiver can help build resiliency is by building routines with their child. Examples of healthy routines include reading together for 20 minutes every day, walking the child to and from the bus stop, asking the child about their day at the dinner table or playing a board game together. Other helpful ways to build resiliency include giving them opportunities to think and act independently, which can be as simple as letting a child choose which book to checkout at the library.
Why is important for my child’s doctor to know about toxic stress?
Pediatric knowledge becomes more robust every year and today’s pediatrician must be more dynamic when caring for children. As trusted authorities in child health and development, pediatricians should support the early identification of developmental concerns with a focus on interventions and community that reduce threats to healthy brain growth and development. Addressing toxic stress may actually be the most effective way to positively affect health care outcomes.
The main role for practitioners is awareness of toxic stress, identifying it and fostering resilience whenever possible. An easy way for practitioners to screen for toxic stress in clinic is to ask: “Since I last saw you, have you, your family or child experienced something upsetting, scary or worrisome?” Asking that question and listening closely to the response can lead to better care and a chance to make sure patients are connected with resources to help build resiliency. Primary care providers and specialists can help to make a pediatric visit a chance to build resiliency.
For more information on toxic stress and its adverse effects, click here.