As a society, we often focus on ways to reduce stress—whether it’s through mindfulness, exercise or creating work-life balance. However, the reality is, not all stress can be eliminated. Sometimes, it’s about learning how to navigate and mitigate its effects. This becomes even more crucial when it comes to children, who are particularly vulnerable to the impacts of prolonged and intense stress.
In our last Curious Neuron article, we discussed 3 different types of stress responses
- Positive stress response
- Tolerable stress response
- Toxic stress response
In this article, we are going to focus on the toxic stress response in children, its effects and how to prevent negative outcomes.
What kind of situations elicit the toxic stress response?
Toxic stress is a term coined by researchers that encompasses
- Abuse (physical, sexual or emotional)
- Neglect (physical and emotional)
- Household dysfunction (parental mental illness, domestic violence, drug abuse and parental incarceration)
When a child’s toxic stress response is triggered by multiple adverse events or it is continuously activated, it can have cumulative long-lasting effects on physical and emotional health. This means, the more adverse childhood experiences (ACEs), the more damage caused and the more negative outcomes. In fact, the reason these stressors are called toxic is because the stress children experience triggers the release of cortisol. In small doses, this is fine, but when exposed to abuse, neglect, and household dysfunction, too much cortisol is produced over too long a period of time. In these large doses, cortisol has been demonstrated to be neurotoxic, that is it undermines neural connectivity and function in the brain and can also affect key body organs in the cardiovascular and immune system.
What are some negative consequences of toxic stress?
Toxic stress can increase health risks including heart disease, mental illnesses such as depression and anxiety disorders, substance misuse, and has long-lasting negative consequences for cognitive functioning, behavioral health, immune functioning, and physical health. Moreover, in most situations, the parents are also affected by toxic stress, leaving them with less ability to respond adequately to their child’s needs. This can lead to insecure attachment between parents and their child. This is too bad, because supportive, nurturant parent-child relationships can buffer the negative impacts of toxic stress.
Insecurely-attached children tend to respond to stress with more anxiety and exaggerated emotional responses; or with avoidant characteristics like suppressing negative feelings and not accepting help.
Are there ways to mediate the effects of toxic stress?
As you probably know there are many parenting programs that exist to help intervene with the hopes of bettering outcomes for families that struggle with toxic stress. However, most programs usually only help with one type of problem i.e. just parental depression or just parental drug addiction. However, these problems are rarely experienced one at a time. Usually, when families experience toxic stress, there are multiple negative experiences occurring simultaneously, creating a complex situation.
Unfortunately, removing the sources of toxic stress entirely is generally not possible, this would likely need an entire overhaul of our societal norms including but not limited to improved social support and universal basic income. However, building on the repeated evidence that supportive relationships can reduce the negative impacts of toxic stress on children’s health and development, here are some science-based ways to help buffer the effects of toxic stress:
- Ensure a child has at least one stable and committed relationship with a supportive parent, caregiver or other adult. This relationship helps build resilience in the child
- The Attachment and Child Health (ATTACH™) program is a 10-12-week program made for parents and co-parents (i.e. father, mother, relatives, friends, or other support person) of preschoolers experiencing various sources of toxic stress.
Take a moment to reflect on what you just read, by listening to this audio:
Q&A with expert Dr. Nicole Letourneau, PhD
How does ATTACH™ work?
Much like the work you do at Curious Neuron, the ATTACH™ program helps parents learn to reflect on their own and their child’s emotions. Over the 10 ATTACH™ sessions parents are given many opportunities to think about their own, their child’s, and other people’s feelings, but also thoughts, intentions, desires, and mental states. There are three components to the program that involve weekly, 1-hour discussions with parents of:
- Videos of the parent playing with their child,
- Real-life mildly stressful situations, and
- Hypothetical mildly stressful situations.
The program can be delivered in person, or online. This offers maximum flexibility and makes it easiest for parents to take part.
Does it only have benefits for biological family members?
The ATTACH™ program is designed for any primary caregiver of a child under 6 years of age and their co-parenting support person. It has been successfully tested and found to work for mothers, fathers, grandmothers, and step-parents. Many mothers have taken part in the program, and they are asked to bring in their co-parenting support person for 2 sessions. This is usually the child’s father and mother’s husband or partner, but they can also be a friend, boyfriend, sister, brother, etc..
What are the benefits of the program for the child, and what about for the parent?
The ATTACH™ program helps parents to become more responsive to their child’s needs, even though experiencing toxic stress. For parents, the program has been shown to:
- Increase parental reflective function so parents have more insight into their child’s thoughts, feelings, and mental states,
- Improve parental sensitivity and responsiveness so they are more able to accurately meets children’s needs,
- Improve parents’ perceptions of social support,
- Improve parents’ executive function, so they can plan and think through ideas before acting,
- Decrease parents’ depression so they can overcome toxic stress themselves, and
- Improve parents’ gene expression linked to downregulation of inflammation and upregulation of anti-viral function.
For children, the ATTACH™ program helps
- Improve attachment, so children are able to explore and learn from their world because they can rely on their parent for comfort and safety,
- Improve children’s development in communication, problem-solving, social, and fine motor skills,
- Improve children’s behaviour by reducing anxiety, aggression, and increasing attention,
- Improve children’s sleep so they can engage optimally with the world, and
- Improve children’s gene expression linked to downregulation of inflammation and upregulation of anti-viral function
How can families access the ATTACH™ program?
Currently, parents can access the program by finding an ATTACH™ certified Facilitator who works in an ATTACH™ program partner agency. Many Facilitators are available in Alberta, Saskatchewan, and Manitoba. But ATTACH™ has been so successful that efforts are underway to deliver the program online soon with a fee-for-service model. If interested, please reach out to Dr. Nicole Letourneau (nicole.letourneau@ucalgary.ca) to find out how to be connected with an ATTACH™ Facilitator who can deliver the program to parents via desktop, laptop or mobile phone.
Meet the expert: Dr. Nicole Letourneau, PhD
Nicole Letourneau, PhD RN, is the co-creator of the ATTACH™ program. She also holds the Alberta Children’s Hospital Foundation Research Chair in Parent-Infant Mental Health and is the Director of RESOLVE Alberta.
She has received over $60 million in research funding over her 20+ year career, with $20+ million as lead investigator. Her Child Health Intervention and Longitudinal Development (CHILD) Studies Program develops and tests interventions to promote health of infants and children growing up in families affected by toxic stressors including parental depression, addictions, intimate partner violence and low-income.
She is also the Principal Investigator of APrON, a 12-year longitudinal follow-up of a pregnancy cohort. Her research focuses on the impact of variables, e.g. parental distress, parent-child relationship quality, attachment, and supportive relationships on children’s health and development as well as the relationship between protective factors of quality parent-infant/child relationships and children’s physiological and developmental health.
Dr. Letourneau’s research promotes understanding of the relationship among social (caregiving) experiences, genetics, stress physiology and immune function, and children’s cognitive, behavioural and social-emotional development. She has published 190+ peer-reviewed papers, 150+ opinion editorials appearing in major print and on-line news outlets and two books for the lay public: Scientific Parenting: What Science Reveals About Parental Influence (2013) and What Kind of Parent Am I?: Self-Surveys that Reveal the Impact of of Toxic Stress and More (2018), both from Dundurn.
