Jane Ellen Stevens

Pediatrics academy tells baby docs: your new job is to reduce toxic stress

According to research over the last 15 years, there’s no doubt now that child trauma causes toxic stress on the brains of babies and children, which causes short-term harm and long-term health consequences. So, it’s not a big surprise that the American Academy of Pediatrics issued a policy statement about the issue. What’s significant is the advice to pediatricians: Radically change how you do your job and take new approaches to protect those fragile developing brains.

The report advised pediatricians to:

  • Integrate a psychosocial approach into doing medicine. “Psychosocial problems and the new morbidities should no longer be viewed as categorically different from the causes and consequences of other biologically based health impairments.”
  • Incorporate into medical school and continuing education classes the knowledge of how childhood toxic stress affects “disruptions of the developing nervous, cardiovascular, immune, and metabolic systems, and the evidence that these disruptions can lead to lifelong impairments in learning, behavior, and both physical and mental health.” A technical report, in press, will provide more details about this.
  • Take an active leadership role in educating everyone — public, policy makers, educators, etc. — about the long-term consequences of childhood toxic stress.
  • Advocate for “new, evidence-based interventions (regardless of the provider or venue) that reduce sources of toxic stress and/or mitigate their adverse effects on young children.”

A fifth recommendation advocates expanding the reach of pediatricians interactions’ with their patients. According to a post about the policy statement by Los Angeles Times Booster Shots reporter Melissa Healy:

One of the policy statement’s most practical recommendations is that pediatricians move aggressively to adopt a relatively new model of medical practice–the patient-centered “medical home.” In that model, pediatricians not only track children’s growth and attend to their ear infections and vaccinations; they also become a gateway to classes for new parents and after-school programs, to resources that ensure good nutrition and school readiness skills, and to help for parents struggling with domestic abuse, divorce or mental illness.

Dr. Claudia Gold, a pediatrician and author of Keeping Your Child in Mind, commended the AAP for the new policy statement on her blog “Child in Mind”, which also appears on Boston.com, and says that what pediatricians can do right now, while all the new approaches are being developed, is to listen:

Being understood by a person we love is one of our most powerful yearnings, for adults and children alike. The need for understanding is part of what makes us human. When our feelings are validated, we know that we’re not alone. For a young child, this understanding helps develop his mind and sense of himself. When the people who care for him can reflect back his experience, he learns to recognize and manage his emotions, think more clearly, and adapt to his complex social world.

11 comments

  6. […] This means they will need to not only check a child for the normal ear infections, colds and administer the typical childhood immunizations but they will also need to ask questions about the home life. In essence baby doctors have been told, “Your new job is to reduce toxic stress.” […]

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  7. […] This means they will need to not only check a child for the normal ear infections, colds and administer the typical childhood immunizations, but they will also need to ask questions about the home life. In essence baby doctors have been told, “Your new job is to reduce toxic stress.” […]

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  9. I am so glad to finally see some validation on what I’ve have felt for years. I ran a therapeutic child care and after school program for years in OK. My staff and I literally subsidized the state of OK’s Title XX program. I say that because we took low salaries in order to accommodate many young children who needed a program and people who cared about them. The state’s reimbursement was so low for these kids it was pathetic.

    All of the children mattered to us. It was not unusual at all for me to call a pediatrician, therapist or counselor to report on a child. We had kids who stayed with us for years, from the time they were born until 13 and even 14 years of age. Others that came to us after having experienced much trauma and had been “kicked out” of preschool or an after school program – which in itself was a traumatic experience for many children. Imagine being not wanted by the very people who were supposed to be caring for you.

    We knew what the trauma in their families was like. We documented, recorded and prayed over these kids. One therapist told me, “I like when you report to me because from you and your staff I get the truth. From the parent or parents I get only their perception of the situation. It was not unusual for me to go to school IEP meetings simple because we had a better take on the child than the parent and more so than most teachers.

    IN 2002 we were part of a research project with Portland State University called “Models of Inclusion”. You can read the final report at: http://pdxscholar.library.pdx.edu/cgi/viewcontent.cgi?article=1042&context=socwork_fac

    Our program was the Broken Arrow Clubhouse, Broken Arrow, OK.

    Linda Ranson Jacobs
    blog.dc4k.org
    ljacobs@dc4k.org

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