Other People’s Children

On the wake of talking about how to raise anti-racist humans, talking a lot about building empathy, and as our government discusses funding (or not) early childhood programs, I wanted to share with you the psychological, emotional, physical, and economic impacts of childhood stress, including and not limited to racism, violence, and poverty. It is estimated that 15-25% of American children suffer adverse childhood events like abuse, neglect, or family dysfunction.

By now, you know the drill…we state the problem this week and the solution (or some that we know about) next week.
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The Issue

In the ‘90s, the US developed grunge, Beanie Babies, and a firmly held belief that cognition (specifically better cognition) was the route to success. The thought was if we could better educate poor kids—sending better teachers to the worse schools, do more drills, more math and reading—we would lift them out of poverty. This view was fueled by the (now famous) spoken word study, which put forth middle-class kids heard thrice more words than poor kids. So the thinking goes, more words → better learning → no more poverty → unicorns and rainbows for all!

Here’s the thing, there are a lot of problems with that study, including a high correlation of other factors like number of hours parents work, poverty, parental stress, education levels. Much to the detriment of music, art and physical education teachers…and, yes, the students.

Since then, intelligence and cognition have been debunked as the critical factor in successful adult outcomes. James Heckman’s research (he’s an economist at the University of Chicago / smart dude) compared life outcomes for GED and high school graduates. On average, GED holders are good test takers (makes sense, the experience ends with a test), with equivalent intellect as high school graduates. Yet, they are more likely to experience lower incomes, higher unemployment, higher incidences of illegal drug use, and higher divorce rates.

So, what’s going on? Heckman points to non-cognitive skills like persistence, delayed gratification, planning and follow-through. Similar to conclusions we’ve discussed here, here, and here.

A new generation of neuroscientists has recognized the powerful connection between an infant’s environment, brain chemistry, and subsequent adult outcomes. It doesn’t have to do with hearing more words or seeing more flashcards. Spoiler alert: it’s stress. Toxic and chronic stress. Good news, there are practical and relatively cheap strategies for combating toxic childhood stress.

Toxic Stress: the poison to non-cognitive skills

Back to the ‘90s, Kaiser (yeah, the HMO) evaluated survey results of 17,000 people (a whopping 70% response rate comprising 75% white, 75% college attendance, with an average age of 57) covering adverse childhood experiences (ACE). Specifically, ten categories of adverse childhood events:

• abuse (physical, sexual, verbal),

• neglect (physical, emotional),

• household dysfunction (family member experiencing depression, substance abuse, incarceration, abuse, or divorce).

The survey results shed light on widespread childhood adversity in the US. Two out of three (11k of the 17k surveyed) had experienced one adverse childhood experience. One in eight had four or more. Kaiser tied this information back to the health records (because they’re still an HMO), and the results were staggering. With every additional ACE, adult outcomes worsened. Those with four or more ACEs were seven times more likely to be alcoholics and have sex before fifteen, twice as likely to have cancer, heart disease, and liver disease, and four times more likely to have emphysema or chronic bronchitis. Those with ACE scores of 6+ were THIRTY TIMES more likely to attempt suicide.

Okay, so…all those adverse outcomes could be correlated and no indication of actual causation → higher consumption of alcohol, drugs, and hot cigs → a lot of health problems. BUT, Kaiser had this data too and was sophisticated enough to strip out that impact. For those that didn’t consume any “sinful” substances, their risk of heart disease was still a whopping 360% higher than those with an ACE score of 0. This suggests there is a pathway here that has nothing to do with behavior, but rather with our stress response.

Here’s where it starts to get interesting (and terribly sad). Another series of studies got to what this biological pathway might be. Our hypothalamic–pituitary–adrenal axis (HPA) is awoken when we sense danger. It’s like a fire alarm; watch out, something might be happening. Cortisol (a stress hormone is released), which causes glucose levels to rise in preparation for having to do something (like ninja kicking a tiger…worth a try. It’s great fun), causing inflammatory proteins to surge. When the HPA is triggered time and again—over and over—we experience wear and tear on our bodies.

Thinking about the teensiest humans: the stress response impacts them differently and more profoundly than adults. Stress affects their prefrontal cortex, that part of our brain responsible for self-control, working memory, executive function, and emotional intelligence (aka the non-cognitive stuff mentioned above), the part of their brain that is in rapid development throughout childhood. There is emerging evidence that a calming response from an adult (more on this next week) goes beyond impacting neurotransmitters and hormones. It actually impacts gene expression, specifically genes expressed in the hippocampus that regulate our bodies’ responses to stress hormones.

So, there is a terrible compounding effect: kids, who experience early stressors without appropriate support from adults, tend to have their HPA pathway triggered more easily in everyday life. This constant triggering, has deleterious effects to their health and executive function, which is often an additional stressor. You might be thinking, this might just be more of that correlation stuff. Nope—scientists have been able to isolate the impact to not just poverty but to stress by looking at working memory in children, their stress hormone load, and income levels.

So on that bright note…

Some of the successful interventions next week.