The AAP put out a call to action, including the following recommendations: a need for understanding that lifelong disparities are determined by social, behavioral and economic determinants proper training of all healthcare providers in the effects of toxic stress and ongoing advocacy by pediatric providers. This framework acknowledges the interactions of personal experiences, environmental influences, and genetic predispositions that shape the learning and behavior of an individual across his or her lifespan. ![]() In January 2012, the AAP published a policy statement on the effects of toxic stress and childhood adversity using an ecobiodevelopmental framework to approach this important public health concern. These adverse health effects include maladaptive coping skills, poor stress management, unhealthy lifestyles, mental illness and physical disease. Children who experience early life toxic stress are at risk of long-term adverse health effects that may not manifest until adulthood. This abnormal stress response consists of a derangement of the neuro-endocrine-immune response resulting in prolonged cortisol activation and a persistent inflammatory state, with failure of the body to normalize these changes after the stressor is removed. Toxic stress can affect anyone, and children are no exception.Ĭhildhood toxic stress is severe, prolonged, or repetitive adversity with a lack of the necessary nurturance or support of a caregiver to prevent an abnormal stress response. Toxic stress responses include a prolonged or permanent abnormal physiologic response to a stressor with risk of end organ dysfunction. In most situations, the physiologic changes associated with the stress response are transient, with the body returning to its baseline state when the stressor is removed. This stress response is a result of stimulation of the sympathetic nervous system resulting in a cascade of neuro-endocrine-immune responses, with reproducible physiologic effects that include an increase in respirations, heart rate, blood pressure, and overall oxygen consumption. The stress response, also known as the “fight or flight” response or general adaptation syndrome, comprises the physiologic changes that occur with any encounter of stress or perceived stress to the individual. Stressors may be physical, emotional, environmental or theoretical, and all may equally affect the body’s stress response. ![]() Stressors are agents that produce stress. Stress is a term commonly used to describe the response to the demands encountered on a daily basis throughout one’s lifetime, and it is related to both positive experiences and negative experiences.
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