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How does the ‘toxic stress’ of poverty hurt the developing brain?

June 27, 2015 at 1:12 PM EDT
A growing body of research shows that the stress of growing up in poverty can have long-term effects on children's brains and cognitive development. How can so-called “toxic stress” be prevented? NewsHour’s Megan Thompson reports in our latest story from the continuing public media series "Chasing the Dream.” Thompson is currently a fellow with the Rosalynn Carter Fellowships for Mental Health Journalism program.

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MEGAN THOMPSON: It’s snack time at the home of Ruth Fajardo in Norwalk, Connecticut – an hour outside New York City.

RUTH FAJARDO: How was school?

KIDS: Good.

MEGAN THOMPSON: Ruth – a 26-year-old immigrant from Honduras – checks in with her four young kids. A normal family scene. But four years ago, the family was in a different place.

RUTH FAJARDO: Everything was a disaster.

MEGAN THOMPSON: Ruth was a stay-at-home mom, living alone with her kids in public housing. The children’s father, a house painter who supported the family, had gone back to Honduras. One night, while the children were sleeping upstairs, bullets came flying through the windows and front door.

RUTH FAJARDO: Everything was breaking in the kitchen – the glass and the mirrors and everything. Everything was like a horror movie.

MEGAN THOMPSON: It was a random, drive-by shooting. Ruth’s children weren’t physically hurt. But her older daughters Andrea and Michele can’t shake the memory.

MICHELE: Yeah I was scared, I was crying.

ANDREA: I thought I would die.

MICHELE: ‘Cuz my mom, she could have gotten shot too. So I was scared that she was going to die.

ANDREA: And we would go in a foster home.

MEGAN THOMPSON: That didn’t happen, but Ruth, with no job, no driver’s license and no high school diploma, was scraping by on cash from having sold the two family cars. Ruth moved in with her mother. She and the four kids shared one room.

RUTH FAJARDO: I was really sad. Having them all together and sleeping on one mattress was messed up. I felt it wasn’t fair.

MEGAN THOMPSON: She felt like she couldn’t help her kids, including the second-oldest, who was being bullied at school, crying all the time and hiding in the closet. Ruth fell into a deep depression.

RUTH FAJARDO: Everything stressed me, I get angry easily, so my kids were like that. They were screaming at each other. They were fighting a lot. So, I thought they were being bad kids in that moment. I thought I was transmitting that to them.

MEGAN THOMPSON: You were transmitting that.

RUTH FAJARDO: Yes.

Jack Shonkoff is a pediatrician and director of the Harvard Center on the Developing Child. He says stressful situations provoke a physical response.

JACK SHONKOFF: Automatically, our heart rate goes up, our blood pressure goes up, stress hormone levels rise in the blood. Our blood sugar goes up. So, it’s the- it’s the biology of the fight or flight response.

MEGAN THOMPSON: Shonkoff says, for children stress is normal and fine in the short- term. But chronic, long-term exposure to stress is something very different. He calls this, “toxic stress.” Shonkoff’s research shows toxic stress can have profound consequences for human bodies and brains – especially in young children.

JACK SHONKOFF: Toxic stress is creating a different kind of- of chemical environment in the brain that is affecting the development of the brain. Toxic stress can disrupt brain circuits that will basically create a weaker foundation for a lot of circuitry that’s essential for learning, for memory, for solving problems, for following rules, for controlling impulses.

MEGAN THOMPSON: Anyone can experience toxic stress. But Shonkoff says, poverty presents the type of chronic adversity that can cause it. Low-income families are also more likely to live in neighborhoods with high rates of crime, drug abuse, and failing schools. Over the last few years, many other scientists have also found links between growing up poor and differences in cognitive development.

MEGAN THOMPSON: Will all kids who grow up in a high poverty situation experience toxic stress or the long-term effects of toxic stress?

JACK SHONKOFF: One thing that’s absolutely clear is that not all children growing up in poverty are experiencing toxic stress. Toxic stress has to do with the extent to which adults in a child’s life are buffering that child from the stressors around the family, and building the child’s ability to cope and adapt, which is building resilience. And the most- the most at risk group are parents who themselves grew up in poverty, who are victims of abuse and neglect

MEGAN THOMPSON: When Ruth was a baby, her mother left for the U.S.

RUTH FAJARDO: I was 18 month when she left me with my grandma in Honduras.

MEGAN THOMPSON: She was raised by her grandmother, who was illiterate. Then, she experienced trauma as a young teen.

RUTH FAJARDO: I was molested, but nobody in my family knew.

MEGAN THOMPSON: She never got help and struggled after coming to the U.S. Four years ago, isolated and with few resources, she plunged into depression.

DARCY LOWELL: And we know the impact of depression on young children is devastating.

MEGAN THOMPSON: Darcy Lowell is a pediatrician and founder of Child First, a non-profit group that works with low-income families in Connecticut, and helped Ruth Fajardo. Lowell says low-income moms like Ruth experience depression at rates much higher than the average. And depression can make it harder to provide the nurturing relationship so vital for children’s development.

DARCY LOWELL: That relationship is the foundation of not just emotional development and mental health. It is the foundation for cognition, for school readiness, for a sense of competence. And that’s what leads to children to be successful in their lives.

MEGAN THOMPSON: Ruth didn’t realize the costs of not interacting with her kids.

RUTH FAJARDO: When they try to make me read, I just tell them, I don’t like reading. I didn’t pay attention to school work, or checking their backpacks. And my kids always are bugging me – “Let’s go to the park. Let’s go- Let’s go outside.” And I couldn’t because I was feeling down.

MEGAN THOMPSON: Did it seem like your mom was happy or did it seem like your mom used to be sad?

MICHELE: Sad.

ANDREA: A little mad.

MEGAN THOMPSON: So what was that like, how did you guys know that she was sad?

MICHELE: Her eyes are red. And her face is red.

ANDREA: And sometimes water is in her eyes.

MEGAN THOMPSON: And how did that make you guys feel? To see her like that?

MICHELE: Sad so…

ANDREA: I felt guilty / because I made my mom feel sad.

MEGAN THOMPSON: Ruth says one day she saw her oldest daughter playing with the other kids – pretending to be Ruth.

RUTH FAJARDO: She started screaming at them, “Stop fighting. You’re gonna get everything ruined,” and “You’re bad kids,” and stuff like that. And when I saw her being so mean with the other ones, screaming – and that’s when I started looking for help.

MEGAN THOMPSON: Ruth found Child First, which provides home visits and counseling at no cost to a thousand low-income families in Connecticut.

SARAH RENDON GARCIA: Hi guys!

MEGAN THOMPSON: A pair of Child First counselors visited Ruth’s family for about two years. A care coordinator found Ruth a Spanish-speaking therapist, who helped diagnose Ruth and get her on medication. She also helped Ruth obtain a driver’s license, clothes and food from local charities, and enrolled her kids in pre-school and summer programs.

SARAH RENDON GARCIA: How’s she doing? Developmentally, she’s doing ok?

RUTH FAJARDO: Yes, they did tests at school, and she passed.

RUTH FAJARDO: Joshua – what happened? You’re mad?

MEGAN THOMPSON: At the same time, Ruth learned better parenting skills.

RUTH FAJARDO: Do you want to have your own time?

MEGAN THOMPSON: The importance of listening to her kids instead of punishing them, talking about their feelings, and modeling good behavior. The kids did activities to help them learn to cooperate more and fight less. And how to better manage their emotions.

RUTH FAJARDO: This is how he handles now his anger now. He wants to have his time along[alone]. Before, he scream and messed up everything, like fighting.

MEGAN THOMPSON: A 2011 study compared 78 children in the Child First program to children not in the program. It showed a 68 percent drop in language problems and a 42 percent drop in aggressive behavior. For moms, there was a 64 percent decrease in depression and other mental health problems. But with about a quarter-million children living in low-income families in Connecticut alone, the group struggles to meet the demand for its services …which it estimates [to] cost about $7800 for a family of four.

DARCY LOWELL: When I think about 300 children on the waitlist here in Connecticut and their families, it’s very hard. We’re going for the source of the problem, we’re going for the root of the problem.

MEGAN THOMPSON: Today, Ruth and her family are in a much better place.

RUTH FAJARDO: Now my depression is practically gone. I feel so better. Now, I’m more empowered, energetic.

MEGAN THOMPSON: Two weeks ago, Ruth graduated high school and was selected to give a speech about overcoming obstacles, her story featured on the local evening news.

MICHELE: I got an A++!

MEGAN THOMPSON: Wow! That means you did way awesome.

MEGAN THOMPSON: She now works two part-time jobs and the children’s father has joined them. Her next goals: college, and then she wants to buy a house. But this family of six lives on about $30,000 a year – still near the federal poverty line – and they still rely on food stamps and Medicaid. But Ruth says, she’s more equipped to handle whatever comes their way.

RUTH FAJARDO: I can say I’m happy. And, I can tell that I’m transmitting happiness to my kids.

Chasing the Dream: Poverty and Opportunity in America is a multi-platform public media initiative that provid​es a deeper understanding of the impact of poverty on American society. Major funding for this initiative is provided by The JPB Foundation. Additional funding is provided by Ford Foundation and the Annie E. Casey Foundation.​

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