Related story: Child abuse and wife abuse are linked. Studies indicate 30% to 59% of mothers of children reported for child abuse also are battered. In homes where domestic violence occurs, the children are at increased risk of physical abuse or neglect. Children who witness battering of their mothers are at risk for psychosocial sequelae including developmental delays and posttraumatic stress disorder. http://www.hawaii.edu/hivandaids/Response_to_Battered_Mothers_in_the_Pediatric_Emergency_Department__A_Call.pdf
Editor’s note: Nadine Burke Harris, a pediatrician, is founder and CEO of Center for Youth Wellness. The opinions expressed in this commentary are solely those of the author.
ADHD or Toxic Stress?
(CNN) — Chances are, you know someone whose child has been diagnosed with attention-deficit (hyperactivity) disorder. Perhaps you’ve received that news about yourself or your own child. In many cases, it’s a legitimate issue and can require medication, therapy or both. But in my experience, ADHD is sometimes a diagnosis that can be mistakenly given based on a pattern of behavior, without appropriate understanding of the underlying biology.
For many children, particularly those in low-income communities, their behavior issues are not really about underactivity of the brain’s attentive function, the hallmark of ADHD. Rather, behavior is just one outward sign of a more significant health threat that doctors are just beginning to understand: toxic stress.
According to the American Academy of Pediatrics, the term “toxic stress” describes the disruption in brain architecture and other developing organ systems that occur when a child is exposed to strong, frequent or prolonged adversity. Unlike ADHD, toxic stress involves many systems of the body and is characterized by a dramatic increase in stress-related disease and cognitive impairment.
I observe its effects every day as a pediatrician working in one of San Francisco’s poorest neighborhoods. We want to prevent, screen and heal those who come under toxic stress.
It can begin in infancy
When we think of the emotional life of a baby, we often reduce the child’s feelings to the way he behaves around a few daily activities. We hear an infant cry when he needs to eat or sleep or when he feels uncomfortable. Most caretakers tune in and attend to those needs.
But an infant’s well-being is not just about food, rest and diapers. There’s a lot more going on inside a baby’s brain and body that we can nurture. Early childhood is a time of dramatic development of the brain and other organ systems. Children’s brains rapidly adapt to the environment around them, for better or worse.
During the critical developmental years, between birth and age 4, some children experience high anxiety or fear because their home or neighborhood environments are unsafe. They’re subject or witness to physical or emotional abuse, community violence or even extreme poverty. This trauma can have a tremendous impact on a child’s brain development, as well as the development of their immune system, their hormone systems and even the way their DNA is read and transcribed.
How childhood trauma could be mistaken for ADHD
ADHD symptoms? Psychologists, psychiatrists should consider child maltreatment as the cause before prescribing meds
Research reveals new ways of understanding ADHD