Childhood Stress and Development

Learning Outcomes

  • Examine concerns about childhood stress and trauma

Stress in Early Childhood

boy looking reflectively at the camera for his picture, while he sits with his arms crossed in front of him on his knees.

Figure 1. Young children exposed to toxic stress are at risk of developing physical, emotional, and social symptoms.

What is the impact of stress on child development? The answer to that question is complex and depends on several factors including the number of stressors, the duration of stress, and the child’s ability to cope with stress.

Children experience different types of stressors that could be manifest in various ways. Normal, everyday stress can provide an opportunity for young children to build coping skills and poses little risk to development. Even long-lasting stressful events, such as changing schools or losing a loved one, can be managed fairly well.

Some experts have theorized that there is a point where prolonged or excessive stress becomes harmful and can lead to serious health effects. When stress builds up in early childhood, neurobiological factors are affected; in turn, levels of the stress hormone cortisol exceed normal ranges. Due in part to the biological consequences of excessive cortisol, children can develop physical, emotional, and social symptoms. Physical conditions include cardiovascular problems, skin conditions, susceptibility to viruses, headaches, or stomach aches in young children. Emotionally, children may become anxious or depressed, violent, or feel overwhelmed. Socially, they may become withdrawn and act out towards others, or develop new behavioral ticks such as biting nails or picking at skin.

Types of Stress

Researchers have proposed three distinct types of responses to stress in young children: positive, tolerable, and toxic. Positive stress (also called eustress) is necessary and promotes resilience, or the ability to function competently under threat. Such stress arises from brief, mild to moderate stressful experiences, buffered by the presence of a caring adult who can help the child cope with the stressor. This type of stress causes minor, temporary physiological and hormonal changes in the young child such as an increase in heart rate and a change in hormone cortisol levels. The first day of school, a family wedding or making new friends are all examples of positive stressors. Tolerable stress comes from adverse experiences that are more intense in nature but short-lived and can usually be overcome. Some examples of tolerable stressors are family disruptions, accidents or the death of a loved one. The body’s stress response is more intensely activated due to severe stressors; however, the response is still adaptive and temporary.

Toxic stress is a term coined by pediatrician Jack P. Shonkoff of the Center on the Developing Child at Harvard University to refer to chronic, excessive stress that exceeds a child’s ability to cope, especially in the absence of supportive caregiving from adults. Extreme, long-lasting stress in the absence of supportive relationships to buffer the effects of a heightened stress response can produce damage and weakening of bodily and brain systems, which can lead to diminished physical and mental health throughout a person’s lifetime. Exposure to such toxic stress can result in the stress response system becoming more highly sensitized to stressful events, producing increased wear and tear on physical systems through over-activation of the body’s stress response. This wear and tear increases the later risk of various physical and mental illnesses.

Consequences of Toxic Stress

Children who experience toxic stress or who live in extremely stressful situations of abuse over long periods of time can suffer long-lasting effects. The structures in the midbrain or limbic system, such as the hippocampus and amygdala, can be vulnerable to prolonged stress (Middlebrooks and Audage, 2008). High levels of the stress hormone cortisol can reduce the size of the hippocampus and affect a child’s memory abilities. Stress hormones can also reduce immunity to disease. If the brain is exposed to long periods of severe stress, it can develop a low threshold, making a child hypersensitive to stress in the future.

With chronic toxic stress, children undergo long term hyper-arousal of brain stem activity. This includes an increase in heart rate, blood pressure, and arousal states. These children may experience a change in brain chemistry, which leads to hyperactivity and anxiety. Therefore, it is evident that chronic stress in a young child’s life can create significant physical, emotional, psychological, social and behavioral changes; however, the effects of stress can be minimized if the child has the support of caring adults.

watch it

This short video explains some of the biological changes that accompany toxic stress.

You can view the transcript for “3. Toxic Stress Derails Healthy Development” here (opens in new window).

Coping with Stress

Stress is encountered in four different stages. In the first stage, stress usually causes alarm. Next, in the second or appraisal stage, the child attempts to find meaning from the event. Stage three consists of children seeking out coping strategies. Lastly, in stage four, children execute one or more of the coping strategies. However, children with a lower tolerance for stressors are more susceptible to alarm and find a broader array of events to be stressful. These children often experience chronic or toxic stress.

managing Stress

Some recommendations to help children manage stressful situations include:

  • Preparing children for everyday stressful situations, such as traveling to new places or going to the doctor. For example, talk to children about the experience to help them understand that it is okay to be stressed and scared.
  • Keeping communication open. This includes making sure that the child feels comfortable talking to a person. This may include being in a comfortable space, such as their bedroom, where they feel safe. The comfort level of the child is important because if a child is not comfortable, or feels forced to speak, they may not open up at all.
  • Spending time together as a family so that no one’s feelings go unseen; ensuring that a child knows that their feelings are valued, and should be expressed in healthy ways.
  • Modeling healthy and successful coping mechanisms (such as going for a walk).
  • Encouraging children to express themselves creatively (as an outlet or to help others to understand what is stressing the child). Some healthy outlets of stress relief include sports or running, writing, reading, art, as well as playing musical instruments.
  • Teaching children to act and think positively when they are faced with a situation to manage the stress before it becomes overwhelming.
  • Providing a safe and healthy home and environment for children.
  • Providing children with proper nutrition and attention.
  • Ensuring children are not exposed to substance abuse or violence. When a healthy environment is provided, children are more likely to be emotionally and physically healthy

watch it

This video describes a variety of factors involved in the development of resilience.

You can view the transcript for “InBrief: The Science of Resilience” here (opens in new window).

Trauma in Childhood

Childhood trauma is referred to in academic literature as adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma, these might include neglect, abandonment, sexual abuse, physical abuse, parent or sibling treated violently, separation or incarceration of parents, or having a parent with a mental illness. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being.

Kaiser Permanente and the Centers for Disease Control and Prevention’s 1998 study on adverse childhood experiences determined that traumatic experiences during childhood are a root cause of many social, emotional, and cognitive impairments that lead to increased risk of unhealthy self-destructive behaviors, risk of violence or re-victimization, chronic health conditions, low life potential, and premature mortality. As the number of adverse experiences increases, the risk of problems from childhood through adulthood also rises. Nearly 30 years of study following the initial study has confirmed this. Many states, health providers, and other groups now routinely screen parents and children for ACEs.

WAtch It

Watch this Ted talk from pediatrician Nadine Burke Harris as she explains the impact of childhood trauma across the lifespan.

You can view the transcript for “How childhood trauma affects health across a lifetime | Nadine Burke Harris” here (opens in new window).

Food Insecurity

In 2017 11.8% of households experienced low food security, or food insecurity, at some point during that year.[1] Food insecurity happens when a family has limited or uncertain availability of safe, nutritious food. The most recent statistics suggest that households with children are more at risk for food insecurity, with nearly 18% of children under the age of 18 living in households that have experienced food insecurity within the year.[2] Lack of proper nutrition is a stress on the body in general. Children who are undernourished may have physical developmental delays. Further, food insecurity has been correlated with poor school performance in both reading and math.[3]

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adverse childhood experiences:
abuse, neglect, and violent experiences that contribute to childhood trauma
food insecurity:
limited or uncertain availability of safe, nutritious food
toxic stress:
excessive stress that exceeds a child’s ability to cope, especially in the absence of supportive caregiving from adults

  1. Coleman-Jensen, Alisha, Matthew Rabbitt, Christian Gregory, and Anita Singh (2018). "Household Food Security in the United States." United States Department of Agriculture Economic Research Service. Retrieved from
  2. No Kid Hungry. "Facts About Childhood Hunger." Retrieved from
  3. Diana F. Jyoti, Edward A. Frongillo,4 and Sonya J. Jones (2005)Food Insecurity Affects School Children’s Academic Performance,Weight Gain, and Social Skills,  American Society for Nutrition.