According to the
Centers for Disease Control and Prevention (2013), nearly six referrals of
child maltreatment occur every minute. The overall total economic burden from
cases of child maltreatment in the United States is about $124 billion each
year (CDC, 2013). Maltreatment can not only lead to physical injuries, such as
broken bones or burns, but the excessive stress caused can also impact the
development of the brain, nervous system, and immune system of a child (CDC,
2013). These adverse childhood experiences are major risk factors for poor
quality of life and illness or premature death in the future (CDC, 2013).
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| Child's drawing about abuse. |
According to a post in The New York Times, this stress from adverse
childhood experiences is known as toxic stress (Bornstein, 2013). Toxic stress specifically refers
to the frequent or continual stress young children face who are not protected
by adults (Bornstein, 2013). This is not to be confused with types of positive
stress, such as learning a new tasks, which can be beneficial for a child’s growth
and development. Unlike positive stress, toxic stress effects a child’s futures
and can increase the risk of cancer, diabetes, drug abuse, suicide, and teen
pregnancy, while reducing school or job performance (Bornstein, 2013).
Unlike
some risk factors for child maltreatment that are more difficult to alter, such
as poverty, toxic stress is a modifiable risk factor. In order to do this, the
quality of the relationship between the parent and child must be examined.
Relationships where adults are attentive and responsive to a child’s cues can
serve as a protective factor against toxic stress (Bornstein, 2013). By being
attentive, adults may more easily be able to recognize situations with damaging
stress for children and shield them to help prevent this.
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| Child Life helps parents communicate effectively. |
Child
Life is one program that helps combat toxic stress (Bornstein, 2013). With the help of a therapist, Child
Life helps parents believe in themselves and their ability to overcome problems
so that they have a better attitude about themselves and their child. This, in
turn, leads to a child feeling loved and valued which helps buffer the stressors
(Bornstein, 2013). By being aware of programs such as Child Life, nurses can
refer parents or caregivers to this program who want to enhance their relationship
with their child.
One
of the objectives of Healthy People 2020 (2013) is aimed at injury and violence
prevention. This includes reducing child maltreatment as well as reducing
children’s exposure to violence (HealthyPeople.gov, 2013). In order to achieve
these standards, child maltreatment and toxic stress must be recognized. Nurses
should be trained to know the signs or symptoms of maltreatment and stress and
what actions to take. Furthermore, because many adult disorders or health
disparities may begin as developmental disorders associated with toxic stress, this
stress needs to be prevented early in childhood. By recognizing situations
where toxic stress is occurring, such as how a parent responds to a child,
nurses can act accordingly to help prevent future health and social issues from
occurring in this population.
This kind of public health issue deserves more attention. If Bornstein's data are true, then public health for decades to come could be at stake. Those of us going into public health or pediatric nursing will likely have greater opportunities to assess family and parenting dynamics than others. I hope that there will be interdisciplinary support for those who do.
ReplyDeleteAs Megan discussed in her post, the effects of child maltreatment and abuse have substantial consequences on the development and health of children. After spending time at a educational facility for children with a variety of cognitive and physical disabilities, the health histories revealed that many of the children suffered from Shaken Baby Syndrome (SBS). According to the CDC, Shaken Baby Syndrome is a preventable and severe form of physical child abuse that causes inflicted traumatic brain injury (ITBI). The CDC also stated that almost all of the victims of SBS suffer serious health consequences, while at least one in four shaken babies die from this abuse. Prevention focuses on education and helping caregivers understand and cope appropriately with a crying or inconsolable baby. (CDC information retrieved from http://www.cdc.gov/concussion/headsup/sbs.html)
ReplyDeleteThanks for bringing this topic to the blog. While I agree that programs like Child Life do great work for a number of families, I think there are larger public health issues at play, too. Having a child is a major transition for new parents and experienced parents alike. Many parents, however, do not have enough time to adjust to the change and do not receive the support necessary to facilitate a positive transition. The maternity leave laws in the US are far stingier than other countries'. According to a New York Times article from February of 2013, "While the United States takes great pride in its family values, it is the only high-income country that does not offer a paid leave program." Increasing paid family leave is not, of course, the golden ticket to better adjusted parents, but it is an -important piece of improving child-parent relationships and therefore, possibly reducing toxic childhood stress.
ReplyDeleteArticle retrieved at: http://www.nytimes.com/2013/02/23/your-money/us-trails-much-of-the-world-in-providing-paid-family-leave.html?_r=0