The exposure to adverse childhood experiences and chronic stress without nurturing support by a caregiver to help the child cope can result in harmful effects to the child’s neurological and physiological development. This is known as toxic stress and can have a deleterious impact on the child’s long-term physical and mental health into adulthood and across generations. The emerging research on genetic and environmental interplay and epigenetics provides further evidence that adverse environments can impact the expression of genetic codes and may carry that impact physiologically through inheritable tendencies.
With increasing frequency, pediatricians are treating a significant number of children with adverse childhood experiences. The short and long-term financial implications for managed care are considerable. For example:
- In 2011, it was determined that there were 5.6 million children treated for mental health disorders, with an associated cost of $13.8 billion.1
- The average cost for treatment of mental health disorders in the same year was $2,465 compared to $969 for treatment of asthma.2
Because early childhood is the time of rapid and extensive development, it provides the best opportunity for prevention and intervention. There are several points within the health care system where the identification of young children and their families exposed to toxic stress and at risk for serious and costly negative health and mental health care consequences can be identified and early intervention can be initiated. These actions can prevent or alleviate the future negative outcomes associated with adverse childhood environments and toxic stress.
The purpose of this series of technical assistance materials is to address those specific points of contact within the managed health care system and provide the practitioners with the necessary information to identify and treat these young children and their families. Specifically, the targeted disciplines are as follows:
- Managed care plan care coordinators and managers
- Occupational, speech, and physical therapists
- Home visitors
- Behavioral healthcare practitioners
This website provides information that is tailored to each discipline regarding:
- Awareness of toxic stress
- Understanding and appreciation for infant and early childhood mental health
- Screening and assessment
- Basic practices that can be used to promote positive development, prevent or provide early interventions within the scope of practice of the discipline
- Referral and linkages to specialty mental health providers when necessary
- Ways to integrate physical and behavioral health care
1 Suni, A. The five most costly children’s conditions, 2011. Estimates for the U.S. Civilian Non-institutionalized children, Ages 0-17. Statistical Brief #434. Rockville, MD: Agency for Healthcare Research and Quality.