Student Achievement, Poverty and “Toxic Stress”

by Robert Pondiscio
January 4th, 2012

It’s a safe bet that not many teachers are avid readers of the medical journal Pediatrics.  But a report that appeared in the publication last week deserves to be read and understood deeply by everyone in education.  It has the potential to transform the way we think and speak about children who grow up in poverty–and education as a means of addressing its worst effects.

The report links “toxic stress” in early childhood to a host of bad life outcomes including poor mental and physical health, and cognitive impairment.  The American Academy of Pediatrics (AAP), in an accompanying policy statement, calls on its members to “catalyze fundamental change in early childhood policy and services” in response.

The term “toxic stress” is not a familiar one in education circles, but it should be.  The Harvard Center on the Developing Child describes a toxic stress response as occurring “when a child experiences strong, frequent, and/or prolonged adversity—such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship—without adequate adult support.”  Think of it as one plus one equals negative two:  something bad happens to a child, and there’s no positive adult response to mitigate the trauma.  The lack of adult support is what makes stress, which is largely unavoidable, “toxic” to a child.  Crucially, repeated or prolonged activation of a child’s stress response system “can disrupt the development of brain architecture and other organ systems, and increase the risk for stress-related disease and cognitive impairment, well into the adult years,” notes the Center’s website.

This cannot be dismissed as pseudoscience or a mere hypothesis.  The report and policy statement notes a “strong scientific consensus” and a growing body of research “in a wide range of biological, behavioral, and social sciences,” on “how early environmental influences (the ecology) and genetic predispositions (the biologic program) affect learning capacities, adaptive behaviors, lifelong physical and mental health, and adult productivity.”

“Game changer” is a trite and overused phrase, but it applies here.  The report should have a profound impact on educators and education policymakers.  At the very least, understanding the language and concept of exposure to toxic stress should inform the increasingly acrimonious, dead-end debate about accountability and resources aimed at the lowest-performing schools and students.

On the one hand, those who insist that improving educational outcomes must be viewed within a broader context of health care, community resources and poverty can claim a victory here and a potential ally in the AAP.  Interventions must start from Day One.  Not Day One of school, Day One of life.  Kindergarten is too late.  Those who favor quality preschool programs have crucial evidence to support their case.  The story in four words:  Geoffrey Canada is right.

But it is equally clear (or should be) that low-income status is not synonymous with toxic stress. Even the worst schools and poorest neighborhoods have a significant number of children from stable homes with engaged, caring adults, who are able to provide the consistency and nurturing necessary to buffer the negative effects of even the most traumatic stressors.  “Research shows that, even under stressful conditions, supportive, responsive relationships with caring adults as early in life as possible can prevent or reverse the damaging effects of toxic stress response,” according to the Harvard Center on the Developing Child.

To this end, no less than pediatricians, schools and teachers–especially in early childhood– have an essential role to play.  In the absence of nurturing relationships at home, children may be able to find the support they need within the educational environment.  According to Rebecca Schrag, Ph.D., psychologist at Healthy Steps at Montefiore Medical Center, supportive adult relationships “can no longer be considered the ‘touchy-feely’ domain of child psychologists alone.  Rather, there is hard science suggesting that they are perhaps the number one protective factor against the negative outcomes of a range of stressors.  The AAP has made a huge step forward in releasing its policy statement on toxic stress, and it would be truly wonderful if other professionals who work with children – educators, most notably – followed suit.”

In light of the important role of supportive adult relationships, the takeaway here is clearly not that exposure to toxic stress makes it impossible for schools to succeed with low-income children.  But it should make clearer that the bar is much, much higher for a significant number of kids who endure extreme levels of chaos and disruption in their lives, children whose brains – even by age 5 – show the deleterious effects of toxic stress exposure.  This does not mean we should throw up our hands and say, “let’s not waste time and money on poor kids.  It’s not going to work.”  But it certainly puts the “No Excuses” mindset at a disadvantage, particularly when most children only begin school in kindergarten.  Given the scientific consensus cited by the report, holding to the idea that schools or teachers should be able to reverse unilaterally the worst effects of toxic stress in all cases begins to sound ill-informed and hopelessly naïve.

At present, the standard reform recipe for improving educational outcomes for all children living in poverty is high expectations, improved teacher quality and muscular accountability.  For many low-income kids, perhaps even most, this may indeed be enough.  For others, more – much more – is clearly required.  It is critical that educators and policymakers begin to differentiate between the two.

31 Comments »

  1. This is where I felt most helpless when teaching.

    Comment by John — January 4, 2012 @ 10:53 am

  2. [...] Student Achievement, Poverty and “Toxic Stress” is by Robert Pondiscio. [...]

    Pingback by The Best Places To Learn What Impact A Teacher & Outside Factors Have On Student Achievement | Larry Ferlazzo’s Websites of the Day… — January 4, 2012 @ 11:05 am

  3. An extremely worthwhile piece of evidence. Thanks for reporting this, Robert.

    Anyone who has ever taught children living in poverty has suspected this all along. What happened at home last night or over the weekend that is causing this child’s abnormal behavior?

    Now that it’s been substantiated by the American Academy of Pediatrics, our worst fears have been corroborated. Unimaginable horror from home, directly or indirectly impacting the minds of these children, young and teenagers alike. Brutal.

    Geoffrey Canada is indeed correct.

    Comment by Paul Hoss — January 4, 2012 @ 11:25 am

  4. A serious article about a serious topic and I appreciate your overview. I do think we need to remember your caveat: this isn’t just about children in poverty. In fact, the words poverty and low-income only appear in the reference section of the article. I would suspect even children from middle or high income backgrounds could suffer from toxic stress so we need to be careful about simply creating a category of “poor kids” who need to have supportive relationships and healthy schools that focus on more than just test scores and academic achievement.

    Comment by Karen R — January 4, 2012 @ 12:44 pm

  5. “Toxic stress” as explained can damage teachers, too. Who doesn’t need adult support when confronting ” strong, frequent, and/or prolonged adversity”? I’m not attempting to minimize the report’s findings, especially since child well- being is always a major teacher concern.. However, a hostile work environment plus negative family support yields exactly the same worrisome outcomes for adults as this study found for children. I would love to hear from teachers who left the profession prematurely because of “toxic stress.” I’m guessing there are many, but of course I have no study to back up this contention.

    Comment by Fred Strine — January 4, 2012 @ 1:19 pm

  6. I work for a parents and education website (tvoparents.com) and I pitched the discussion on toxic stress that we taped in our studio a couple of years back http://bit.ly/A32pOL – I always wish we could have spent a ton more time with Dr. Charles Nelson who talked about the effects of toxic stress on the children they studied in Romanian orphanages…it was heartbreaking. It’s a horribly cautionary tale about what children need…
    just fyi tvoparents is part of TVO the public and educational network in toronto…and non-profit. ;)

    Comment by Nicola Pulling — January 4, 2012 @ 2:47 pm

  7. @Karen R: you’re right, of course, but there are lots of data showing that toxic stress dwells more in lower income brackets. . .not that surprising when you think about it; if you have no money, live in a crime-ridden area, etc., you are yourself stressed, and will find it harder to be supportive of your kids (the buffer that is protective for kids under stress, and the lack of which makes it toxic).
    @Fred Strine: the effects of toxic stress are much more profound for the young because the neural system is less stable as it’s still developing

    Comment by Dan Willingham — January 4, 2012 @ 4:07 pm

  8. This report deserves a wide reading, because it further supports what many in the mental health community have been saying for years. I first became aware of this concept of “toxic stress” about 14 years ago while discussing, with my psychologist wife, the 12 year old boy I was mentoring in the Big Brothers program – call him CD.

    CD was a black kid born into a stereotypical inner-city situation – the never-married mother had five children by four different men, none of whom was involved in any way with his offspring. CD was the oldest, and by age four had seen his biological father beat up his mother many, many times. The last straw came when four year old CD stepped between his parents to try to protect his mother, and the father threw him into a wall. CD’s maternal grandmother took him in and raised him for the next 10 years, eventually enrolling him in the Big Brothers program in Minneapolis where I was matched with him.

    CD struggled in school, both academically and with behavior issues, in large part because of a bipolar condition. My wife explained to me that brain specialists believed that the effect of repeated trauma could actually re-wire the brain, with negative behavior a common consequence. CD has been in and out of jail, has never held a job, and at this time is drifting aimlessly – where I don’t know. Despite my having a long term and affectionate relationship with CD, I just couldn’t do enough myself to put him on the right path.

    As a society, we need to help these kids by pouring on the social services at an early age, for both moral and economic reasons – incarceration costs at least $30,000 per year per prisoner.

    But even if we do everything possible in the way of social programs, these kids are still going back to often violent and unsupportive home environments. The child protection system is extremely reluctant to take kids away from biological parents, even after repeated instances of neglect and abuse. At what point do parental rights end and the long-term welfare of children begin?

    Comment by John Webster — January 4, 2012 @ 4:30 pm

  9. This report deserves a wide reading, because it further supports what many in the mental health community have been saying for years. I first became aware of this concept of “toxic stress” about 14 years ago while discussing, with my psychologist wife, the 12 year old boy I was mentoring in the Big Brothers program – call him CD.

    CD was a black kid born into a stereotypical inner-city situation – the never-married mother had five children by four different men, none of whom was involved in any way with his offspring. CD was the oldest, and by age four had seen his biological father beat up his mother many, many times. The last straw came when four year old CD stepped between his parents to try to protect his mother, and the father threw him into a wall. CD’s maternal grandmother took him in and raised him for the next 10 years, eventually enrolling him in the Big Brothers program in Minneapolis where I was matched with him.

    CD struggled in school, both academically and with behavior issues, in large part because of a bipolar condition. My wife explained to me that brain specialists believed that the effect of repeated trauma could actually re-wire the brain, with negative behavior a common consequence. CD has been in and out of jail, has never held a job, and at this time is drifting aimlessly – where I don’t know. Despite my having a long term and affectionate relationship with CD, I just couldn’t do enough myself to put him on the right path.

    As a society, we need to help these kids by pouring on the social services at an early age, for both moral and economic reasons – incarceration costs at least $30,000 per year per prisoner.

    But even if we do everything possible in the way of social programs, these kids are still going back to often violent and unsupportive home environments. The child protection system is extremely reluctant to take kids away from biological parents, even after repeated instances of neglect and even abuse. At what point do parental rights end and the long-term welfare of children begin?

    Comment by John Webster — January 4, 2012 @ 5:01 pm

  10. Also, just to piggyback on Dan Willingham’s comment, there is excellent research demonstrating that if you yourself did not experience supportive adult relationships as a child (i.e., have a “secure attachment,” as it’s referred to in the psychology literature), the likelihood goes way down that you will be able to provide such a relationship for — or, more accurately, as relationships are bidirectional, have such a relationship with — your child. And this is actually controlling for the variables that Dan mentioned, including socioeconomic status, maternal age, level of education, etc. Although of course toxic stress can exist at all income levels, this is yet another way that the cycle often repeats itself in underserved communities.

    Comment by Rebecca Schrag — January 4, 2012 @ 5:20 pm

  11. There have been hints of this being part of what affects children in the literature for years. Paul Tough discusses the impact of toxic stress on short term memory in his book on the the Harlem Children’s Zone. As this economic crisis continues I wonder at how this generation of children will be affected by their parent’s economic crisis. What is even more disturbing is that the types of intervention needed for these kids has been considerably eroded by budget cuts.

    Comment by DC Parent — January 4, 2012 @ 7:55 pm

  12. @ Rebecca – just finished Robert Massie’s new bio of Catherine the Great. She was Great in many ways, but not as a mother. Massie attributes this to her own poor relationship with her mother, and to the poor relationship she had with her mother-in-law, Elizabeth. Catherine’s children were taken from her at birth and she did not get to see them again for many years. And I’m going to guess that being the Czar means you’re pretty high SES, no?

    @ Dan, @ Robert. Didn’t Dobbie and Fryer claim that it was the schools alone, and not the services, that accounted for the difference in the test scores for kids who were accepted into the HCZ lottery? I was suspicious of their conclusions, but they are ‘serious’ academics, no?

    Comment by matthew — January 4, 2012 @ 9:46 pm

  13. I teach in a high poverty school and have experienced firsthand the frustration of working with children who are in environments full of toxic stress. You do what you can for each child, but as budgets shrink and resources get scarcer these are the children who suffer the most. Putting more pressure on teachers to hold them accountable does nothing to help. Most teachers are already doing everything possible and are frustrated that they can’t do more. I can’t count the number of times I have heard a teacher say how they wished they could take that child home with them every night instead of having to send them to what is far from an ideal environment. Many people say “Just report them to Child Protective Services” but teachers and other professionals who work in these situations know it takes a long time to build a case file and one incident or teacher suspicions usually will not immediately change the situation. Often by the time CPS takes action serious damage has already occurred. Clearly a better system for preventing toxic stress in the first place in needed. What is not helpful is punishing teachers for something that is clearly beyond their control.

    Comment by Mary S. — January 5, 2012 @ 3:04 am

  14. Unfortunately, I’ll bet that this will just be used as another excuse for kids coming out of HS functionally illiterate and innumerate. Since it’s really not possible to change the kids (large-scale, in the short term), why not get back to what did work for many generations. Starting in kindergarten, teach kids appropriate behaviors (self-control, decent manners, perseverence etc.), teach phonics, grammar, spelling, composition, classic literature, math (Singapore or Saxon) and the disciplines – explicitly, in homogeneous groups, with plenty of reinforcement and immediate help for those struggling. Forget the guide on the side, full inclusion, groupwork, spiral math curricula, readers’ and writers’ workshop, invented spelling, discovery learning, multi-culti everything,grammar avoidance, differentiated learning and the rest of the fads. Give the kids a rich curriculum and teach them what they need to know to expand their opportunities by looking ahead and planning for a better future. Let someone outside the schools handle the non-academic stuff; academics are job enough for the schools.

    Comment by momof4 — January 6, 2012 @ 6:46 pm

  15. Mom,

    Wow! You’ve created a plethora of ammunition for some things that are actually effective in the classroom.

    In addition, teach in homogenous groups? I hope not. And unfortunately, if we believed someone outside the schools could handle the affective stuff, we’d be dreaming and avoiding one of society’s realities.

    While I agree, the primary role of our schools should be academics, we simply cannot avoid the “non-academic” stuff.

    Comment by Paul Hoss — January 7, 2012 @ 8:13 am

  16. In case anyone missed the New York Times this morning, Nicholas Kristof writes on this very topic.

    http://www.nytimes.com/2012/01/08/opinion/sunday/kristof-a-poverty-solution-that-starts-with-a-hug.html?_r=1&ref=opinion

    Comment by Paul Hoss — January 8, 2012 @ 10:00 am

  17. Paul Hoss, what exactly is your objection to ability grouping, since you state “I hope not” in response to the idea of teaching in homogenous groups. Ability grouping is not the same as tracking.

    Comment by J.D. Salinger — January 12, 2012 @ 2:08 pm

  18. Where do we go from here. I have never heard such a thing as “toxic stress”. I understand that we have students every year that are in poverty, have learning disabilities,are below proficient,and/or have family issues but we have to always keep in mind that this comes with the territory of teaching. Despite the myth of American individualism, our self definition or sense of selfhood is actually shaped not by seperation but by affiliation, by bonding and identifying with others. our optimal goal is to make sure our students sucessfully succeed. No matter what the issues are.

    Comment by Marilyn Mason — January 18, 2012 @ 12:07 am

  19. Toxic stress is a new word to me as well, however the definition is nothing I haven’t heard or seen before. “When a child experiences strong, frequent, and/or prolonged adversity—such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship—without adequate adult support.” Teachers have tried to help fill these voids in many students lives over the years, but sometimes it just isn’t enough. So we as teachers need to continue having high expectations, hold them accountable, improve our quality of teaching, and be a strong leader for them. After all didn’t we become teachers because we wanted to work with children? So why wouldn’t we want to do whatever it takes to help make these students successful in school and for life?

    Comment by Lindsey Hall — January 18, 2012 @ 2:15 pm

  20. Lindsey,
    I do agree with you. I can speak for myself on why I went into this profession. I came into this profession because I have the zeal and passion for working with children. I know that was my calling because my heart is deepen in it no matter what obstacles I face my heart doesn’t change.

    Comment by Marilyn Mason — January 19, 2012 @ 12:20 am

  21. Marilyn,
    I also agree with you in that our number one goal is to make sure our students successfully succeed no matter what it takes. Every year we have students with some type of problem, issue, disability, etc and it is our job to help them overcome it and succeed. Teachers need to believe in themselves and work with their students instead of making excuses for why they cant/aren’t able to be successful.

    Comment by Lindsey Hall — January 22, 2012 @ 10:41 pm

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  23. [...] at the Core Knowledge blog, Robert Pondisco commented that “the report should have a profound impact on educators and education [...]

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  29. When low income students attend a Head Start class, the Head Statt staff can support the student – emotionally and academically and take away some of the toxic stress. This also would introduce the students to school routines and rules. The staff would be stable figures in their lives who they can go to for support.

    Comment by Sharon Samuels — July 1, 2012 @ 4:01 pm

  30. As
    a school psychologist who listens to teachers, administrators, mental
    health providers, children and youth workers I hear a sense of
    discouragement as to what to do for the most effective outcome for
    children. The most consistent, available thing we can provide is
    affliation and positive relationships. Knowledge of such things as toxic
    stress is important to understand. Also, an understanding that positive
    outcomes may not be immediately seen.

    Comment by Gretchen Warren — July 29, 2012 @ 4:44 pm

  31. [...] http://blog.coreknowledge.org/2012/01/04/student-achievement-poverty-and-toxic-stress/ [...]

    Pingback by Toxic Stress | Shime @ Stanford Studio — October 30, 2013 @ 1:12 am

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