The World Health Organisation (WHO) is warning that the presence of a caregiver is vital in situations of prolonged exposure to childhood adversities (toxic stress).

In a recently WHO-published document titled Optimizing brain health across the life course, it is noted that toxic stress can cause “changes in the development of brain architecture, including areas of the brain that are responsible for modulating our body’s responses to stress (overactivation of the amygdala, hypothalamus and pituitary and weakening of the prefrontal cortex and anterior cingulate), with lifelong implications for a person’s vulnerability for stress-related mental and physical health conditions”.

Among the potential associated issues were decreased brain volume, cognitive impairments and dementia in the later life. Emerging evidence suggests that financial security at both the individual and community levels can have impacts on brain health.

According to the WHO, “Brain health is the state of brain functioning across cognitive, sensory, social-emotional, behavioural and motor domains, allowing a person to realise their full potential over the life course, irrespective of the presence or absence of disorders”.

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While it is key to note that exposure to stress is an important and natural part of childhood development, loving and responsive interactions between a child and their caregiver are referred to as “serve and return” interactions and have a positive impact on the structural development of a child’s brain. Caregivers can serve as important buffers to ensure that the stresses faced by children remain tolerable.

Typical causes of toxic stress in children include prolonged exposure to maltreatment (physical abuse, sexual abuse, neglect); parental maladjustment (parental mental health conditions, substance use, parental criminal behaviour, family violence); interpersonal loss (parental divorce, parental death, other parental loss); and other childhood adversities (physical illness, family economic adversities).

The document states that toxic stress has been linked to school attrition, incarceration and lower economic productivity and investment in early childhood development has been proven to be a cost-effective way to counteract some of the negative impact.