The Biological Embedding of Child Abuse and Neglect: Implications for Policy and Practice and commentaries

Abstract

E ach year within the US alone over 770,000 children are victimized by abuse and neglect (US Department of Health and Human Services, 2010), and this figure is likely to underestimate the extent of the problem. Researchers have long recognized that maltreatment has adverse effects on children's mental health and academic achievement. Studies of adults show that adverse childhood experiences like maltreatment increase risk for chronic diseases of aging, including Type II diabetes and cardiovascular disease. What the field does not fully understand is why maltreatment has such pervasive effects. Studies on the neuroscience of maltreatment have begun to offer some clues. Victims of maltreatment differ from non-victims with respect to brain structure and function, hypothalamic-pituitary-adrenal-(HPA) axis and autonomic nervous system function, immune function, and epigenetic markers. These studies identify potential mechanisms by which maltreatment increases risk for poor mental and physical health and poor school performance by affecting systems that subserve memory, attention, the response to stress, and inflammation. The findings highlight the importance of broadening the scope of child welfare beyond child protection to include child wellbeing. A focus on child well-being would require integrated services, wherein comprehensive mental and physical health care are routinely offered to victims of maltreatment and case workers, pediatricians, and psychologists would work as teams to determine how best to deliver care to children and families in the child welfare system. In working with the family, such efforts could potentially reduce the risk of re-victimization which commonly jeopardizes long-term gains in child well-being. The Biological Embedding of Child Abuse and Neglect:Implications for Policy and Practice From the EditorsThere are many risk factors that negatively impact the brain development of a young child, one of which is child abuse and neglect or child maltreatment. Children who experience maltreatment in the early years are at risk for a variety of poor outcomes, including school failure, problem behaviors, and psychological stress. The emerging field of neuroscience is beginning to provide insight on how maltreatment impacts the development of children's brain and neurological functioning. Uncovering this would facilitate appropriate and effective interventions for children who experience maltreatment and prevent child abuse. Institutes of Health, DHHS. The proceedings encouraged the translation of science leading to innovative approaches to addressing the needs of children who experience maltreatment. In addition to providing comprehensive research linking maltreatment to change in children's neurodevelopmental behavior and functioning, the authors, Jaffee and Christian, call attention to interventions that can prevent child abuse and support children who are maltreated, highlighting the importance of comprehensive and integrated services for these children.From a federal research vantage point, Boy...

Implementing a Trauma-Informed Approach in Pediatric Health Care Networks

“…Toxic stress may disrupt the development of brain circuitry and other physiological systems, which in turn can heighten risk for impairments in cognitive development, behavioral and psychological functioning, and physical health well into the adult years. 29,30 …”

Should Parents' Physical Punishment of Children Be Considered a Source of Toxic Stress That Affects Brain Development?

“…Thus, high glucocorticoid levels damage the same area of the hippocampus responsible for tamping them down, leading to high levels of glucocorticoids even after the stressor is no longer present (Tarullo & Gunnar, 2006). In a vicious cycle, these high levels are thought to result in further damage to the hippocampus and subsequent mental and physical health problems (Jaffee & Christian, 2014).…”

Looked after Children and Young People in England: Developing Measures of Subjective Well-Being

“…A strong evidence base (e.g. Jones et al 2011;Jaffee and Christian 2014) shows that the impact of child maltreatment can be long lasting. Consequences include mental and/or physical disabilities resulting from the initial injuries; psychological problems related to experiencing trauma such as post-traumatic stress disorder, hyperarousal, anxiety, depression; cognitive problems such as lack of curiosity and short attention span; and later health problems such as the development of diabetes and heart conditions.…”