Toxic Stress 

Early exposure to adverse experiences, such as child abuse or neglect, poverty, neighborhood and domestic violence, and parental mental illness causes enduring trauma to a child’s developing brain. Known as “toxic stress,” adverse experiences in infancy and early childhood disrupt the developing brain architecture and can lead to permanent changes in learning, behavior and physiology. The effect of toxic stress is cumulative, and it is most harmful when there are numerous stressors over an extended period of time.

Research suggests that toxic stress levels in early childhood contribute to the development of adult chronic disease, including cardiovascular disease, autoimmune diseases, chronic obstructive pulmonary disease, and depression. Adverse experiences include: frequent socioeconomic hardship, parental divorce or separation, parental death, parental incarceration, witnessing domestic violence, witnessing violence in the neighborhood, experiencing racial or ethnic discrimination, living with someone who is mentally ill or suicidal, and living with someone who has problems with substance abuse. Nearly one in four infants and toddlers in the U.S. has experienced one or more adverse experiences. Even after excluding economic hardship, children under age three who live in poverty are four times more likely to experience two or more adverse experiences. 

Highlights on Toxic Stress from Rhode Island KIDS COUNT

Toxic stress indicators from the 2019 Factbook:

The following indicators from The 2019 Rhode Island Kids Count Factbook track progress on factors directly related to toxic stress.

Issue Briefs 

  • Young Children in the Child Welfare System, December 2015
    In Rhode Island and in the U.S., young children under age 6 are more likely to experience maltreatment (neglect or abuse) than older children. Safe, stable, nurturing relationships in the first years of life are fundamental for healthy brain development. Child maltreatment disrupts the development of the brain and biological systems, resulting in short-term harm and long-term negative outcomes.

    Young Children in the Child Welfare System provides an overview of data on child maltreatment, how the child welfare system responds to abuse and neglect, the role of kinship and non-kinship foster homes, and includes recommendations for keeping children safe and meeting their developmental needs.
  • Infants, Toddlers, and their Families in Rhode Island, June 2015 - This report includes information and data on issues affecting Rhode Island infants, toddlers, and their families, including: economic security, parental education, family home visiting programs, quality early childhood education, healthy births, developmental screenings and other health issues, and paid family leave. 
  • Child Poverty in Rhode Island, January 2015 - poverty is an issue affecting children and families in every city and town in Rhode Island. Children in poverty, especially those who experience poverty in early childhood and for extended periods, are more likely to have physical and behavioral health problems, experience difficulty in school, become teen parents, and earn less or be unemployed as adults. Children in poverty are less likely to be enrolled in preschool, more likely to attend schools that lack resources and rigor, and have fewer opportunities to participate in extracurricular activities. Statewide and community-specific child poverty rates are presented in the Issue Brief
  • Young Children with Developmental Delays & Disabilities, November 2013 - this report outlines the benefits young children receive from early developmental screenings and high-quality intervention and education programs, and key issues related to young children with disabilities. Children who are most at risk for developmental problems are those that have experienced multiple risk factors during early childhood. 
  • Disparities in Children's Health, February 2012 – this report provides information on racial and ethnic disparities in maternal and child health in Rhode Island, including perinatal health, infant health, asthma, and obesity.

Special Publications

  • Early Learning Fact Sheet: Focus on Evidence-Based Family Home Visiting, October 2015 – Healthy brain development depends on attentive, nurturing caregiving in infancy and early childhood. Research shows that there is a negative impact on brain development when young children do not have consistent, supportive relationships with caregivers and are exposed to “toxic stress.” Providing early and intensive support to families with multiple risk factors improves child development outcomes. This report includes data and information on infants born with key risk factors, and provides a comprehensive overview of Evidence-Based Family Home Visiting Programs in Rhode Island.
  • Next Steps for Rhode Island's Infants, Toddlers, and Their Families, June 2015 - Next Steps is a set of recommended policy priorities for Rhode Island infants, toddlers, and their families. Developed under the leadership of a public-private steering committee using input from more than 200 early childhood experts from across the state and technical assistance from Zero to Three, Next Steps has been endorsed by a variety of statewide planning groups, including the Rhode Island Early Learning Council and Successful Start. The four policy focus areas are: Economic Security, Mental Health & Well-Being, Parenting & Family Support, and High-Quality Early Learning & Development Programs.



Rhode Island KIDS COUNT works to improve the health, safety, education, economic security, and development of Rhode Island’s children.


Rhode Island KIDS COUNT
One Union Station
Providence, RI 02903


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