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Published On Dec 23, 2015

Clinical Research

Relief Valves

Pilot programs teach kids and parents skills for coping with stressful lives.

In a sense, it’s simple. Everyone already knows how to prevent the devastating effects that early childhood stress can have on children later in life. “We could eliminate poverty, violence, racial discrimination and child maltreatment,” says Jack Shonkoff, director of the Center on the Developing Child at Harvard University. “Then we would see huge improvements in the health of our population.” The question is: What can we do in the meantime?

Shonkoff’s center has helped develop 20 pilot programs that begin to answer that question. He compares them to the clinical trials used to test new drugs and translate research into practice. “We’re not assuming that the same thing will work for everyone,” Shonkoff says. “We need to adapt the model of precision, of personalized medicine, to address the social determinants of disease.”  

In one program, called FIND, researchers film low-income parents playing with their children. They capture moments of positive interactions in which the parent engages in “serve and return” interaction with a child—responding to a baby’s smile with a hug and coo, or to a toddler’s question with a conversation. The researchers then use those moments to coach parents about how to help their child’s development and be the child’s safe haven in a stormy environment.

Another program teaches parents to play games with their pre-school children that require learning a set of rules to play by. The theory is that these games enhance not just learning and school readiness, but also build skills that help both parent and child better cope with adversity. During this game-based program, researchers found that kids who were good at paying attention made significant gains in abilities linked to cognitive flexibility, or the ability to shift behaviors according to different sets of rules or environments—a skill that comes in handy during adverse conditions. Those with poor attention skills showed no such gains, and researchers worked to improve their attention skills along with the games.

Finding programs that work means taking varied approaches, and then communicating positive results when they happen. Shonkoff’s group has also launched a new research network, working with the National Scientific Council on the Developing Child and the American Academy of Pediatrics, to develop and test new biological measures of toxic stress in pediatric settings. James Perrin, associate chair of MassGeneral Hospital for Children and the immediate past president of the American Academy of Pediatrics, is also involved. Perrin sees the mounting research on the effects of childhood stress as the first step in evolving better treatments for them. “The AAP wants to take the new science of stress and make a difference in the community and pediatric practice,” he says.

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