The lifelong effects of early childhood adversity and toxic stress

Jack P. Shonkoff, Andrew S. Garner, Benjamin S. Siegel, Mary I. Dobbins, Marian F. Earls, Laura McGuinn, John Pascoe, David L. Wood, Pamela C. High, Elaine Donoghue, Jill J. Fussell, Mary Margaret Gleason, Paula K. Jaudes, Veronnie F. Jones, David M. Rubin, Elaine E. Schulte, Michelle M. Macias, Carolyn Bridgemohan, Jill Fussell, Edward GoldsonLaura J. McGuinn, Carol Weitzman, Lynn Mowbray Wegner

Research output: Contribution to journalArticlepeer-review

3047 Scopus citations


Advances in fields of inquiry as diverse as neuroscience, molecular biology, genomics, developmental psychology, epidemiology, sociology, and economics are catalyzing an important paradigm shift in our understanding of health and disease across the lifespan. This converging, multidisciplinary science of human development has profound implications for our ability to enhance the life prospects of children and to strengthen the social and economic fabric of society. Drawing on these multiple streams of investigation, this report presents an ecobiodevelopmental framework that illustrates how early experiences and environmental influences can leave a lasting signature on the genetic predispositions that affect emerging brain architecture and long-term health. The report also examines extensive evidence of the disruptive impacts of toxic stress, offering intriguing insights into causal mechanisms that link early adversity to later impairments in learning, behavior, and both physical and mental well-being. The implications of this framework for the practice of medicine, in general, and pediatrics, specifically, are potentially transformational. They suggest that many adult diseases should be viewed as developmental disorders that begin early in life and that persistent health disparities associated with poverty, discrimination, or maltreatment could be reduced by the alleviation of toxic stress in childhood. An ecobiodevelopmental framework also underscores the need for new thinking about the focus and boundaries of pediatric practice. It calls for pediatricians to serve as both front-line guardians of healthy child development and strategically positioned, community leaders to inform new science-based strategies that build strong foundations for educational achievement, economic productivity, responsible citizenship, and lifelong health.

Original languageEnglish (US)
Pages (from-to)e232-e246
Issue number1
StatePublished - Jan 2012
Externally publishedYes


  • Advocacy
  • Brain development
  • Disease prevention
  • Ecobiodevelopmental framework
  • Health disparities
  • Health promotion
  • Human capital development
  • New morbidity
  • Pediatric basic science
  • Social inequalities
  • Toxic stress

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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