Early Literacy Research Library (ELRL) - Article

Preventing Childhood Toxic Stress: Partnering with Families and Communities to Promote Relational Health

Garner, A., Yogman, M., COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY HEALTH, SECTION ON DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS, COUNCIL ON EARLY CHILDHOOD. (2021) Preventing Childhood Toxic Stress: Partnering With Families and Communities to Promote Relational Health. Pediatrics, 148(2), e2021052582.,

Access: FREE/Open Access

Publication year


study description

Policy statement.

core topic(s)

Early Relational Health

Exposures, Outcomes, Other

Disparity/Adversity , Mental Health , School Readiness and Educational Outcomes


To discuss a revised policy statement on preventing toxic stress and promoting relational health.


Toxic stress and relational health.

outcomes evaluated

Health, education, and economic stability across the lifespan.


Topics Discussed: Spectrum of adversity; Ecobiodevelopmental model of disease and wellness; Components of public health approach to toxic stress; Emerging science of relational health; Links between relational health and resilience; Public health approach to build relational health; Vertical integration to match levels of need with specific interventions; Horizontal integration across sectors at the community level; Centrality of relationships in pediatric care; Acknowledging the role and toll of social isolation; A renewed commitment to science-based policy formation; Application of science based principles to strengthen pediatric practice [Support nurturing relationships; Reduce external sources of stress on families, Strengthening core life skills].




This revised policy statement on childhood toxic stress acknowledges a spectrum of potential adversities and reaffirms the benefits of an ecobiodevelopmental model for understanding the childhood origins of adult-manifested disease and wellness. It also endorses a paradigm shift toward relational health because SSNRs not only buffer childhood adversity when it occurs but also promote the capacities needed to be resilient in the future. To translate this relational health framework into clinical practice, generative research, and public policy, the entire pediatric community needs to adopt a public health approach that builds relational health by partnering with families and communities. This public health approach to relational health needs to be integrated both vertically (by including primary, secondary, and tertiary preventions) and horizontally (by including public service sectors beyond health care).


The American Academy of Pediatrics asserts that SSNRs are biological necessities for all children because they mitigate childhood toxic stress responses and proactively build resilience by fostering the adaptive skills needed to cope with future adversity in a healthy manner.


Not discussed.