INTERGENERATIONAL RISK TRANSMISSION AND TOXIC STRESS: IMPACT ON CHILD DEVELOPMENT IN A COMMUNITY SOCIAL PEDIATRICS CONTEXT

Abstract

BACKGROUND: Child well-being and development is closely dependent on his proximal environment. Early life chronic adversity exposure engenders toxic stress that will jeopardize cognitive, emotional, and health development. Poverty is a well-documented risk factor. However, less is known about the intergenerational transmission effects of cumulative risk factors such as maternal history of early adversity (MHEA) and low socio-economic status (SES). Because childhood SES influences developmental outcomes with effects sustained in adulthood, it is essential to address the influence of MHEA on child well-being in the context of low SES. OBJECTIVES: Community Social Pediatrics is an integrated social medicine model that brings together expertise from the medical, legal and social science in an eco-biological way in order to detect, reduce or eliminate sources of toxic stress in vulnerable children. Services and multidisciplinary interventions are provided in a single location, the community social pedi-atric center (CSPC). The goal of this study is to examine the influence of maternal history of early adversity (MHEA) and toxic stressors on child well-being in the context of CSPC. DESIGN/METHODS: Two groups were compared: CSPC users (mothers-children dyads, age 18 to 48 months, n = 34) and a low SES sub-sample (mothers-children dyads, age 48 months, n = 64). The latter is taken from a longitudinal study on maternal adversity. MHEA was assessed using the Childhood Trauma Questionnaire (CTQ) and child behavior was measured using the Child Behavior Checklist (CBCL). RESULTS: Results show that MHEA is significantly higher among CSP users than in normative samples (p