Toxic stress in childhood and the power of nurturing relationships

The impact of Adverse Childhood Experiences (ACEs) has been well established since a landmark population-based study published in the late 1990s demonstrated a strong association between exposure to toxic stress in childhood and a wide range of adverse mental and physical health outcomes in adulthood--from substance use to cancer.

One thing to keep in mind is that these findings are population-level associations. An individual’s ACE score does not determine their specific health trajectory. In other words, history is not destiny—which underscores the importance of understanding the protective factors that mitigate risk.

Notably, the original ACE study examined outcomes in relation to adversity without accounting for the presence of protective influences. Since then, a growing body of research has highlighted the critical role of safe, stable, and nurturing relationships (SSNRs) as key buffers against the negative effects of early adversity.

This represents a significant advancement in the science of resilience.

Positive Childhood Experiences (PCEs)—experiences that promote relational health and emotional safety—are now recognized as strong predictors of mental health and well-being, even in the presence of adversity. Unlike many risk factors, PCEs are elements of a child’s environment that parents, caregivers, and communities can directly influence—and they are protective factors that can be intentionally cultivated.

PCEs are operationalized as the presence of the following:

• Feeling able to talk to family members about feelings

• Receiving family support during challenging times

• Participating in community traditions

• Experiencing a sense of belonging in school

• Maintaining supportive friendships

• Having at least two non-parent adults who genuinely cared

• Feeling safe and protected at home

These findings provide a hopeful and actionable framework. 

Investing in your parenting and family relationships will buffer your child against stress and promote long-term health.