RT Book, Section A1 Asnes, Andrea G. A1 Greeley, Christopher S. A2 Kline, Mark W. SR Print(0) ID 1182917578 T1 Childhood Adversity and Toxic Stress T2 Rudolph's Pediatrics, 23e YR 2018 FD 2018 PB McGraw-Hill Education PP New York, NY SN 9781259588594 LK accesspediatrics.mhmedical.com/content.aspx?aid=1182917578 RD 2024/03/29 AB While some degree of trauma and exposure to adversity in childhood is both commonplace and may even be an asset to healthy development, sustained exposure to trauma or severe trauma can result in long-term negative health consequences. This trauma may be physical, but it is often the more insidious emotional, psychological, or social forms of trauma. Early traumatic experiences can affect the way the genome is read, the development of the hypothalamic–pituitary–adrenal (HPA) axis, and the way the developing brain is wired. Because a child’s brain continues to grow long after birth, environmental exposures, both positive and negative, can profoundly impact the developing child. The first 3 years of life are a particularly vulnerable period, given the plasticity of the brain in infancy and early childhood. Traumatic exposures (often collectively referred to as adversities) can influence learning, behavior, and health in children as well as result in adult risky behaviors, serious health problems, and early death. An understanding of the ways in which adversity affects the growing child can help the pediatric provider both to mitigate the influence of traumatic exposures in children and to shore up community resources that promote resiliency and protect against some of the negative lifelong consequences of childhood trauma.