Researchers know that chronic stress – living with a continual sense of threat or peril – can have harmful effects on human brains.
In very young humans, whose brains and other internal networks still are developing, such stress can have lifelong consequences in large part because of how the stress hormone cortisol affects the brain's structure and circuitry. Long-term exposure can contribute to mental health disorders, learning problems, inability to regulate emotions and a cascade of other troubles, researchers say.
But researchers also know that nurturing relationships with caregivers can relieve such stress in children and even reverse some of the damage done by such situations.
That's why child advocates and researchers around the nation – including a team led by Jason Hustedt, assistant professor in the University of Delaware's Department of Human Development and Family Studies – are looking for effective ways to help families and caregivers build healthy, supportive relationships with the children in their care. Stronger relationships may be precisely the foundational shift children need to overcome the effects of harmful stressors such as conditions of poverty, abuse and/or neglect.
The University's Starting At Home project led by Hustedt is part of the federally funded Buffering Toxic Stress Consortium, which also includes five other research projects to evaluate promising approaches to reducing high stress levels in children.
The consortium, created by the Administration for Children and Families' Office of Planning, Research and Evaluation, a division of the U.S. Department of Health and Human Services, also includes the University of Maryland, New York University, Washington University, the University of Colorado's Anschutz Medical Campus and the University of Denver.
A $2 million five-year grant supports UD's study of "Promoting First Relationships," or PFR, an intervention approach designed to improve parent-child interactions. When the study is complete, the team will make recommendations on the maintenance and sustainability of the PFR model in Early Head Start.
The goal of PFR is to help community providers work with families and caregivers to understand and meet children's needs, focusing on five areas:
• Promoting love and attention on a daily basis;
• Responding with empathy and understanding;
• Providing comfort during times of distress;
• Building a predictable environment; and
• Promoting play and exploration.
The study is part of the legacy of the Head Start program, Hustedt said, which not only offers services to families but provides a platform for research so that those services can be improved and have greater impact for future generations.
"I feel like we've had this great opportunity to look into something that has the potential to be really important in Early Head Start," he said. "We're hoping our study provides a model for something like this that could be sustained outside of the University of Delaware – not just to influence practice on campus, but have a larger-scale impact on Early Head Start, a national program."
In addition to Hustedt, the UD research team includes associate professors Rena Hallam, Myae Han, and assistant professor Jennifer Vu.
Among their questions:
• What role do high stress levels have in the lives of children and families served by the Early Head Start program?• How can the PFR intervention be implemented in the context of existing home- and center-based Early Head Start programs?• How effective is PFR in buffering Early Head Start children from toxic stress?
The families participating in the UD study all have children enrolled in UD's New Directions Early Head Start programs. In an initial wave of the study, almost half of the families were African-American, a third were Hispanic/Latino, Hustedt said.
Children in the study include those who receive services in their homes or at partnering child care centers based at Neighborhood House in Wilmington's Southbridge section, Hilltop Lutheran Community Center in Wilmington and UD's Early Learning Center in Newark.
Heidi Beck directs the New Directions Early Head Start program, which is part of the Delaware Institute for Excellence in Early Childhood.
Participants agreed to 10 home visits with a trained worker, agreed to allow their children's saliva to be tested for the stress hormone cortisol and agreed to participate in interviews and allow videos of their interactions with their children for the study. The idea is to help parents and caregivers build on their strengths and increase their ability to tune in to and respond to their children's needs.
"It's wonderful that the University has this Early Head Start program already," Hustedt said. "It provides opportunity for close partnership with Early Head Start that would be more work to navigate if they weren't right here. We were able to build on a strong partnership that already existed and that allows a lot of close contact and deep mutual understanding. Usually in these types of studies, navigating and building relationships with Early Head Start groups can require an intensive initial investment of time. Here, we were able to build on existing relationships. For example, we already knew what type of staff the Early Head Start program had, and we knew the program goals and values."
UD hosted visitors from the U.S. Department of Health and Human Services' Administration for Children and Families last month. The group – which included policy analysts, research analysts, strategic advisers and program directors – toured two of the Early Head Start centers and heard from several of the program's home visitors.
"For me, this reinforced that I am not the expert," said Esther Lauser, one of the home visitors. "I help them connect the dots. I don't draw conclusions for them. I create opportunities so they can do that in a way that feels real and genuine for them."
The home visitors are mentored by Leah Leader, who helps them navigate their encounters with families and children.
The studies continue, with published results and recommendations likely in about a year, Hustedt said.
"These are the most devoted people," said Bahira Trask, chair of UD's Department of Human Development and Family Studies. "There is a lot of criticism about ivory towers and research. What this group is doing is a model in terms of translational research."
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