The ACE Study exposed powerful relationships between exposure to ACEs (i.e. Parental Incarceration) during the first 18 years of life and adult morbidity, mortality, and disability. ACEs have been linked to:




The acute stress response, more commonly known as "fight-or-flight," triggers a near-immediate release of stress hormones (like adrenaline and cortisol) which stimulate physiological changes in preparation for the body to fight a threat or flee to safety.

In 2005, the National Scientific Council on the Developing Child released a groundbreaking paper explaining the physiologic basis for poor adult outcomes in individuals exposed to early adversity. They coined the term “toxic stress” to describe the effects of excessive or prolonged activation of the stress response system on a child’s developing brain and body.

They described a child’s three responses to stress:

  • Positive: Normal, healthy development occurs when a mild, acute stressor triggers a brief stress response. Physiological changes spontaneously return to baseline once the threat resolves.

  • Tolerable: A severe stressor triggers a vigorous stress response. Supportive relationships with adults can buffer the physiologic changes back to baseline. In the absence of these protective relationships, tolerable stress can become toxic.

  • Toxic: Severe, chronic, and unbuffered stress causes excessive or prolonged activation of the stress response system, resulting in damage to a child’s developing brain, immune, metabolic and cardiovascular systems.

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