Like most pediatricians, Dr. Kathryn Cambi routinely asks parents about non-medical problems that can affect their child’s mental and physical health, like job losses, divorce, drug and alcohol abuse and safety at home.  

“You need to be able to approach these delicate topics with parents,” Cambi, who practices at Flanders Pediatrics in East Lyme, said Thursday. “You have to have a good relationship with patients, and make these questions part of your regular screenings, just like questions about eating and drinking.”

Since 2002, when she and other pediatricians in Connecticut encounter families in need of help, they’ve been able to tap the “Help Me Grow” program of the state Office of Early Childhood to connect parents and their children with services to help with developmental and behavioral problems and fill basic needs. 

Created in 1997 at the Connecticut Children’s Medical Center in Hartford and then expanded statewide, “Help Me Grow” is now being replicated in 25 states and territories.

In Connecticut, about 4,000 to 5,000 families per year use the Child Development Infoline, said Dr. Paul Dworkin, executive vice president for community child health at CCMC.

Now, CCMC is launching a new national program to enhance identification of children at greatest risk from the effects of various kinds of trauma.

Last week, it announced its “toxic stress” initiative, designed to help pediatricians and parents recognize the cumulative impact of repeated stresses on a child’s life, and become aware of possible long- and short-term effects and how to lessen them.

“We are not yet screening for toxic stress per se in pediatricians’ offices, but now we will be,” said Dworkin.

“Toxic stress” is a term recognized by mental health professionals and the American Academy of Pediatrics as prolonged exposure to stress from conditions in the home such as domestic violence, emotional abuse, neglect, substance abuse, mental illness and economic hardships.

In children, this can lead to damaging effects on learning, behavior and health.

Children who grow up with toxic stress are more prone to mental and physical health problems as adults.

“Research has shown that the number of adverse experiences in childhood matter,” Dworkin said. “Cumulative stress has a so-called ‘toxic effect’ on children's well-being and can contribute to long-term health issues, such as adult heart disease and malignancies, as well as mental illness.”

The new initiative is being funded through a grant from the New York-based JPB Foundation.

Dworkin said the private, nonprofit group provided the funding in November, and since then CCMC staff have been working on how to bring the program to pediatricians.

He said the foundation asked that the amount of the grant be kept private.

“Over the next several months,” Dworkin said, “we’ll go out and start working with pediatric practices.”

That will include trainers visiting pediatricians to teach them about toxic stress and how to work with families to lessen the effects, as well as providing screening tools and parenting support, he said.

Pediatricians are being invited to contact CCMC to request the training.

“We’re hoping we’ll be overrun with requests,” Dworkin said.

Cambi, for one, is interested in taking advantage of the new program.

She said she has rarely used the term "toxic stress," but now that there’s more emphasis on identifying it, may start to use it more often.

While some may dismiss the notion of "toxic stress" with the mantra that "kids are resilient," Cambi believes the term is valid and that more people need to understand that stress can be toxic to health.

In her talks with parents, she said, she would emphasize that “toxic stress” puts children at greater risk for health problems in adulthood such as heart disease and diabetes, and can make them more prone to drug and alcohol abuse as teenagers, she said.

“It’s a new term that can make parents realize that when a child is exposed to repeated stress, there are going to be effects,” she said. “It’s not just going to be something they bounce back from.”

j.benson@theday.com

Twitter: @BensonJudy 

'Help Me Grow' has resources for parents, physicians

By calling the Child Development Infoline, (800) 505-7000, doctors and parents can find the best resources in their own communities.

Created in 1997 at the Connecticut Children's Medical Center in Hartford and then expanded statewide, "Help Me Grow" is now being replicated in 25 states and territories. In Connecticut, about 4,000 to 5,000 families per year use the service.