Our City: Are Ottawa’s kids under stress?

6 MIN READ
In Ottawa, many youth are in situations of emotional distress—they struggle with things like depression, anxiety, or even isolation. That’s why United Way and our community partners invest in programs that minimize what we call “negative life outcomes”—things like poor mental health, socioeconomic inequality or unhealthy lifestyles down the road. By investing in early childhood, together we are addressing their needs now, but also laying the foundation for future success.

It’s essential that we work together to do everything we can to support healthy development in children’s early years.

By Paul Steeves, Senior Manager, Evaluation and Analytics, United Way Ottawa; and Paula Quig, Researcher, Community Initiatives, United Way Ottawa

By now, most kids in Ottawa have settled back into the school routine following their return from winter holidays, and they find themselves in their classrooms both ready and excited to learn. But for some, learning and succeeding in school can be a real struggle.

While there are many reasons for this, among them is the unsettling reality that many of Ottawa’s kids deal with toxic stress, which can have damaging effects on their learning, behaviour and long-term physical and mental health.

However, with the right early intervention and prevention strategies, United Way and our partners can play a vital role in minimizing, or even preventing, the serious and long-term impacts of toxic stress.

What is toxic stress?

We all experience a certain amount of stress in our lives, and not all types of stress are actually bad for us.

Positive stress, such as the stress experienced when facing challenges like meeting new people or first-day-of-school jitters, is actually essential for a child’s development. The positive stress response tends to be short-lived and mild, and when children are emotionally supported with reassurance and protection, their experiences with this type of stress allow them to gain resilience—helping them later on in life.[i]

Tolerable stress, such as that experienced when dealing with the death of a loved one, is a more severe type of stress. Thankfully, a child’s brain will usually recover from this type of stress if they are protected with healthy relationships and strong social and emotional supports.[ii]

Toxic stress is different. It’s caused by things like as abuse, neglect, extreme poverty, violence, household dysfunction and food scarcity[iii]—hardships that can be detrimental to mental and physical health in the long term.

Toxic stress results in prolonged activation of the stress response. In a toxic stress situation, there is a lack of caregiver support, reassurance or emotional attachment, which prevents the buffering of the stress response and the return of the body to its normal functioning.

Why is toxic stress during a child’s early years so dangerous?

Medical research has shown that early toxic stressors—particularly those experienced during the first six years of life—increase a child’s vulnerability to outcomes such as unhealthy lifestyle, socioeconomic inequality and poor physical and mental health. Evidence also shows that toxic stress in these early years can actually result in permanent changes to the brain.[iv]

This is because the time between a child’s birth and the moment they reach age six is a crucial period in their long-term development.  In fact, during these key years an infant’s brain actually triples in size as the physical circuity of the brain is established.[v]

Brain connection density over time – Corel, J. L. (1975). The postnatal development of the human cerebral cortex. Cambridge, MA: Harvard University Press.

Negative experiences during a child’s early years—such as those resulting from toxic stress—are harmful to brain development and can have lasting, lifelong impacts.  These impacts can include post-traumatic stress disorder (PTSD), difficulty in the regulation of emotional responses and behavior, psychosis, depression, and an increase in suicide attempts. Toxic stress can also result in poor health outcomes including increased risk of infections in children, alcoholism, chronic obstructive pulmonary disease, cancer, obesity, heart disease, and an increase in suicide attempts.[vi]

The powerful impact of toxic stress is clear. Early intervention and prevention strategies are needed to minimize serious long-term impacts.

How vulnerable are Ottawa’s young children?

The Early Development Instrument (EDI) gives insights into the health and wellness of senior kindergarten students across five domains that affect their development. United Way uses data from the EDI, along with data from the Ottawa Neighbourhood Study (ONS), to better understand where Ottawa’s most vulnerable kids are located. This allows us to effectively address the needs of our city’s most vulnerable children.

Based on these tools, we know that 25% of Ottawa’s young children are vulnerable in one or more domains that affect their development when they start school. When we compare Ottawa to the provincial baseline of EDI scores, we see that our kids are falling behind significantly in two specific areas: social competence and emotional maturity.

This is important, because vulnerability in these two areas are strong predictors of mental health challenges later in life.

In low-income areas of Ottawa, the need for support becomes even greater—as areas with lower neighbourhood income are associated with poorer EDI scores.[vii]

How can we work together to improve the outcomes for Ottawa’s most vulnerable children?

United Way is fortunate to have Dr. Paul Roumeliotis—a passionate champion and advocate for early childhood development—as a member of our Board of Directors. In this video, he shares his insight into the importance of a child’s first 18 months of life and its effects over the course of a lifetime.

Dr. Paul’s message is clear: Early childhood lays the foundation for the future. This is why it’s essential that we work together to do everything we can to support healthy development in children’s early years.

In Ottawa, significant segments of our youth populations are in situations of emotional distress:

  • More than 1,300 Ottawa students (4%) reported that they had attempted suicide in 2017-2018 and one in nine (11%) Ottawa students in grades 7 to 12 reported that they had considered suicide in the past year.[viii]
  • Since 2010, mental health emergency visits at the Children’s Hospital of Eastern Ontario (CHEO) have increased by 75%.[ix]
  • More than 50% of Ottawa’s homeless population had reported a past diagnosis of mental illness.

Together with our donors, we help create nurturing, more stable and engaging environments where our city’s kids can develop, learn and grow.

Here’s how we do it:

  • Parenting programs that improve overall infant/toddler development and attachment relationships with mothers.
  • Individual parenting sessions based on brain development research, targeted parent/child interactive groups, attachment-focused parenting group programs and individual interventions.
  • Social skills programs that teach anger-management and problem-solving strategies.
  • Outreach services in shelters that connect parents and families with early intervention children education programs, culturally specific playgroups, after-school programs, and food security programs.
  • Intensive, individualized supports for parents and families in crisis. This includes active outreach to highest risk families for referrals to services, helping to reduce socio-economic and psychosocial stressors.

United Way also collaborates with incredible local initiatives to go beyond the stats and discuss with local experts what we’ve learned, what it means, and what we should do about it.These organizations include:

  1. The Ottawa Neighbourhood Study (ONS)(led by the University of Ottawa), provides data on strengths and challenges for our city’s neighbourhoods. This work allows United Way and agency partners to identify neighbourhoods that could benefit from more resources.
  2. The Parent Resource Centre and its Data Analysis Coordinators (DACs)  provide innovative support services within the early childhood sector by facilitating research activities, monitoring child outcomes, and enhancing capacity for evidence-informed planning.
  3. The Ottawa Child and Youth Initiative envisions a community that is committed to supporting children and youth to reach their full potential. To do so, they outline key indicators that will help us understand whether or not we’re making a difference.

[i] Franke, Hillary A. Toxic Stress:  Effects, Prevention and Treatment.   Children (Basel). 2014 Dec.; 1(3); 390-402; Center on the Developing Child, Harvard University. Toxic Stress.  Available online at https://developingchild.harvard.edu/science/key-concepts/toxic-stress-stress/.  See also Gunnar, Megan R. PhD, Herrera, Adriana MA, and Hostinar, Camelia E. BS.  Stress and Early Brain Development.  University of Minnesota, USA.  June 2009.  Encyclopedia on Early Childhood Development.

[ii] Franke, supra.

[iii] Franke, supra.

[iv] Franke, supra.  National Scientific Council on the Developing Child. (2005/2014). Excessive Stress Disrupts the Architecture of the Developing Brain: Working Paper 3. Updated Edition. http://www.developingchild.harvard.edu.

[v] Dr. Jean Clinton   Supporting Ontario’s youngest minds:  Investing in the mental health of children under 6.  Ontario Centre of Excellence for Child and Youth Mental Health.  November 2014 at 13.

[vi] Franke, supra.   See also generally the results of the Ace Study, available online on the Centre for Disease Control website at https://www.cdc.gov/violenceprevention/acestudy/about.html

[vii] See Canadian Institute for Health Information.  Children Vulnerable in Areas of Early Development:  A Determinant of Child Health.  Ottawa, ON:  CIHI; 2014 at page 8

[viii] Note as well that in 2015 Canada was cited as one of the five countries with the highest teenage suicide rates (10 per 100,000 teens).  See  Organization for Economic Co-operation Development Family Database.  CO4.4:  Teenage suicides (15-19 years old) [Internet].  OECD; 2017 Oct 17 [cited 2018 Jul].  Available online at:  http://www.oecd.org/els/family/CO_4_4_Teenage-Suicide.pdf).

[ix] See Canadian Institute for Health Information.  Child and youth mental health in Canada [Infographic on internet].  Ottawa:  CIHI; 2018 [cited 2018 Jul].  Available online at:  https://www.cihi.ca/en/child-and-youth-mental-health-in-canada-infographic.  It is noted that from the 2007-08 to 2016-17 period there was a 66% increase in emergency department visits, and a 55% increase in hospitalizations, of children and youth (5 to 24 years) due to mental health concerns.  More generally, self-harm hospitalizations for children and youth in Canada increased a 90% between 2009-2014.  See Canadian Institute of Health Information.  Self-harm and assault:  A closer look at children and youth [Internet].  Ottawa:  CIHI; 2014 Nov [cited 2018 Jul].  Available online at: https://secure.cihi.ca/free_products/Public_Summary_Intentional_Injuries_EN.PDF

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