Early Life Stress Effects on Children's Biology, Behavior, and Health: Evidence, Mediators, Moderators, and Solutions

This review synthesizes and critiques research on early life adversity and stress effects on multidomain health outcomes in child samples to fill a gap in the literature that has largely focused on adults. Prioritizing evidence from meta-analytic and systematic reviews as well as findings from (quasi-)experimental or large prospective longitudinal studies, we integrate interdisciplinary findings to characterize patterns of evidence for stress associations with child outcomes, including mental, physical, and positive health; academic, social, and justice system–related domains; and intermediary phenotypes that may predict disease, including biomarkers. We note cohesive evidence for sensitive periods of susceptibility to stress exposure and describe key mediators and moderators of stress effects, especially family-level factors. Then we highlight interventions targeting malleable factors that hold promise for ameliorating the effects of stress on children. Leveraging a developmental lens, we conclude with field-wide limitations and propose future directions for stress and health research that centers child development.