Early Head Start University Partnership Grants: Buffering Children from Toxic Stress, 2011-2016

Early experiences influence life-long health and well-being. A growing cluster of research on early adversity, trauma and toxic stress underscores the importance of both reducing stressors on the children and families ACF serves and helping them cope with these experiences. The Buffering Toxic Stress Consortium is a set of six grants evaluating promising parenting interventions in Early Head Start settings to help buffer children from toxic stress. Ultimately, they are answering the question: Can parenting interventions buffer children from toxic stress?

  • The grants were awarded to New York University, University of Colorado Denver, University of Delaware, University of Denver, University of Maryland School of Social Work, and Washington University in St. Louis.
  • The 6 grantees, OPRE staff, and EHS staff from the national office have formed a consortium in which they have identified common measures of risk and protective factors to assess across all of the projects (e.g., SES, poverty, and financial hardship; neighborhood characteristics; maternal depression, anxiety, and substance use; parenting stress). 
  • Results from this research will help build a cumulative knowledge base regarding the role Early Head Start can play in promoting parenting practices that buffer children from toxic stress.

The point of contact is Aleta Meyer.

Early Head Start University Partnership Grants: Buffering Children from Toxic Stress, Research Grantees

New York University

Project Title: The Playing and Learning Strategies (PALS) Intervention in Early Head Start Programs: Reducing the Effects of Toxic Stress for Children in Poverty

Principal Investigator: Clancy Blair

Co-Principal Investigator: Cybele Raver

Project Funding Years: 2011 – 2016

Project Abstract: The primary purpose of this study is to implement an evidence-based parenting intervention, Playing and Learning Strategies (PALS) to evaluate the role of parenting quality in buffering children from toxic stress associated with poverty. Specifically, the project will: (1) measure young children’s exposure to 15 indicators of poverty related hazards, constituting “toxic stress” and determine the extent to which exposure to these dimensions are associated with lower levels of parenting quality and elevated levels of stress physiology biomarkers for children; (2) implement the ABC parenting intervention and document how the intervention can be adapted and implemented within existing EHS activities; and (3) evaluate the efficacy of the PALS parenting intervention. For the third goal, families will be randomly assigned to either (1) home–visiting services where they will receive 14 weeks of intervention in addition to regularly delivered services or to a (2) ‘business as usual’ control condition. Results from this study are expected to advance applied developmental neuroscience and contribute to the field’s knowledge base regarding the role of Early Head Start in supporting parenting and buffering children from the effects of toxic stress.


  • 160 low-income families enrolled in 7 EHS programs in New York City
  • 80 moderate to higher income children and families

University of Colorado Denver

Project Title: An Evaluation of Parent Child Interaction Therapy and the Emotional Availability Intervention: Mitigating Toxic Stress among American Indian Children in Early Head Start

Principal Investigator: Michelle Sarche

Project Funding Years: 2011 – 2016

Project Abstract:  The University of Colorado Anschutz Medical Campus, in partnership with a tribal Early Head Start and behavioral health program, is implementing a study to assess the relationship between major environmental stressors and hair cortisol for American Indian children and their caregivers, as well as the role of parent-child relationships in buffering children from the effects of these stressors on development. The aims of the project are to: (1) examine the nature, extent and developmental course of environmental stressors among American Indian children between the ages of 10 and 36 months; (2) assess hair cortisol as a marker of toxic stress; and (3) adapt two promising interventions for strengthening the parent-child relationship for mobile (e.g. text messaging, social media) delivery and piloting. The study has been approved by the tribal Institutional Review Board; it also employs a Community Advisory Board consisting of Early Head Start parents, teachers, and staff, as well as representatives from other tribal community programs serving young children and families.  The study will yield information about stress and its effects among American Indian children and their caregivers,  establish a mobile (mHealth) parenting intervention that increases the reach of critical parenting interventions within this tribal context, and inform efforts  for serving broader populations of tribal children and families.

University of Delaware

Project Title: Starting at Home: Incorporating a Parent-Child Interaction Intervention into Early Head Start Home Visiting

Principal Investigator: Jason Hustedt

Co-Principal Investigators: Rena Hallam Myae Han Jennifer Vu

Project Funding Years: 2011 – 2016

Project Abstract:  The purpose of this project is to incorporate the Promoting First Relationships (PFR) parenting intervention for use in the home visiting components of Early Head Start (EHS) home- and center-based models. This project will be conducted in collaboration with a multi-site EHS program serving both urban and suburban populations, comprised of African-American, Latino, and Caucasian families, and providing both center- and home-based programs in the state of Delaware. The project will examine: (1) the role that toxic stress plays in the lives of children and families served by a large EHS program, (2) how the PFR intervention can be implemented in the context of these existing home- and center-based EHS programs, and (3) the effectiveness of the PFR intervention in buffering EHS children from toxic stress. Results are expected to identify impacts of the PFR intervention for parents and children and will be used to make recommendations about maintenance and sustainability of this intervention model in EHS programs.

Sample: Approximately 150 EHS children and families

University of Denver

Project Abstract: Project Title: A Microsocial Video-Coaching Intervention for Toxically Stressed EHS Families

Principal Investigator: Sarah Watamura

Co-Investigators: Phillip Fisher Amanda Moreno

Project Funding Years: 2011 – 2016

Project Abstract: This study seeks to understand how toxic stress leads to psychological and physical health problems and identify ways to buffer children enrolled in Early Head Start (EHS) from such stressors. The project was developed in close collaboration with our partner EHS site, Clayton Early Learning Center, and also collaboratively includes several other EHS partners in the Denver metro area. Specifically, the project has the following objectives: (1) identify families at risk for dysregulated stress physiology as a function of toxic stress exposure, (2) implement the preventative intervention Filming Interactions to Nurture Development (FIND) to improve child’s well being, (3) assess the effectiveness of the intervention’s implementation, and (4) assess the effectiveness of the FIND intervention. Families will be randomly assigned to EHS standard supports or EHS standard supports with the FIND video-coaching intervention. The project includes careful attention to factors influencing implementation success and aims to create a fully scalable intervention. Results are expected to determine whether interventions targeted at parenting in general, and caregiver sensitivity in particular, among toxically stressed EHS families improve child development outcomes. The project also includes a wealth of data on family physiologic and psychological functioning, stresses and supports, and hopes to inform the scientific discussion around conditions, contexts and factors that contribute to and buffer from toxic stress.

Target enrollment: 250

University of Maryland School of Social Work

Project Title: Buffering Children from Toxic Stress through Attachment-Based Intervention: An Early Head Start-University Partnership

Principal Investigator: Lisa Berlin

Co-Principal Investigator: Brenda Jones Harden

Project Funding Years: 2011 – 2016

Project Abstract: The project is being conducted in collaboration with five Early Head Start programs in the greater Washington, DC area that serve predominantly new immigrant Latino families:

  • Family Services, Inc.
  • The Lourie Center
  • The Rosemount Center
  • United Planning Organization
  • Centro Nia (Washington, DC and Takoma Park, MD)

Together we are conducting a randomized trial of home-based Early Head Start services with and without a supplemental, attachment-based parenting program, Dozier’s “Attachment and Biobehavioral Catch-up” (ABC) intervention. The sample will be comprised of  200 Early Head Start families with 6- to 18- month old children.

There are three key aims:

Aim 1 - Validation:  to define criteria for identifying EHS families at risk for experiencing toxic stress and to validate these criteria empirically.

Aim 2 – Early Head Start + Parenting:  to evaluate through a randomized trial the efficacy and “value added” of supplementing home-based EHS services with Dozier’s ABC program.

Aim 3 – Implementation and Sustainability:  to evaluate the implementation and sustainability of the ABC program within the EHS context and the linkages between implementation characteristics and program impacts.

Key outcomes include observed parenting behaviors and children’s stress regulation, assessed both behaviorally and physiologically (e.g., cortisol production, vagal tone). The study’s findings will advance the knowledge of how EHS can increase support for early parenting and thus buffer infants and toddlers from toxic stress.

Washington University

Project Title: Buffering Toxic Stress: Novel Application of Intensive Group-based Parent Training

Principal Investigator: John N. Constantino

Project Funding Years: 2011 – 2016

Project Abstract: The study is examining whether a parenting intervention, an adaptation of the Incredible Years Toddler program, can buffer high-risk children in Early Head Start (EHS) from toxic stress and its consequences by fostering supportive and responsive care giving. Specifically the study is determining: (1) the efficacy of the proposed intervention; (2) how a range of variables relate to the occurrence of toxic levels of stress within the EHS population; and (3) whether the intervention buffers children from toxic stress and/or its consequences. Families are being randomly assigned to either a “care as usual” control group or an intervention group whereby bi-weekly socialization groups are replaced with the Incredible Years Toddler curriculum over a period of 6 months. Results are expected to generate implementation data and further validation of the Incredible Years Toddler intervention with respect to reducing toxic stress, to improve the field’s understanding of how toxic stress occurs and how it may be reduced. In addition, if the intervention is effective in reducing toxic stress, broader implementation of this supplemental intervention would represent a new opportunity for supporting emotional and cognitive development among at-risk children.

Sample: 165 EHS toddlers, including 110 experimental subjects and 55 control subjects

Related Resources

Early Head Start University Partnership Grants: Buffering Children from Toxic Stress, Research Grantees