
Through the Eyes of a Child
The barrage of strife, unrest, and outrage over the deaths of Black people in this country falls hard on the young
Maybe it hasn’t actually been the worst year ever, as internet memes are calling it, but for most of us, 2020 really has been “extra.” Against the backdrop of a pandemic that has created economic havoc and kept people from loved ones and purpose-defining work, the country has endured its greatest social unrest in decades, largely driven by a relentless daily barrage of horrifying racial incidents delivered up close and in real time. And, in the ultimate betrayal, these incidents—from the killings of Black men at the hands of police to countless “Karen” encounters on public and private property—have often been encouraged by the very government meant to protect us.
If you, as an adult, have been feeling anxious and distressed, imagine what all this is doing to children.
“This year has been exceptionally challenging for Black youth,” says James Huguley, interim director of the University of Pittsburgh’s Center on Race and Social Problems. “Because of the racial disparities in our broken system, they’re more likely to know someone affected by COVID-19. The social isolation makes everything worse, and most kids who receive mental health support get it at school, where most of them have not been since February. And at the same time all these racial atrocities in policing are happening.”
Racial trauma operates on many levels, Huguley notes, from microaggressions to personal experiences with discrimination to longstanding, intentionally instituted structural disadvantages that over hundreds of years have led to ingrained economic hardship, housing insecurity, carceral system injustice, unsettling family dynamics, and other adverse consequences. “We do surveys with Black youth here in Pittsburgh, and kids ages 10 to 15 are reporting that people have been racist toward them,” he says. “By tenth grade about fifty percent of them have encountered racial discrimination.”
“The biology makes it clear: The body doesn’t forget. Early experiences both positive and negative literally shape the architecture of the developing brain.”
Black parents and educators point out that while white people are becoming more aware of discrimination, “where you stand depends on where you sit,” according to Altha Stewart, past president of the American Psychiatric Association and a senior associate dean for community health engagement in the College of Medicine at the University of Tennessee Health Science Center. “If you sit in the midst of a storm of the kinds of events that don’t usually make the news, that happen day in and day out in your community, it really is nothing new. The newness comes from the rapidity with which these images are coming at our kids.”
And, Huguley points out, although children may not be experiencing firsthand the things they’re seeing online or on television, “they’re identifying with the person who is experiencing it, who looks like them, so the trauma is vicarious.”
According to a 2018 paper in Social Science & Medicine, children are especially vulnerable to indirectly experienced racism because “children’s lives are inevitably linked to the experiences of other individuals, and they are in critical phases of development.” The researchers’ review of the literature on vicarious racism and child health found thirty-eight statistically significant childhood outcomes—including “general illness,” weight issues, depression, anxiety, socioemotional difficulties, delayed cognitive development, and externalized behavior problems—that can be associated with a child’s indirect exposure to the prejudice and discrimination that friends, family, and strangers may experience and to experiences that “threaten a child’s sense of the world as just, fair, and safe.”
The effects of childhood trauma, whatever its cause, can be lifelong. A 2019 paper published in the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report found that adverse childhood experiences, or ACEs, can “derail optimal health and development by altering gene expression, brain connectivity and function, immune system function, and organ function”; compromise “development of healthy coping strategies, which can affect health behaviors, physical and mental health, life opportunities, and premature death”; and have been linked with “increased risk for alcohol and substance use disorders, suicide, mental health conditions, heart disease, [and] other chronic illnesses,” including stroke, asthma, lung disease, cancer, kidney disease, diabetes, and depression. Other studies have associated adverse childhood experiences with obesity, physical inactivity, and high-risk sex behaviors, and, the MMWR authors write, these experiences have “been linked to reduced educational attainment, employment, and income.”
Bone deep
The roots of these effects can be seen far earlier than once thought possible. “We used to think that preschool kids experiencing a lot of adversity where they live or in their family didn’t understand what was going on or were too young to remember,” says Jack Shonkoff, an HMS professor of pediatrics at Boston Children’s Hospital and director of Harvard’s Center on the Developing Child, where he chairs the JPB Research Network on Toxic Stress, a research collaboration that is developing biological and behavioral measures of stress activation and resilience in children 4 months to 5 years old. These metrics include pro-inflammatory cytokine levels, epigenetic effects, cortisol levels over time, and measures of executive functioning skills and attention span.
“The general public belief is that early experiences don’t have lasting impacts until kids get older,” says Shonkoff, who is also the Julius B. Richmond FAMRI Professor of Child Health and Development at the Harvard T.H. Chan School of Public Health and Harvard Graduate School of Education and a research associate at Massachusetts General Hospital. “But now we know that even very young kids are affected. The biology makes it clear: The body doesn’t forget. Early experiences both positive and negative literally shape the architecture of the developing brain and other biological systems from the beginning.”

Alisha Moreland, a member of the HMS faculty of psychiatry and director of trauma-informed treatment, consultation, and outreach at McLean Hospital’s Center of Excellence in Depression and Anxiety Disorders, explains that the brain develops “from the bottom up and the inside out,” with deep brain structures like the amygdala, hippocampus, and hypothalamus that play a role in fear conditioning and the stress response; the brain stem and midbrain structures handling basic functions like regulating heart rate, breathing, sleeping, and eating; and the topmost parietal and frontal lobes managing sensation, perception, and executive function.
“Adolescents are impulsive and need external cues because their brains are still developing,” she says. “Part of the work of becoming an adult is learning how to modulate the fear response and move toward safety. But when the sense of threat never goes away, and you’re in a chronic state of seeking safety, that short circuits higher-order functions.”