Childhood exposure to violence carries long-term neurodevelopmental risks

Exposing young children to the perpetual cycle of violence in the home has massive long-term ramifications on their health and well-being. It disrupts their fundamental sense of safety, corrodes the trust they’ve built in their environment and in their caregivers and leads to profound mental health and cognitive implications.

What’s worse, it activates the stress-response system, which leads to elevated stress levels during critical periods of the brain’s development. This is according to Dr Lucinda Tsunga, whose research focuses on how exposure to violence affects children’s mental health and cognitive development, with specific focus on low- to middle-income countries (LMIC).

Dr Tsunga is a University of Cape Town (UCT) alumna. She completed her PhD in the Department of Paediatrics and Child Health and currently works as a neuropsychologist at Cambridge University Hospitals. Her research uncovered a set of startling fundings: exposing young children to violence contributes to high levels of anxiety, withdrawal, and aggressive and impulsive behaviour (which manifests at the age of five). Further, she said, it also leads to poor selective attention (an inability to focus on one specific task while filtering out or ignoring irrelevant distractions), difficulty regulating emotions, and language and learning challenges.  

“These findings highlight that children are active participants in – and recipients of – their environments. Their emotional needs are as significant as adults and ensuring their safety and emotional well-being must be a priority,” Tsunga said.

The impact of violence  

Expanding on why heightened stress levels are detrimental to a young child’s health, well-being and overall development, Tsunga said it directly interferes with the way in which the brain’s neural circuits (responsible for emotional regulation, executive functioning, attention and learning) mature.

“The impact [of violence] manifests very early.”

She said when violence occurs in the home and involves caregivers, it also disrupts attachment processes and compromises children’s ability to use their caregivers as a source of safety to help regulate their emotions. In response, she said, children develop adaptive coping mechanisms like hypervigilance, emotional numbing, and heightened reactivity. While these responses may be protective in the short term, they come at a developmental cost.

“Violence exposure shapes not only children’s emotional well-being, but also their cognitive development and long-term mental health trajectories,” Tsunga said. “The impact [of violence] manifests very early. In my research, measurable associations with mental health and cognitive outcomes were already evident by age five – indicating that exposure to violence affects development well before formal schooling starts.”

Far-reaching consequences

It doesn’t end there. Tsunga said supporting research revealed that the consequences of childhood exposure to violence extend into adulthood. It leads to an increased risk of adult mental health disorders, including depression, anxiety, post-traumatic stress disorder, substance use disorders, as well as chronic physical health conditions like cardiovascular disease, metabolic disorder and immune dysfunction.

“Early exposure to violence is not a transient childhood issue but a developmental and public health concern with lifelong implications, particularly when early risk is not mitigated by stable, supportive relationships or timely intervention,” she said.

She added that childhood exposure to violence is also a lot more prevalent in LMICs, due to poverty and inequality, community and domestic violence, limited access to mental health and social services, and intergenerational trauma.

Leveraging protective figures

Sadly, Tsunga said there is no single solution to the problem. However, she suggested a multi-pronged strategy. She said families should provide safe caregiving spaces for their children and should stop using harsh discipline strategies. Schools should implement trauma-informed practices (a framework that recognises trauma’s widespread impact and integrates trauma knowledge into policies and practices to create safe, trusting and empowering environments); and mental health practitioners in communities should adopt evidence-based, culturally responsive care and facilitate parenting workshops to support parents and caregivers.

“Violence is not just a social issue, but a neurodevelopmental and public health issue.”

Further, she also advised leveraging protective figures like teachers, sports coaches and community workers to assist. These figures, she said, can help to identify tell-tale signs among affected children and facilitate the referral process. She urged protective figures to look out for sudden behavioural or emotional changes, persistent attention and/or learning difficulties, as well as social withdrawal and aggression – and to act fast.

“Their role is to notice, respond with consistency and care and facilitate the referral process. Because protective figures provide places of safety for children, it’s absolutely crucial that they are able to identify the signs and act when they notice anything out of place,” she said. “Violence is not just a social issue, but a neurodevelopmental and public health issue. Addressing it early has profound implications for mental health, education and societal well-being.”