Tough’s story begins with a remarkable study performed by Kaiser Permanente in the 1990s. This health maintenance organization began surveying members with a focus on gathering information on traumatic childhood experiences. The information collected could then be correlated with the organization’s medical records for the survey participants. The results were tabulated for a large group that was representative of the middle class rather than having any particular association with issues of poverty. The results were published in a paper written by Vincent Felitti and Robert Anda under the title The Relationship of Adverse Childhood Experiences to Adult Health: Turning Gold into Lead. This work is commonly referred to as the ACE study with the acronym representing "adverse childhood experiences."
The first revelation from the study was the frequency of childhood trauma.
When correlations were made between the results of the survey and the health outcomes of the patients, startling results were obtained.
We are used to thinking that social and emotional problems can lead to unhealthy lifestyles that can cause enhanced probability for disease, but there is more going on than that.
The conclusion that was reached by the authors and subsequent researchers was:
Researchers have since concluded that the villain in this story, the one that causes physical and mental damage to bodies, is the response to stress that evolution has developed in our bodies. For most of our evolution stress was associated with life or death situations. The appropriate response in that case is to max out all possible reactions to a threatening situation. Unfortunately for modern humans, stress has become frequent, often long and drawn out, and sometimes chronic. A response system designed to be life saving, can be life threatening if over used.
Some of these responses are apparent to us such as higher blood pressure and a faster heart rate. Others are less observable to us:
The burden this stress response places on the body is referred to as alostatic load. Too high an alostatic load:
How does this specifically relate to poverty and learning? Being poor is not detrimental in itself, but poverty makes it likely that children will experience more frequent and more intense stressful situations. Physical, sexual, and emotional abuse become more likely. Physical security and emotional security are often at risk. Not knowing where your next meal will come from can definitely be stressful.
Those who study the physiology of stress have learned that the prefrontal cortex is the part of the brain most susceptible to damage in children subjected to abnormal amounts of stress.
Tough refers to these "self-regulatory activities" controlled by the prefrontal cortex as "executive functions." He does not view the fact that these processes have been compromised in many poor children as the end of the story.
Tough provides examples where disadvantaged children with poor early educational experiences were converted into productive students with potentially bright futures. He emphasizes that the rehabilitation of these children’s educations requires not just better approaches to subjects like math and reading comprehension, but it also requires a conscious effort to help students attain greater control of these executive functions.
Further discussion of Tough’s book and the subject of enhancing the performance of disadvantaged children can be found in Education: Success, Failure, and Character.