Practitioner review: early adversity and developmental disorders

J Child Psychol Psychiatry. 2005 May;46(5):451-67. doi: 10.1111/j.1469-7610.2004.00402.x.


Background: Knowledge of genetic influences, on developmental disorders such as autism spectrum, attention deficit/hyperactivity disorder and learning disabilities, has increased the opportunities for understanding the influences of the early environment.

Methods: This paper provides a selective, narrative review for clinicians of the effects of factors such as exposure to toxins and stresses in utero and in postnatal life; brain injuries and perinatal compromise; neglect, malnutrition and selective food deficiencies. It also considers what is known about the mechanisms through which early adversities operate.

Results: Gaps in the research are identified and suggestions made about clinical investigations. Several types of environmental adversity have associations with later disorders that suggest a causal role. The effects are often on a broad range of psychological processes, and are not always quickly reversible. Several adversities often coexist, calling for skilled judgement about priorities in treatment.

Conclusions: Individuals vary considerably in their exposure to adversity and their vulnerability to its effects, and genetic inheritance can influence both.

Publication types

  • Review

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / etiology
  • Autistic Disorder / etiology
  • Child
  • Communicable Diseases / complications
  • Developmental Disabilities / etiology*
  • Environment
  • Female
  • Health Personnel*
  • Humans
  • Learning Disabilities / etiology
  • Pregnancy / psychology
  • Prenatal Exposure Delayed Effects*
  • Professional Competence*
  • Risk Factors
  • Toxins, Biological / adverse effects


  • Toxins, Biological