HealthySteps Participates in Groundbreaking Research: The HERO Study

A little boy with long wavy hair touches his mother's face
HealthySteps Participates in Groundbreaking Research: The HERO Study

There are new and emerging opportunities to use biological information to help assess how adverse experiences and preventive interventions affect young children’s healthy development before serious problems arise. HealthySteps is a proud collaborator in the Health’s Early Roots & Origins (HERO) Study, led by Jack Shonkoff, MD, at the Harvard Center on the Developing Child and The JPB Research Network on Toxic Stress.

What is the HERO Study?

The HERO Study is a multi-site, feasibility trial to prevent disease and impairment due to toxic stress.

The goal of the HERO Study is to develop a fully validated, final battery of biomarkers that will make it possible to:

  1. Identify child stress effects and resilience, family assets and stressors, and key behavioral indicators in children as young as two months of age
  2. Target preventive services before overt problems emerge
  3. Measure short-term impacts of interventions on learning, behavior, social-emotional development, and health indicators to facilitate rapid-cycle learning and iteration

What are the early findings?

Early pilot data show that babies whose families are experiencing more stressful events (reported by their mothers) had lower electrical activity in the brain at age 2 months.

A biomarker of stress in the urine at age two months is associated with a change in electrical activity in the brain.

Who’s involved in the HERO Study?

Dr. Jack Shonkoff and colleagues at the Harvard University Center on the Developing Child are leading the study with The JPB Network on Toxic Stress. The JPB Network on Toxic Stress includes developmental scientists, community leaders, and primary care practices working collaboratively to prevent disease and impairment due to toxic stress.

Why is HealthySteps involved?

The types of pediatric practices that bring HealthySteps onboard are innovative, thoughtful, and progressive practices, making them great partners for the HERO work. Multiple HealthySteps sites are participating in the collection of biosamples to validate the biomarker panel to identify evidence of toxic stress and its impacts on the development of young children.

Within six participating HealthySteps sites, we are engaged in the validation and feasibility work that will eventually lead to the ability to identify children at risk and measure the impact of an intervention like ours.

What are you measuring?

  • Hair samples to test cortisol levels, which are linked to a person’s ability to learn and adapt to stress
  • Inflammatory markers found in saliva and cheek swabs to assess stress activation as a physiological response in the immune system
  • Eye-tracking to measure attention in babies as young as two months
  • Brain scans to measure the effects of stress since children who have experienced significant neglect tend to have less electrical activity
  • Executive function skills
  • Family social context, e.g., where families live and work, social stressors, life events

How can I learn more?

To learn more about the Harvard Center on the Developing Child and The JPB Research Network on Toxic Stress, visit

HealthySteps Participates in Groundbreaking Research with the Harvard Center on the Developing Child: The HERO Study

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