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136 EFFECTS OF EARLY MALTREATMENT AND STRESS0.80.70.60.5Cortisol in g/dl0.40.30.20.10Home 1st DayLastDay1st Day5thDay9thDay5thMonthAdaptationSeparationSecureInsecureFigure 6-3 Salivary cortisol levels for toddlers in secure and insecure attachment relationshipswith their mothers assessed before starting child care, during an adaptation periodwhen the mothers accompanied them in child care, and during their first weeks andmonths of child care. Figure adapted from Ahnert et al., 2004.(National Institute of Child Health and Development Early Childcare ResearchNetwork, 2000). They found that care providers who were actively and positivelyengaged with the child prevented the child care rise in cortisol, whereas this risewas increasingly steep as these facets of caregiving were less often observed.Taken together, the studies just reviewed indicate that in humans there is a periodwhen the HPA axis is relatively quiescent but that this period is under strong socialregulation. When the child is receiving sensitive, responsive, supportive care,the HPA axis remains quiescent, even when the child is behaviorally upset anddistressed. When that care is removed and not immediately replaced by similarlyhigh quality care from a substitute caregiver, the HPA axis becomes highly responsiveto stressors.Disturbances in the Social Regulatory Systemand Stress-Emotion FunctioningAlthough the development of the stress-emotion system may be of interest to scholars,the critical question for those who fund our research is whether any of thismatters for the child’s development, and if so, can we do anything to repair stress-