The Profile of a Vulnerable Child

Sheri Marino MA, CCC-SLP

Sheri Marino MA, CCC-SLP

Former Director, Pediatric Health Initiatives | BIO

At Focus for Health, we believe the “vulnerable child” is one who is pre-disposed to developing a chronic disease secondary to pre-existing medical conditions, genetics, toxic environmental exposures and the influence of social determinants of health. Identifying those more susceptible to developing chronic illness is a critical step in protecting children from developing life-long health issues. If this subset of children can be characterized and recognized, then measures can be applied to protect this vulnerable population from harm. autism

Our founder, Barry Segal, has a passion to help this growing population of children which he strongly believes stems from the effects of a heavy toxic load and other environmental factors.

I saw a major need to advocate for the protection of this vulnerable population-children who were more susceptible to developing autism and other neurological disorders after being exposed to environmental toxins, heavy metals, vaccination, and other immunological triggers.

– Barry Segal, Founder of Focus for Health

A child’s overall health is determined by a myriad of factors, including genetics, environmental exposures and where they live and play. Like a puzzle, these parts work together to make a whole. If one piece is out of place, the whole can be affected, leaving the child more susceptible to chronic disease.

  • CHRONIC DISEASE A chronic disease is defined by the U.S. National Center for Health Statistics as one lasting 3 months or more and cannot be prevented by vaccines or cured with medicine. In 1988, the Federal Maternal and Child Health Bureau expanded the definition to include developmental, physical, emotional and behavioral conditions. With the prevalence of chronic childhood illnesses increasing from 12.8% in 1994 to 26.6% in 2006, it is imperative that factors beyond genetics be considered. Protecting the “vulnerable child” from developing chronic disease must include a focus on each individual’s unique immune system.
  • IMMUNE SYSTEM The ability for our bodies to defend against invaders such as communicable diseases and environmental toxins is dependent upon the integrity of the immune system. Factors such as heredity, stress, and toxic exposures can influence immune dysregulation and promote vulnerability to illness. If an already compromised immune system is exposed to foreign invaders, the body may under or over react, leaving the individual vulnerable to chronic disease. When a child exhibits signs of either a weakened immune response (frequently gets sick) or a heightened immune response (autoimmunity/allergies), he or she may be more vulnerable to damage from environmental influences.
  • EPIGENETICS Although science has focused heavily on genetic causes of disease, researchers are learning more about epigenetics, or gene expression, and its influence on disease manifestation. Epigenetics refers to the ability of genes to be turned “on” or “off” by external influences without changing the DNA sequence or genetic code. Essentially, genes not only control, but can be controlled by, outside mechanisms. Although epigenetics can be passed down from one generation to the next, not all genes are active at all times. Triggers such as environmental toxins or social factors can alter gene expression and increase vulnerability to disease.
  • ENVIRONMENTAL INFLUENCESSome children are particularly vulnerable to environmental influences. Determining the characteristics of the child most at risk for injury may be the most important step in preventing chronic illness related to the environment.
    “In 2006, the World Health Organization (WHO) released a comprehensive study that suggests more than 33% of diseases affecting children under the age of five are caused by environmental exposures.”
    These environmental exposures include toxins in our water, soil, food, and even pharmaceutical products. Known neurotoxins, many of which are unregulated, come from a variety of sources such as coal mining factories, manufacturing plants, pesticides, contaminated land applications (biosolids), and even chemicals added to medications and immunizations. Young children, the immunocompromised, and pregnant women, are particularly vulnerable. Just as alcohol and tobacco use can have negative effects on a fetus, research has shown that certain medications can have debilitating effects, even lethal outcomes, for fetuses exposed in utero. Similarly, certain chemicals, including many widely used pesticides, have been linked to a wide range of diseases.
  • SOCIAL DETERMINANTS Social determinants of health play an integral role in how the immune system is set up to fight disease. Lack of access to prenatal care, healthy food, or clean water can put an infant at risk for developing chronic illness. Maternal stress or stressful living situations in early life similarly adversely affect a child’s ability to fight disease. Promoting equality among all socioeconomic groups can reduce the number of vulnerable children, and lead to lower incidence of chronic illness in the U.S.

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Any combination of these risk factors has the potential to put a vulnerable child at risk for chronic disease.

Exposure to environmental toxins

  • Lead
  • Mercury
  • Aluminum
  • PCB's
  • Glyphosate/insecticides
  • Preventative medicine
  • Flame retardants

Maternal health

Pre-existing medical conditions

  • GI disorders
  • Seizures/epileptic or febrile
  • Chronic ear infections
  • Metabolic/Mitochondrial disorder
  • Immune disorders
  • Infections
  • Obesity
  • Prematurity/low birth weight
  • Allergies/eczema
  • Frequent antibiotic use

Genetics or genetic predisposition

  • Celiac
  • Fragile X
  • Autism genes
  • Mitochondrial disorder
  • Syndromes/congenital defects

Social Determinants

  • Parental education
  • Parental age
  • Access to healthcare
  • Financial distress
  • Food insecurity/poor nutrition
  • Unstable home


Protecting the vulnerable child is the responsibility of every parent, health care provider, and government regulatory agency. Assessing a child’s risk factors and implementing individualized health care practices can work to reduce vulnerability to chronic disease. Parents can take action to minimize risks by communicating all risk factors to their physicians, but ultimately, autismthe parent is the number one advocate for their child. Parents should be proactive and take measures to ensure the best possible outcome for their children. Some of these steps include:

  • Proper prenatal nutrition
  • Prenatal care
  • Limiting toxic exposures in foods and products
  • Individualizing medical care
  • Reducing stress
  • Sharing all family history of disease with physicians
  • Weigh the risks and benefits of maternal/pre-natal vaccinations
  • Weigh the risks and benefits of vaccinating a vulnerable child

Sheri Marino MA, CCC-SLP

Former Director, Pediatric Health Initiatives

Sheri is a pediatric speech and language pathologist with over 25 years of clinical experience specializing in autism. As the former Director of Pediatric Health Initiatives for the Focus for Health Foundation, Sheri contributed her clinical expertise authoring articles on autism and other chronic health issues and also managed the pediatric health grantees. Sheri’s professional experiences helped guide the Foundation’s mission addressing chronic health issues related to environmental causes from 2014 through 2019. Sheri also serves as the Executive Director of The Autism Think Tank, NJ, a non-profit organization which offers medical videoconferences with a team of renowned medical experts who collaborate on medically complex cases of autism around the globe. She is the founder of Rocking Horse Rehab, a pediatric rehabilitation and family wellness center specializing in therapy services for children with various disabilities including, autism, cerebral palsy, spinal muscular atrophy, brain tumors, and rare syndromes, neuromuscular and psychiatric disorders. Sheri has been featured on CBS News, NBC News, NJN and multiple cable networks.

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