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Understanding the Orchid Child

by Berkeley Wellness  

W. Thomas Boyce, MD, is chief of the division of developmental medicine at the University of California, San Francisco, School of Medicine. He researches how severe stress shapes the lives and health of highly sensitive children, also known as orchid children. Here he discusses the characteristics of such children and the conditions under which they can thrive.

Who are orchid children, and why are they so affected by stress?

Any child can be stressed by certain experiences, such as starting school or moving. But most children will take it in stride. Their stress response systems may increase cortisol secretion in their body for a few days as they adapt, but in the longer run they’re going to be just fine. Like the dandelion, they can adapt and thrive wherever you plant them.

Orchid children—about 15 to 20 percent of all kids—are highly sensitive, likely the result of the interplay of genetic variation and early environmental experiences. When under stress, they have exaggerated, prolonged activation of their stress response systems. Their cortisol levels rise and stay high, and their autonomic nervous systems may be chronically activated, putting them at risk for many problems. They also have more illness when they’re subjected to stress and have more injuries and psychiatric problems.

As we’ve studied these kids, however, we’ve also found that they’re more sensitive and responsive to positive, supportive environments. Orchid children, it turns out, have an unusual capacity for really positive, healthy trajectories of development. In the right circumstances, they’re healthier and more successful than all of their peers. But in stressful, adverse circumstances, they’re sicker than anybody else. Like the orchid, they can have exceptional grace and influence, but they are exceptionally sensitive to the kind of environment in which they’re grown.

What are the right circumstances for an orchid child?

They’re circumstances in which kids are being supported by their peers and by the adults in their environment. Where there’s no maltreatment, where there’s a certain amount of predictability—routines that are followed—so that there’s a kind of coherence to their social experience. Like the orchid, these children bloom only when nurtured carefully.

How do you know if you have an orchid child?

The defining characteristic is a laboratory measurement; these are the kids who have greater neurobiological responses to standard stressors. But we don’t usually put kids in laboratories, so how can a parent tell? Parents eventually know just by watching their kids grow up. It becomes clear that one child has a special sensitivity to experiences. A parent with four kids will go to the pediatrician and say, ‘my kids are all basically healthy, except that one.”

Also, certain behavioral predispositions are associated with being an orchid child. Orchid kids are often shy and introverted relative to other kids (although not always). They can also have sensory hypersensitivities, like taste or sound aversions. They may startle more easily. My daughter is an orchid child par excellence. She couldn’t stand having her socks wrinkled inside her shoes. It just drove her batty to have a wrinkle at the bottom of her shoe.

Do you see orchid kids across all levels of society?

First, parents should know that it’s not as if there are two buckets—one for orchid kids and one for dandelion kids—and every child falls into one or the other. It’s a continuum. At the far end on one side of the spectrum are these highly sensitive kids we call orchid kids.

But what’s interesting is that the prevalence of these highly sensitive children is greater at the two ends of most social and economic scales. When we look at environments that are high stress vs. low stress, or poverty vs. wealth, it’s a U-shaped distribution. You see more orchid children at both ends of the scales.

Why is that?

We think the characteristics of an orchid child don’t just come from genes. They come from an interaction between a child’s genes and early experience. These children are highly sensitive to threat. In an adverse environment, the characteristics of an orchid child help them sense when a threat is coming. That would explain why we see more orchid children living on the high stress end of the socioeconomic scale.

At the other end of the socioeconomic scale, there’s probably an increased prevalence because these kids are more receptive to all of the positive, good stuff that can come from living in a well-off environment. Orchid kids actually have better health and greater success than other kids when they’re in positive, nurturing social environments.

We think kids are sensing the character of their early environments and are changing their characteristic behavior and temperament—their phenotype—as they grow up to become more like an orchid or more like a dandelion.

I don’t want your readers to think that the socioeconomic environment solely shapes these kids. You can grow up poor with a nurturing family who protects you, just like you can grow up wealthy with parents who neglect or mistreat you. Parents and home life are really the keys. The unfortunately truth, however, is that kids living in poverty are more likely to face violence in the community or home or other stressors in their environment.

What new research are you doing right now, and what may it reveal about orchid children?

At the deepest level of stress response are the epigenetic changes that turn on and turn off the activation of genes. Epigenetic literally means “on top of the gene.” And we hypothesize that environmental experiences—such as being abused as a young child—can place a chemical tag on a gene that changes the frequency and intensity with which that gene is decoded. Like a dimmer switch on a light, the chemical tag can actually turn up the decoding of the gene or turn it down and silence it. We think that early experiences probably modify scores or even hundreds of genes that result in kids becoming sicker or healthier, mentally and physically.

The more we understand the needs and predispositions of orchid and dandelion children, the better we can help these kids live healthy, successful lives.

Watch a video of Dr. Boyce's 2014 presentation, "The Orchid Child and the Science of Kindness."

This opinion does not necessarily reflect the views of the UC Berkeley School of PublicHealth or of the Editorial Board at