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Lesson 6 · Development · interactive 3D

Nature and Nurture

Follow a life from the moment sperm meets egg to old age. Move the slider through the weeks of pregnancy and the years of life, add the exposures and social conditions a family may face, and see what research says they do to the body, the brain, the classroom and the community.

Builds on Lesson 5. In DNA and the Epigenome you saw how experience adds chemical tags that switch genes on or off. This lesson shows when those experiences matter most and how they add up across a lifetime. Nature is the code; nurture decides much of how it is read.

Loading the 3D model…
Sperm meets egg
Before fertilization
Exposure simulator

What the mother is exposed to, and what research links it to

Choose exposures. The model assumes each one lasts from conception to the week on the slider, so move the slider to see how timing changes the picture. Colored particles flowing from the placenta show the exposures you picked.

Illustrative chances for this baby

The black line is the U.S. average. The red bar adds the exposures you chose.

A teaching model, not a prediction. It combines published group averages as if each exposure acted on its own, which real life never does. Exposures cluster together, and most babies exposed to any one of these are born healthy. No one can predict a single baby's outcome from this page.

Also linked to

Critical periods: when each body part is most sensitive

Dark bars: major structural defects are possible. Light bars: smaller defects and changes in how the organ works. Weeks are counted from fertilization; add two for pregnancy weeks. Adapted from the classic embryology chart (Moore et al., 2020), with the timing confirmed by (Sadler, 2017) and (Nangle et al., 2025).

Theorists at this point in life

Stage theories

Click a bar to jump to that age.
Before birth

From sperm to birth in thirteen steps

Click any row to see it on the model.

StageWhenWhat happens

The three germ layers

In week 3, cells of the embryonic disc move through the primitive streak and sort into three layers. Every organ comes from one of them.

EctodermBrain, spinal cord, nerves, skin, hair, eye lens, tooth enamel
MesodermHeart, blood, bones, muscles, kidneys, sex organs
EndodermLining of the gut and airways, lungs, liver, pancreas, thyroid

Why timing matters

In the first two weeks after fertilization, a harmful exposure usually either ends the pregnancy or does no lasting harm (the "all or none" period). Weeks 3 to 8 after fertilization (weeks 5 to 10 of pregnancy) are when organs form, so this is when most major birth defects begin, often before a person knows they are pregnant (Sadler, 2017) (Nangle et al., 2025). After that, the brain keeps developing until birth and beyond, so exposures later in pregnancy more often affect growth, behavior and learning than body structure.

Risks

Risks before and after birth

Teratogens are anything in the environment that can disrupt development: drugs, chemicals, infections, maternal illness and, research now shows, chronic stress and racism. The numbers below come from meta-analyses and large studies published in the last ten years.

Exposure in pregnancyWhat studies foundLater in life

After birth

Born too early or too small

About 10.4% of U.S. babies are born preterm and 8.5% weigh under 2,500 g (CDC, n.d.). Preterm babies face more breathing problems, infections and later learning and attention difficulties, so early intervention and support at school matter.

Newborn withdrawal

Neonatal abstinence syndrome rose from 4.0 to 7.3 per 1,000 hospital births between 2010 and 2017 (Hirai et al., 2021). Babies can be irritable, feed poorly and sleep badly in the first weeks; treatment that keeps parent and baby together helps.

Sudden infant death

Smoking during pregnancy more than doubles the risk of sudden unexpected infant death (adjusted odds ratio 2.44) (Anderson et al., 2019). Safe sleep (alone, on the back, in a crib) and a smoke-free home lower risk.

Fetal alcohol spectrum disorders

An estimated 1.1% to 5% of U.S. first graders have an FASD (May et al., 2018), and about 7.7 per 1,000 children worldwide (Lange et al., 2017). Most are never diagnosed, so they show up in class as attention, memory and behavior problems.

Adverse childhood experiences

63.9% of U.S. adults report at least one ACE and 17.3% report four or more (Swedo et al., 2023). Four or more ACEs are strongly linked to later mental illness, substance use and violence (Hughes et al., 2017), and an estimated 44.1% of adult depression could be prevented by preventing ACEs (Merrick et al., 2019).

Poverty and the developing brain

Family income is tied to children's cognition and brain structure (Tomasi & Volkow, 2021). In a randomized trial, a monthly cash gift to low-income mothers changed infant brain activity within a year (Troller-Renfree et al., 2022), evidence that the link is partly caused by poverty itself, and can be changed.

From the body to behavior

How social determinants become classroom and community behavior

Stress gets under the skin through the HPA axis you met in Body and Brain and through the epigenetic tags from Lesson 5. What a teacher sees as "behavior" is often the end of this chain.

1 · Conditions

  • Poverty and food insecurity
  • Neighborhood violence
  • Racism and discrimination
  • ACEs at home

2 · Stress biology

3 · The brain

  • Threat system (amygdala) on alert
  • Memory (hippocampus) and planning (prefrontal cortex) strained
  • Differences in brain structure by race shrink when adversity is accounted for (Dumornay et al., 2023)

4 · The classroom

5 · The community

What a teacher may see

  • HypervigilanceStartles easily, watches the door, reacts fast to a raised voice. The threat system is doing its job in the wrong place.
  • Shutting downHead down, "doesn't care". Often a freeze response, not laziness.
  • Trouble holding instructionsWorking memory is weaker on average in trauma-exposed youth (d = −0.49) (Op den Kelder et al., 2018).
  • Hunger and tirednessFood insecurity is linked to behavior, emotional and academic problems (Shankar et al., 2017) and worse child health (Thomas et al., 2019).

What helps

  • Positive childhood experiencesAdults with 6–7 positive childhood experiences had far lower odds of depression or poor mental health than those with 0–2 (OR 0.28), even with ACEs (Bethell et al., 2019).
  • Protective adults and schoolsFamily, school and community supports soften the effects of community violence (Ozer et al., 2017); state social spending does too (Ricard et al., 2026).
  • Trauma-informed schoolsPromising and widely used, though strong trials are still few (Maynard et al., 2019) (Avery et al., 2021).
  • Pointing to mechanismsTreatment can target the threat, memory and emotion pathways trauma changes (McLaughlin et al., 2020).
A cultural standpoint

Academic outcomes through the lens of culture and identity

Development does not happen in a cultural vacuum. This section follows the psychological framework of the author's dissertation, Toward Equity: Cultural Belonging and Racial Identity Among Non-White Students at HBCUs, and his pilot study on the mother's traumatic stress during pregnancy.

Foundation

Critical Race Theory and culturally relevant pedagogy

Bell's Critical Race Theory explains why gaps in outcomes follow lines of race and law rather than ability (Bell, 1980). Ladson-Billings' culturally relevant pedagogy answers it with three goals: academic success, cultural competence and critical consciousness (Ladson-Billings, 1995). Culturally relevant teaching is how that pedagogy looks in a lesson. A research synthesis links it to better engagement and achievement across subjects (Aronson & Laughter, 2016), and an ethnic studies course raised attendance, grades and credits for at-risk ninth graders (Dee & Penner, 2017).

Identity

Cross's Nigrescence theory

Cross described how Black identity can move from pre-encounter (race seen as unimportant, or anti-Black messages absorbed), through an encounter that challenges that view, to immersion-emersion and internalization, a secure identity that is open to others (Cross, 1991) (Vandiver et al., 2002) (Worrell et al., 2023). A strong, positive ethnic-racial identity is linked to better academic adjustment, though the effects are small (Miller-Cotto & Byrnes, 2016), and it buffers some of the harm of discrimination (Yip et al., 2019).

The person in the group

Adler and Vygotsky

Adler saw every child as striving to belong; a child who feels inferior or left out may strive in useless ways, and encouragement builds social interest (Adler, 1927). Vygotsky showed that learning happens in a culture, with more skilled others guiding a child through the zone of proximal development (Vygotsky, 1978). Together they say the same thing to a teacher: belonging and culturally familiar guidance come before learning. Belonging predicts persistence nationally (Gopalan & Brady, 2020).

Transactions

Berne's transactional analysis

Berne described the Parent, Adult and Child ego states people speak from (Berne, 1964), and Ernst's "OK Corral" maps the four life positions, from "I'm OK, you're OK" to "I'm not OK, you're OK" (Ernst, 1971). In the dissertation these serve as a theoretical bridge: a student who absorbs "I'm not OK" messages about their group mirrors the internalized oppression the IROS measures, while a classroom that keeps every transaction "I'm OK, you're OK" models belonging.

How the dissertation measures it

Culturally Engaging Campus Environments (CECE)

Museus's CECE model names nine features of a campus, such as cultural familiarity, culturally relevant knowledge and holistic support, that help diverse students succeed (Museus, 2014). The CECE scale measures them (Museus et al., 2016), and culturally engaging environments predict sense of belonging, especially for students of color (Museus et al., 2018).

Internalized Racial Oppression Scale (IROS)

The IROS measures how far Black individuals have absorbed negative messages about their group (Bailey et al., 2011). Internalized racism is linked to worse mental and physical health in meta-analyses (r ≈ .23 to .26) (Gale et al., 2020) (James et al., 2025). In the dissertation it is validated through Cross's pre-encounter and immersion-emersion stages.

Why HBCUs

Black medical students at HBCU medical schools reported more belonging than those at predominantly white schools (Nguemeni Tiako et al., 2023). HBCU graduates had 35% lower odds of metabolic syndrome in midlife (Colen et al., 2021), and studies are now tracking HBCU attendance and later depression (Thyden et al., 2023) and cognition (Thomas et al., 2026).

What gets in the way

Discrimination is linked to lower grades and worse mental health in adolescents (Benner et al., 2018). Teachers who do not share a student's race expect less of Black students (Gershenson et al., 2016), while having one Black teacher in grades K–3 raised Black students' chances of graduating and going to college (Gershenson et al., 2022). Stereotype threat effects are real but smaller in real testing settings (d ≈ −.14) (Shewach et al., 2019).

The thesis

The gap the pilot study found

The author's pilot study, completed in Bowie State University's Counseling Psychology program, followed twenty mothers in marginalized communities of color from 20–25 weeks of pregnancy until birth, asking how a mother's traumatic stress relates to the psychological development of the child she carries (McGee, n.d.). It found a gap in stage theory: Freud, Erikson and Piaget begin development at birth, yet a child begins responding to the mother's social environment at about 20 weeks in utero. That is why the timeline above starts before birth, and why the treatment below starts there too.

Treatment protocol

McGee's Trauma-Focused Cognitive Biological Stage Theory (TF-CBST)

With an Adlerian focus, TF-CBST engages caregivers and children in ongoing, age-appropriate conversations, activities and practice around traumatic stress, including racial stress, to build coping and resistance. It names five stages. At each one the connection between mother and child can be adequate (the connection succeeds) or inadequate (mother and child struggle).

The examples under each stage were written for this lesson to show how the model connects to the research above.

The eight-session training

  1. Maternal mental healthStress, depression and anxiety in pregnancy and after birth, and why they matter for the baby (Jarde et al., 2016).
  2. Fetal developmentThe stages on this page: what is forming each week and when the baby begins to respond.
  3. TraumaWhat traumatic and racial stress are, and how they reach the body and the next generation (Lesson 5).
  4. Coping skillsPractical tools for stressful moments, planned with the mother's own supports and culture.
  5. MeditationBreathing and mindfulness practice to calm the stress response.
  6. AssessmentThe Depression Anxiety Stress Scales (DASS) (Lovibond & Lovibond, 1995) and the Psychological Distress Profile, taken before and after the training.
  7. Termination, follow-up and referralsClosing the group well and connecting mothers to counseling, prenatal care and community help.
  8. Career planningEducation and work goals that lower stress for the whole family over time.

How the risks on this page map to TF-CBST

Try it on the model

Jump to week 22 of pregnancy, the start of the Activation stage, and add maternal stress and racism to see where the training steps in.

The training is being studied. The model does not change the risk bars for it, because no outcome data have been published yet.

Connect the lessons

Back to Lesson 5 and beyond

Lesson 5 · From zygote to birthHow a mother's stress hormones and epigenetic tags reach the baby, the biology behind the exposure simulator here. Lesson 5 · Stress across generationsWhy the conditions in the "After birth" model can echo into grandchildren. Body and Brain · The HPA axisThe cortisol loop that turns social stress into body changes. Substance Use PreventionPrevention for the alcohol, tobacco, cannabis and opioid exposures above. Academic StressHow stress shows up for college students in the Operating stage. Equity in EducationDiscipline gaps, teacher diversity and what leaders can change. Research postersThe generational trauma poster and the pilot study behind TF-CBST. TheoristsFull profiles of Freud, Erikson, Piaget, Vygotsky, Adler, Bronfenbrenner, Ainsworth and Cross.
Practice

Games and flashcards

🧬 Put development in order

Click the stages from first to last.

❓ Quick quiz

Flashcards

Learn more

Videos, reading and sources

▶ Conception and early embryo

▶ Embryo to birth

▶ Prenatal exposures and critical periods

▶ Stress, ACEs and the developing brain

▶ Lifespan theories

▶ Equity, identity and trauma-informed schools

📖 Read (free)

🤰 For families

Research from the last ten years (86)

  1. Anderson, T. M., Lavista Ferres, J. M., Ren, S. Y., Moon, R. Y., Goldstein, R. D., Ramirez, J.-M., & Mitchell, E. A. (2019). Maternal smoking before and during pregnancy and the risk of sudden unexpected infant death. Pediatrics, 143(4), e20183325. https://doi.org/10.1542/peds.2018-3325 free to read
  2. Arabzadeh, H., Doosti-Irani, A., Kamkari, S., Farhadian, M., Elyasi, E., & Mohammadi, Y. (2024). The maternal factors associated with infant low birth weight: An umbrella review. BMC Pregnancy and Childbirth, 24(1), 316. https://doi.org/10.1186/s12884-024-06487-y free to read
  3. Aronson, B., & Laughter, J. (2016). The theory and practice of culturally relevant education: A synthesis of research across content areas. Review of Educational Research, 86(1), 163–206. https://doi.org/10.3102/0034654315582066
  4. Avery, J. C., Morris, H., Galvin, E., Misso, M., Savaglio, M., & Skouteris, H. (2021). Systematic review of school-wide trauma-informed approaches. Journal of Child & Adolescent Trauma, 14(3), 381–397. https://doi.org/10.1007/s40653-020-00321-1 free to read
  5. Azuine, R. E., Ji, Y., Chang, H.-Y., Kim, Y., Ji, H., DiBari, J., Hong, X., Wang, G., Singh, G. K., Pearson, C., Zuckerman, B., Surkan, P. J., & Wang, X. (2019). Prenatal risk factors and perinatal and postnatal outcomes associated with maternal opioid exposure in an urban, low-income, multiethnic US population. JAMA Network Open, 2(6), e196405. https://doi.org/10.1001/jamanetworkopen.2019.6405 free to read
  6. Bekkar, B., Pacheco, S., Basu, R., & DeNicola, N. (2020). Association of air pollution and heat exposure with preterm birth, low birth weight, and stillbirth in the US: A systematic review. JAMA Network Open, 3(6), e208243. https://doi.org/10.1001/jamanetworkopen.2020.8243 free to read
  7. Bell, Z., Nguyen, G., Andreae, G., Scott, S., Sermin-Reed, L., Lake, A. A., & Heslehurst, N. (2024). Associations between food insecurity in high-income countries and pregnancy outcomes: A systematic review and meta-analysis. PLOS Medicine, 21(9), e1004450. https://doi.org/10.1371/journal.pmed.1004450 free to read
  8. Benner, A. D., Wang, Y., Shen, Y., Boyle, A. E., Polk, R., & Cheng, Y.-P. (2018). Racial/ethnic discrimination and well-being during adolescence: A meta-analytic review. American Psychologist, 73(7), 855–883. https://doi.org/10.1037/amp0000204 free to read
  9. Bethell, C., Jones, J., Gombojav, N., Linkenbach, J., & Sege, R. (2019). Positive childhood experiences and adult mental and relational health in a statewide sample: Associations across adverse childhood experiences levels. JAMA Pediatrics, 173(11), e193007. https://doi.org/10.1001/jamapediatrics.2019.3007 free to read
  10. Carter, E. B., Temming, L. A., Akin, J., Fowler, S., Macones, G. A., Colditz, G. A., & Tuuli, M. G. (2016). Group prenatal care compared with traditional prenatal care: A systematic review and meta-analysis. Obstetrics & Gynecology, 128(3), 551–561. https://doi.org/10.1097/AOG.0000000000001560 free to read
  11. Centers for Disease Control and Prevention, National Center for Health Statistics. (n.d.). FastStats: Infant health [Births: Final data for 2024]. https://www.cdc.gov/nchs/fastats/infant-health.htm free to read
  12. Centers for Disease Control and Prevention. (2026). Data and statistics on birth defects. https://www.cdc.gov/birth-defects/data-research/facts-stats/index.html free to read
  13. Chatzakis, C., Ville, Y., Makrydimas, G., Dinas, K., Zavlanos, A., & Sotiriadis, A. (2020). Timing of primary maternal cytomegalovirus infection and rates of vertical transmission and fetal consequences. American Journal of Obstetrics and Gynecology, 223(6), 870–883.e11. https://doi.org/10.1016/j.ajog.2020.05.038
  14. Choi, E. J., Kim, N., Kwak, H.-S., Han, H. J., Chun, K.-C., Kim, Y.-A., Koh, J.-W., Han, J. Y., Joo, S. H., Lee, J. S., & Koren, G. (2021). The rates of major malformations after gestational exposure to isotretinoin: A systematic review and meta-analysis. Obstetrics & Gynecology Science, 64(4), 364–373. https://doi.org/10.5468/ogs.20373 free to read
  15. Christensen, J., Pedersen, L., Sun, Y., Dreier, J. W., Brikell, I., & Dalsgaard, S. (2019). Association of prenatal exposure to valproate and other antiepileptic drugs with risk for attention-deficit/hyperactivity disorder in offspring. JAMA Network Open, 2(1), e186606. https://doi.org/10.1001/jamanetworkopen.2018.6606 free to read
  16. Colen, C. G., Pinchak, N. P., & Barnett, K. S. (2021). Racial disparities in health among college-educated African Americans: Can attendance at historically Black colleges or universities reduce the risk of metabolic syndrome in midlife? American Journal of Epidemiology, 190(4), 553–561. https://doi.org/10.1093/aje/kwaa245 free to read
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  22. Dumornay, N. M., Lebois, L. A. M., Ressler, K. J., & Harnett, N. G. (2023). Racial disparities in adversity during childhood and the false appearance of race-related differences in brain structure. American Journal of Psychiatry, 180(2), 127–138. https://doi.org/10.1176/appi.ajp.21090961 free to read
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Foundational theory and the author’s own work

Classic sources for the theories, kept because the theories are named after them.

  1. Adler, A. (1927). Understanding human nature (W. B. Wolfe, Trans.). Greenberg.
  2. Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Erlbaum.
  3. Arnett, J. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55(5), 469–480. https://doi.org/10.1037/0003-066X.55.5.469
  4. Bailey, T.-K. M., Chung, Y. B., Williams, W. S., Singh, A. A., & Terrell, H. K. (2011). Development and validation of the Internalized Racial Oppression Scale for Black individuals. Journal of Counseling Psychology, 58(4), 481–493. https://doi.org/10.1037/a0023585
  5. Bell, D. A., Jr. (1980). Brown v. Board of Education and the interest-convergence dilemma. Harvard Law Review, 93(3), 518–533. https://doi.org/10.2307/1340546
  6. Berne, E. (1964). Games people play: The psychology of human relationships. Grove Press.
  7. Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. Basic Books.
  8. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
  9. Cross, W. E., Jr. (1991). Shades of Black: Diversity in African-American identity. Temple University Press.
  10. Erikson, E. H. (1950). Childhood and society. Norton.
  11. Ernst, F. H., Jr. (1971). The OK corral: The grid for get-on-with. Transactional Analysis Journal, 1(4), 231–240. https://doi.org/10.1177/036215377100100409
  12. Freud, S. (1953). Three essays on the theory of sexuality. In J. Strachey (Ed. & Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 7). Hogarth Press. (Original work published 1905)
  13. Kohlberg, L. (1981). Essays on moral development: Vol. 1. The philosophy of moral development. Harper & Row.
  14. Ladson-Billings, G. (1995). Toward a theory of culturally relevant pedagogy. American Educational Research Journal, 32(3), 465–491. https://doi.org/10.3102/00028312032003465
  15. Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Psychology Foundation.
  16. McGee, M. L. (n.d.). Fetal psychological development and the mother’s traumatic stress [Unpublished pilot study]. Counseling Psychology program, Bowie State University.
  17. Museus, S. D. (2014). The culturally engaging campus environments (CECE) model: A new theory of success among racially diverse college student populations. In M. B. Paulsen (Ed.), Higher education: Handbook of theory and research (Vol. 29, pp. 189–227). Springer. https://doi.org/10.1007/978-94-017-8005-6_5
  18. Piaget, J. (1952). The origins of intelligence in children (M. Cook, Trans.). International Universities Press.
  19. Vandiver, B. J., Cross, W. E., Jr., Worrell, F. C., & Fhagen-Smith, P. E. (2002). Validating the Cross Racial Identity Scale. Journal of Counseling Psychology, 49(1), 71–85. https://doi.org/10.1037/0022-0167.49.1.71
  20. Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Harvard University Press.
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Lesson 7 · Race, Myth and Medicine

Where the myths behind racism came from, and how they still shape medicine and mental health.

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