The overall goal of this roundtable meeting was for participants to explore the added value of biological constructs in our efforts to better understand both the theories and intervention strategies behind early toxic stress and development. Specifically, this meeting sought to address three key questions: 1.) What do we already know about toxic stress from the relevant research in the field? 2.) Can we identify the specific gaps in our knowledge that would be vitally useful for promoting healthy development in child care, Head Start, home visiting, and child welfare populations? 3.) Which of these findings and recommendations for future directions are ready for dissemination for programs and policy makers? (author abstract)