Early relational health is a framework that explores the role of early relationships and experiences in healthy development across a child’s lifetime. Relationships, especially in the early years, are biological necessities to build a foundation for lifelong growth and development.

Relationships should be:

  • Safe: The relationship is free of physical or psychological harm. Children believe their caregivers will protect them.
  • Stable: The adult is dependably there for the child. Children believe their caregivers will meet their needs.
  • Nurturing: The child’s physical, emotional, and developmental needs are sensitively and consistently met. Children believe their caregivers will use warmth and clear expectations to foster their development.

Supporting early relational health in practice

Pediatricians remain a highly trusted source of information and support for families. There are 15 scheduled well child visits in a child’s first 5 years, providing an ongoing opportunity to equip families with tools to support their child’s social, emotional, and cognitive development.

Early relational health can be supported in practice through the principles of a family centered medical home and in the recommended anticipatory guidance found in Bright Futures. Pediatricians can support early relational health through

  • Universal Prevention - Promotion of safe, stable, nurturing relationships to all families through developmentally specific anticipatory guidance; safe, effective parenting practices; and modeling effective communication and care for others.
  • Targeted Interventions - Assessment of development and protective factors including child, family, and community factors, parent knowledge about access to supports, healthy parent and family communication styles, and social supports in the community.
  • Indicated Treatments - Interventions and referrals such as identifying and addressing social drivers of health including, family or child adverse childhood experiences.
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American Academy of Pediatrics