From zero to thrive: A model of cross‐system and cross‐sector relational health to promote early childhood development across the child‐serving ecosystem

Abstract

Early relational health between caregivers and children is foundational for child health and well‐being. Children and caregivers are also embedded within multiple systems and sectors, or a “child‐serving ecosystem”, that shapes child development. Although the COVID‐19 pandemic has made this embeddedness abundantly clear, systems remain siloed and lack coordination. Fostering relational health amongst layers of this ecosystem may be a way to systematically support young children and families who are facing adversity. We integrate theory, examples, and empirical findings to develop a conceptual model informed by infant mental health and public health frameworks that illustrates how relational health across the child‐serving ecosystem may promote child health and well‐being at a population level. Our model articulates what relational health looks like across levels of this ecosystem from primary caregiver‐child relationships, to secondary relationships between caregivers and child‐serving systems, to tertiary relationships among systems that shape child outcomes directly and indirectly. We posit that positive relational health across levels is critical for promoting child health and well‐being broadly. We provide examples of evidence‐based approaches that address primary, secondary, and tertiary relational health, and suggest ways to promote relational health through cross‐sector training and psychoeducation in the science of early development. This model conceptualizes relational health across the child‐serving ecosystem and can serve as a template for promoting child health and well‐being in the context of adversity.

Environmental contaminants and child development: Developmentally‐informed opportunities and recommendations for integrating and informing child environmental health science

“…It can be further helpful to characterize these contexts and the individuals acting within them as an overarching “child serving ecosystem” or CSE (Miller, Stein et al., 2022 ). The CSE spans systems and sectors that serve children directly and indirectly.…”

“…The CSE spans systems and sectors that serve children directly and indirectly. Individuals in the CSE include parents and caregivers, educators, and clinical care providers who directly shape child health and development, as well as (among others) the public health workforce and policymakers who shape child health indirectly (Miller, Stein et al., 2022 ). Indirect influences are particularly important for CEH considerations, as regulation of toxicants is driven by both local and higher‐level policies, which are often siloed from each other and from systems meant to protect the public's health (Korfmacher, 2020 ).…”

“…Indirect influences are particularly important for CEH considerations, as regulation of toxicants is driven by both local and higher‐level policies, which are often siloed from each other and from systems meant to protect the public's health (Korfmacher, 2020 ). Developmentally‐informed conceptual models that articulate connections across the CSE can help identify and leverage opportunities to intervene in key contexts to protect CEH threats (Bachrach et al., 2010 ; Miller, Stein et al., 2022 ).…”

“…High‐quality childcare is characterized by positive relationships between young children and childcare providers and thus has the potential to mitigate impacts of exposures through early relational health pathways (Ettinger et al., 2019 ; Hanna‐Attisha et al., 2022 ; Schnur & John, 2014 ). Specialized early intervention (EI) services for young children may also be more successful when families trust and feel supported by their providers, reflecting relational health between families and providers (Jimenez et al., 2012 ; Miller, Stein et al., 2022 ). A recent analysis found that EI services, which entail individualized service plans tailored to child and family needs, mitigated the impact of lead exposure on later math and reading scores (Stingone et al., 2022 ).…”

“…Others address complexity by examining specific mixtures (e.g., Merced‐Nieves, Robledo, Schildroth (this issue) or broad exposures (e.g., Ugarte (this issue)), and some study candidate bio‐behavioral explanatory mechanisms (e.g., inflammation, Parenteau (this issue); ANS reactivity, Ugarte (this issue); learning tasks, Merced‐Nieves (this issue). Finally, some studies identify possible protective factors that moderate the impact of exposure (e.g., weight status, Robledo (this issue); hippocampal volume; Miller (this issue). This issue thus begins to illustrate how developmental scientists are contributing to CEH science.…”