Placing Relationships at the Core of Early Care and Education Programs

Abstract

Esteemed among physicians devoted to humanizing medical care, Brazelton's insistent focus has been on two figural relationships: pediatricians' relationships with children and parents, and the parent-child relationship. In his view, nurturing the former promotes the latter, and both promote the healthy development and functioning of children and families. Less heralded is the long reach that Brazelton has had in fields outside pediatrics; this chapter highlights the instantiation of his orientation within early care and education. The Development of Brazelton's Approach to Early RelationshipsFor several decades, Brazelton has promoted a model of infant and family development that posits satisfying relationships as both a hallmark of thriving in infancy and early childhood and a vehicle for attaining developmental goals. Well situated with like-minded theoreticians and practitioners (e.g., Minuchin's Family Systems Theory [1974], Bronfenbrenner's Developmental Ecological Model [1979], and Sander's Organismic Perspective [1977] on infant development), Brazelton's approach is a model for relationshipsbased practice within pediatrics and beyond (Hulbert, 2003). Brazelton (2000) credits Louis Sander's "model of systems regulation" (1977) as a provocation for his reflection on the contributions of internal biological systems and "external" systems (family, cultural context) to infant development. The Touchpoints framework was developed partially to overcome the limitations of "stimulus-response" paradigms of development (Brazelton, 2000).

Video-Delivered Family Therapy for Home Visited Young Mothers With Perinatal Depressive Symptoms: Quasi-Experimental Implementation-Effectiveness Hybrid Trial

“…Home visitors refer depressed mothers for treatment but they infrequently obtain it or complete it [7-12]. Between 8% and 32% of depressed home visited mothers report receipt of some mental health treatment [3,6,7,12-14]. One study showed that about 19% of home visited mothers recover from depression as a result of the illness’s natural course, reduced stressors, or mental health treatment in the community [3].…”

Institutionalisation and deinstitutionalisation of children 2: policy and practice recommendations for global, national, and local actors

“…The goal of our recommendation for this global strategy is both to secure the right of a child to a family and to promote recognition that supportive family dynamics improve human and social capital outcomes across the entire life of a child. [49][50][51][52] We have identified five ways in which multilateral organisations can affect the pursuance of this goal: (1) by engaging in advocacy and public information; (2) by issuing policy statements on children outside of, or at risk of losing, parental or family care; (3) by highlighting and generating evidence related to the benefits of safe and nurturing family-based care, the harms of institutionalisation, and examples of the reform process; (4) by supporting and resourcing government policies and programmes, including by providing technical assistance to support family-based care, the reintegration of children, and the progressive elimination of institutions, and by financing projects that show the benefits of a family-centred child welfare system; and (5) by pressing for the assemblage of data relevant for monitoring the situation of children in all forms of care. Multilateral organisations can advocate globally to show that the institutionalisation of children is not an appropriate or cost-effective response to poverty, risk, vulnerability, or the loss of family, and they can work together to issue joint resolutions, strategies, and statements on the norms and approaches for supporting family-based care and the progressive elimination of institutions.…”