Relationships matter: How clinicians can support positive parenting in the early years

Abstract

A secure attachment relationship with at least one healthy adult is essential for a child to develop optimal coping abilities. Primary care providers like paediatricians and family physicians can help by supporting parents in practice settings. Every clinician encounter is an opportunity to ask parents about children’s relationships and their behaviour, daily routines, and overall family function. This statement, which focuses on children aged 0 to 6 years, describes basic principles in support of positive parenting and recommends in-office practices to promote secure parent–child relationships, engage families and build trust with parents. Crying, sleep, and difficult behaviours are described as opportunities for clinicians to provide anticipatory, responsive guidance to parents.

Relative contribution of maternal adverse childhood experiences to understanding children’s externalizing and internalizing behaviours at age 5: findings from the All Our Families cohort

“…48,49 Conversely, there are many low-cost, effective, nonstigmatizing community-based interventions to improve parenting practices, parental mental health and child behaviour, and the Canadian Paediatric Society has provided guidance on discussing parenting in the context of well-child visits. [50][51][52] Our results are consistent with other findings that the influence of maternal ACEs on child outcomes is minor relative to the influence of other factors. 53,54 For example, research by the…”

Early relational health: Innovations in child health for promotion, screening, and research

“…Early relational health (ERH) has been an emergent and expanding concept over the last decade in child health and public health systems, elevating the centrality of positive, nurturing and stimulating experiences as a key driver of the future health and wellbeing of children (Frosch et al., 2019; Klass & Navsaria, 2021; National Scientific Council on the Developing Child, 2004; Williams et al., 2019). ERH is a two‐generational and attachment‐based concept, mindful of the simultaneous influences of community resilience and the social, economic, racial, and cultural contexts of families (FrameWorks Institute, 2020).…”

“…ERH has galvanized the interest of many stakeholders, thought leaders and policymakers across child health, public health, behavioral health and early childhood systems, drawing attention to the essential early relational experiences that contribute significantly both to child development and overall child and family well‐being (Doyle et al., 2019; Schor, 2018; Weatherston & Rosenblum, 2018; Williams et al., 2019; Zeanah et al., 2018). The ERH concept challenges practitioners, researchers, and policymakers to work with families and communities in new ways to develop clinical approaches, measurement tools, interventions, and strategies that will be transformative for child health systems in its universal promotion of holistic health and wellbeing (see Figure 1) and its mission of the prevention of future disorders.…”

Minding the Baby versus usual care: study protocol for a quasi-cluster-randomized controlled study in Denmark of an early interdisciplinary home-visiting intervention for families at increased risk for adversity

“…Results from studies across a range of countries and cultures suggest that approximately 40% of children have an insecure attachment to their primary caregiver [17]. Having an insecure attachment and, in particular, a disorganized attachment to the caregiver leads to a higher risk of later mental health and behavior problems [18][19][20][21][22][23]. The quality of the attachment bond depends on the sensitivity of the caregiver [14,[24][25][26].…”