Early Relational Health in Practice

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Dyadic Neuroscience Social-Emotional Development Flourishing Disruption and Continuity in ERH and Flourishing ERH in Practice Longitudinal Study of ERH

Supporting Early Relational Health in intervention strategies, such as infant mental health, maternal health, and home visitation programs, among other early childhood or family support programs, is foundational to improving the health and well-being of children and their caregivers. A common element of the success of these programs is engaging families in the design, implementation, and ongoing quality improvement of the program.

In addition, Early Relational Health research into understanding factors that support practice emphasizes the importance of developing and supporting the early childhood workforce across sectors and the need to facilitate and maintain connections at multiple levels (interpersonal, familial, community, and societal).

What Research Tells Us:

  1. The workforce — that includes doulas, community health workers, home visiting nurses, primary pediatric care clinicians, and early childcare providers, among others — supports the parent and child connection and is essential for the promotion of Early Relational Health in communities.
  2. A growing body of research focused on building understanding around the promotion of ERH shows that parent partnership is essential for supporting ERH in practice. Parents bring practical wisdom and cultural knowledge that can guide strategies for practice transformation. Bringing caregiving voices, experiences, and cultural perspectives also strengthen ERH research and practice in early childhood ecosystems.
  3. ERH in practice should include a multi-tiered, holistic approach that includes equitable, family-centered supports for prevention and targeted interventions for mitigation.

How Is Early Relational Health Promoted Through Early Childhood Programs?

Early childhood programs that focus on the parent-child connection promote Early Relational Health. Below are some examples of how:

Helping parents and caregivers understand how their everyday interactions help meet what their babies and toddlers need:

Activities that help parents learn to “read” their child’s emotional needs and respond in ways that make the child feel understood and safe are foundational for supporting Early Relational Health. Circle of Security Parenting is one such video-based program that asks reflective questions to support caregivers in exploring their strengths and struggles in meeting their children’s attachment needs.

Supporting simple, everyday routines and interactions:

Parent-child interactions like holding, feeding, playing, reading, and bedtime routines are building blocks of Early Relational Health. Programs like Vroom or Simple Interactions help adults see the importance of these ordinary moments. Additionally, Reach Out and Read encourages reading aloud as a way to support positive parent and child interactions.

Building on what parents are already doing well:

Interventions that provide support or skills building in parenting while also recognizing parent strengths offer opportunities to promote Early Relational Health. Promoting First Relationships is one such program that helps adults to be responsive and tuned in to their children’s feelings and needs.

Helping connect families with the support they need:

There is strong research to show that supports that include ensuring parents are linked to other resources in their community help children and their families thrive. Programs like HealthySteps, Help Me Grow as well as home visiting can offer those supports to families. 

Bringing support into places families already go:

Promoting Early Relational Health in settings that are already part of families’ lives means that more children and their caregivers will get the support they need. For instance, programs like HealthySteps or Reach Out and Read work in pediatric clinics. They can offer support and check-ins during regular checkups.

Using parent coaching tools to help adults see and learn about their interactions with their baby:

Research shows that parent coaching programs can empower parents and caregivers, enhance family relationships, and create a more positive and supportive home environment for children and adults alike. Programs like Attachment and Biobehavioral Catch-up (ABC) or Filming Interactions to Nurture Development (FIND) use video to show caregivers how they interact with their child and help them practice new ways of responding. PlayReadVIP is another program that uses video coaching in pediatric clinics to promote responsive parenting.

Helping childcare caregivers who work with young children in places like daycare:

Supporting the early childhood workforce is crucial because it directly impacts the quality of care and education young children receive, which in turn affects their development and future success. For instance, Infant and Early Childhood Mental Health Consultation helps teachers and other providers support children’s feelings and development.

Supporting families with stress-management or trauma-healing programs:

Stress due to adversity and tough times can put a strain on the development of positive, early relationships between parents and their young children. Programs like the Circle of Security Parenting, which incorporates trauma-informed care principles that are focused on building resilience, support parent-child bonding and provide parents with tools to manage their stress in healthy ways.

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