Support early relational health at every clinic visit: Canadian Paediatric Society

Positive relationships are critical for young children’s healthy development, and primary care providers need to promote “relational health” in their visits with children and families, says a new statement from the Canadian Paediatric Society.

While a growing body of evidence has linked adverse childhood experiences (ACEs) with both short- and long-term health and well-being, a focus on adversity can overlook how safe, stable, and nurturing relationships can buffer against toxic stress and help children build resilience.

Children grow and develop in an environment of relationships, and child health practitioners can help to promote healthy relationships and positive childhood experiences at every visit.

“We cannot overstate the importance of a child having a stable and supportive relationship with at least one close adult,” said Dr. Robin Williams, Chair of the CPS Early Years Task Force. “Because parenting behaviours can be learned and modified, we can have a lifelong impact on our patients by recognizing and supporting their families’ strengths.”

Parents themselves are often affected by their own ACEs, but may not be aware of how their history is affecting their current relationships. Clinicians have an opportunity to help them make this connection and break negative intergenerational cycles.

Child health providers are already experts in recognizing secure attachment and signs of healthy parenting. They can highlight early relational health by verbally acknowledging those micro-moments in clinic, such as when a parent-and-child exhibit serve and return interactions or a parent successfully soothes their infant.

In addition to relational health, the statement recommends that health professionals promote other drivers of child development, including:

• Parental health and well-being;
• Breastfeeding;
• Early literacy and shared reading;
• Developmentally appropriate play; and
• Connection with community resources.