Early Relational Health

Early relational health focuses on building safe, stable, and nurturing relationships between parents and children. This is particularly critical in a child’s earliest years, as strong emotional bonds develop through sensitive, consistent and responsive parenting. Physical health is linked to these early experiences, and these bonds help infants, children, and adolescents develop high self-esteem, seek out social connection and support, and learn how to manage their feelings and behaviors.

This type of strong connection between a child and their parent(s) is known as secure attachment, and helps foster resiliency in children. These emotional bonds are crucial to success later in life, and serve as a buffer when children encounter challenges like poverty, family instability, parental stress, or depression. A recent study of 14,000 US children demonstrated that 40% of children lack strong parental attachments1. Children who lack secure attachments may have poorer language and behavior before entering school, and these negative impacts can continue to impact children throughout their lifespan.

As children see their pediatrician for an average of 15 well child visits in their first 5 years, this provides an ongoing opportunity to equip parents with tools to support their child’s social, emotional and cognitive development during these routine healthcare interactions.

Together with the New Jersey Department of Children and Families, the New Jersey Chapter, American Academy of Pediatrics is offering the Mount Sinai Parenting Center Keystones of Development curriculum as a Maintenance of Certification (MOC) Part 4 Project ECHO® program for community pediatricians. Originally piloted in 8 national pediatric residency sites in July 2018, the curriculum has shown statistically significant changes in knowledge, confidence, and self-reported behaviors related to advising parents on ways to promote child development. We anticipate that this curriculum will be equally beneficial for practicing physicians, helping to create nurturing parenting environments within the confines of routine care.   

The Keystones of Development promote children’s cognitive and emotional growth by training pediatricians to provide parents and caregivers with confidence, skills and satisfaction in parenting. This curriculum equips pediatricians to deliver information and model positive behaviors that strengthen parent-child relationships and foster child development within the context of well-child visits.

The six developmental keystones that are covered in the curriculum and woven into well-child visits include:

  1. Secure attachment
  2. Autonomy
  3. Self-Regulation
  4. Perspective Taking
  5. Problem Solving
  6. Academic Knowledge
  1. Moullin, S., Waldfogel, J., & Washbrook, E. (2014). Baby Bonds: Parenting, Attachment and a Secure Base for Children. Sutton Trust.