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Early Relational Health

Clinical Pearls Video Series

Video Chapters

Click on the three lines in the upper left corner to see chapter information or reference the chapter table of contents below to navigate to specific chapters.

  • Assessment
    • Why is relational health important for pediatric care? (0:13–1:31)
    • What influences the early relationship between parents and young children? (1:32–3:17)
    • How can I distinguish between normal child behavior and early signs of parent-child relationship challenges? (3:18–5:44)
    • What other issues might come up alongside parent-child relationship difficulties? (5:45–6:31)
    • How do early relationship problems affect a child’s emotions and behavior, and what should I look for? (6:32–8:38)
    • How can early relationship problems be mistaken for other mental health disorders, and how can I tell the difference? (8:39–9:46)
    • What signs of relationship challenges should I watch for in children with conditions like autism? ADHD? Other forms of trauma? (9:47–11:45)
  • Management
    • What can I do in my practice to promote healthy child-parent relationships and positive childhood experiences when families are under stress? (11:46–14:46)
    • How can therapy help promote healthy parent-child relationships? (14:47–15:55)
    • What types of therapy are most effective for improving these relationships? (15:56–17:56)
    • What can families, schools, or communities do to support positive interactions within these settings? (17:57–18:48)
    • Outside of families, what other community and care team members can be important in addressing relational health? (18:49–19:56)
    • Are there ways to prevent challenges and promote healthy parent-child relationships? (19:57–20:53)
    • When should I suggest interventions and how can I support families aside from using medications? (20:54–21:48)
    • When might medications be considered to augment other non-pharmacologic interventions? (21:49–22:14)
  • Key Takeaways (22:1523:25)
Rena Menke

Rena Menke, Ph.D., Maternal & Infant Psychologist, University of Michigan

Early Relational Health is a determinant of pediatric outcomes. The relationship between a caregiver and child provides the neurodevelopmental and psychosocial foundation for a child’s cognitive, social, emotional, and physical development. Key factors influencing this relationship include, but are not limited to, attachment, parental mental health, social drivers of health, and child characteristics. Recommended strategies for assessing relational health include validated screening and direct observation of caregiver-child exchanges during visits.

Relational challenges can overlap with common clinical concerns (such as sleep issues, behavior problems, growth concerns, or repeated visits) and can sometimes be mistaken for disorders like anxiety, depression, Attention Deficit Hyperactivity Disorder, or Autism Spectrum Disorders. Management of relational health emphasizes non-judgemental, trauma-informed care and linkage to support programs. The focus is on strengthening the caregiver-child relationship.

Bell A, Agnihotri R. Early relational health care: What is known and what is new for family physicians. Can Fam Physician. 2024 May;70(5):298-302. doi: 10.46747/cfp.7005298. PMID: 38744506; PMCID: PMC11280644.

Frosch CA, Schoppe-Sullivan SJ, O’Banion DD. Parenting and Child Development: A Relational Health Perspective. Am J Lifestyle Med. 2019 May 26;15(1):45-59. doi: 10.1177/1559827619849028. PMID: 33447170; PMCID: PMC7781063. https://pmc.ncbi.nlm.nih.gov/articles/PMC7781063/#bibr79-1559827619849028

Prinzie P, Stams GJJM, Deković M, Reijntjes AHA, Belsky J. The relations between parents’ Big Five personality factors and parenting: a meta-analytic review. J Pers Soc Psychol. 2009;97:351-362. doi: 10.1037/a0015823

Willis, D. W., Long, D., Johnson, K. (2024). Relational Health in Pediatrics. Pediatric Clinics of North America, 71(6), 1027-1045. Doi: 10.1016/j.pcl.2024.07.011

Test your knowledge with an optional 5-question quiz below. (Note: If you wish to receive a certificate of completion for this MC3 Clinical Pearl, you must receive a passing score of 80%.)

/5

Early Relational Health Quiz

1. Which of the following most accurately encapsulates a comprehensive approach to assessing early relational health in pediatric care?

2. Secure attachment in early parent-child relationships is MOST associated with:

3. In evaluating a child’s withdrawal and emotional regulation difficulties, what is an important first step before diagnosing a mental health disorder?

4. Which evidence-based program was developed to improve parent-child relationships by providing psychoeducation, self-care skills, and reflective opportunities for parents?

5. To support relational health for families under stress, providers should prioritize:

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