Early Relational Health: A Foundation for Healthy Development Across the Lifespan

When asked to recall our earliest memories, many of us are not able to pinpoint exactly when or where they occurred. However, we can often remember who was there. Go ahead and try it—what is one of the earliest moments you can recall? Approximately how old were you, and where did it take place? Who was there with you?

If the picture your mind painted was blurry, but the actors were clear, this is because we grow up in the context of our relationships with others. This concept is central to early relational health, the notion that safe, stable, and nurturing relationships (SSNRs) in early childhood build the foundation for healthy development across the lifespan. Decades of child development research in scientific fields such as psychology, neuroscience, and public health have established the importance of SSNRs in a child’s life in enabling optimal physical and emotional development.

Birth to 3 years old is an astonishing window of opportunity for growth and learning. In these early years, 1 million new neural connections form in the brain each second. Supportive adult caregivers provide infants and children with opportunities to safely explore their environments, build meaningful relationships, and express their needs and emotions—all of which are important for meeting developmental milestones. SSNRs signal to children that they can take risks and trust others to care for them and that their basic and emotional needs will be met and responded to appropriately. In contrast, an absence of caring adults leads to missed opportunities for growth and can hinder children’s ability to build essential skills and the connections needed to thrive. Early relational health is key for ensuring that young children meet their potential and lead happy, healthy lives.

A large portfolio of research initiatives led and funded by the National Institutes of Health (NIH) has made strides in studying early childhood health and development. The Environmental influences on Child Health Outcomes (ECHO) Program and HEALthy Brain and Child Development (HBCD) Study are examples of large-scale, state-of-the-art longitudinal studies that have yielded novel discoveries about social, behavioral, and environmental factors (including social relationships) that improve or impair children’s health.

A recent ECHO-funded study created and tested a survey for parents to measure their early relationships with their children. Higher scores were linked to better child health and well-being, while lower scores were associated with more emotional and physical distress (Blackwell et al., 2022). More findings from the ECHO study are available on the program website. Researchers and trainees may request access to ECHO data for secondary analysis. The first HBCD data release is expected in 2025.

The All of Us Research Program is another NIH-led initiative that explores longitudinal associations among biological characteristics, social and physical environments, and health outcomes. All of Us recently launched a new pediatric cohort to investigate lifestyle characteristics, genetics, and environmental exposures in infancy and early childhood that may affect disease risk. The program is currently enrolling children from birth through age 4. Additional rounds of recruitment are anticipated to expand pediatric enrollment to older age groups.

OBSSR has co-funded ECHO and HBCD awards and is excited to support the All of Us pediatric cohort as it develops. In addition to promoting NIH studies that explore early childhood development and children’s health outcomes, OBSSR and other partners across NIH have expressed interest in conducting a consensus study on early relational health in collaboration with agencies and organizations. This consensus study would gather child development experts from various disciplines (e.g., developmental psychology, neuroscience, public health), as well as those involved in the daily care of young children (e.g., caregivers, pediatricians, early care and education providers), to identify programs and research that could inform next steps for promoting early relational health, and thus healthy foundations, among all children.

OBSSR is proudly committed to supporting research on the ways in which early childhood relationships influence positive health trajectories. Check out the following resources for more information about the importance of relationships and positive health outcomes:

by Jane M. Simoni, Ph.D.