parents effect on child behavior essay

Parents’ Influence on a Child Essay: How Parents Affect Behavior and Development

Do you wonder how parents influence their child? Read our parents’ influence on a child essay example and learn about the parental impact on behavior and development.

Introduction

• Financial Resources
• Education Level

Unemployed Parents

• Involvement of Parents
• Support from Parents
• Understanding of the Child’s Future
• Motivation from Parents
• Parental Goal-Setting
• The Importance of Discipline

Parents are means of structuring their child’s future. They have a very crucial role to play in their child’s growth and his/her conduct. During the days when schooling was considered to be accessible only to the children of the opulent, those who were not privileged enough to go to school, remained at home and helped their parents in daily chores.

Such children used to emulate their parents in their deeds and conduct. “In large part, we as children are shaped by what we see our parents do and how we see them act. I know that I have tried to model after my parents in many ways because I think they have done many things right” (Enotes, 2010).

But during the years, owing to the numerous opportunities available, parents have started devoting more time towards their work. Moreover, education has been simplified and has easy access. Children have started going to schools and as such, both parents and their children don’t have enough time to spend with each other. But still there are parents who devote time towards their children and try and teach them.

It has been observed that children, who have their parents’ guidance and participation in their school activities, achieve more in life as compared to those who totally depend on their schools. “…is that when parents get involved in their children’s education, they offer not only information specific to the classroom, but likely help in giving children a broader level of academic information” (Jeynes, 2011).

There are a few factors related to parents that have a major role to play in the child’s upbringing and education. These are:

Financial resources of parents

Financial resources mean the income of the parents. If the income of parents is good, they can afford to provide extra study material to their child at home. There is a lot of referencing material required by children and as such parents earning better can provide their child with books, periodicals, magazines, etc. Technological devices like the computer play an important role in a child’s standard of education. Parents earning handsomely can provide their child with a computer at home so that he/she can complete online projects. “Poverty takes a toll on students’ school performance. Poor children are twice as likely as their more affluent counterparts to repeat a grade; to be suspended, expelled, or drop out of high school; and to be placed in special education classes” (Education).

Education level of the parents

If the parents are well educated, they ought to understand the importance of education and will encourage their child to study better and up to high levels. Uneducated or less educated parents will not be able to understand the importance of moulding their child’s career from the early school days. On the contrary, well educated parents will understand that for achieving success and objectives, the foundation of their child should be strong.

Unemployed parents are disgruntled and as such the atmosphere at home is not conducive for a child to study. Children find it suffocating at home and as such can’t concentrate on their studies even at their schools. Nicole Biedinger remarked that “…it is hypothesized that the home environment and family background are very important for the cognitive abilities and for their improvement” (Biedinger 2011). He further continues that “Previous research has shown that there exist developmental differences of children from different social classes” (Biedinger, 2011).

Involvement of parents

It will not be contradictory to state that parents and schools have an equal effect on the development of children. Both have an important role to play and are links to a child’s future. Even if one of the links is missing, it will have a negative impact on the child. Parents can get involved in their child’s upbringing by keeping a constant vigil on his/her school work. They can also visit his/her school on occasions such as parent-teacher meetings, annual days, sport events, social get-togethers, etc. All this will help in developing confidence in the child and also a sense of safety and protection.

Once a child is grown up, the parents can still contribute towards building their child’s confidence and identifying his/her qualities by talking to him/her on various career related issues.

Support from parents

Even if parents are not able to contribute financially by providing the essential tools for education, they can at least act as moral boosters for their child. They can inculcate, in their child, the habit of studying hard in order to attain success in life. Such children can defy all odds and prove to fulfil their parents’ aspirations. Alison Rich emphasized that “A cognitively stimulating home need not be one that is rich in material resources. Parents can simply discuss issues of importance with their children, talk to them about what they are doing in school, or spend time doing activities that will develop their skills and abilities” (Rich, 2000).

Parents’ understanding of their child’s future

Simply by getting involved in their child’s school activities, parents cannot guarantee their child’s success. Parents should be well acquainted with the ongoing educational process and various courses available. Information on when to go for any particular course is very crucial. As for example, parents must be aware of any courses that their child might require before going to the college. There are various pre-college courses that improve the grasping power of students. Further, a child will not be able to tell as to what he/she wants to achieve in life. But parents, by knowing his/her interests, can assess their child’s inclination and can further encourage him/her to pursue those interests.

Motivation from parents

Usually, parents tell bed-time stories to their children. These stories have a great impact on the way a child thinks and are instrumental to quite some extent in moulding his/her behaviour and conduct. So parents should tell such stories that have some moral values. The child will get inspired from them and behave accordingly. Stories of heroes and successful people will encourage the child to be like one of them. Parents can also motivate their children by doing good acts themselves.

Parents to set goals for their child

Achieving one’s goals in life is a very important factor of success. Success comes to those who achieve their aims and objectives. Even though there are no fixed parameters for achieving success, it solely depends on the hard work, enthusiasm and motivation of a person. These qualities don’t come instantly but have to be nurtured since childhood. So parents, who want their child to succeed, should start giving him/her small targets to be completed in a given time-frame. Gradually, the child will be habituated to achieve targets and this will be helpful to a great extent in his/her future life, may it be his/her education or career.

Inculcating the importance of discipline

Being disciplined is one of the most critical requirements of being successful. Similar to the habit of achieving targets, discipline also doesn’t come instantly. It has to be inculcated since childhood.

Parents can teach discipline to their child by following certain rules. They can have strict time frames for different activities of their child at home such as study hours, watching the television programmes, having supper and other meals, and going to bed. A sense of responsibility can also be imposed on the child by allocating to him/her certain house-hold tasks.

Having mentioned all the above factors, it can be concluded that parents have an ever-lasting impact on their child’s education. It has been observed that in cases where parents have involvement in their children’s education, the children portray the following virtues: better grades at school, better rates of graduation, fewer absentees from school, better inspiration and confidence, abstaining from drugs, smoking, alcohol and other sedatives, transparency, and being responsible.

Both parents and the school have to work in mutual co-operation to enhance the educational experience of a child and to mould his/her career. In fact, schools encourage parents to be more involved in their children’s activities because the school authorities know that parents’ involvement can bring about great positive changes in the students. That’s the reason schools invite parents to attend various school activities and functions.

Biedinger, N. (2011). The influence of education and home environment on the cognitive outcomes of preschool children in Germany . Web.

Education. (n.d.). Out-of-school influences and academic success-background, parental influence, family economic status, preparing for school, physical and mental health . Web.

Enotes. (2010). How do parents influence children in life? Web.

Jeynes, W. (2011). Parental involvement and academic success . New York: Routledge.

Rich, A. (2000). Beyond the classroom: How parents influence their children’s education . Web.

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IvyPanda. (2018, November 6). Parents’ Influence on a Child Essay: How Parents Affect Behavior and Development. https://ivypanda.com/essays/parents-influence-on-a-child/

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Primeros Pasos

Interview: Changing Parental Behavior with Behavioral Tools Can Help Children Reach their Full Potential

August 6, 2018 por Andrea Proaño Calderon 3 Comments

How do we make decisions when our lives are so complex? An increasingly popular way to approach this question is through behavioral sciences —the science of evaluating psychological, cognitive, emotional, cultural, neuroscience and social factors and their impact on decisions. To explore the intersection between behavioral sciences and public policies, the Inter-American Development Bank has launched a series of webinars featuring renowned subject experts and convened by our co-editor Florencia Lopez Boo .

We spoke to Ariel Kalil, Director of the Center for Human Potential and Public Policy and Co-Director of the  Behavioral Insights and Parenting (BIP) Lab at the University of Chicago , on the application of behavioral economics to Early Childhood Development policies.

A powerful thing you said during your webinar is that “parents are the single greatest influence on children.” How and why is the role of parents paramount to child development?

Usually when we think about child learning and development, we think about schooling and institutions outside the home. My hypothesis is that most people will say we can fix childhood issues through schooling. Consequently, the role of parents has become kind of lost both in research and policy. But if you look at where children spend their time, especially during their first and most critical years, it’s in a family environment. They spend less time in school versus in the company of their parents and caregivers. Even beyond caregiving, parents play a critical role throughout the years. For example, parents select their children’s environments all the time based on things they think are good for them, like neighborhoods, schools, etc., although some constraints exist. All this suggests parents are the number one influence on children.

How true is it that parents in low income contexts, usually under stress, tend to procrastinate more in their interactions with children than those in higher income contexts?

It’s the 20-million-dollar question… There’s a general notion that life is more complex and complicated in low-income contexts, and that as stress increases so does the probability of procrastination. Under stress, it might be more appealing to choose leisure time or watching TV for 20 extra minutes rather than reading to your child because you’ve had a long day and you think you’ll read tomorrow. There’s no question this happens in all families, but it might be more common in low income households because there are more – or different – kinds of stressors. This does not mean these parents don’t value the return on time investment in the early childhood. Surveys of parents of young kids show that parents have very high expectations for their children’s future and are therefore willing to invest in the present time to increase their cognitive development. But less educated or low-income parents have a harder time converting what they wish to do into what they actually do.

Do children in these contexts learn to procrastinate?

That’s an interesting question. Children behavior is modelled on their parents, and maybe if they grow up in households that don’t have routines or language about doing things today because it’s important for the future — such as: ‘You need to read today because you’re going to kindergarten tomorrow’— that can be possible. If children don’t grasp the idea that the reason you do things now is for a future reward, their horizon might be different.

Evidence suggests more educated parents spend more time with their children. What implications does this have for vulnerable contexts? What strategies can we implement to change this?

Assuming parent-child interactions have an impact on development, we should be concerned if one group of kids gets the benefits of parental time and another doesn’t. However, over time low-income parents have vastly increased the time they spend with their children. Less educated parents now spend the same amount of time with their kids than more educated parents did 30 years ago. But highly-educated parents have also increased their time investments over time, and thus we still see income-based inequality in parent engagement. If there’s a minimum threshold for time investment, parents in low income families have reached it, but a puzzle we still need to solve is whether there is such a threshold or if more is always better.

How to close these gaps turns out to be easier than we might have thought because we know low-income parents share the same aspirations for their kid’s development. They do not enjoy time with their kids any less, and they do not completely lack the tools to promote their development. Most homes have at least some books. But the answer is not to give them more books; rather, we must provide tools for optimal decision-making, where the optimal decision is parents doing the things they say they want to do.

Evidence also suggests parents with lower levels of education have just as much positive feelings about spending time in child care and with their children, even though they spend less time in those activities. What does this apparent paradox tell us?

  That given the opportunity, they would do it more and enjoy it as much. At the BIP Lab , we’ve learned a lot about why parents do or don’t do certain things, rejecting long-standing assumptions. For example, it’s not always true less-educated parents don’t do a particular thing for their kid because they lack information. When we survey them, it turns out they know a lot! So if they know, why are they not doing it? Behavioral economics places parenting in a decision-making framework.

  The decisions parents make on whether they read to their kids need not be different to any other decision to something not related to kids. It comes down to this: if you have an hour in front of you, how will you use it? This is a very new way of thinking about parenting. Interventions designed around this concept aim to create the conditions, so they can make decision A vs B: to read vs not; brush their teeth vs not, eat healthier vs not.

How to achieve this goal?

We want to help parents go from doing none of what they say they want to do most of the time, to doing at least a little bit of it much of the time. To do this, we need to manage different cognitive biases that are standing in the way of parents doing things they say they want to do . We want parents to be goal-oriented and think about the future by bringing the future to the present.

The tools we use are not expensive, don’t demand a lot of parent time, and work in many different income contexts.  For example, we send parents reminders via text about setting and meeting a goal for reading time with their kids that week. Or, if parents think other kids are missing school as much as theirs, we show them that might not be true, changing normalization patterns that get in the way of them doing things differently. It’s about finding the right match and tool, matching tools that already exist to behaviors you want to change.

To finish out interview, a very important question: you mentioned “the key to closing the gap in child outcomes is closing the gap in what families do with their children.” What are some examples of what parents could do to this end?

There are some key things parents should be doing, and cognitive stimulation is right up there: talking, reading, stimulating quality interactions and strong communications … There’s no app or media or TV that’s a substitute for active dynamic interaction with human beings, which takes many forms.

Second, children need consistency, so there needs to be routine in caregiving. They need to know where their next meal is coming from, metaphorically, to have confidence about their environment. Parents should be affectionate and warm, and they should be so consistently.

An important aspect parents need to care for is their children’s health. This unfortunately changes a lot between high and low-income households. Our research shows the number one infection in children, and also the most preventable, are cavities! This is largely a function of one behavior: toothbrushing. Most parents have what they need to prevent this: a toothbrush.

All this shows that approaching parenting through a decision-making lens and shaping parent behavior can definitely pave the way for children to reach their full potential. We need to be their best allies.

Which activities would you want to share with your children more? Leave your comments below or mention  @BIDgente  on Twitter.

Andrea Proaño Calderon  is the communications consultant for the Inter-American Development Bank’s Social Protection and Health Division.

Lee en español.

Andrea Proaño Calderon

Andrea Proaño es consultora en comunicaciones en la División de Protección Social y Salud del Banco Interamericano de Desarrollo. Tiene experiencia en creación y edición de contenidos, manejo de redes sociales, y comunicación estratégica en organizaciones internacionales, empresa privada, academia y sociedad civil. Es licenciada en Periodismo Multimedios por la Universidad San Francisco de Quito, en Ecuador, y Máster en Comunicación Internacional con enfoque en Desarrollo Social por la American University de Washington.

Reader Interactions

October 6, 2020 at 11:00 pm

A child’s exposure to language will support their ability to communicate appropriately. Reading is a means of language processing. New words will be added to the vocabulary, making children quickly understand what is communicated. You can do it by letting them express how they feel about a book’s ending. This way, they can practice speaking their feelings properly.

August 30, 2021 at 10:49 pm

While reaching potential is what every parent aspire, it’s important that the focus is firmly placed on the child. Check my blog Powerful Ways to Help Children Reach Their Full Potential

Cheers, Caroleann

September 14, 2021 at 9:28 pm

Amazing info article to read. Thank you for sharing information.

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Why Parenting Styles Matter When Raising Children

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Amy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk,  "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time.

Verywell / Laura Porter

The Four Parenting Styles

• Impact of Parenting Style

Advantages of Authoritative Parenting

Can you change your parenting style.

• Limitations and Criticism

Parenting styles are constructs used to describe the different strategies parents tend to utilize when raising children. These styles encompass parents' behaviors and attitudes and the emotional environment in which they raise their children.

Developmental psychologists have long been interested in how parents affect child development. However, finding actual cause-and-effect links between specific actions of parents and later behavior of children is very difficult.

Some children raised in dramatically different environments can later grow up to have remarkably similar personalities . Conversely, children who share a home and are raised in the same environment can grow up to have very different personalities.

Despite these challenges, researchers have posited that there are links between parenting styles and the effects these styles have on children. And some suggest these effects carry over into adult behavior.

In the 1960s, psychologist Diana Baumrind conducted a study on more than 100 preschool-age children. Using naturalistic observation , parental interviews, and other research methods , she identified some important dimensions of parenting.

These dimensions include disciplinary strategies, warmth and nurturing, communication styles, and expectations of maturity and control. Based on these dimensions, Baumrind suggested that the majority of parents display one of three different parenting styles. Later research by Maccoby and Martin suggested adding a fourth parenting style. Each of these has different effects on children's behavior.

The four parenting styles that have been identify by Baumrind and other researchers are:

• The authoritarian parenting style
• The authoritative parenting style
• The permissive parenting style
• The uninvolved parenting style

What's Your Parenting Style?

This fast and free parenting styles quiz can help you analyze the methods you're using to parent your kids and whether or not it may be a good idea to learn some new parenting behaviors:

Authoritarian Parenting

In this style of parenting, children are expected to follow the strict rules established by the parents. Failure to follow such rules usually results in punishment.

Authoritarian parents don't explain the reasoning behind these rules. If asked to explain, the parent might simply reply, "Because I said so."

Other common characteristics:

• While these parents have high demands, they are not very responsive to their children.
• They expect their children to behave exceptionally and not make errors, yet they provide little direction about what they should do or avoid in the future.
• Mistakes are punished, often quite harshly, yet their children are often left wondering exactly what they did wrong.

Baumrind says these parents "are obedience- and status-oriented, and expect their orders to be obeyed without explanation." They are often described as domineering and dictatorial. Their approach is "spare the rod, spoil the child." They expect children to obey without question.

Effects of Authoritarian Parenting

Authoritarian parenting styles generally lead to obedient and proficient children, but they rank lower in happiness, social competence, and  self-esteem . They may also be more likely to lie to avoid punishment.

Authoritative Parenting

Like authoritarian parents, those with an authoritative parenting style establish rules and guidelines that their children are expected to follow. However, this parenting style is much more democratic.

Common characteristics of the authoritative parenting style:

• Authoritative parents are responsive to their children and willing to listen to questions.
• These parents expect a lot of their children, but they provide warmth, feedback, and adequate support.
• When children fail to meet expectations, these parents are more nurturing and forgiving than punishing.

According to Baumrind, authoritarive parents are good at setting standards and monitoring their children's behavior. Their disciplinary methods are assertive and supportive rather than intrusive, restrictive, or punitive.

For authoritative parents, the goal is to raise children who are socially responsible, cooperative, and self-regulated. The combination of expectation and support helps children of authoritative parents develop skills such as independence, self-control, and self-regulation. 

Effects of Authoritative Parenting

Authoritative parenting styles tend to result in happy, capable, and successful children.

Permissive Parenting

Permissive parents , sometimes referred to as indulgent parents, make very few demands of their children. These parents rarely discipline their children because they have relatively low expectations of maturity and self-control.​

• Other common characteristics of permissive parenting:
• Permissive parents prioritize being their child's friend rather than being a parent.
• They are warm and attentive but tend to set few rules, rarely enforce rules, and have few expectations.
• They allow their children to make their own decisions. 

According to Baumrind, permissive parents are responsive to their children but not demanding. Because they do not expect mature behavior from their children, kids may struggle to set limits for themselves. On the positive side, this can help kids become more self-sufficient and independent. On the downside, it can contribute to poor self-regulation.

Permissive parents are generally nurturing and communicative with their children, often taking on the status of a friend more than a parent.

Effects of Permissive Parenting

Permissive parenting often results in children who rank low in happiness and self-regulation. These children are more likely to experience problems with authority and tend to perform poorly in school.

Uninvolved Parenting

In addition to the three major styles introduced by Baumrind, psychologists Eleanor Maccoby and John Martin proposed a fourth style: uninvolved or neglectful parenting.

An uninvolved parenting style is characterized by few demands, low responsiveness, and very little communication.

Other characteristics of the uninvolved parenting style:

• While these parents fulfill the child's basic needs, they are generally detached from their child's life.
• They might ensure that their kids are fed and have shelter but offer little to nothing in the way of guidance, structure, rules, or even support.
• These parents may seem indifferent, unresponsive, and dismissive.
• In some cases, these parents may reject or neglect the needs of their children. They may also be physically or emotionally abusive.

A 2019 study found that children raised by neglectful parents tend to struggle in school, experience more depression, have worse social relationships, have difficulty controlling their emotions, and experience more anxiety.

Effects of Uninvolved Parenting

Uninvolved parenting styles rank lowest across all life domains. These children tend to lack self-control, have low self-esteem, and are less competent than their peers.

The Impact of Parenting Styles

Research suggests that parenting styles can have a range of effects on children. Some of the areas of a child's life that may be affected in the present and in the future include:

• Academics : Parenting styles can play a part in academic achievement and motivation.
• Mental health : Parenting styles can also influence children's mental well-being. Kids raised by authoritarian, permissive, or uninvolved parents tend to experience more anxiety, depression, and other mental health problems.
• Self-esteem : Kids raised by parents with an authoritative style tend to have strong self-esteem than kids raised by parents with other styles,
• Social relationships : Parenting styles can impact how kids relate to other people. For example, kids raised by permissive parents are more likely to be bullied, while kids raised by authoritarian parents are more likely to bully others.
• Adult relationships : Researchers have also found that kids raised by strict, authoritarian parents may be more likely to experience emotional abuse in adult romantic relationships.

Because authoritative parents are more likely to be viewed as reasonable, fair, and just, their children are more likely to comply with their parents' requests. Also, because these parents provide rules as well as explanations for these rules, children are much more likely to internalize these lessons.

Rather than simply following the rules because they fear punishment (as they might with authoritarian parents), the children of authoritative parents are able to see why the rules exist, understand that they are fair and acceptable, and strive to follow these rules to meet their own internalized sense of what is right and wrong.

Mixing Parenting Styles

The parenting styles of individual parents also combine to create a unique blend in each family. For example, the mother may display an authoritative style, while the father favors a more permissive approach.

This can sometimes lead to mixed signals. To create a cohesive approach to parenting, parents must learn to cooperate and combine their unique parenting styles.

Get Advice From The Verywell Mind Podcast

Hosted by therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares what mentally strong parents do.

Follow Now : Apple Podcasts / Spotify / Google Podcasts

If you notice that you tend to be more authoritarian, permissive, or uninvolved, there are steps you can take to adopt a more authoritative parenting style. Strategies that may help include:

• Listen : Spending time listening to what your child has to say. Let them share their opinions, ideas, and worries with you. 
• Establish rules : Create a clear set of rules for your household and communicate your expectations to your child. In addition to telling your child what the rules are, be sure to explain why these rules exist.
• Consider your child's input : Authoritative parents set the rules but are also willing to listen to their child's feelings and consider them when making decisions.
• Be consistent : Enforce rules consistently, but be sure to provide consequences that are fair, proportionate, and educational. 

Developing a more authoritative parenting style takes time. With practice and consistent effort, however, you will find that your approach to parenting gradually shifts to a more supportive, involved approach that can lead to better developmental outcomes.

Limitations of Parenting Style Research

Links between parenting styles and behavior are based on correlational research , which is helpful for finding relationships between variables . However, such research cannot establish definitive cause-and-effect relationships.

While there is evidence that a particular parenting style is linked to a specific pattern of behavior, other variables, such as a child's temperament, can also play a significant role.

Children May Affect Their Parents' Styles

There is also evidence that a child's behavior can impact parenting styles. One study found that the parents of children who exhibited difficult behavior began to exhibit less parental control over time. Such results suggest that kids might misbehave not because their parents were too permissive but because the parents of difficult or aggressive children gave up on trying to control their kids.

Outcomes Vary

Some researchers have also noted that the correlations between parenting styles and behaviors are sometimes weak. In many cases, the expected child outcomes do not materialize. For example, parents with authoritative styles may have children who are defiant or who engage in delinquent behavior. Parents with permissive styles may have self-confident and academically successful children.

Cultural Factors Play a Role

Cultural factors also play a significant role in parenting styles and child outcomes. There isn't a universal style of parenting that is always best. For example, while authoritative parenting is linked to better results in European and American cultures, research has also found that this style is not linked to better school performance Black and Asian youth.

Parenting styles are associated with different child outcomes, and the authoritative style is generally linked to positive behaviors such as strong self-esteem and self-competence. However, other important factors, including culture, children's temperament, children's perceptions of parental treatment, and social influences, also play an important role in children's behavior.

A Word From Verywell

Understanding more about your own parenting style can help you explore different approaches to parenting your children. If you notice that you tend to have a more strict, indulgent, or dismissive approach, there are steps that you can take to become more involved and authoritative in how you relate to your children.

Baumrind D. Child care practices anteceding three patterns of preschool behavior . Genet Psychol Monogr. 1967;75(1):43-88.

Durrant J, Ensom R.  Physical punishment of children: lessons from 20 years of research .  CMAJ . 2012;184(12):1373-7. doi:10.1503/cmaj.101314

Power TG. Parenting dimensions and styles: a brief history and recommendations for future research .  Child Obes . 2013;9 Suppl(Suppl 1):S14–S21. doi:10.1089/chi.2013.0034

Kuppens S, Ceulemans E. Parenting styles: A closer look at a well-known concept .  J Child Fam Stud . 2019;28(1):168-181. doi:10.1007/s10826-018-1242-x

Alizadeh Maralani F, Mirnasab M, Hashemi T. The predictive role of maternal parenting and stress on pupils' bullying involvement .  J Interpers Violence . 2019;34(17):3691-3710. doi:10.1177/0886260516672053

Beyarslan SD, Uzer T. Psychological control and indulgent parenting predict emotional-abuse victimization in romantic relationships . Curr Psychol . 2022;41(8):5532-5545. doi:10.1007/s12144-020-01072-w

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PARENTAL INFLUENCE: DIRECT INTERACTIONS

Emotional identification, family stories, indicators of family relevance, other influences on child development, the role of parents in children's psychological development.

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Jerome Kagan; The Role of Parents in Children's Psychological Development. Pediatrics July 1999; 104 (Supplement_1): 164–167. 10.1542/peds.104.S1.164

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This article reviews the three major ways parents influence children: direct interaction, identification, and transmission of family stories. This essay summarizes some of the relevant empiric data in support of this claim and describes the operation of other mechanisms that also contribute to the child's development.

The profile of cognitive abilities, beliefs, ethical values, coping defenses, and salient emotional moods that characterizes each child at each developmental stage is the result of diverse influences operating in complex ways. Most students of human development agree that the most important determinants of the different profiles include 1) the inherited physiologic patterns that are called temperamental qualities, 2) parental practices and personality, 3) quality of schools attended, 4) relationships with peers, 5) ordinal position in the family, and, finally, 6) the historical era in which late childhood and early adolescence are spent. 1   Each of these factors exerts its major influence on only some components of the psychological profile and is usually most effective during particular age periods. For example, the quality of social relations with peers affects primarily the child's beliefs about his/her acceptability to others and has its major effect after school entrance. 2   By contrast, parental conversations with the child, and especially naming unfamiliar objects, affect the child's future verbal talents and have maximal effect during the first 6 years of life. 3  

Current discussions of the consequences of parental practices, whether in the media or in professional journals, favor one of two positions. One awards seminal power to parental factors; the other minimizes the family. The advocates of attachment theory, for example, propose that the relationships established between an infant and its caretakers during the first 2 years of life have a permanent effect on the child's future. 4   But Harris's recent book, The Nurture Assumption , makes the opposite claim by arguing that parents have little or no permanent influence on their child's future personality. 5   Although the attachment theorists take too strong a position, I side with a majority of developmental scholars who, in disagreement with Harris, believe that parents do affect their child's psychological growth. This article summarizes what most developmental scientists believe to be the major effects of parents on children.

It is important to appreciate, however, that some of these effects are difficult to quantify and, as a result, scholars working in this domain are caught between two opposing imperatives. On the one hand, they recognize that conclusions must be based on empiric evidence; if one does not have valid measurements, one should be cautious. On the other hand, investigators also recognize the error of awarding significance only to statements that rest on objective measurements. Because the current Zeitgeist is more positivistic than it was a half-century earlier, contemporary scientists usually have ignored important causative conditions that are subtle in their expression.

Parents can affect their children through at least three different mechanisms. The most obvious, and the one easiest both to imagine and to measure, involves the consequences of direct interactions with the child that could be recorded on film. For example, a mother praises a 3-year-old for eating properly, a father threatens the loss of a privilege because a child refuses to go to bed, a parent names an unfamiliar animal in a picture book. These everyday events that involve the rewarding of desirable actions, the punishment of undesired ones, and the transfer of knowledge from parent to child have a cumulative effect. Failure to discipline acts of disobedience and/or aggression is correlated with children's asocial behavior. 6   Display of interest in a young child's activities is correlated with greater levels of responsivity in the child. 7  

However, these first-order effects can have second-order consequences that appear later in life. A 7-year-old with a more extensive vocabulary than her peers, because her parents encouraged language development 5 years earlier, will master the tasks of the elementary grades more easily and, as a result, perceive herself as more competent than her peers. This belief is likely to embolden her to resist domination by others and, perhaps, motivate the initiation of unusually challenging tasks. The 7-year-old who was not chastised for aggressive behavior earlier or who had abusive or overly intrusive parents is likely to be aggressive with peers. As a result, these children provoke peer rejection and eventually come to question their acceptability to others. 8–10  

An emotional identification with either or both parents represents a second, quite different way in which the family affects children. By age 4 to 5 years, children believe, unconsciously, that some of the attributes of their parents are part of their own repertoire, even although this belief might have no objective basis. 11   A girl whose mother is afraid of storms and large animals is tempted to assume that she, too, is afraid of these dangerous events; a girl with a relatively fearless mother will come to the opposite conclusion. In addition, children share vicariously in some of the experiences that occur to the parents with whom they are identified. A boy whose father is popular with friends and relatives, for example, will find it easier to conclude that he, too, has qualities that make him acceptable to others.

The more distinctive the features shared between child and parent, the stronger the identification of the former with the latter. A father who is tall, thin, and has red hair and freckles will, other things equal, engender a stronger identification in a son with these four features than in a son who is short, chubby, brown-haired, and has no freckles. 1   That is why many members of minority groups that possess distinctive features have a strong identification; for example, whites in South Africa are more strongly identified with their ethnic group than whites in the United States.

Children also can identify with the class, ethnic, or religious group to which their family belongs and often feel an imperative to honor the identification. To fail to do so is to violate a principle of cognitive consistency between an ethical standard and an action and, as a result, to feel uncertain. Some adolescents for whom the group identification generates anxiety may attempt to minimize bases for the perceived similarity; hence, some Jews change their last name, some Mexicans try to lighten their skin, and some African-Americans straighten their hair.

The importance of identification for personality development means that the parents' personality, talents, and character, as they are perceived by the child, are of significance. When the content of parental rewards and punishments is in accord with the adult's persona as a role model, the content of adult socialization is potentiated. A child praised for her intellectual competence by parents who read books and display a curiosity about the world is more likely to value intellectual pursuits than one whose parents praise academic success but do not display any interest in intellectual competence in their personal lives. Children tend to honor what parents do rather than what they say.

The power of identification can be seen in the robust relation between the educational level of the parents, which is a good index of the social class of the family, and many psychological outcomes, including level of school achievement, frequency of aggressive behavior, and attitude toward authority. 12   The psychological differences between young adults born to college graduates, compared with those born to parents who never graduated from high school, cannot be explained completely as a result of direct interactions between parents and children. These psychological products also involve the child's identification with the family's social class. The features that define social class, as distinct from ethnicity, include place of residence, nature of the neighborhood, and material possessions. But because most parents do not remind their children of their social class and signs of family's social class position can be subtle, a child's discovery of the family's class is conceptually more difficult than discovery of his/her gender or ethnicity and usually is not articulated before 7 years of age.

The proportion of economically stressed families in a particular region will affect the strength of a child's identification. An awareness of those who are affluent and those who are not is most distinctive in societies like our own, where there is considerable variation in material wealth. No uniform psychological outcomes flow from absolute poverty, but many predictable outcomes flow from the belief that one's family is either advantaged or disadvantaged relative to others. Because many Americans believe that persistent hard work and intelligence are all that are needed to gain the wealth that has become, in this century, a defining feature of personal worth, class has a greater potential for shame in America than it does in many countries of the world. Ten-year-olds who identify with their relatively poor families are vulnerable to feelings of shame or psychological impotence if they wonder whether their family's status is attributable to the fact that their parents were either lazy or incompetent. The literary critic Frank Kermode, born to poor parents, once admitted to feeling like an outsider, “Looking the part while not being equal to it seems to be something I do rather well.” 13   Because identification with a poor family can generate anxiety, shame, or anger, it can represent a chronic psychological stress that might contribute to the generally poorer health of the economically disadvantaged. 14  

It has proven difficult to gather the objective evidence needed to affirm beyond doubt the truth of these statements about identification because of insufficiently sensitive procedures. However, some evidence does support this claim. In one unpublished study from my laboratory, white high school students, all with good grades, who came from either upper-middle or working-class families in the Boston area, came to a laboratory at Harvard University to be interviewed and evaluated for autonomic functioning. The working-class adolescents were more subdued in their interaction with the female examiner. In addition, the working-class youth had greater power in the lower-frequency band of the cardiac spectrum. This second fact implies greater sympathetic tone on the baroreceptor reflex, perhaps attributable to greater apprehension in a context that was symbolic of affluence and privilege.

A third mechanism of family influence is related to identification, but is more symbolic. Some parents tell their children stories about relatives —uncles, aunts, grandparents, cousins—who were, or are, especially accomplished in some domain. Perhaps an uncle made an important discovery, accumulated wealth, performed a courageous act, was a talented athlete or writer, or a respected public official. The child is likely to feel pride on hearing these stories because of the implication that if he or she is biologically related to this important family member, the child, too, must also possess some admirable characteristics. George Homans, an influential Harvard sociologist, noted in a memoir written shortly before his death that he coped with his childhood anxiety over poor school grades and unpopularity with peers by reminding himself that he could trace his pedigree back to John Adams. 15   Charles Darwin's description of his father glows with awe for his father's intelligence, sympathy, kindness, and business sense. 16   Darwin knew about the inheritance of psychological features through his acquaintance with animal breeders and may have felt that his cognitive talents were inevitable given his family's eminence.

Direct interactions, identification, and knowledge of the accomplishments of family members are three important ways in which families influence children. The first mechanism has its greatest effect on intellectual development and character traits, especially the control of aggression and motivation for achievement. The second and third mechanisms, identification and family myths, have a greater influence on the child's confidence or doubt about his/her talent and, therefore, on the child's expectation of future success or failure.

A persuasive source of support for the significance of family experience is found in follow-up studies of young children who suffered serious privation, usually the result of war, and were later adopted by nurturant families. Many of the orphans produced by World War II and the Korean conflict, who had extremely fragile bonds to any caretaker in their early years, appeared to develop well after adoption by loving foster parents. 17   ,18   More recently, a group of children who had spent the first year in depriving orphanages in Romania were adopted by nurturant British parents. When they arrived in London, they were emaciated and psychologically retarded, as one would expect, given their harsh experience. However, when they were evaluated several years later, after adoption by middle-class parents, a majority, although not all, were similar in their intellectual profile to the average British child (Michael Rutter, personal communication, 1998).

A study of 13 624 families living in 10 different cities provides a particularly persuasive demonstration of the importance of the family. The children, who were observed as infants and again at 3 years of age, had experienced varied forms of early care. Some were in day care centers, some were in family day care, and some were raised only at home. The form of care outside the home had little effect on the prevalence of problems with self-control, compliance, and asocial behavior; variation among the families was a critical determinant of differences in these psychological traits. 19  

Although empiric data affirm that parental behaviors and personality traits influence the child's talents, motivation, academic performance, and social behavior, 20   their influence is part of a larger web of conditions that includes inherited temperamental biases, ordinal position, social class, ethnicity, quality of peer friendships, and the historical era in which adolescence is spent. The importance of temperament is seen in a longitudinal study of a large group of healthy children. Approximately 20% of these healthy infants inherited a temperament that was revealed at 4 months of age in vigorous levels of motor activity and irritability to unfamiliar stimulation. 21   Approximately one third of these infants, called high reactive, were shy and fearful to unfamiliar people and settings during the preschool years, and approximately one fourth were likely to develop anxious symptoms when they were 7 years old. 22   Although only 20% of the high reactive infants were consistently shy and fearful from 14 months to 8 years of age, it was rare for a high reactive infant to become a consistently bold, extroverted child.

The influence of ordinal position is affirmed by the fact that, controlling for social class, first-born children obtain better grades and are more often high school valedictorians than later born children. 23  

The influence of historical era is revealed in a study of the cohort of Americans that was between 10 and 20 years of age during the economic Depression in America from 1930 to 1940. A large proportion of these American adolescents, who are now in their 7th decade, saved more money than the generation before or after and conducted their lives with a gnawing concern over financial loss. 24  

The protest against the Vietnam War at the end of the 1960s also affected large numbers of privileged adolescents who turned against the values of established authority. College students seized administration buildings or shared sexual partners in unheated communal homes. High school youth defiantly left their classrooms to protest the war, and they got away with it. It is heady for a 16-year-old to defy the rules of authority and escape punishment. For many youth, such experiences eroded a tendency to worry about coming to work at 10:00 in the morning instead of 9 and leaving at 4 instead of 5. Many of these middle-class youth thumbed their noses at authority because they happened to be born during a brief period when segments of American society were uncertain as to which actions were legitimate. When history tears a hole in the fabric of consensual assumptions, the mind flies through it into a space free of hoary myth to invent a new conception of self, ethics, and society.

The influence of these extrafamilial factors suggests that it is more accurate to state that parental qualities contribute to a child's psychological profile, rather than to conclude that family conditions determine a particular outcome. An infant's secure attachment to a parent does not guarantee a benevolent outcome or protect a child against psychological problems later in life, but the secure attachment probably constrains the likelihood of producing an adult who is homeless. Physicians are familiar with this form of restrained conclusion. Chronic middle ear infection during the first 2 years of life does not always lead to language delay, but it can make a small contribution to that phenomenon.

Eleanor Maccoby, a colleague and a distinguished developmental psychologist, wrote that the contribution of parental practices to children's personality cannot be viewed in isolation. Each parental behavior or parental personality trait is part of a complex system that in some respects is unique to each parent–child relationship. 25  

This conclusion is not different in substance from most generalizations about complex natural phenomena, including the appearance or extinction of a species or the duration of an infectious epidemic. The proper conceptual posture is restraint on shrill dogma that claims either that the family is without significance or that it represents the only conditions that matter.

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The Parent Effect. How Parenting Style Affects Adolescent Behavior and Personality Development . Joanne E. Carlson

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Nicole Smith, The Parent Effect. How Parenting Style Affects Adolescent Behavior and Personality Development . Joanne E. Carlson, Social Work , Volume 67, Issue 3, July 2022, Pages 302–303, https://doi.org/10.1093/sw/swac023

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The rich content found in The Parent Effect provides great insight and guidance, during what can be a difficult time with parents and their adolescent teenagers. Carlson shines a bright light on how parents can observe the association with their parenting style and their adolescent behavior.

In the introduction of the book, Carlson lays out Erik Erikson’s theory of the eight stages of development and then explains in detail what is “normal adolescent behavior.” Then she presents the five types of parenting styles that are the focus of her book. A quiz is provided for readers who are parents to explore their parenting style.

In my social work experience, Carlson is spot on when she explains how the adolescent is affected by parenting styles; I see it in the behaviors of the adolescents I work with. However, parenting styles are half of the problem of an adolescent’s behavior. The parents’ behavior can and does cause huge problems within an adolescent’s life and may result in adolescents living in foster care, living with friends, going to juvenile facilities, or entering inpatient hospitalization. Overall, parental figures’ irresponsible actions cause additional problems in what is an already troubled situation in the environment of the home for the adolescent.

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The impacts of children's emotions and behavior on parenting

While both inherited traits and environmental influences affect parent-child interactions, not much is known about how child behavior impacts parenting and, in turn, later child outcomes.

Elizabeth Shewark, a former Penn State doctoral student in developmental psychology and current postdoctoral research fellow at Michigan State University, is examining the evocative gene-environment correlation, the process through which children’s inherited characteristics, such as their negative emotions, influence parenting environments.

The work, which appears in The Journal of Child Psychology and Psychiatry , was part of Shewark’s dissertation and is the first of three planned papers.

“I was interested in examining how inherited child traits are associated with child emotion, and how children’s genetically influenced emotions during early childhood are linked to parenting and later child behavioral outcomes,” Shewark said. “Much of the research on child behavior and parenting focuses on families rearing their biological children. However, parents and children share both genes and environments, so it is difficult to tease apart genetic and environmental influences.” 

The research team utilized the Early Growth and Development Study, a longitudinal adoption study, which includes 561 adopted children from two cohorts and their linked adoptive parents and birth parents, following them from infancy to early adolescence. The adoption design helps to clarify genetic and environmental influences because adoptive parents are genetically unrelated to the child but provide the rearing environment, while birth parents are genetically related to the child but do not provide the rearing environment.

“I was very fortunate to have access to longitudinal, genetically informed data. By using these data, we were able to assess the role of certain environmental influences, such as parenting, and inherited traits in child adjustment,” said Shewark, who was advised at Penn State by Social Science Research Institute cofunded faculty Jenae Neiderhiser and Kristin Buss.

The research team assessed inherited traits via biological parent temperament, child anger and sadness at 4 1/2 years, followed by child behavior problems and social competence at 7 years. In addition to child emotions and behavior, the research team examined adoptive parent hostility and warmth.

The researchers found that child anger at 4 1/2 years evoked hostility from their adoptive parents at 6 years of age, which was then linked to an increase in child behavioral problems at 7 years of age. 

“We also found different associations with anger and sadness. For example, we found that child anger was associated with more hostile parenting, and this was partially because of the inherited traits of the child. We were surprised to find that child anger and sadness were not associated with warm parenting in our study,” Shewark explained. “Warm parenting has been shown to be important for child adjustment. Evocative gene-environment correlation findings with warm parenting have been mixed, suggesting that evocative effects may be present for specific positive parenting behaviors rather than overall parental warmth.”

According to Neiderhiser, this study shows how important it is to consider the role of the child in their own development.

“In this study we found that children influence the way they are parented, while parents still help to shape child behavior. In other words, both parents and children influence child adjustment,” said Neiderhiser.

This study is the first in a series of three dissertation papers. “The next paper focuses on how children’s behaviors and inherited traits might impact teacher-child relationships and, in turn, be linked to child adjustment,” Shewark said. “My dissertation work really inspired me to continue examining how children’s inherited traits and their environment impact children’s developmental outcomes. Currently I’m extending this work to include neighborhoods.”

Other researchers on the project include Amanda Ramos, postdoctoral research fellow at University of North Carolina at Chapel Hill; Chang Liu, postdoctoral researcher at George Washington University; Jody Ganiban, professor of clinical/developmental psychology at George Washington University; Gregory Fosco, associate professor of human development and family studies at Penn State; Daniel Shaw, distinguished professor of psychology at the University of Pittsburgh; David Reiss, professor of clinical child psychiatry at Yale School of Medicine; Misaki Natsuaki, associate professor of psychology at the University of California, Riverside; and Leslie Leve, associate director of the prevention science institute and alumni faculty professor of education at the University of Oregon.

The project was supported by the National Institutes of Health and OBSSR, NIH’s Eunice Kennedy Shriver National Institute of Child Health & Human Development as well as the Institute of Education Sciences.

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The contributions that parents make to child development have been heavily investigated but the potential links between parents’ child rearing beliefs and school involvement levels have been overlooked. In this study, a model was proposed where parental involvement was examined as a potential mediator in the relationship between parents’ child-rearing beliefs and internalizing and externalizing outcomes in children. Using data from the NICHD SECCYD study, these constructs were examined in first, third, and fifth grade ( N = 1128). SEM analyses supported our hypothesis regarding the mediating effect of parental involvement and it appeared to act as a potential mediator through which parental child rearing beliefs may be associated with children’s externalizing behavior. However, parallel mediating pathways for the internalizing behavior outcome returned non-significant estimates. Overall, these findings highlight the importance of home-school relationships and the need to examine interventions designed to promote and facilitate student support among/between parents and educators.

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Child Ability and Parental Attributions: Development and Validation of the Reasons for Children’s Behavior Scale

• Published: 20 May 2024

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Parent attributions for children’s behavior affect parenting practices and emotional reactions. The current study aimed to create a new measure of parental attributions, called the Reasons for Children’s Behavior (RCB), to capture how parents take developmental ability into account when making attributions for specific behaviors. A 224-item survey was completed by 836 participants, including original items and established parent attribution and parenting construct scales. Exploratory factor analyses and item-response theory analyses were utilized to develop the RCB, which includes 30 items comprising seven subscales. The RCB demonstrated an extremely stable factor structure, high levels of internal consistency across 25 demographic groups, reasonable test-retest correlations across 2 weeks, appropriate convergent and discriminant validity, and unique predictive validity (i.e., incremental validity). The RCB offers researchers and clinicians a novel tool to better understand how parent attributions for child behavior impact parenting and larger family dynamics.

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This study was not preregistered. Data presented have not appeared in previous publications. All study IRB materials and the syntax used for the analyses are available at https://osf.io/mcy84/ . The data is also available at that location upon reasonable request.

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This work was conducted in conjunction with the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, which is funded by grants from the National Institute on Alcohol Abuse and Alcoholism. Additional information about Collaborative Initiative on Fetal Alcohol Spectrum Disorders can be found on the website www.cifasd.org . This research was supported by the National Institute of Health under Award #U01AA026104. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Carson Kautz-Turnbull, Ronald Rogge, and Christie Petrenko. The first draft of the manuscript was written by Carson Kautz-Turnbull and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Kautz-Turnbull, C., Rogge, R.D. & Petrenko, C.L. Child Ability and Parental Attributions: Development and Validation of the Reasons for Children’s Behavior Scale. Child Psychiatry Hum Dev (2024). https://doi.org/10.1007/s10578-024-01713-2

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How Parents Fighting Could Affect a Child's Mental Health

• Why It's a Problem
• Long-Term Effects
• When It Becomes a Problem

Diminishing the Effects

No matter how healthy a couple’s relationship is, there’s bound to be a few squabbles here and there. And a few occasional disagreements usually aren’t a big deal. Mature conversations, keeping it generally out of the kids’ view, and refusing to name-call all show a child how to deal with disagreements in a healthy manner. But more serious conflict definitely takes a toll on kids.

Studies show parents' fights affect their children’s mental health.

Physical altercations, insults, and tactics such as “the silent treatment,” are just a few of the toxic interactions parents can have that are likely to create some emotional damage to a child in the long run.

Why Parents Fighting Is a Problem

There’s research to suggest that a child as young as 6 months old can be negatively affected by  parents who fight . But it’s not just young kids who are affected by parents fighting. Other studies show that young adults up to age 19 can be sensitive to conflicts in their parents’ marriage.

It goes to show that children of all ages, from near infancy through early adulthood, are impacted by how their parents choose to handle their differences. Researchers believe high-conflict marriages take a toll on a child’s mental health. Here are some of the ways kids are impacted.

• It can cause insecurity. Fighting undermines kids’ sense of security about the stability of the family. Children exposed to a lot of fighting may worry about divorce or wonder when one parent’s silent treatment is going to end. It can make it difficult for them to have a sense of normalcy in the family since fights may be unpredictable.
• It can affect the parent-child relationship. High-conflict situations are stressful for parents too. And a stressed-out parent might not spend a lot of time with kids. In addition, the quality of the relationship may be affected as it may be difficult for parents to show warmth and affection when they’re angry and upset with the other parent.
• It can create a stressful environment. Overhearing frequent or intense fighting is stressful for kids. Stress can take a toll on their physical and psychological well-being and interfere with normal, healthy development.

Long-Term Mental Health Effects

In 2012, a study was published in the journal Child Development that looked at the effect of parental conflict on children from kindergarten through seventh grade.   Participants were part of 235 middle-class families in the midwest and northeast United States with an average income between $40,000 and $60,000.

When their children were in kindergarten, the parents were asked about how much conflict they experienced in their marriage. They were also asked to talk about a difficult topic, such as finances, and researchers looked at how critical the partners were of one another.

Seven years later, researchers followed up with the families. Both the kids and the parents were asked about fighting in the parents’ marriage and the emotional and behavioral health of the kids.

Kindergarteners who had parents who fought meanly and frequently were more likely to experience depression, anxiety , and behavioral issues by the time they reached seventh grade.

Those aren’t the only issues kids are likely to face when their parents fight often. Here are some things researchers have found when examining the effects parental fighting can have on kids.

Decreased Cognitive Performance

A 2013 study published in Child Development found that the stress associated with living in a high-conflict home may impair a child’s cognitive performance.   Researchers found that when parents fought often, kids had more difficulty regulating their attention and emotions.

Their ability to rapidly solve problems and quickly see patterns in new information was also compromised. Meanwhile, other studies have found that living in a high conflict family increases the odds of dropping out of high school and getting poor grades.

Relationship Issues

Being exposed to parents fighting increases the chances that kids will treat others with hostility. It’s common for kids to begin solving sibling squabbles with the same tactics they’ve witnessed you using.

Children may also struggle to maintain healthy relationships when they’re older if they’ve grown accustomed to family discord or they may struggle to identify who they can really trust in life.

Behavior Problems

Parental conflict has been linked to increased aggression, delinquency, and conduct problems in children. Additionally, children are more likely to have social problems and increased difficulty in adjusting to school.

Eating Disorders and Physical Issues

Several studies have linked eating disorders, such as anorexia and bulimia, to high parental discord. A child might also have physical effects from the fighting, such as sleep problems, stomachaches, or headaches.

Substance Use

Researchers have found that living in a home with high levels of conflict increases the odds of smoking, binge drinking, and marijuana use, relative to a low conflict married-parent family.

Negative Outlook on Life

Children who are raised in high-conflict homes are more likely to have negative views of their family relationships. They are also more likely to view themselves in a negative way. A 2012 study published in the  Journal of Youth and Adolescence  found that children exposed to parental fighting are also more likely to have low self-esteem.

When Fighting Becomes Problematic

No matter the age of your children or whether you’re seeing effects of marital strife, take a close look at how you argue. Just because your fights don’t get physical doesn’t mean they aren’t harmful to your kids. There are a number of tactics parents use that are destructive to children.

Destructive Disagreement Tactics

• Name-calling
• Threats of abandonment (such as divorce)
• Any form of physical aggression (including throwing things)
• Walking out or withdrawing from the argument
• Capitulation (giving into the other parent)

So, while you might think walking away from an argument and giving your partner the silent treatment for three days isn’t a big deal—it’s a big deal to your kids. Your kids see how you handle disagreements and they learn problem-solving skills, emotion regulation skills, and conflict resolution skills from you.

It’s also important to think about the message that you’re sending to your kids about loving relationships. If you and your partner treat each other with disrespect, your kids will grow up thinking that it’s OK to do the same—and perhaps they’ll believe it’s OK to let others treat them poorly, too.

Sometimes, a disagreement gets out of hand. One person says something they don’t mean, another parent doesn’t realize that their children are listening on the other side of the wall.

A spat or two doesn’t mean you’ve irreparably harmed your child. However, you might want to take a few steps to lessen the effects of what they saw and heard. If your disagreement grows disrespectful, you might take these steps to address the situation with your kids:

• Discuss the fight : Although you don’t have to get into specifics about what you and your partner were disagreeing about, hold a family meeting to say something like, “Daddy and I had an argument the other night that got out of hand. We didn’t have the same opinion on something that was important to both of us, but it was wrong for us to fight like that.”
• Reassure the kids : Remind them that this was just an argument and not indicative of bigger problems. Reassure them that you still love each other and that you’re not going to get divorced (assuming, of course, that it’s a true statement).
• Bring closure : Make sure your children understand that you’re still a strong family. Explain that arguments happen sometimes and people can lose their tempers. However, you all love each other, despite your disagreements.

If you believe that your fights with your spouse or partner are harming your child’s mental well-being, consider seeing a therapist.

A therapist can determine whether one of you could benefit from individual therapy to learn skills, like anger management or emotion regulation, or whether you should attend couples counseling to work on your relationship together.

Are Kids Better Off in Two-Parent Families?

Kids usually do best in two-parent families. But, it’s important for parents to get along. If there’s a lot of fighting, kids may fare better if their parents separated. Many parents wonder whether they are better off staying together for the sake of the kids or just getting divorced. It’s clear that divorce can take a psychological toll on kids .

In addition, kids who grow up with single parents often experience other problems—like economic issues—and they may not do as well as kids who grow up in two-parent families. And clearly, remarriage and living in a blended family can be complicated for kids, too.

But, living in a high-conflict home is likely to be equally as stressful—or perhaps even more stressful for kids—than if their parents got divorced . When parents get along during and after a divorce, kids usually don’t experience long-lasting emotional scars.  

So if you find yourself in a high-conflict relationship, staying together for the kids might not do your children any favors. It’s important to seek help to reduce the conflict or make changes to the relationship so that your kids can grow up happier and healthier.

Arguments in the home linked with babies' brain functioning . University of Oregon.

Cummings EM, George MR, Mccoy KP, Davies PT. Interparental conflict in kindergarten and adolescent adjustment: Prospective investigation of emotional security as an explanatory mechanism . Child Dev . 2012;83(5):1703-15. doi:10.1111/j.1467-8624.2012.01807.x

Hinnant JB, El-sheikh M, Keiley M, Buckhalt JA. Marital conflict, allostatic load, and the development of children's fluid cognitive performance . Child Dev. 2013;84(6):2003-14. doi:10.1111/cdev.12103

Lee CM, Bax KA. Children's reactions to parental separation and divorce . Paediatr Child Health . 2000;5(4):217-8.

George MW, Fairchild AJ, Cummings EM, Davies PT. Marital conflict in early childhood and adolescent disordered eating: Emotional insecurity and the marital relationship as an explanatory mechanism .  Eating Behaviors . 2014;15(4):532-539. doi:10.1016/j.eatbeh.2014.06.006

Mccoy K, Cummings EM, Davies PT. Constructive and destructive marital conflict, emotional security and children’s prosocial behavior . Journal of Child Psychology and Psychiatry . 2009;50(3):270-279. doi:10.1111/j.1469-7610.2008.01945.x

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By Amy Morin, LCSW Amy Morin, LCSW, is the Editor-in-Chief of Verywell Mind. She's also a psychotherapist, an international bestselling author of books on mental strength and host of The Verywell Mind Podcast. She delivered one of the most popular TEDx talks of all time.

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How adolescent parenting affects children, families, and communities.

Even for the most prepared parents, raising a healthy and happy child is one of life’s major challenges.

Having the ability to check off commonly accepted parenting prerequisites — a quality education, a good job, mental and emotional stability, a safe home — can make the challenge easier to tackle and overcome.

Unfortunately, adolescents who become parents often have a shortage of key life skills and other resources that are vital to the parenting process. This sad reality is supported by research showing that, on average, children who are born to teen parents are less likely to ever reach their full potential. And the effects of teenage pregnancy on parent, baby, and community can be devastating.

According to The Urban Child Institute, adolescent parenting is one of the major risk factors associated with early childhood development. In addition to its other effects, teen parenting is likely to hinder a child’s social and emotional wellbeing.

When a baby is born to a teenage mother, he is likely to have more difficulty acquiring cognitive and language skills as well as social and emotional skills like self-control and self-confidence. These abilities are already developing in infancy, and they are essential for school readiness.

Studies on early childhood development find that adolescent mothers (19 years of age and younger) are less likely than older mothers to engage in emotionally supportive and responsive parenting. They tend to have less knowledge about child development and effective parenting, and often misjudge their infant or toddler’s ability to adapt and learn.

We don’t need research to prove that, generally speaking, age brings maturity, self-assuredness, knowledge and experience. By the age of 21, one has typically graduated from high school and is pursuing post-secondary education or participating in the workforce (or both).

Throughout our childhood and teenage years we are acquiring life skills and problem-solving abilities that prepare us to confront and navigate challenges – both unforeseen and anticipated - in adulthood. As a result, those who are beyond their teen years are more likely to make informed choices, use effective coping strategies, and think through important decisions. It’s not hard to see how these qualities lead to more effective parenting.

When a baby is born to an adolescent mother, there are several interrelated risk factors at play, meaning that the likelihood that one or more unfortunate outcomes will occur is stronger.

A dream deferred – Adolescent parents commonly view quitting school as a solution to finding the time it takes to raise a baby. Feelings of embarrassment and shame associated with early pregnancy, or difficulty keeping up academically can also drive them to drop out. The popular MTV reality series “16 and Pregnant” offers numerous examples of these unfortunate outcomes, and serves as a glaring reminder of the need to direct more attention and resources to sex education for teens as well as programs encouraging teen mothers to stay in school.

Harsh parenting - Research has found that teen parents are more likely to engage in harsh parenting practices like yelling and spanking. Having fewer life experiences and coping skills, compared to older parents, can make it harder to handle the irritability and frustration that sometimes arise when caring for a new baby. Depressive symptoms or persistent stress from other sources can increase these feelings of anger and resentment.

Single parents – In a majority of cases, adolescent parents are not married and the discovery of pregnancy is unexpected. Too often, teen fathers abandon their parenting responsibilities due to fear and inability to adequately provide for their child, leaving the mother with even less social support and financial assistance.

Unfortunately, teen pregnancy doesn’t only affect the individuals involved — its impact is far-reaching. High rates of teen births can weaken a community’s economic conditions.

According to The Urban Child Institute, the prevalence of births to adolescent mothers negatively affects high school graduation and increases unemployment. Without a high school diploma or equivalent, teens and adults have greater difficulty securing quality employment and have lower earning potential. A less educated population and unskilled workforce negatively affects the economy, and makes it difficult for communities to break aggressive cycles of poverty and crime as resources are consistently depleted.

In Shelby County, teen pregnancy is not a new or isolated issue — it is a full-blown epidemic. The latest figures indicate that although the teen birth rate is declining, it is still above the national rate and among the highest in the country.

In 2011, national news coverage of Shelby County’s teen birth rate sparked a local movement to reduce teen pregnancy. Efforts like the countywide ‘No Baby’ campaign helped to increase education for pregnancy prevention methods among teens, and public awareness throughout the community.

On a more positive note, it is important to understand that not all babies born to adolescent parents are doomed to fail. Increased risk is not a guarantee of future problems.

Clearly, many children of teen parents go on to become successful adults, but it often involves parents making greater sacrifices than older parents have to make. For example, some adolescent parents may abandon their own aspirations in an effort to ensure that academic and career success is attainable for their child.

However, research shows that children born to adolescent mothers are more inclined to repeat their parents’ behavior. The Urban Child Institute reports that they are more likely to drop out of school, have more health problems, face unemployment and become teen parents themselves.

So what can be done to stop this cycle from continuing? Sex education programs that teach the benefits of abstinence and pregnancy prevention are essential. Parents and educators can share in this responsibility by ensuring that teens gain this knowledge at home and at school. Avoiding discussion on the issue of sex and safe practices only heightens potential for teen pregnancy to occur.

Promoting positive parenting among young mothers can also improve their children’s chances for success. Increasing parents’ knowledge about child development and effective parenting strategies will help them buffer their children from many of the risks that accompany early parenthood.

Starting at birth, children begin to develop social and emotional skills. It is important for parents, no matter their age, to ensure their children are adequately prepared to face challenges later in life by maintaining a loving home environment that nurtures their ability to learn about themselves and the world around them. A strong foundation of social and emotional skills will help them make better choices in adulthood, and decrease the probability that they will search for love in the wrong places.

This article also appears in the Tri-State Defender .

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New Research Finds That a Parent's Presence Really Matters

A parent’s presence might impact how a child's brain responds to fear..

Posted May 25, 2024 | Reviewed by Abigail Fagan

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Have you ever been in a situation where your child is scared or nervous about something and you want to encourage them to be brave and confident but aren’t sure what to say or what to do? An emerging line of research finds that a parent’s presence alone might be enough to change how your child responds when they are scared or nervous. A new study that was just published in the journal Developmental Science even suggests that a parent’s presence might impact how a child’s brain responds to fear .

Research consistently shows that children learn from their parents what is safe versus dangerous and when to be scared. Children learn fear from their parents by associating something neutral with a fear response. For example, children have no reason to be afraid of a hot stove but they learn from their parents to be afraid of it. The first time that they reach their hand toward a hot stove and their parent yells or grabs their hand, they learn to associate the neutral object (a stove) with fear. Researchers refer to this as “fear conditioning”. Children also learn that they are safe by paying attention to their parents. For example, they learn to associate an event that causes fear (such as a new person or place) with safety when they see their parents staying calm. Previous research shows that children are more likely to show brave behavior (that is, approach something they have been taught to fear) if their parents are present. This new study adds to our understanding of this learning process by showing that a parent being present reduces the fear response in the brains of children.

Study Details

This study included children from 6 to 17 years. The children were placed in a brain scanner and taught to associate random shapes with a loud, startling noise (see below). The researchers compared the fear response when the parent was present with the child (standing next to the child in the brain scanner and putting a hand on the child’s hand or leg) versus when the parent was not in the room.

Study Findings

The researchers found that the children showed less of a response in the amygdala (translation: the amygdala is a part of the brain that is linked to fear) for the loud noise when parents were present before learning the association. This suggests that parents “buffer” the fear response in their children (translation: although the children may still experience fear, their fear response is less intense).

The children also showed a slightly weaker activation of the medial prefrontal cortex (mPFC) while learning a new fear association when their parents were present. This suggests a parent’s presence might also influence how children learn about new fears.

Overall Translation

The big takeaway message here is that just your presence as a parent is so important in how your child responds to fear and learns about new fears. This study along with previous research suggests that the simple presence of parents impacts children’s fear response and fear learning.

What does this mean for your everyday life? It may mean that your child will be less scared when you are present, particularly if you let them know physically that you are present with them (holding their hand, touching their shoulder or leg, etc). It may also mean that they are less likely to develop new fears when you are present with them. This is a very small study and further research is needed, but it may be empowering for parents to know that their presence does seem to matter.

What are some examples of how you might apply this in the real world?

Your child is nervous about starting preschool. So you ask the teacher if you can walk them in on the first day. Just holding their hand and being a calm presence for them may help them feel less nervous.

When your child is scared of something, whether it is dogs, thunderstorms, or putting their head underwater in the pool, help them to gently and gradually face their fears during times when you can be fully present with them.

If you want your child to try something new, like going on a roller coaster or jumping off the diving board, offer to do it with them.

If your child is nervous about a sports game or a performance at school, make sure that they see you in attendance (assuming you are able to attend). You can also give them a physical sign of your presence before the game or performance by going up to them and hugging them or patting them on the back.

If your child is nervous about a public speaking event or giving a presentation at school, have them practice with you until they are less nervous.

Above all, remember that just your presence alone is powerful — even if you feel like you don’t know what to say or do!

Abramson, L., Callaghan, B. L., Silvers, J. A., Choy, T., VanTieghem, M., Vannucci, A., ... & Tottenham, N. (2024). The effects of parental presence on amygdala and mPFC activation during fear conditioning: An exploratory study. Developmental Science , e13505.

Cara Goodwin, Ph.D., is a licensed clinical psychologist who specializes in translating scientific research into information that is useful, accurate, and relevant for parents.

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E-Cigarette Use Among Youth

What to know.

E-cigarettes are the most commonly used tobacco product among U.S. youth. No tobacco products, including e-cigarettes, are safe, especially for children, teens, and young adults. Learn more about e-cigarette use among youth.

• In the United States, youth use e-cigarettes, or vapes, more than any other tobacco product. 1
• No tobacco products, including e-cigarettes, are safe, especially for children, teens, and young adults. 2
• Most e-cigarettes contain nicotine, which is highly addictive. Nicotine can harm the parts of an adolescent's brain that control attention, learning, mood, and impulse control. 2
• E-cigarette marketing, the availability of flavored products, social influences, and the effects of nicotine can influence youth to start or continue vaping. 3 4
• Most middle and high school students who vape want to quit. 5
• Many people have an important role in protecting youth from vaping including parents and caregivers, educators and school administrators, health care providers, and community partners.
• States and local communities can implement evidence-based policies, programs, and services to reduce youth vaping.

E-cigarette use among U.S. youth

In 2023, e-cigarettes were the most commonly used tobacco product among middle and high school students in the United States. In 2023: 6

• 550,000 (4.6%) middle school students.
• 1.56 million (10.0%) high school students.
• Among students who had ever used e-cigarettes, 46.7% reported current e-cigarette use.
• 1 in 4 (25.2%) used an e-cigarette every day.
• 1 in 3 (34.7%) used an e-cigarette on at least 20 of the last 30 days.
• 9 in 10 (89.4%) used flavored e-cigarettes.
• Most often used disposable e-cigarettes (60.7%) followed by e-cigarettes with prefilled or refillable pods or cartridges (16.1%).
• Most commonly reported using the following brands: Elf Bar, Esco Bars, Vuse, JUUL, and Mr. Fog.

Most middle and high school students who vape want to quit and have tried to quit. 5 In 2020:

• 63.9% of students who currently used e-cigarettes reported wanting to quit.
• 67.4% of students who currently used e-cigarettes reported trying to quit in the last year.

Most tobacco use, including vaping, starts and is established during adolescence. There are many factors associated with youth tobacco product use . These include:

• Tobacco advertising that targets youth.
• Product accessibility.
• Availability of flavored products.
• Social influences.
• Adolescent brain sensitivity to nicotine.

Some groups of middle and high school students use e-cigarettes at a higher percentage than others. For example, in 2023: 6

• More females than males reported current e-cigarette use.
• Non-Hispanic multiracial students: 20.8%.
• Non-Hispanic White students: 18.4%.
• Hispanic or Latino students: 18.2%.
• Non-Hispanic American Indian and Alaska Native students: 15.4%.
• Non-Hispanic Black or African American students: 12.9%.

Many young people who vape also use other tobacco products, including cigarettes and cigars. 7 This is called dual use. In 2020: 8

• About one in three high school students (36.8%) who vaped also used other tobacco products.
• One in two middle school students (49.0%) who vaped also used other tobacco products.

E-cigarettes can also be used to deliver other substances, including cannabis. In 2016, nearly one in three (30.6%) of U.S. middle and high school students who had ever used an e-cigarette reported using marijuana in the device. 9

• Park-Lee E, Ren C, Cooper M, Cornelius M, Jamal A, Cullen KA. Tobacco product use among middle and high school students—United States, 2022 . MMWR Morb Mortal Wkly Rep. 2022;71:1429–1435.
• U.S. Department of Health and Human Services. E-cigarette Use Among Youth and Young Adults: A Report of the Surgeon General . Centers for Disease Control and Prevention; 2016. Accessed Feb 14, 2024.
• Apelberg BJ, Corey CG, Hoffman AC, et al. Symptoms of tobacco dependence among middle and high school tobacco users: results from the 2012 National Youth Tobacco Survey . Am J Prev Med. 2014;47(Suppl 1):S4–14.
• Gentzke AS, Wang TW, Cornelius M, et al. Tobacco product use and associated factors among middle and high school students—National Youth Tobacco Survey, United States, 2021 . MMWR Surveill Summ. 2022;71(No. SS-5):1–29.
• Zhang L, Gentzke A, Trivers KF, VanFrank B. Tobacco cessation behaviors among U.S. middle and high school students, 2020 . J Adolesc Health. 2022;70(1):147–154.
• Birdsey J, Cornelius M, Jamal A, et al. Tobacco product use among U.S. middle and high school students—National Youth Tobacco Survey, 2023 . MMWR Morb Mortal Wkly Rep. 2023;72:1173–1182.
• Wang TW, Gentzke AS, Creamer MR, et al. Tobacco product use and associated factors among middle and high school students—United States, 2019 . MMWR Surveill Summ. 2019;68(No. SS-12):1–22.
• Wang TW, Gentzke AS, Neff LJ, et al. Characteristics of e-cigarette use behaviors among US youth, 2020 . JAMA Netw Open. 2021;4(6):e2111336.
• Trivers KF, Phillips E, Gentzke AS, Tynan MA, Neff LJ. Prevalence of cannabis use in electronic cigarettes among U.S. youth . JAMA Pediatr. 2018;172(11):1097–1099.

Smoking and Tobacco Use

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• v.15(1); Jan-Feb 2021

Parenting and Child Development: A Relational Health Perspective

A child’s development is embedded within a complex system of relationships. Among the many relationships that influence children’s growth and development, perhaps the most influential is the one that exists between parent and child. Recognition of the critical importance of early parent-child relationship quality for children’s socioemotional, cognitive, neurobiological, and health outcomes has contributed to a shift in efforts to identify relational determinants of child outcomes. Recent efforts to extend models of relational health to the field of child development highlight the role that parent, child, and contextual factors play in supporting the development and maintenance of healthy parent-child relationships. This review presents a parent-child relational health perspective on development, with an emphasis on socioemotional outcomes in early childhood, along with brief attention to obesity and eating behavior as a relationally informed health outcome. Also emphasized here is the parent–health care provider relationship as a context for supporting healthy outcomes within families as well as screening and intervention efforts to support optimal relational health within families, with the goal of improving mental and physical health within our communities.

‘Viewing development through the lens of relational health reflects recognition of the critical role that relationships play in children’s social, emotional, health, and cognitive outcomes.’

“In order to develop normally, a child requires progressively more complex joint activity with one or more adults who have an irrational emotional relationship with the child. Somebody’s got to be crazy about that kid. That’s number one. First, last and always.”—Urie Bronfenbrenner “If a community values its children it must cherish their parents.”—John Bowlby

Introduction

Bronfenbrenner recognized the critical importance of the emotional relationship between a child and an adult, whereas Bowlby’s observation underscores the responsibility of communities and practitioners in supporting healthy child development by supporting parents. The belief that we can support children directly, without supporting their parents, overlooks the complex system of relationships within which children develop. 1 Together, Bronfenbrenner and Bowlby remind us that to support healthy development, we must focus on the emotional quality of the relationships within which the child participates—as well as consider how the larger community supports those relationships.

Yet parenting is a broad topic and an exhaustive review is beyond the scope of any one article. Informed by the field of infant mental health with its explicit relational focus 2 and in an effort to contribute to our understanding of parenting as multiply determined, 3 we focus our discussion here on the construct of relational health as a tool for promoting socioemotional and physical health among young children. Relational health reflects a sense of “connectedness” with attuned others, including caregivers, family members, and other individuals within the community. 4 Such a focus is consistent with the field of lifestyle medicine—which considers the environment as a social determinant of health and well-being 5 —and research on health and social behavior, which highlights parents as significant influences on children’s health. 6 Viewing development through the lens of relational health reflects recognition of the critical role that relationships play in children’s social, emotional, health, and cognitive outcomes. 3 Accordingly, the revised Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC-05) 7 considers how characteristics of the broader caregiving environment, such as coparenting quality and other close relationships, relate to developmental and mental health diagnoses. 2

Relational Health Within Primary Care: The Parent-Provider Relationship

We suggest that the parent-provider relationship provides a potentially valuable, although far less emphasized, context for promoting relational health. We present a review of the literature surrounding relational health science and encourage the health care provider to view their patients through the relational health lens. When considered from this angle, for children and their caregivers, the relationship is the patient. As health care providers endeavor to encourage healthy lifestyle choices in the families they serve, each decision a family makes—whether to the benefit or detriment—will occur in the context of their relationships. The health care provider must learn to consider and then acknowledge the family support relationships present in the exam room, the waiting room, and at home to best engage a family’s healthy choices. When caring for patients through this approach, the provider will consider the patient’s treatment choices in their realistic and relational context, rather than as compliant versus noncompliant. Moreover, by acknowledging the provider’s own relationship to the family, the provider can become a supportive member of the treatment decision team rather than an information broker, motivational interviewer, or reticent supplier of difficult-to-follow advice.

The relational health perspective considers the practitioner as a supportive (or unsupportive) “other” in navigating the sometimes difficult, uncertain, or fear-provoking experience of parenting a child from preconception through adulthood. An awareness of relational health in pediatric and adult medicine settings may increase positive outcomes in both parents and children through increased empathy. Specifically, during challenging situations, the practitioner should assess and address relationship quality rather than judging parenting or assigning sole credit or blame to either the parent or child. The focus lies in identifying strengths and opportunities in service to the relationship. 4

Relational Health Within Families: The Parent-Child Relationship

A relational health perspective on development embodies a family systems perspective as well, which recognizes the interconnectedness of individuals and relationships within families 8 and the bidirectional, transactional nature of relationships 9 ; parents affect children and children affect parents. 10 A relational health approach to understanding parent-child relationships emphasizes the dyadic connection between parent and child. Although a multitude of factors have been explored as correlates and predictors of parenting and child outcomes, we focus here on a subset of the factors that may influence relational health, with the goal of increasing practitioners’ understanding of relationship-focused approaches to health promotion within families.

Parent-Child Attachment Relationships: Parental Sensitivity and Reflective Functioning

One of the most influential relationship-focused frameworks for understanding development is attachment theory. An extensive literature describes the early parent-child attachment relationship as an enduring, emotional bond that enables children to explore the environment, 11 yet maintain the proximity and contact necessary for healthy development. Parent-infant attachment relationships, therefore, provide the earliest contexts for children’s relational health. Secure attachment balances developmentally appropriate exploration of the world with seeking closeness and comfort from the caregiver when distressed. Secure parent-child attachment relationships are associated with a range of positive social and emotional outcomes in children. 12 , 13 Conversely, disorganized attachment, a form of insecure attachment, is a risk factor for poorer developmental outcomes 14 and has been linked to disturbed caregiving behavior. 15 - 17 Efforts aimed at increasing security within these critical early relationships remain of interest to researchers and clinicians. 18 Interventions including Attachment and Biobehavioral Catch-up (ABC), 19 , 20 Circle of Security, 21 and Video Intervention for Positive Parenting and Sensitive Discipline (VIPP-SD) 22 have been effective in promoting secure attachment and positive child outcomes (including fewer behavior problems) via creation of measurable, positive changes in parents’ sensitive and responsive behavior, a key factor in secure attachment. 23 , 24 Yet these interventions are not widely available to the public, thus limiting the ability of clinicians to offer them to their patients and families.

Perhaps the most effective mediator toward creating change in parental sensitivity and responsiveness is fostering growth in a parent’s reflective functioning (RF). RF reflects the extent to which a parent can consider the mental states (ie, thoughts, feelings, intentions) that may motivate the behavior of self and other. 25 This capacity can be described in terms of both self-focused RF and child-focused RF. 26 , 27 Interventions such as Minding the Baby 28 , 29 and Mothering from the Inside Out 30 , 31 appear effective in supporting healthy relational outcomes via a focus on growing RF. The concept of RF is also relevant for understanding how adults’ own early relational experiences may affect their parenting. 32

Recommendations for Providers

These 2 elements of parenting—sensitive, responsive caregiving and RF—support the formation of secure parent-child relationships. 24 We suggest that health care providers use thoughtful questioning that may support parental RF, as recently suggested and detailed by Ordway et al. 33 Health care providers can also demonstrate and model RF and help build this capacity in families via routine care and also in medically intensive environments. In environments such as the neonatal intensive care unit (NICU), for example, barriers to parent-neonate relational health development are prominent because of parents coping with fears of infant death and infants experiencing frequent stressors. 34 - 39 Although NICU staff recognize the critical role they play in supporting early parent-child relational health and promoting positive socioemotional outcomes among infants born prematurely, 40 this role may come secondary to the provision of direct medical support to neonates. Professionals’ engagement in reflective practice, with its focus on awareness of the mental and feeling states of self and others, 41 may be one pathway toward promoting positive infant outcomes via the provision of greater psychological support to parents of premature and medically fragile newborns. Building reflective capacity among a range of health care providers may further strengthen the foundation of early relational health within families. 33

Mothering, Fathering, and Grandparenting

Although attachment perspectives historically have emphasized the mother-child relationship, attachment theory and research has been extended to a variety of other caregiver-child relationships, including father-child relationships. 42 - 44 A family systems perspective 8 on relational health suggests that to understand development, we must consider how mother-child and father-child relationships may independently or interactively contribute to developmental outcomes.

Rigorous recent research indicates that children benefit socially and emotionally when fathers are more involved in their lives. 45 Moreover, the benefits of father involvement hold for nonresident as well as resident fathers. 46 Yet fathers’ engagement in parenting is multiply determined, 47 and individual, family, and institutional-level factors may all play important roles in predicting paternal involvement. At an individual level, a father’s identity as a parent, 48 , 49 as well as a father’s attitudes and beliefs about his role in his child’s life, 50 , 51 matter for his engagement. At the family level, evidence highlights the quality of the father’s relationship with a child’s mother. For example, mothers are more likely to be gatekeepers within families, controlling fathers’ access to children as well as the quantity and quality of fathers’ interactions with their children. 52 , 53 At a policy level, compared with countries such as Sweden where paternal leave is supported, the lack of paid paternal leave within the United States may also present barriers to fathers’ involvement with their young children as well as erode fathers’ sense of efficacy in the parental role. 54

Above and beyond these individual, family, and policy variables, mothers’ and fathers’ parenting may differ and uniquely predict developmental outcomes. For example, mothers may be the primary providers of emotional security for children via the establishment of early parent-child attachment relationships, whereas for fathers, exploration of the world may be a primary emphasis in parenting. 55 Fathers’ more stimulating play style—often involving rough-and-tumble play—may promote positive outcomes in children, including developmentally appropriate risk taking and establishment of autonomy. 56 , 57 Mothers, by contrast, are more likely to engage in object-mediated teaching interactions as well as providing structure for their children. 58 However, though mothers and fathers may have interaction styles that differ, the fact remains that many children in the United States are raised in households headed by mothers and may experience wide variability in contact with their biological fathers. 59 This fact, coupled with increasing acceptance and prevalence of families headed by same-sex parents, cautions against a return to the belief that to develop optimally, children require both fathers and mothers (known as the “essential father” hypothesis). 60

We must also recognize that nonparental primary caregivers may play a central role in the care and raising of young children. For example, the increasing number of grandparent-headed households means that more grandparents—with their own sets of strengths and challenges—are making health and wellness decisions for children and may require a unique set of supports from health care providers. 61 Even when not primary caregivers, many grandparents—especially maternal grandmothers—report being involved and influential in their grandchildren’s lives. 62 In fact, involvement of maternal grandmothers with grandchildren may buffer young children from the risks to their development posed by difficult temperament and harsh parenting by mothers. 63 A wider relational health perspective suggests that grandparents (both custodial and noncustodial) be considered as potential sources of support in children’s health and well-being.

Shifting demographics suggest that fathers, nonparental caregivers, and grandparents play an active and involved role in the lives of children. As providers, recognition of the range of relationships in which the child is embedded is critical. Examining potential biases around who is most knowledgeable or best equipped to care for children may help providers approach each adult who is involved in the child’s life as a potential partner in health promotion. 64

Coparenting Relationships

The recognition that children develop within relationships between multiple caregivers, including mothers, fathers, grandparents, and others, makes it critical to also consider the health of the relationships among these adults (ie, coparents) who share responsibility for raising particular children. 65 , 66 Whereas constructs such as marital quality or marital satisfaction focus on the intimate partner relationship, the coparenting relationship, although related, is separate and distinct. Coparenting reflects a wider range of relationship structures and processes specific to parenting. 67 , 68 For example, coparenting relationships occur among a variety of individuals who share responsibility for parenting, whether romantically involved or not, 65 , 69 such as same-sex parents, adoptive parents, divorced or never married parents, and mothers and maternal grandmothers. 70

Consistent with a family systems perspective, 8 better coparenting relationship quality is associated with children’s positive social and emotional development over and above the effects of both romantic relationship quality between parents (if present) and mothers’ and fathers’ parenting. 71 Notably, coparenting relationship quality among same-sex parents shows similar associations with children’s socioemotional development. 72 If supportive, coparenting relationships may help caregivers, especially fathers, promote children’s positive socioemotional development, 73 but undermining or conflictual coparenting relationships may have a detrimental effect on child development. For instance, although grandmother involvement may benefit children, conflict between mothers and grandmothers can be detrimental to children’s socioemotional development. 63 , 74 Thus, prevention and intervention programs have been developed to support effective relationships between coparents. 75 , 76 For example, Feinberg’s Family Foundations program targets couples expecting their first child and focuses on building strong coparenting relationships across the transition to parenthood 77 , 78 —a critical foundation for parent-child relational health.

Coparenting research highlights the role of supportive versus undermining coparenting for children’s development. Often, the extent to which coparents support or undermine one another stems from whether they share the same views on parenting goals and practices and have a similar perspective on the child’s development. Thus, when interacting with patients, we suggest inquiring about the extent of agreement versus disagreement among the adults who make decisions regarding the child’s health and development. For example, the primary custodial parent may emphasize healthy food choices and regular physical activity, whereas the nonresidential coparent may provide markedly different choices during visitation periods. Alternatively, one parent may have concerns about a child’s language or motor development, whereas a grandparent may continually emphasize that the child is “just fine.” These discrepancies in perceptions of typical versus atypical development may delay or interfere with prevention efforts, medical diagnosis, and treatment. Disagreements among multiple caregivers may create stress and tension within families, and challenges with coparenting can be addressed through prevention and intervention programs.

Parental Characteristics That Contribute to Parenting and Relational Health

Psychosocial resources and mental health.

Belsky’s early model of parenting competence suggests that multiple factors affect parenting and child outcomes, with parents’ psychosocial resources playing a prominent role. 3 Individual differences between parents in their personality characteristics affect the quality of their parenting. 79 In particular, higher openness, conscientiousness, extraversion, and agreeableness, and lower neuroticism has been related to more optimal parenting cognitions, practices, and behaviors, including parental warmth and support for autonomy. 79 - 81

For parents with common mental health issues such as anxiety and depression, the experience of parenting may be especially challenging. Maternal depression has been linked consistently with more negative and disengaged parenting behavior and lower engagement in healthy feeding and sleep practices. 82 Less research has considered fathers’ mental health in relation to their parenting, 83 although there has been a recent increase in attention to fathers’ antenatal and postnatal depression, 84 and fathers who experience postpartum depression demonstrate lower levels of developmentally appropriate positive engagement with their infant children. 83 Anxiety disorders in fathers as well as mothers have been linked with more overinvolved parenting behavior that does not foster age-appropriate independence in children. 85

Although prevalence rates suggest the importance of considering parental anxiety and depression, other mental health disorders should be considered as well. For example, for mothers diagnosed with borderline personality disorder, higher levels of negative affectivity as well as lower rates of effortful control 86 and sensitivity, and support for child autonomy 87 have been reported. Less maternal sensitivity has also been reported among mothers with obsessive compulsive disorder. 88

Screening for parental mental health concerns from pregnancy (or from pregnancy planning) throughout the child’s development is consistent with a relational health approach. Beyond screening, health care providers can become aware of evidence-based treatments that may support healthy outcomes in children by supporting maternal mental health and parenting skills. 89 For example, the attachment-based, group intervention Mom Power, which emphasizes parenting, self-care, and engagement in treatment, holds promise for supporting positive outcomes for children by supporting maternal mental health and parenting competence. 90 With increased knowledge of evidence-based treatments for fathers’ mental health and parenting, we may be able to move beyond a focus on mothers to provide all parents with a stronger support system and resource base for effective parenting.

Parental Developmental History and Adverse Experiences in Childhood

According to Belsky’s model of the determinants of parenting, a parent’s psychosocial resources stem from their developmental history. 3 The experience of adversity and toxic stress during development may affect brain architecture , 91 a term used to convey how early experiences help build the structural foundation for healthy brain development. Under conditions of sustained, persistent stress such as maltreatment or neglect, the hypothalamic pituitary adrenal axis may be affected, contributing to atypical diurnal patterns of cortisol and increased risk over the course of development. 92 As our understanding of the impact of toxic stress on children has grown, the focus on understanding patterns of intergenerational transmission of impaired parenting has grown as well. Experiences of adversity and toxic stress in one generation are linked to poorer parenting and developmental outcomes in the next generation. 93 Thus, improving the quality of the caregiving environment as early as possible may help improve stress responding in young children. 92

Foundational work on adverse childhood experiences (ACEs) as predictors of physical, relational, and behavioral health has contributed to a growing understanding of the dose-response relation between experiences of adversity in early childhood (conceptualized as exposure to abuse and household dysfunction) and well-being in adulthood 94 as well as the experience of parenting. 95 Pregnant women reporting higher levels of ACEs in early childhood, for example, exhibit more hostile parenting toward their own infants; this pattern of hostile parenting then increases the child’s risk for poorer developmental outcomes. 96

In response to growing recognition of the impact of adversity and toxic stress within families, in 2012, the American Academy of Pediatrics (AAP) released a policy statement recommending education for health professionals on ACEs along with 2-generational screening for ACEs within families. 97 , 98 By screening for parental and child ACEs, health providers may be able to provide referrals to trauma-informed therapeutic supports within the community that can help build or rebuild relational health.

Yet, in the face of adversity, the presence of individuals who are connected to the child, such as family members, can help mitigate its negative effects. 4 In addition to exploring multiple factors related to the experience of adversity, a relational health perspective suggests the importance of identifying and growing supportive connections. For example, the neurosequential model of therapeutics focuses on relational health and connectedness with others. 99 Results from recent work with this model highlight the importance of promoting the health, safety, and positivity of the parent-child relationship.

Although pediatric health care providers are aware of the impact of ACEs on parenting and developmental outcomes, additional research, education, and resources are necessary to support practitioners in identifying and addressing these impacts within families. 100 The limitations and potential cost-benefit analysis of screening for ACEs must also be considered because screening without provision of adequate referrals to evidence-based treatments may undermine the possible value of the screen. 101 Moreover, identification of appropriate screening tools for ACEs remains an important consideration. Focusing on the experiences of adversity as an ACE score that relates to poorer health outcomes may confuse correlation with causation; thus, to best inform policy and practice, factors such as timing of adversity, the overall pattern of stress, and the absence or availability of protective factors must be considered. 4 Yet through increased awareness of ACEs (both the parent’s and the child’s) as well as other psychosocial risk factors for impaired relational health, professionals can widen their lens of assessment when interacting with parents and children during medical visits.

Child Characteristics That Contribute to Parenting and Parent-Child Relational Health

Another set of key factors in the quality of parenting and parent-child relationships involves characteristics of the child. Recognizing the bidirectional nature of relationships between parents and children, Bornstein noted that “caregiving is a two-way street.” 102 Although early literature emphasized the parents’ impact on the child, a relational health approach to development suggests that we consider child contributions to parenting as well as to the overall parent-child relationship. Among a number of child characteristics that may affect parent-child relational health, research has focused on child temperament and age as well as children with special health care needs.

Temperament

Although early research on temperament emphasized the child’s inborn characteristics (eg, rhythmicity, mood) and temperament types such as easy, difficult, and slow to warm up, 103 our current understanding of temperament reflects the interplay between biological and environmental factors over the course of an individual’s development. 104 Definitions of temperament typically include individual differences in activity, emotionality, attention, and self-regulation. 104 However, particularly relevant to the experience of parenting is the temperamental characteristic of reactivity, defined as the extent to which the child is predisposed to experiencing strong negative and/or positive emotions, which may reflect the sensitivity of the nervous system to environmental stimuli. 105

Although difficult child temperament has long been viewed as a risk factor for poorer parent-child relational health, 106 more recent theory and research on the concept of differential susceptibility suggest that children with difficult or highly reactive temperaments may be more susceptible to both the negative and positive effects of the parenting environment. 105 , 107 For example, children with more difficult temperaments, reflecting higher levels of reactivity, may be particularly susceptible to the detrimental effects of negative parenting. 108 In contrast, for highly reactive children, the experience of more positive parenting is associated with fewer child behavior problems 109 and greater social competence. 110 Parenting intervention studies have further shown that more reactive children appear to benefit more from experimentally induced positive changes in parenting. 111 Thus, it is important for practitioners to shift their perspectives on “difficult” children from vulnerability to opportunity and support parents in adopting a similar view. Indeed, to the extent that the biological parents of a highly reactive child may share similar underlying genetic sensitivities, 112 these parents may be especially responsive to practitioners’ efforts, just as their children are particularly responsive to their parenting.

Because the demands and challenges of parenting change as a function of children’s age, parents must have opportunities to gain research-informed recommendations for supporting relational health with their children from birth throughout the life span. For example, within early childhood, toddlers’ and preschoolers’ growing autonomy and self-awareness creates new demands and opportunities for both parent and child. Thus, supporting parents in reflecting on the thoughts, feelings, and beliefs regarding their child’s increasing autonomy could be one strategy for supporting relational health as children move through the early childhood years. Moreover, the roles of various parenting practices for supporting children’s self-regulatory capabilities may differ across early childhood, with responsiveness most critical in infancy and other forms of support becoming more critical during the preschool years. 113 Research must, therefore, identify which practices are most relevant, at which age, 113 and for which outcome of interest. Doing so will help practitioners provide targeted support to families, based on parents’ concerns regarding their child’s particular social and emotional strengths and challenges.

Special Health Care Needs

Children with special health care needs represent a growing demographic, 114 and expert recommendations continue to promote early detection in primary care. 115 , 116 Just as providers should consider the parent factors contributing to relational health, the child’s contribution to parent-child relationships is paramount. Within the family context, a child with a developmental disability and/or special health care needs may require disproportionate resources and time compared with neurotypical siblings. 117 The child’s condition may translate into added health care costs and increased stress for parents along with decreased access to social support and leisure activities within the community. 118 , 119 For example, a systematic review of parenting stress in the face of chronic child illness indicated that among parents who were parenting a child with chronic illness, significantly higher levels of parenting stress were found; in turn, this stress was related to lower levels of psychological adjustment among parents and children. 120 Among parents of children with autism specture disorder (ASD), higher levels of parenting stress and psychological distress have also been reported. 121 , 122 These higher levels of parental stress and distress may, in turn, affect parental availability and sensitivity, thus affecting relational health.

In light of the evidence on child contributions to parenting and developmental outcomes, it seems important to consider the “what” and “how” of child contributions to relational health. Identifying the ways in which child characteristics influence and interact with parenting behaviors and relational health may provide practitioners with the tools and questions necessary to shift from a focus on the effects of parenting on children to also consider how parenting has been influenced by the child and how the overall health of the relationship has been shaped by both relational partners.

Contextual and Process Variables That May Affect Relational Health

Although the bidirectional nature of parent-child relationships underscores the importance of considering parent and child contributions to relational health, a family systems approach, coupled with a bioecological approach, suggests that the social and contextual contexts in which parent-child relationships are embedded should be considered as well.

Parent-Child Feeding Practices

The promising protective role of healthy parent-child relationships in the development of obesity 123 in early childhood is also evident, perhaps via links with more optimal self-regulation in young children. 124 , 125 For example, theoretical models 125 and research 126 on the development of appetite self-regulation and positive physical activity habits, 127 , 128 which are critical to weight-related health throughout the life span, highlight the important role of parenting. Parental behaviors such as permissiveness or indulgence have been associated with weight status and obesity in childhood. More specifically, allowing children too much freedom regarding food choices in society’s obesogenic food environment can increase children’s risk for obesity. 123 Similarly, unrestricted, unmonitored screen time has also been associated with unhealthy weight status. 129 Yet the question remains to what extent these cycles occur within families, whereby parents’ lack of control over their own food choices and screen time contribute to unhealthy weight status for their children and the unhealthy weight status of children contributes to parents’ continued struggles with their own food choices and activity levels. Thus, a family-level relational approach to understanding risks for obesity may be particularly advantageous.

Given that parents’ attitudes and beliefs can shape a range of parenting behaviors related to health and wellness, including feeding practices, exploring relational correlates and predictors of feeding practices beginning in infancy seems prudent. Parents’ feeding practices provide a unique window into parent-child relationship health, because from birth, feeding makes up a critical part of parents’ daily interactions with young children. Decisions regarding breastfeeding and/or bottle-feeding can cause considerable stress for parents. 130 And although children’s eating behavior emerges early and is relatively stable over time, eating is influenced more by external factors across development. 131

Mothers who use food to soothe their distressed infants or toddlers have reported lower parenting self-efficacy and higher child negativity. 132 Using food to soothe was also linked with higher weight status among children, particularly for children who were perceived as having more negative temperaments. 132 Among preschoolers, parents’ use of food for the purpose of emotion regulation was associated with children’s increased intake of sweets when not hungry, a pattern that may reflect the early origins of children’s emotional eating. 133

Eating behaviors and nutrition are important components of lifestyle medicine. In promoting healthy eating behavior and weight outcomes for children, health care professionals can consider how parents’ attitudes may shape their feeding practices—above and beyond a child’s weight status—and how dyadic and family-level interactions around food may support or undermine relational health. From birth, providers can recognize that decisions regarding feeding (eg, breast and/or formula; homemade meals versus fast food) may be multiply determined and best understood through a relational health lens, where parent and child factors are viewed as contributing to parenting practices, practices that may differ from recommended best practices for promoting child health outcomes.

The Household Environment: Family Chaos, Technology, and Social Media Use

The home environment represents an important context for parent-child relational health, including the quality of parenting as well as children’s well-being and health. 134 - 138 Recent research, focused on household chaos, has highlighted the role of disorder/disorganization 139 and instability/turbulence 140 for understanding parenting quality and family well-being. Lower levels of household chaos (evidenced by greater organization, stability, and predictability) are associated with higher-quality parenting behavior than home environments characterized as noisy, crowded, unpredictable, and disorganized. 138 Among preschoolers, recent evidence suggests that higher rates of household chaos are also associated with higher screen use. 141

In fact, parents’ and children’s increasing engagement with, and reliance on, technology and social media suggest the need for providers to consider technology and social media as interactive partners. For example, Facebook may provide new parents with an important source of social capital, 142 and parents report using the internet to gain information about pediatric health. 143 , 144 Yet parents (and grandparents) do not report universally positive effects of their technology use. For example, parents may experience a range of internal tensions surrounding their use of mobile technology, such as cognitive, emotional, and relationship tension. 145 Researchers are documenting how technology may interrupt the flow of interaction patterns between children and their parents—a concept known as technoference. 146 For example, higher levels of child internalizing and externalizing behavior problems have been reported by mothers who also reported higher levels of technoference in their interactions with their children. 146

Supporting parents in identifying, reducing, or coping with household chaos, as well as technoference, may be promising avenues for supporting relational health. Because the experience of chaos in the home environment often co-occurs with poverty 139 as well as parental mental health symptoms, 147 screening and intervention approaches aimed at identifying and addressing the multiple co-occurring factors that relate to family chaos may be warranted. Moreover, gauging the perceived impact of technology and social media use on parent-child relational health may be an important area of inquiry for health practitioners.

Cultural Context and Relational Health

Understanding relational health requires us to also consider the impact of race, ethnicity, and culture on parent-child relationships; accordingly, consideration of diversity has moved to the forefront of our current research and practice efforts. Although broad parenting goals are remarkably similar across diverse cultures, 102 the processes by which parents in varying cultural contexts seek to achieve these goals may differ. For example, some scholars have suggested that the concept of sensitivity, the primary determinant of secure attachment according to attachment theorists, may be biased toward more individualistic cultures because it is focused on meeting the child’s individual needs. 148 Moreover, the meaning of parenting constructs such as controlling behavior may vary across cultures. For example, Asian American parents may emphasize strict control of children as part of culturally embedded approaches to parenting, which are not equivalent to western notions of harsh/controlling parenting and do not appear to have negative effects on their children’s development. 149 , 150

These debates can support practitioners in reflecting on how their own beliefs about what is the “best” kind of parenting to promote relational health and positive child outcomes may be shaping their messaging for parents. For example, among immigrant families, attention to acculturation—the process of adapting to a new culture—rather than parenting behavior, per se, may provide a window into relational health. For example, acculturation may happen at different rates for children and parents, and greater discrepancies in the level of acculturation may contribute to increased parent-child conflict. 151

The roles of culture, race, and ethnicity in parenting practices are particularly apparent with respect to discipline practices. For example, higher rates of corporal punishment, including spanking, are generally reported by African American parents, in comparison to Hispanic or white parents, 152 although recent evidence suggests similar endorsement of spanking by African American and Hispanic mothers, along with longitudinal associations between endorsement of spanking and children’s later internalizing and externalizing behaviors. 153 Evidence continues to highlight the negative impact of corporal punishment on children 154 and the AAP’s 2018 statement on effective discipline emphasizes the need for positive alternatives to corporal punishment and spanking. 155 And, although many parents report spanking their young children, these same parents may also be looking for nonphysical, effective alternatives for guiding their children’s behavior. 156

Understanding how cultural beliefs and practices shape parents’ expectations and socialization goals may help us better define what relational health is, both within and across diverse families. Health care professionals can be a source of guidance and support for parents to choose discipline strategies that align with research and support parent-child relational health. When practitioners recognize the larger context in which parents’ discipline decisions are embedded, they may more readily identify the beliefs, histories, and socialization goals that underlie families’ discipline practices. Health providers can recognize parents’ concerns regarding children’s behavior and provide culturally responsive, research-informed, preventive recommendations for helping parents identify alternative strategies to the use of corporal punishment and physical discipline.

Reducing Risks to Relational Health: Screening and Referral

Given that the parent-child relationship is critical for healthy development, health providers must adopt a dyadic-level, family systemic, and culturally informed approach to screening, referring, and treating parent-child dyads to integrate research with practice. Equipping health professionals with knowledge of relational health may provide a solid foundation for supporting parent-child relational health from birth. For example, evidence from research with pediatric residents suggests that training in a parent-child relational framework was effective in supporting residents’ observational skills and knowledge of child development. 157

An emphasis on transactional associations within families further underscores the importance of screening and early intervention to support child and parental well-being and use of positive parenting practices. 10 Commonly used assessments in parent-child attachment research, such as the Strange Situation Procedure 158 Attachment Q-Set, 159 are labor-intensive and were not developed as clinically relevant screening tools. Moreover, even when insecurity in the parent-child relationship is suspected, access to attachment-based interventions (ie, VIPP-SD, ABC) may be extremely limited.

Whereas much of the research literature on early parent-child relationships (typically mother-child relationships) has focused on attachment, recent work highlights the dyadic-level construct of emotional connection for understanding early parent-child relational health. The development of the Welch Emotional Connection Screen (WECS) 160 reflects an effort to provide practitioners with a rapid and valid screening tool for parent-child relational health from birth to 5 years. The WECS considers the presence or absence of 4 mutual behaviors that may serve to promote and maintain emotional connection within a parent-child dyad: attraction, facial responsiveness, vocal responsiveness, and sensitivity/reciprocity. Based on the overall interaction, a score of EC+ (connected) or EC− (not connected) is assigned to the dyad.

The WECS developed out of work with the Family Nurture Intervention, which seeks to support the development of emotional connection and coregulation via the provision of calming sessions that focus on the sensory experiences of touch, vocal soothing, and skin-to-skin contact. 161 - 163 Results from an RCT study indicated that mothers and infants participating in the Family Nurture Intervention showed improvements in face-to-face dyadic interaction, including increased frequency and quality of mothers’ touch and for boys, infant’s vocal affect and gaze. 164

Emotional connection, as assessed by the WECS in infancy, has been associated with healthier autonomic responding among infants born prematurely 165 as well as with fewer internalizing and externalizing behavior problems in a full-term, longitudinal sample. 166 Thus, emerging evidence suggests that the WECS holds promise for screening, anticipatory guidance, and referral of early parent-child relationships that may benefit from support and intervention to promote healthy regulatory functioning and decrease risk for later child behavior problems. Efforts are under way to train a range of professionals—from pediatric residents to infant mental health practitioners and home visitors—to be reliable raters of parent-child relational health using the WECS.

In families with elevated risk for maltreatment, the automated self-report survey, the CARTS (Computerized Childhood Attachment and Relational Trauma Screen), reflects a relational approach to the assessment of trauma in childhood. 167 , 168 The CARTS considers what trauma occurred and assesses caregivers’ emotional availability, along with responses to the reported maltreatment. In contrast, the SEEK program (Safe Environment for Every Kid) focuses on risk factors related to child maltreatment, including parental depression, stress, and substance abuse. 168 , 169 Thus, the SEEK program may benefit pediatric primary care professionals through its focus on psychosocial stress within families, which if addressed early, may prevent child maltreatment.

Notably, SEEK embodies a relational health perspective by acknowledging the parent’s love for the child as a pathway to healthy outcomes for both parent and child as well as by acknowledging the relationships between health professionals and parents as protective factors for parents and children. 169 , 170 For example, part of the SEEK program is the SEEK Parent Questionnaire, which begins by empathetically validating the sometimes challenging everyday experience of being a parent while simultaneously offering support to parents dealing with concerning circumstances. SEEK also aims to support relational health through the REAP approach, which encourages health care providers to Reflect-Empathize-Assess-and Plan with parents.

Intervention approaches that incorporate mindfulness practices, such as the 9-week Mindful Parenting course tested in the Netherlands, also hold promise for supporting relational health within families. Mindful Parenting aims to increase awareness, decrease parental stress, and improve coparenting. 171 Both parents participating in the program and their children report reductions in internalizing/externalizing symptomology. The interpersonal focus of mindfulness-based interventions supports healthy parent-child relationships through increased awareness of parent-child interactions as well as positive changes in both child and parent functioning. 172

Summary and Conclusions

Beyond attachment theory, which emphasizes parental sensitivity and responsivity as a primary determinant of attachment security, a relational health science approach offers a wider lens for understanding how parent-child relationships may affect children’s development. A relational health approach recognizes both partners’ contributions to the establishment and maintenance of relational processes and highlights the potential value of the health care provider as a relational partner for parents and children. Our focus here was on socioemotional development; future work will consider how a relational health framework can be applied to a range of parent-child health decisions from vaccinations and sleep behaviors, to physical activity, and medication use.

Although we view primary care as a valuable context for supporting relational health, continued development and validation of screening tools for relational health that are suitable for clinical and applied contexts remain an important goal along with more widespread availability of effective interventions. Moreover, given the existing demands on health care providers, we recognize that a relational health perspective on development may create additional demands on providers. Perhaps a necessary first step is a shift in perspective, more than a shift in practice. By viewing the parent-child relationship as part of the “patient” and, therefore, part of health promotion, the long-term gains may be worth the initial investment.

By networking with community resources, health care providers can build a pipeline of referrals for parents as a component of pediatric and primary care. Offering parent-friendly pamphlets, information sheets, and face-to-face communication that reflects a relational health view on development may help parents see themselves as partners in relational health, rather than as the cause of their child’s mental health, behavioral, or developmental problems. Such negative attributions may contribute to feelings of shame and guilt—feelings that may undermine parenting self-efficacy and parents’ engagement in children’s wellness and treatment. The AAP’s recent call for pediatricians to partner with parents in supporting healthy outcomes through the sharing of information regarding child development and parenting 155 reflects the promise of a relational health approach.

Returning to the opening quote from Bowlby, we suggest that health care providers are in a strong position to serve children by valuing their parents and viewing child development through the lens of relational health. Perhaps by uncovering who that person is—the one who is “irrationally crazy” about the child, as Bronfenbrenner advised—professionals can help cultivate and reinforce that connection. And in its absence, we can seek to identify ways to build a web of relational health for the child and for the parent, a web that can support each partner in service to the relationship.

Acknowledgments

We are grateful to Ariana Shahinfar, Robert Ludwig, and Mark Lopez for feedback on an earlier version of this article.

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The authors received no financial support for the research, authorship, and/or publication of this article.

Ethical Approval: Not applicable, because this article does not contain any studies with human or animal subjects.

Informed Consent: Not applicable, because this article does not contain any studies with human or animal subjects.

Trial Registration: Not applicable, because this article does not contain any clinical trials.