Improving child health depends on healthy relationships


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Behavioral and emotional problems are seen in increasingly younger children, and at least some of these children are diagnosed with mental disorders and prescribed psychotropic drugs to control their symptoms. But this medical approach may overlook a common cause of disruptive child behaviors: parenting.

An editorial in Monday’s issue of the Archives of Pediatrics & Adolescent Medicine calls on health experts to consider the importance of caregiver relationships in the physical and mental development of children. The editorial is part of a theme issue focusing on child health in early life and outside influences, including caregiving, television, maternal use of antidepressants and nicotine, and exposure to trauma.


In their commentary, Dr. David Rubin and Kathleen Noonan, an attorney, both with the Children’s Hospital of Philadelphia, note that misbehaving children are easily labeled with depression, attention-deficit hyperactivity disorder, bipolar disorder, conduct disorder or other diagnosable mental illnesses that often lead to drug therapies instead of shining a light on the roots of the behavior problem, which may exist in the child’s relationship to his or her parents, foster parents or other caregivers.

‘Missing from the discussion is that at the heart of many of these disruptive behaviors are the biological effects of failed relationships, failed attachment, and multiple traumatic disruptions,’ the authors wrote.

Instead of psychiatric diagnoses and medications, therapies could focus on relationships. They note that an intervention called Parent-Child Interaction Therapy is promising but not widely available.

Supporting secure and functional caregiver relationships could have a huge impact on child health and, they said, ‘lead to the sustained changes in the brain that will promote resiliency in children.’

-- Shari Roan