Williams Robin C
Canadian Paediatric Society, Early Years Task Force, Ottawa, Ontario, Canada.
Paediatr Child Health. 2023 Sep 23;28(6):377-393. doi: 10.1093/pch/pxad025. eCollection 2023 Oct.
Children grow and develop in an environment of relationships. Safe, stable, nurturing relationships help build resilience and buffer the negative impact of adverse experiences. Promoting relational health in clinical practice shifts the focus from adverse childhood experiences (ACEs) to positive childhood experiences (PCEs). This approach evaluates a family's strengths and assets, and can be incorporated into both well-child and subspecialty care. While the optimal window for such interventions is in the prenatal period or as early as possible within the first 3 years of life, it is never too late to start. This statement describes how clinicians can bring a relational health approach to any medical encounter by understanding: what toxic stress is and how it can affect the developing brain, family relationships, and child development; how positive relationships, experiences, and behaviours can help buffer such effects and build resilience; observable signs of relational health and risk in parent-child interactions; the attributes of trustful, therapeutic relationships with families; and how to optimize these benefits through conversation and clinical practice.
儿童在人际关系的环境中成长和发展。安全、稳定、滋养性的人际关系有助于培养复原力，并缓冲不良经历的负面影响。在临床实践中促进关系健康，将关注点从儿童期不良经历（ACEs）转向儿童期积极经历（PCEs）。这种方法评估家庭的优势和资产，并可纳入健康儿童保健和专科护理中。虽然此类干预的最佳窗口期是在孕期或生命的头3年内尽早进行，但开始实施永远都不晚。本声明描述了临床医生如何通过理解以下内容，在任何医疗接触中引入关系健康方法：什么是毒性应激以及它如何影响发育中的大脑、家庭关系和儿童发展；积极的关系、经历和行为如何有助于缓冲此类影响并培养复原力；亲子互动中关系健康和风险的可观察迹象；与家庭建立信任、治疗性的关系的特质；以及如何通过对话和临床实践优化这些益处。
