Why Early Relationships Matter: What New Research Tells Us About Building Resilient Children

By Dr. Bob Carey

Recently I came across a study by Roby, O’Connell, Griffin and their colleagues (Roby, E., O’Connell, L.K., Griffin, M.G. et al. Promoting early relational health and resilience in pediatric primary care: a qualitative study. Pediatr Res (2026) on promoting early relational health in pediatric primary care. What struck me most was how closely the findings align with what many of us working in behaviour and developmental psychology have been saying for years. In many ways, the study reinforces a simple but powerful truth about children: behaviour rarely exists in isolation. It grows out of relationships, environments, and systems that surround the child.

The researchers explored how pediatric primary care settings—those routine visits families make to see their child’s doctor—can become an important place to support something called early relational health. At its core, early relational health refers to the quality of the emotional connection between young children and their caregivers. It includes the everyday interactions that shape a child’s sense of safety in the world: a caregiver responding when a baby cries, a parent noticing when a child is overwhelmed, or a moment of shared joy during play. These small relational moments may seem ordinary, but developmental research tells us that they are the building blocks of emotional regulation, resilience, and long-term mental health.

What I found particularly compelling about the study is that it challenges the traditional view that pediatric care should focus mainly on physical development—things like weight, height, vaccinations, and illness. Instead, the authors argue that pediatric visits offer a unique opportunity to support the relational environment in which a child is growing. Nearly every family brings their child to these appointments, which means clinicians are in a position to gently guide parents toward responsive caregiving, help them recognize signs of stress in their child, and reinforce the importance of positive interactions within the family.

For anyone familiar with the Positive Systems Approach (PSA), this perspective will sound very familiar. One of the central ideas in PSA is that behaviour must always be understood within the system in which it occurs. Children do not simply “produce” behaviour on their own. Their actions emerge from the complex interaction between their emotional state, their relationships, and the environments they inhabit. When a child struggles, the question is not simply “What is wrong with this child?” but rather “What is happening within the system surrounding this child?”

The Roby study reflects exactly this way of thinking. Instead of focusing exclusively on diagnosing behavioural or emotional problems once they appear, the researchers emphasize strengthening the relational foundation that shapes development in the first place. When caregivers feel confident, supported, and emotionally connected with their child, the entire system becomes more stable. That stability, in turn, helps children develop the ability to regulate their emotions and cope with stress.

In my own work with families, I often see how easily behaviour can be misunderstood when we focus only on the surface. A child who lashes out may be overwhelmed by anxiety. Another who refuses to participate in activities may be experiencing social stress or sensory overload. In the Positive Systems Approach we remind caregivers that behaviour is rarely random; it is usually a form of communication. When a child’s needs are unmet or their environment feels unsafe, behaviour becomes one of the ways they express that distress. Seeing behaviour through this lens changes the conversation entirely. Instead of reacting with punishment or control, we begin to ask what the child might be trying to tell us.

The Roby study supports this shift in thinking by highlighting the role of secure relationships in building resilience. Children who experience consistent, emotionally responsive caregiving develop stronger coping skills and greater emotional flexibility as they grow. They learn, through thousands of small interactions, that the world is predictable and that trusted adults can help them navigate difficult feelings. Over time, these relational experiences become internalized, allowing the child to regulate themselves more effectively.

What is fascinating is how early this process begins. Infants and toddlers do not yet have the neurological capacity to regulate their own emotions. Instead, they rely on what psychologists call co-regulation. When a caregiver soothes a crying child, helps them calm down after a frightening experience, or simply sits beside them during a moment of frustration, the caregiver’s nervous system is helping stabilize the child’s. These repeated experiences gradually shape the developing brain. Eventually the child learns to manage emotions independently, but the foundation of that ability is built through relationships.

This is why the concept of early relational health is so important. It reminds us that resilience does not suddenly appear when a child reaches school age. It grows slowly through everyday interactions long before formal education begins. The pediatric setting, as the researchers point out, is one of the few places where professionals have regular contact with families during these critical early years. By encouraging parents to notice and nurture their relationship with their child, clinicians can help strengthen the very system that protects mental health.

Another theme that runs through both the research and the Positive Systems Approach is the importance of positive interactions. In PSA we often talk about the value of providing children with frequent experiences of encouragement, warmth, and attention that are not simply dependent on “good behaviour.” When children feel valued and connected, they are far less likely to seek attention through disruptive actions. The Roby study echoes this principle by emphasizing how caregiver responsiveness and emotional attunement foster a sense of security that supports healthy development.

Perhaps the most important implication of this research is that it moves the field of child mental health toward prevention rather than reaction. For decades, many mental health systems have focused on treating problems after they become serious. By that point, families may already be dealing with entrenched patterns of anxiety, aggression, or emotional dysregulation. Strengthening early relationships offers a different path. When caregivers receive guidance and reassurance early in their child’s life, many behavioural challenges can be reduced before they escalate.

This is one of the core ideas behind the Positive Systems Approach as well. Instead of waiting for behaviour to reach a crisis point, PSA encourages caregivers and professionals to build supportive systems from the start. That means paying attention to routines, communication patterns, emotional climate within the home, and the quality of relationships that surround the child. When those systems are healthy, behaviour tends to stabilize naturally.

Reading the Roby study left me with a sense that the broader field of psychology is gradually catching up to something many parents instinctively understand. Children do not thrive because we control their behaviour. They thrive because they feel safe, understood, and connected to the people who care for them.

When relationships are strong, resilience grows. When caregivers feel supported, they become more responsive and confident. And when children experience that sense of emotional security early in life, they carry it with them into the many challenges they will inevitably face as they grow.

In the end, this research reminds us of something both simple and profound. If we want to support children’s mental health, we cannot focus only on the child. We must strengthen the relationships and systems that surround them. When those systems are healthy, children have a remarkable capacity to grow, adapt, and flourish.