Promoting First Relationships in Pediatrics

June 22, 2023 by Nancy Meenen

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Relationship-Focused Practice to Support Responsive Caregiving

Because the First 3 Years Last a Lifetime….

Course Content

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CHAPTER 1

Introduction 2 Topics

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Supporting Responsive Caregiving

How this E-Learning Course is Organized

CHAPTER 2

PFR Approach to Relationship-Focused Care 7 Topics

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Strategy One: Joining

Strategy Two: Reflective Observation

Strategy Three: Positive and Positive Instructive Feedback

Strategy Four: Supporting Reflective Capacity

Strategy Five: Offering Information about Social and Emotional Development

Practice Using PFR Strategies After Observing a Video Example of Parents & Baby at 4-month Well-Child Checkup

Example of PFR Well-Child Care Connecting Strategies for Providers

CHAPTER 3

Social Connectedness: The Importance of Children’s First Relationships 5 Topics

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The Parent-Child Attachment Relationship

Quiet Alert State of Newborns

Twins Talking

4-Month-Old Meeting Her Aunt For the First Time Video

Translation to the Clinical Setting

CHAPTER 4

Elements of a Healthy Relationship

1. Understanding Cues in Order to Support Sensitive Caregiving 7 Topics

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Engagement and Disengagement Cues

Potent Disengagement Cues: Boy Scared to Touch Worm

Subtle Disengagement Cues: Boy Being Shown Something “Yucky”

Subtle Disengagement: Child and Mother Playing with Dolls and Warming Up to a New Person

Multiple Types of Cues in Real-time: Mother and 3-month-old Talking Back and Forth

Multiple Types of Cues in Real-Time: Father and Son Stringing Beads

Translation to the Clinical Setting

2. Alleviation of Distress 4 Topics

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Alleviation of Distress: Longer Version of Boy Scared to Touch Worm

Alleviation of Distress: Father Helping Son Adjust to a New Place

Alleviation of Distress: Puppy Learning to Go Down the Stairs – Scaffolding in the Zone of Proximal Development

Translation to the Clinical Setting

3. Mutuality 4 Topics

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Mutuality: Mother and Toddler Son Reading a Book Together

Mutuality: Father and 19-Month-Old Son Having a Conversation about a TV Show

Mutuality: Mother and 6-Month-Old Talking Back and Forth Together

Translation to the Clinical Setting

CHAPTER 5: FEEDING, SLEEP & DEVELOPMENT VIEWED THROUGH A RELATIONAL LENS

Feeding 8 Topics

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Feeding: 12 Months Through Early Childhood

Feeding: Translation to the Clinical Setting

Feeding: Conclusion

Sleep 8 Topics

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Sleep: Translation to the Clinical Setting

Development: Early Infancy 4 Topics

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Newborn

Early Infancy: 2 Months

Early Infancy: 4 Months

Early Infancy: Translation to the Clinical Setting

Development: Later Infancy 3 Topics

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Later Infancy: 6 Months

Later Infancy: 9 Months

Later Infancy: Translation to the Clinical Setting

Toddlerhood 3 Topics

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Toddlerhood: 12-24 Months

Emerging Inhibitory Capacity

Toddlerhood: Translation to the Clinical Setting

Putting Feeding, Sleep & Development Together: Example of a Well Child Care Tip Sheet for Providers

CHAPTER 6

Understanding Children’s Behavior as Their Language of Distress

Triggers for Children’s Difficult Behaviors

Understanding & Meeting the Social-Emotional Needs of Children

Qualities in the Parent-Child Relationship that Support Meeting Children’s Social-Emotional Needs

Conclusion

CHAPTER 7

Reframing Challenging Behavior: It’s All About Feeling Connected

Understanding the Scope of the Presenting Problem: Joining with Parents & Containing Their Distress

Next Steps: Understanding & Identifying Feelings & Needs

CHAPTER 8

Challenging Behavior Cases 5 Topics

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Case #1: 2-Year-Old With Difficult Adjustment to New Child Care Setting

Case #2: Grandmother and the Terrible Tantrums

Case #3: 3-Year-Old About to Be Expelled From Preschool

Case #4: Little Boy with Hitting Behavior in Child Care Setting

Case #5: Little Girl with Hitting & Pinching Behavior in Child Care Setting

CHAPTER 9

Supporting Relationship-Centered Care in Primary Care

Pediatric Resident Training

Building New Models of Care – Childhaven-Harborview Early Relational Program

Supporting the Pediatric Care Provider through Reflective Practice

Appendices

Appendix A: Parent Handouts

Appendix B: Well-Child Care Tip Sheets for Providers

Appendix C: Well-Child Care Connecting Strategies for Providers Sheets

Appendix D: List of Videos