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A mother brings her toddler in for a well-child visit. When the pediatrician asks how things are going, the mother says everything’s fine. The pediatrician asks whether she’s getting enough support at home, to which she cautiously responds that some days can feel like more than she can handle. Delving a little deeper, the pediatrician learns that the mother recently lost her father, is having trouble sleeping, and hasn’t been engaging and playing with her child. After the pediatrician determines that the mother is not at immediate risk for harming herself or her child, the clinic nurse helps her make an appointment with her primary care provider.
A single father brings his 6-year-old child to a family physician for increased wheezing. When the physician asks about asthma triggers, the father responds that he and his child have been sleeping in the car some nights and at a friend’s apartment other nights. A social worker who works in the physician’s office refers them to a shelter that can help with temporary housing as well as food, clothing, and job counseling.
Supporting children’s health and development often starts with supporting the parents. Children’s brains develop rapidly during their first few years of life, and acquisition of knowledge and skills during early childhood sets the stage for future health and well-being. Parents shape children directly through the environment they create at home and indirectly through their choices of community, childcare, and schools. Studies have consistently documented the importance of the parent–child relationship for children’s well-being and healthy development. Researchers have identified a wide range of parenting practices associated with improved child outcomes in areas such as social–emotional and cognitive functioning, school performance, and mental and physical well-being (see table).
Physicians (and other clinicians providing primary care) are expected to offer parents of young children anticipatory guidance addressing many of these topics. For example, physicians can discuss appropriate discipline and...