Relational health explains how SSNRs buffer adversity and promote the skills needed to be resilient in the future. BStC, biological sensitivity to context; PTSD, posttraumatic stress disorder. Chp 2- evolutionary theories Theories of development Theories give a certain perspective Advantages: narrows down way to look at things Negatives: disadvantages to see everything around that one theory (it filters out too many things) Depending on what you are looking at may add different theories NOT JUST 1 5 theories will be seen (removing evolutionary)-Psychoanalytic theories-Humanistic . 2. Neurology also plays a role in the biological perspective of psychology. The buffering and skill-building roles of responsive relationships are biologically embedded, and they are essential promoters of healthy development.59 Existing AAP reports on managing perinatal depression,90 supporting grieving children,195 fostering male caregiver engagement,196 partnering with home visiting programs,142 encouraging developmentally appropriate play,74,197 discouraging screen time,125 and promoting shared-book reading67,68 include additional recommendations on ways primary care pediatricians might promote SSNRs. Efforts to repair strained or compromised relationships are likely to be more effective if other potential barriers to SSNRs are being addressed (eg, parental mental illness and basic needs) and additional efforts are being made to actively promote SSNRs (eg, the provision of developmentally appropriate play). 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Biological sensitivity to context is a theory with emerging evidence that children differ in their susceptibility to environmental influence in a for better and for worse manner, depending on their psychobiologic reactivity to stress. As a consequence, the very characteristics that are often thought of as childrens frailties (eg, high stress reactivity) can also be their strengths, given the right context.*,91,131,134,206. The mechanism offers an explanation for the historical trauma. The ecobiodevelopmental model suggests that, to improve the likelihood of positive developmental outcomes across the life span, efforts should be made to improve the salient features of the child's environment. Foremost on the advocacy agenda will be the need for serious payment reforms that consider the complexity of care attributable to adverse family and community contexts and include financial supports that incentivize families to engage with an FCPMH.204 Payment reforms need to be sufficient to allow FCPMHs to spend more time with families, function as interdisciplinary teams, integrate into their communitys initiatives and services to support children and families (horizontal integration), and anchor medical neighborhoods that not only foster wellness in childhood but promote positive outcomes across the life span. "The . In this way, the victims play an active role in communicating with and understanding the offenders, and the offenders have the chance to take responsibility for their actions, identify steps that might prevent offending behaviors in the future, and redeem themselves in the eyes of the victims and community (as per Garner and Saul17). Changing all of the potentially salient features of a childs environment cannot be reduced to a single intervention or program, so there will be no singular panacea when it comes to addressing childhood toxic stress responses. An integrated, biodevelopmental framework is offered to promote greater understanding of the antecedents and causal pathways that lead to disparities in health, learning, and behavior in order to inform the development of enhanced theories of change to drive innovation in policies and programs. ancillary support services (interpretation, telemedicine, transportation, etc) enabling youth with special health care needs to access the many layers of support that they frequently require. HealthySteps is an evidence-based, interdisciplinary pediatric primary care program that promotes positive parenting and healthy development for infants and toddlers, with an emphasis on families living in low-income communities. To translate this relational health framework into clinical practice, generative research, and public policy, the entire pediatric community needs to adopt a public health approach that builds relational health by partnering with families and communities. By focusing on the safe, stable, and nurturing relationships (SSNRs) that buffer adversity and build resilience, pediatric care is on the cusp of a paradigm shift that could reprioritize clinical activities, rewrite research agendas, and realign our collective advocacy. Advances in fields of inquiry as diverse as neuroscience, molecular biology, genomics, developmental psychology, epidemiology, sociology, and economics are catalyzing an important paradigm shift in our understanding of health and disease across the lifespan. Copyright American Academy of Pediatrics. If nothing else, pandemic-mandated stay-at-home orders should increase our collective awareness of the distress associated with being socially isolated or vulnerable. Many of the components of a public health approach to prevent, mitigate, and treat toxic stress responses (see examples) are also components of a public health approach to promote, identify barriers to, and repair SSNRs. 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