Advancing Emotional Connection Through Collaboration

For the second school year in a row, I found myself with a double-dose of worry as I sent my kids off to school. I worried about them getting COVID as a result of being around so many others in close quarters, and I also worried about their ability to learn amidst a global pandemic, particularly after losing so many months of in-person learning. These worries were layered on top of the ongoing concerns about raising two Black children in America today.

How will our children get through these challenging times? How will we?

I was reminded of the sage words of john powell from a June 2020 episode of the Greater Good Science Center podcast, The Science of Happiness. Just a few months into the pandemic, john reminded us:

At a time of so much stress, isolation, and resulting disconnection, it is important to heed powell’s call for mutual healing. That is one reason why our Bonding strategy is foundational to the work of Einhorn Collaborative. Leveraging the scientific research of the Nurture Science Program at Columbia University and the growing knowledge and emphasis on early relational health, we are investing in ways to use the power and potential of autonomic emotional connection to improve health and well-being for children and adults.

The Power and Potential of Emotional Connection

Research from the Nurture Science Program demonstrates that our bodies – specifically the gut – are the primary regulators of emotional behavior. This process of co-regulation occurs between two people and their autonomic nervous systems. Most of us know about the central nervous system which is comprised primarily of the brain and spinal cord. But it is our autonomic nervous system that learns from stimuli and then triggers responses in the body – and ultimately in the brain – based on those stimuli. Relationships with loved ones train our autonomic nervous systems over time that the sight, sound, smell, touch, and even taste of a loved one can trigger a calming effect. This is what we call autonomic emotional connection.

We can all use some calming these days, and the process of training and conditioning our bodies to calm each other begins with the foundational relationships between parents and babies starting in the first few weeks, months, and years of a child’s life. The field of early relational health describes the healthy and positive child development that emerges best in the context of nurturing, warm, and responsive early parent-child relationships, when children and their families are sufficiently resourced and surrounded by safe communities with strong trust and social connectedness. At Einhorn Collaborative, we know that supporting early relational health and parent-child emotional connection builds the foundation for a society where all people have the ability to bridge across differences to connect with each other, embrace our common humanity, and solve the pressing issues facing our country, together.

A Year of Progress

These beliefs informed our strategy when we launched Einhorn Collaborative a little more than a year ago. What have we learned since then, and how has our strategy evolved as a result of our learning? We now understand – even more than we did before – the importance of relationships and mutuality, not just in connection for parents and babies, but in how we as a funder can collaboratively drive progress in the field so more families have that emotional connection more often.

In our first decade of grantmaking, we supported a portfolio of grantees who each played a role in advancing our vision, but primarily acted on their own. That worked fine while the research was still underway to understand the science of autonomic emotional connection.

Now, field leaders and policymakers are moving towards implementation, embracing a focus on parent-child relationships as a critical component of child health and development. The American Academy of Pediatrics (AAP) has called on pediatricians to partner with families and communities to promote early relational health. At the same time, emotional connection tools and supports are being embedded in NICUs, early education, and programs like Reach Out and Read. In response, we have shifted to a collaborative strategy, which seeks to connect the diverse stakeholders who together can plan the translation and dissemination processes, while also tackling the systemic barriers facing families, to help more children and their caregivers experience deep emotional connection with each other. Using tools from Collective Impact and lessons about field catalysts and field building, this new stakeholder group, which includes parents and pediatricians, will become a partner collaborative that will guide Einhorn Collaborative’s strategy for the next several years. The Early Relational Health Coordinating Center at the Center for the Study of Social Policy (CSSP) will provide the backbone support for this collaborative effort with a shared goal that more family-facing professionals are equipped to help parents discover the power of autonomic emotional connection with their children.

This collaboration will develop, test, refine, and spread emotional connection training for parent-facing professionals, starting with pediatricians in Reach Out and Read, a program that already reaches 20 percent of American families. Authentic partnership with families will guide our strategies and learning. Together, we will apply the science to see its impact at scale.

The AAP’s call to incorporate early relational health into pediatric primary care has prompted interest among clinicians for tools that support parent-child relationships and can be incorporated into standard practice. With the evidence from Reach Out and Read and other partners, the AAP will be poised to update Bright Futures guidelines and pediatric residency accreditation standards within the next decade.

We know, however, that families with young children intersect with many other systems in their communities beyond pediatrics. Over time, CSSP will expand its collaboration to include other sectors like home visiting, community health workers, doulas, and early care and education – so that communities can build an all-in approach to supporting early relational health.

Addressing Systemic Barriers

This partner collaborative will support parent-child emotional connection through training and new practice approaches for family-facing professionals. Yet, there are larger obstacles in the broader early childhood health field that must also be addressed, including public financing reforms and improved technology solutions that are parent-centered and integrate with electronic medical records. Addressing these issues will create the enabling conditions for more families to experience emotional connection.

To advocate for these broader systems-level changes, we continue to deepen our engagement with the Pediatrics Supporting Parents (PSP) initiative we helped launch nearly five years ago. During its first three years, PSP and its partners conducted a landscape analysis of evidence-based programs to extract a set of 14 common practices, like modeling activities that nurture parent confidence or integrating new roles into the care team. These practices, when embedded in pediatric primary care, can promote social-emotional development and foster nurturing parent-child relationships. Field leaders cautioned that the spread of the 14 practices is hindered by larger challenges in the field. This prompted PSP to support the creation of a Blueprint for unlocking the funding potential of Medicaid and the Children’s Health Insurance Program (CHIP), a multi-state National Medicaid Workgroup, and a complementary guide to leveraging opportunities between Title V and Medicaid. This practice-to-policy approach is core to the success of PSP and many related efforts in early relational health.

In its next phase, PSP will intentionally center the voices of communities, families, and field leaders. Three to five communities across the nation will participate in a multi-year, shared-learning initiative where they select, test, and measure the effectiveness of concrete changes to pediatric primary care and related sectors. The goal is to lift up these proof-point communities that effectively improve social and emotional development and cultivate nurturing parent-child relationships. These communities will also co-create the governance structure and strategic priorities for the multi-year collaboration.

We listened to our partners with whom we began this work in our first decade of grantmaking who told us, “[Einhorn is] remarkable on individual relationships, and they think about field building…. But is there a more active way to create a connected community with funders who care about the same things and among grantees?”