Although relationship quality between children and carers improved over 2.5 years, it did not directly predict later emotional or behavioral outcomes, a study found.1 These findings highlight the need for targeted interventions to support care-experienced children’s long-term mental health, as early caregiver-child relationships play a crucial role in shaping emotional and behavioral development.
This longitudinal study is published in European Child & Adolescent Psychiatry.
The field of developmental psychopathology has advanced by recognizing the vital role of context in understanding risk and resilience, with caregiver relationships standing out as one of the most influential factors in a child’s development.2 Early caregiving experiences—shaped by daily interactions, caregivers’ perceptions of their child, and broader social and cultural contexts—greatly influence behavioral outcomes due to the brain’s high plasticity in early life.
“The results of this study provide insight into how relationship quality between carer and child change over time spent in care, and the degree to which these relationships are implicated in the emotional and behavioral outcomes for the child,” wrote the researchers of the study.1 “This study shows that the quality of the relationship between carer and child over time does not predict emotional and behavioral outcomes for the child, but the overall quality of this relationship is significantly stronger later in the child’s journey in care than early on.”
This study analyzed data from the Best Services Trial, collected between 2011 and 2022, to examine the link between carer-child relationship quality and child mental health over 2.5 years. The sample included 220 children entering foster or kinship care, aged between 0.08 (approximately 1 month) and 5.58 years at baseline.
Relationship quality was assessed using the Parent-Infant Relationship Global Assessment Scale (PIR-GAS), while emotional and behavioral difficulties were measured with the Strengths and Difficulties Questionnaire (SDQ) and the Infant Toddler Social Emotional Assessment (ITSEA). Data were collected at 2 time points—shortly after entering care and again 2.5 years later—to evaluate changes in relationship quality and associations with later mental health outcomes.
Findings showed that the quality of carer-child relationships significantly improved over the 2.5-year period. Mean (SD) PIR-GAS scores increased from 66.12 (17.09) at baseline to 79.67 (16.52) at follow-up, indicating a shift toward more positive and secure relationships.
However, the researchers noted some limitations, including a smaller sample size and site imbalances, which may have limited generalizability. Future research should examine the impact of adversity, neurodevelopmental conditions, and care system differences to better support care-experienced children, explained the authors.
Despite these limitations, the researchers believe the study highlights that while carer-child relationships improve significantly over time in foster and kinship care, these improvements alone do not predict later emotional or behavioral outcomes.
References
1. Sparks R, Rizeq J, Crawford K, Minnis H. A longitudinal study examining the effect of carer-child relationship quality on child’s emotional and behavioral difficulties while in care. Eur Child Adolesc Psychiatry. doi:10.1007/s00787-025-02900-9
2. Humphreys KL, Garon-Bissonnette J, Hill KE, et al. Caregiving relationships are a cornerstone of developmental psychopathology. Dev Psychopathol. 2024 Dec;36(5):2218-2231. doi:10.1017/S0954579424000300