Flourishing Childhood Frameworks: A Scoping Review.

Davis, Jacqueline A; Talati, Zenobia; Gibson, Lisa Y; Kennare, Jack; Bethell, Christina; Hinton, Christina; Block, Hannah; DSilva, Tara et al. · Pediatrics · 2026

systematic_review · Level I

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Abstract

Experiences in early life impact childhood, lifelong flourishing, and overall well-being. Yet a framework to guide promoting and measuring flourishing in early childhood has not emerged. The objective of this study was to identify frameworks and measures related to promoting and assessing early-childhood flourishing (0-5 years) to build on a preexisting, community-informed framework. A systematic search was conducted across electronic databases and the gray literature for articles published between 2014-2026. Of 13 902 total references, 8592 were eligible for screening. A machine learning-assisted tool (Research Screener) was used to streamline screening of the abstracts against the inclusion criteria. A deductive approach guided by a preexisting community-informed framework was used to interpret the data. From 32 studies, we identified 6 frameworks and 9 measures that related to early-childhood flourishing. Frameworks typically identified preconditions of flourishing and indicators of child flourishing. Child flourishing measures commonly included items assessing healthy attachment, resilience, engagement and curiosity, and emotional openness and well-being. The National Survey of Children's Health Child Flourishing Index was the most cited measure. A new "curiosity" domain was added to the preexisting framework. Findings will guide the development of a new assessment tool. Studies from Western, high-income countries were largely represented. Optimizing early-childhood flourishing requires a positive health promotion approach that both fosters preconditions for and monitors flourishing as an outcome. This paper presents a unified, operational framework for measuring flourishing across key domains.