For decades, field leaders and funders have focused on developmental screening and kindergarten readiness as markers of child and family well-being. While those efforts have advanced a policy and community emphasis on Head Start, universal Pre-K, and other efforts in early education, public officials have placed much less emphasis on the critical importance of foundational relationships between children and caregivers in the first weeks, months, and early years of life, until recently. This conversation delves into the paradigm shift at the core of focusing on early relational health as an indicator of well-being.