The Future of Children, Princeton - Brookings: Providing research and analysis to promote effective policies and programs for children.

The juxtaposition of early and extensive exposure to child care with evidence of the importance of early experiences (see the article by Thompson in this journal issue), raises compelling questions about the developmental effects of child care as it is now experienced by infants and toddlers in the United States. These questions are often phrased as, "Is child care good or bad for babies?" Research indicates that child care is not a monolith. There is no single story to tell about how child care affects children.^6,7 But it does affect them.

Sometimes, child care enhances the lives of young children and fosters their development. Sometimes, it puts children at risk and undermines their development. Both the positive and negative effects derive not from child care alone, but also from how the family responds to the circumstances that led them to use child care in the first place, and how they respond to their children when they are with them. Indeed, one of the most important findings from research on child care is that parents and the home environments they create remain the predominant influences on young children's adjustment and well-being, despite the substantial time that many youngsters spend in nonparental child care settings. The question today is not whether child care affects development or which environment—home or child care—has the greater influence, but rather how child care intersects with what transpires at home to affect early development.

Research on child care and the mother-infant relationship provides a useful illustration. Under some circumstances, child care can protect children from the problematic parent-infant interactions that can accompany family-based risk (such as poverty, maternal depression, or high levels of conflict), but it can also exacerbate risks that children face at home.

The premise that good out-of-home environments can compensate for high-risk home environments underlies the nation's early intervention policies. This idea has been supported by a large amount of literature on both early intervention and more typical child care programs.⁸ The child care research has, for example, reported positive associations between child care and parent-infant interactions for children exposed to maternal depression and poverty. In the NICHD study, mothers living in poverty whose infants were enrolled in full-time, high-quality child care were more positively engaged with their babies than were mothers of infants not in child care or in low-quality care. Similarly, depressed mothers who relied on child care interacted more positively with their infants than did similarly depressed mothers who used no child care.⁹ Other studies have also reported that child care can buffer infants from the detrimental effects of maternal depression.¹⁰

Yet, other research has found that certain patterns of infant child care use, in the context of troubled family functioning, are associated with disrupted mother-infant relationships.¹¹ In the NICHD study, when children under age two had insensitive or unresponsive mothers and also experienced child care that lasted more than 10 hours per week or was of poor quality or unstable, insecure mother-infant attachment relationships become more common.¹² When neither the home nor the child care setting provides the supportive, responsive caregiving that infants require, their capacity to establish positive bonds to their parents (and perhaps to their caregivers, as well) can be compromised.

Mother-child interactions in families that are not characterized by obvious risk factors are also affected by child care. For example, among families in the NICHD study with higher incomes and nondepressed mothers, infants who spent more time in child care experienced somewhat less favorable patterns of mother-infant interactions than did the infants not enrolled in child care. These patterns persisted over the first three years of life.¹³

In sum, it is no longer appropriate to ask whether child care is good or bad for children without simultaneously considering what they are experiencing at home. Child care can expose young children to risk or protect them from it; it can exacerbate troubling family circumstances or it can provide beneficial experiences for children who do not receive them at home. Research has also revealed a great deal about the characteristics of child care that matter most in affecting whether children get off to a promising or worrisome start in life.

Child care's contributions to children's development hinge on whether children's experiences in care support or undermine their needs for responsive, dependable, and stimulating caregiving (see the article by Thompson in this journal issue). Researchers who study variation in the quality of child care now focus on the interactions that transpire moment by moment between child care providers and the children in their care. Does the caregiver respond quickly to the child's bids for attention or are they frequently ignored? Does she talk and read to the child a lot or just a little? Does she engage the child in age-appropriate activities and foster supportive friendships? Is she warm and affectionate or distant and harsh? Is she patient or easily overwhelmed by frustration?

One of the most consistent findings in developmental research links the quality of care that young children receive to their well-being, developing skills, and subsequent adjustment.^6,7 The associations, while statistically significant, are often relatively small in magnitude when considered one by one. Yet, when considered in light of the vast numbers of children involved and the extensive history of child care that most young children now experience, their collective impact may be quite large.¹⁴

Beneficial child outcomes are most likely when caregivers are responsive, warm, and sensitive to the children and surround them with rich language. Therefore, benefits are associated with the features of care that foster those interactions, such as small ratios of children to adults, as well as qualified and stable child care providers.^15–17 This finding has emerged repeatedly in studies across the country that observe children in different types of care and examine different outcome measures (for example, language acquisition, cognitive skills, peer interactions, behavior problems, and school readiness skills, such as task persistence and compliance with adult requests).

For infants and toddlers, the number of children that a child care provider is responsible for (the child-caregiver ratio) appears to be particularly important in fostering developmentally supportive exchanges in all types of child care.¹⁵ Caregiver qualifications also matter for infants and toddlers. Home-based caregivers of infants provide more responsive and stimulating care if they received specialized training. Across types of care, toddlers receive better care when their child care providers are more highly educated. Finally, no or minimal TV viewing is also associated with significantly better outcomes for children in child care.¹⁷ The caregiver's experience alone (years spent providing child care) is rarely associated with higher-quality child care or better developmental outcomes.

Beyond the developmental contributions of child care quality, there have been longstanding debates regarding the effects of "exposure" to child care of any quality. Exposure is typically measured as cumulative hours in care, but it is also studied with regard to age of entry into care.¹⁸ The evidence on this issue is less consistent than that on quality of care, with some studies reporting that more hours in child care are associated with negative outcomes for children, while others fail to find such an association.

This issue was recently thrust back into the forefront of concern based on evidence from the NICHD study that children who spent more time in nonmaternal care during the first four and one-half years of life were perceived by their preschool and kindergarten teachers as more aggressive, assertive, and defiant than children of the same age who spent less time in child care.¹⁹ The vast majority (83%) of the children who experienced an average of 30 or more hours of child care per week prior to school entry were not rated as showing aggressive behavior, and the overall distribution of teacher ratings for these children matched what one would find in a random sample of kindergartners. But the 17% of these children who were perceived as more aggressive stands in contrast to the 9% of their age-mates who experienced little or no child care and were similarly perceived. Among the children who were in higher-quality care or raised by relatively more sensitive mothers, teachers were somewhat less likely to distinguish between those who spent more or less time in child care, but the relationship between time in care and aggressive behavior remained, even for these children.

Future evidence will indicate if this relationship endures or disappears as children move through the elementary school years. In the meantime, researchers can only speculate about its interpretation. One possibility is that part of spending time with peers, particularly when children first make the transition to peer groupings as preschoolers or kindergartners, involves the display of some aggressive behavior by some children. Problems may also arise from child care staffing changes-child care providers typically receive little training in how to promote positive social skills, and yearly staff turnover rates are high. It is clear that, as a nation, we need to pay much greater attention to fostering healthy social relationships among young children, as noted in the article by Thompson in this journal issue.

With regard to type of care, children who spend more time in group- or center-based child care settings after the first year of life are better prepared for the academic work of school but, in some instances, show more assertive and aggressive behavior toward classmates.^20,21 The positive cognitive outcomes may be associated with the generally higher qualifications of center-based child care providers and stronger literacy environments found in child care centers as compared to other child care settings. The social outcomes may reflect poor adult management of children's interactions with their peers in child care settings. Both speculations await careful study.

In sum, the developmental effects of child care derive primarily from the quality of the interactions and experiences they provide for young children. Recent evidence further demonstrates the importance of paying greater attention to the social development of young children who spend a considerable number of hours in child care as it exists in the United States.

Although the type of child care used has implications for children's experiences in care and for their development, it is essential to keep in mind that wonderful and woeful care can be found in all types of arrangements. Caregiver qualifications and skill in managing classroom interactions, rather than the type of child care per se, appear to be the active ingredients linking the type of care to child outcomes.

There is, thus, no shortcut to finding developmentally beneficial child care for infants and toddlers. It requires taking the time to observe how caregivers interact, talk, and play with the children in their care; how they support their early learning; and how they manage children's earliest social relationships.