Daycare: a word that tends to strike fear in the heart of most parents. The idea of passing up your baby, infant, toddler, or child to someone else to take care of stresses almost every parent out to some degree or another. After all, you wouldn’t walk up to a stranger on the street and hand over your child, would you? And while daycare is qualitatively different than that (these people are trained and licensed – well, most of the time), that doesn’t stop the barrage of bad stories you hear about in the news of day care workers neglecting or even abusing the young children in their care (see  for examples). We also have to consider that daycare work isn’t always going to attract the most stable people, even though these people will be working with children. It’s woefully underpaid, the hours are long and let’s face it, the work can suck. For most, it’s not an ideal job. At best, you get people who don’t need a decent income in order to live and so they can do the job out of love (these are the best and when you get someone like this – cherish them). At most, you can end up with individuals who are working towards something more coming in part time and liking the work they do, but the turnover will be high. At worst, you get individuals who simply aren’t qualified—mentally or otherwise—to care for children but because of demand, they find a job working with kids. Comparing this with the alternative of children being cared for by family, it’s a bit of a letdown, to say the least. Excluding the really horrible, many of us also wonder what more subtle damage is being done to our children by placing them in care. Are we harming our children by placing them in the care of others for hours a day? What about starting care as early as six weeks, as some individuals have to? Has the break-down of our community and sense of value placed on family placing a disproportionate amount of the burden on our youngest?
Contrary to what we might expect, there actually are studies that suggest there is no qualitative difference between extended use of daycare and child problems. One such study out of Canada was cited by the government in a court case over a woman requesting extended maternity leave benefits for having had twins with special needs. This study, conducted by economists, used large national data to examine the question of whether or not greater time at home, due to an increase in parental leave in Canada from six months to a year, resulted in better child outcomes. Based on their analyses, mothers were spending an additional three months at home, on average, and child outcomes were no better than when the maternity leave levels were lowers and children were put into daycare. A few problems though (aren’t there always?). First, an additional three months is hardly comparable to having policies that allow for family to stay home for extended periods of time, like Finland or Sweden or Norway, where mothers can take up to 2 or 3 years unpaid parental leave. Second, the child outcome measures were all maternal-report which is known to have a huge confounding interest when it’s a parent who spends more time with their child. When you only spend 4 hours a day with your kid when he or she is awake, then the question “How much does your child cry?” is going to elicit a very different answer than when you spend 12 hours a day with him or her. It’s like comparing apples and oranges—an accurate assessment simply can’t be made. Third, the results are based on statistical analyses that don’t account for the time-series nature of the data. Not using appropriate time-series techniques has been known to cause problems with respect to the interpretations of the results. Fourth, similar to point one, the data focuses on women who returned to work, not those who decided to stay home with their children, so the comparison is between children who got, on average, six months with a parent and nine. No comparisons to those who got six months, nine months, and then three years. One last thing (that was even brought up by the authors), the change in policy also led to a drastic decline in babies being cared for by smaller, home daycares and family members. When mothers returned to work after six months, they were placing their children in the care of friends and family, but after 12 months, their kids are going to group daycares. That’s a very significant point that the authors make little of. The individual care and attention the children are getting is much closer to a parent’s at a small daycare or with family than in a group setting and this may have been buffering the potential negative effects of daycare use.
However, the majority of work suggests behavioural problems linked to the time a child spends in care outside the home – problems that can persist throughout elementary school (e.g., ). But to talk of this as being as simple as a daycare = bad formula also is too simplistic. Yes, there are deficits associated with daycare, but there may be nuances that can provide some hope for the many families who have to rely on daycare. In comes Dr. Jay Belsky, a researcher at the University of London (who also serves as an advisor the government there), who is part of a team examining the long term effects of early child-care experiences and the potential mediators and moderators that may explain some of these negative attributes. Over the years he has hypothesized and studied the reasons why daycare seems to elicit such negative outcomes for children. Years ago, he hypothesized that one of the mechanisms that may be in place is that child-care induced insecure attachments which led to other problems, such as difficulty regulating emotions, which in turn led to externalizing behaviours; however, upon examination, there was no support for this hypothesis. A second hypothesis he made was that the time in child-care was time not spent with parents and thus parents didn’t know their children as well and thus had problems regulating their behaviour. This received some confirmation in that early child-care exposure was found to be related to less sensitive maternal behaviour and more conflict in the mother-child interactions, but a full explanation, it did not make, and thus more research was undertaken, the results of which are coming out now.
Dr. Belsky and the NICHD Study of Early Child Care and Youth Development have extensively examined various factors pertaining to child care and long-term outcomes in order to understand these relationships and to advise policy on the matter. Over the past five years, certain key papers have been published highlighting these findings, and I will share them here. Note that in all of this research, being raised by a family member who is responsive and caring comes out on top and is most predictive of better positive outcomes and fewer negative ones. And while that may make some people upset, it’s simply a fact of life. We are creatures that require an immense amount of time and energy in our early years and the people best equipped to do that are family. But what Dr. Belsky’s research offers us is hope because there does seem to be a way to minimize the deleterious effects, so let’s get to it…
This has turned out to be the biggest factor relating to children’s experience in daycare. And it should come as no surprise, after all, even amongst parents, the quality of care is most important. Notably, care from relatives was rated as being of higher quality than care by non-relatives and care in centers was found to be of lower quality than any care provided in-home (including nannies). However, regardless of where the care took place or by whom it took place, the quality of care was found to be related to academic behaviours at 4.5 years of age, grade 1, grade 3, grade 5, and at 15 years of age. In fact, quality of care was such an important predictor of academic achievement that when placed in a model to test significance of all paths, it alone remained the significant factor (out of amount of time spent in daycare, whether it was a center or home, and then quality).
Quality of child care was also found to be related to externalizing problems (worse care = more problems) at all of these age points. At age 15, the quality of child care was also mildly associated impulsivity and risk-taking, with lower quality associated with higher values on these outcomes. The effects of quality of childcare on externalizing problems, however, was also moderated by child temperament. Specifically, these effects are much stronger for children with a difficult temperament. Children with difficult temperaments who were in low-quality childcare demonstrated significantly greater externalizing problems and lower social competence. Similarly, high-quality childcare seemed to help these children by reducing these problems to levels lower than those children of easy temperament in the same high-quality settings.
B. Quantity of Child Care
Not as significant a predictor as quality of care, the amount of time a child spends in daycare still holds some water. This is particularly evident in the social domain, though an increase in child-care usage over time (from 3 to 54 months) was associated with lower vocabulary scores by fifth grade. However, socially, at 4 ½ years of age, children who spent more time in child care were more likely to demonstrate externalizing behaviours and engage in teacher-child conflict. Luckily, these effects decreased with time during middle childhood, such that by fifth grade, there seemed to be no effects of the quantity of daycare on externalizing problems. However, something seems to reverse in the teenage years in that the amount of time spent in daycare is significantly associated with impulsivity and risk taking at age 15. This relationship holds and remains significant even when previous levels of externalizing problems (at 4 ½ and grades 1, 3, and 5) are accounted or controlled for. It’s unclear why there’s a sudden shift again, but it may be owing to the fact that the teenage years are more tumultuous than middle childhood anyway and so problems that lay dormant for a while, rear their ugly heads again.
C. Type of Child Care: Centre versus Non-Maternal Home Care
Some individuals have posited that the mere nature of the child care centre poses problems for children. The large number of kids all together with a larger child-to-staff ratio should equate with poorer outcomes for the kids in their care. While there was no effect for academic performance, there was some support for this notion in that children who were in centre care showed greater externalizing rates across childhood (4 ½ years through grade five). Furthermore, centre care interacted with quantity of care in that children who spent more time in child care that was a centre also showed higher levels of externalizing problems in childhood. By age 15, though, these effects have disappeared. Important to consider, though, is that centre care is confounded with both quality and quantity. That is, centre care was linked with lower quality care and a greater amount of time spent in care. The results listed above are those that held above and beyond this confound, and if we didn’t include quality and quantity in the analysis, all of the aforementioned results would be listed here in the type of care analysis. So there definitely seems to be some truth the idea that centre care is not-so-great, but by and large it seems due to the poorer quality and the longer hours spent it in than when a child is raised in a smaller home-care, with a nanny, or with relatives.
What’s the take-home message here? Well, for starters, non-parental early child care comes with a cost and there’s probably no use denying it. That said, there are clearly differences between types of child care, with family or home-based care typically offering better quality than centre care. The differences are also magnified for children with a more difficult temperament, making them particularly susceptible to the pitfalls associated with early child care. My own thoughts are that this is most likely due to the fact that it’s quite difficult for child care workers to provide the type of constant attention these infants and children need with many other children in their midst whereas parents, with their vested interest, are able to do what is needed for their offspring. Unfortunately, not all parents with high-needs kids have the capacity to afford the high-quality daycares that can help provide protective elements for their children. Personally, I think we need to find a way to push for higher-quality child care for our children. If this means reducing the number of child-care centers and returning to smaller, at-home daycares where the smaller child-to-staff ratio means the children receive better care, so be it. But if we aren’t able to tackle the problems that have led to the widespread use of daycare right away, we can at least focus on getting our children into high quality programs to help ease the long-term effects of child care.
What day care arrangements do you have for your family? How do you feel about them? What would you like to have?
 http://www.leesburg2day.com/news/article_184a4828-26a6-11e1-83bc-001871e3ce6c.html (Accessed December 29, 2011)
 http://juneauempire.com/local/2011-12-15/day-care-shut-down-after-abuse-report (Accessed December 29, 2011)
 Baker M, Milligan K. Evidence from maternity leave expansions of the impact of maternal care on early child development. Journal of Human Resources 2010; 45.
 Bates J, Marvinney D, Kelly T, Dodge K, Bennett R, Pettit G. Child care history and kindergarten adjustment. Developmental Psychology 1994; 30: 690-700.
 Magnuson K, Meyers M, Ruhm C, Waldfogel J. Inequality in preschool education and school readiness. American Educational Research Journal 2004; 41: 115-157.
 Vandell D, Corasaniti H. Child care and the family: complex contributors to child development. New Directions for Child Development 1990; 49: 23-37.
 Hofferth S. Child care in the first three years of life and preschoolers’ language and behavior. Paper presented at the biennial meetings of the Society for Research in Child Development. Albuquerque, NM. April 1999.
 Loeb S, Bridges M, Bassoka D, Fuller B, Rumberger RW. How much is too much? The influence of preschhol centers on children’s social and cognitive development. Economics of Education Review 2007; 26: 52-66.
 Belskey J. Infant day care: a cause for concern? Zero to Three 1986; 6: 1-9.
 Belsky J. Quantity of nonmaternal care and boys’ problem behavior/adjustment at 3 and 5: exploring the mediating role of parenting. Psychiatry: Interpersonal and Biological Processes 1999; 62: 1-21.
 Vandell DL, Belsky J, Burchinal M, Steinberg L, Vandergrift N, NICHD ECCRN. Do effects of early child care extend to age 15 years? Results from the NICHD study of early child care and youth development. Child Development 2010; 81: 737-756.
 McCartney K, Burchinal M, Clarke-Stewart A, Bub KL, Owen MT, Belsky J. Testing a series of causal propositions relating time in child care to children’s externalizing behaviours. Developmental Psychology 2010; 46: 1-17.
 Belsky J, Vandell DL, Burchinal M, Clarke-Stewart KA, McCartney K, Owen MT, NICHD ECCRN. Are there long-term effects of early child care? Child Development 2007; 78: 681-701.
 Pluess M, Belskey J. Differential susceptibility to rearing experience: the case of childcare. Journal of Child Psychology and Psychiatry 2009; 50: 396-404.