Center-based Care Research Articles

Do increased availability and reduced cost of early childhood care and education narrow social inequality gaps in utilization? Evidence from Norway

Prior theoretical models and empirical research suggest that specific parent, child, and family factors are related to the utilization of early childhood education and care (ECEC). The political context of Norway provides a unique opportunity to test whether increased availability and affordability of care over time due to policy change reduces the gap between high- and low-socioeconomic status (SES) families in utilizing center-based care compared to other care arrangements. Progressive Norwegian child care policies were also expected to reduce the effect of child and family characteristics that might make a family less likely to enroll their child in center-based care. Using a large sample from the Norwegian Mother and Child Cohort Study (MoBa, n?=?60,270), this research examined selection factors predicting enrollment in center-based ECEC at age 18 months across cohorts from 2002 to 2006. While families with higher parental education and income-to-needs ratios were more likely to enroll their children in center-based care, the progressive universal child care policy did succeed in reducing the utilization gap between the most and least educated families across time. The policy appeared to be protective against the effect of most other factors predictive of ECEC use, but the high number of children was still associated with underutilization.

Hours in non-parental child care are related to language development in a longitudinal cohort study.

The effects of child care services on several domains of child development have been extensively investigated, but evidence regarding the effects of child care on language development remains inconclusive. Within a large-scale population-based study, we examined the longitudinal associations between non-parental child care and language development from 1 to 6 years (n = 5375). Results showed that more hours in non-parental child care were associated with better language abilities. However, more hours in care in the first year of life were associated with less language proficiency at ages 1 to 1.5. At later ages, this effect disappeared and language proficiency increased. Furthermore, children who spent more hours in centre-based care had better language scores than children in home-based care. Ethnicity, socio-economic status, gender or parity did not change these results. This large, multi-ethnic study demonstrates beneficial effects of non-parental child care, particularly centre-based care, on language proficiency later in childhood.

Can center-based childcare reduce the odds of early chronic absenteeism?

This study was the first to position itself in the intersection on research on center-based care and on chronic absenteeism. Given the growth in the utilization of center-based care and given the recent vocalized policy concerns of the detrimental effects of chronic absenteeism in early school years, this study inquired as to whether attending center-based care predicted differential odds of early absence patterns. Using a newly-released national large-scale study of children (the Early Childhood Longitudinal Study – Kindergarten Class of 2010–2011), the findings indicated that children who attended center-based care in prekindergarten had lower odds of being chronically absent in kindergarten. The conclusions were consistent even after employing multiple methodological approaches (fixed effects, propensity score matching) as well as exploring multiple definitions of chronic absenteeism, though were not differentiated by socioeconomic status. Additional noteworthy findings are discussed, including the significance of children's internalizing symptoms and parental mental health.

Living long but living well? Health-related Quality of Life Tools for Singapore's Integrated Care Sector

In Singapore, the national integrated care effort is focused on elderly care services delivered in the intermediate and long term care (ILTC) sector. The elderly often have chronic diseases, multiple comorbidities, and varying levels of social support. The vision of Singapore’s integrated care effort is to enable the elderly to live well and age gracefully in the community. Therefore, good quality of life (QoL) is one of the key targets for such effort. Health related quality of life (HR-QoL) is often assessed in various settings. While a wide range of HR-QoL tools are available, care providers often have difficulty in choosing appropriate ones for the specific setting (e.g. nursing home) or target population (e.g. dementia patient). The QoL literature, although rich, does not specify HRQoL tools appropriate for the ILTC sector. This study aims to fill such a void by conducting a systematic literature review on HR-QoL tools that can be used in Singapore’s integrated care sector. A systematic review of the literature published in English was performed by electronically searching sources such as MEDLINE, PubMed, Web of Science, EBSCO, Cochrane Library and Google Scholar. Main keywords are HR-QoL, tool/measurement, elderly, and integrated care/long term care. CASP (Critical Appraisal Skills Programme) appraisal tools were used to assess the applicability, reliability and validity of the studies. We expect to develop a taxonomy of HR-QoL tools for clients utilizing integrated care services in Singapore. Specifically, we will identify appropriate HR-QoL tools and classify them according to type of services, type of clients, and type of assessors. The taxonomy will contribute to the QoL literature by focusing on integrated care settings such as residential-based, center-based and home-based care. It will enable care providers to select suitable tools to assess their clients’ QoL, cross-sectionally or longitudinally, so as to inform their service planning, delivery and enhancement. One limitation of this study is that the recommended HR-QoL tools might need to be validated before wide application in Singapore. Further research can validate tools in specific settings.

Compared to what? Variation in the impacts of early childhood education by alternative care type

Early childhood education research often compares a group of children who receive the intervention of interest to a group of children who receive care in a range of different care settings. In this paper, we estimate differential impacts of an early childhood intervention by alternative care type, using data from the Head Start Impact Study, a large-scale randomized evaluation. To do so, we utilize a Bayesian principal stratification framework to estimate separate impacts for two types of Compliers: those children who would otherwise be in other center-based care when assigned to control and those who would otherwise be in home-based care. We find strong, positive short-term effects of Head Start on receptive vocabulary for those Compliers who would otherwise be in home-based care. By contrast, we find no meaningful impact of Head Start on vocabulary for those Compliers who would otherwise be in other center-based care. Our findings suggest that alternative care type is a potentially important source of variation in early childhood education interventions.

The role of parental immigration status in Latino families' child care selection

Prior studies that have investigated child care arrangements among Latino immigrant families have often overlooked the role of parental immigration status and neighborhood factors in shaping child care selection. Thus, this study considers the effects of parental immigration status and neighborhood contexts, on child care selection among Latino immigrant families using a sample of 862 young children (ages 0–5) from the 2001 Los Angeles Families and Neighborhood Survey. Results from a hierarchical multinomial regression model suggest that, irrespective of immigration status, children of Latina mothers were significantly less likely to use center-based care than parental care, but the relationship was stronger for the children of undocumented Latina mothers. The findings also indicate that children living in poor neighborhoods were less likely to use formal center-based care, all else equal.

Toddler Activity Intensity During Indoor Free-Play: Stand and Watch

ObjectiveMovement patterns among toddlers (16–36 months) differ from other early developmental periods; toddlers practice coordination, balance, and control. Toddler care environments may afford repetition of these emerging skills. This study examined intensity and type of movements during free-play indoors in child care among toddlers. MethodsA convenience sample (n, 41; mean, 26.5 months) was observed for intensity of physical activity (PA), motor activity type, activity context, and teacher prompts in center-based care using a modified version of the Observational System for Recording Physical Activity for Children–Preschool. ResultsThe most frequent PA intensity level was sedentary with limb movement. No significant gender differences emerged. Standing, sitting/squatting, and walking were the most frequent activity types. Dominant activity contexts included fine motor manipulative, self-care, and onlooking. Logistic regression results indicated that onlooking significantly decreased the odds of moderate to vigorous PA. Teachers offered few prompts to increase PA. Conclusions and ImplicationsToddlers demonstrate predominantly sedentary behaviors during free-play. Further observational research across the entire day is warranted to accurately assess intensity and teacher's support for moderate to vigorous PA.

Using Propensity Score Methods to Approximate Factorial Experimental Designs to Analyze the Relationship Between Two Variables and an Outcome

Researchers have become increasingly interested in programs’ main and interaction effects of two variables ( A and B, e.g., two treatment variables or one treatment variable and one moderator) on outcomes. A challenge for estimating main and interaction effects is to eliminate selection bias across A-by- B groups. I introduce Rubin’s causal model to approximate factorial experimental designs for studies with partial randomization and nonrandomization. I apply a Monte Carlo simulation to evaluate several propensity score applications. The findings suggest the following two applications for reducing bias and mean square error of parameter estimates when analyzing the relationship of two variables and an outcome: (a) inverse of propensity score weighting based on one multinomial propensity score model and (b) subclassification based on two binary propensity score models. As a demonstration, I examine whether the effects of the Head Start program, compared to other center-based care, for improving children’s reading achievement vary by child care quality.

Centre-based day care for children younger than five years of age in low- and middle-income countries.

Because of poverty, children and families in low- and middle-income countries often face significant impediments to health and well-being. Centre-based day care services may influence the development of children and the economic situation of parents by providing good quality early childhood care and by freeing parents to participate in the labour force. To assess the effects of centre-based day care without additional interventions (e.g. psychological or medical services, parent training) on the development, health and well-being of children and families in low- and middle-income countries (as defined by the World Bank 2011). In April 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE, PsycINFO, ERIC and 16 other sources, including several World Health Organization (WHO) regional databases. We also searched two trials registers, websites of government and non-government agencies and reference lists of relevant studies. We included randomised and quasi-randomised controlled trials and prospective non-randomised studies with contemporaneous control groups and assessments both before and after intervention. We considered non-randomised controlled trials, as centre-based care in low- and middle-income countries is unlikely to be studied using randomised controlled trials (Higgins 2011). We included the following outcomes: child intellectual development, child psychosocial development, maternal and family outcomes and incidence of infectious diseases. Two review authors independently assessed risk of bias and extracted data from the single included study. Only one trial, involving 256 children, met the inclusion criteria for this review. This study was assessed as having high risk of bias because of non-random allocation, incomplete outcome data and insufficient control of confounding factors. Results from this study suggest that centre-based day care may have a positive effect on child cognitive ability compared with no treatment (care at home) (assessed using a modified version of the British Ability Scale-II (BAS-II) (standardised mean difference (SMD) 0.74, 95% confidence interval (CI) 0.48 to 1.00, 256 participants, 1 study, very low-quality evidence). This study did not measure other variables relevant to this review. The single study included in this review provides limited evidence on the effects of centre-based day care for children younger than five years of age in low- and middle-income countries. This study was at high risk of bias and may have limited generalisability to other low- and middle-income countries. Many of the studies excluded from this review paired day care attendance with co-interventions that are unlikely to be provided in normal day care centres. Effectiveness studies on centre-based day care without these co-interventions are few, and the need for such studies is significant. In future studies, comparisons might include home visits or alternative day care arrangements.

Centre-based day care for children younger than five years of age in high-income countries.

A large proportion of children younger than five years of age in high-income countries experience significant non-parental care. Centre-based day care services may influence the development of children and the economic situation of parents. To assess the effects of centre-based day care without additional interventions (e.g. psychological or medical services, parent training) on the development and well-being of children and families in high-income countries (as defined by the World Bank 2011). In April 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE, PsycINFO, the Education Resources Information Center (ERIC) and eight other databases. We also searched two trials registers and the reference lists of relevant studies. We included randomised and quasi-randomised controlled trials of centre-based day care for children younger than five years of age. We excluded studies that involved co-interventions not directed toward children (e.g. parent programmes, home visits, teacher training). We included the following outcomes: child cognitive development (primary outcome), child psychosocial development, maternal and family outcomes and child long-term outcomes. Two review authors independently assessed the risk of bias and extracted data from the single included study. We contacted investigators to obtain missing information. We included in the review one trial, involving 120 families and 143 children. Risk of bias was high because of contamination between groups, as 63% of control group participants accessed day care services separate from those offered within the intervention. No evidence suggested that centre-based day care, rather than no treatment (care at home), improved or worsened children's cognitive ability (Griffiths Mental Development Scale, standardised mean difference (SMD) 0.34, 95% confidence interval (CI) -0.01 to 0.69, 127 participants, 1 study, very low-quality evidence) or psychosocial development (parental report of abnormal development, risk ratio (RR) 1.21, 95% CI 0.25 to 5.78, 137 participants, 1 study, very low-quality evidence). No other measures of child intellectual or psychosocial development were reported in the included study. Moreover, no evidence indicated that centre-based day care, rather than no treatment (care at home), improved or worsened employment of parents, as measured by the number of mothers in full-time or part-time employment (RR 1.12, 95% CI 0.85 to 1.48, 114 participants, 1 study, very low-quality evidence) and maternal hours per week in paid employment (SMD 0.20, 95% -0.15 to 0.55, 127 participants, 1 study, very low-quality evidence) or household income above £200 per week (RR 0.86, 95% CI 0.57 to 1.29, 113 participants, 1 study, very low-quality evidence). This study did not report on long-term outcomes for children (high-school completion or income). This review includes one trial that provides inconclusive evidence as regards the effects of centre-based day care for children younger than five years of age and their families in high-income countries. Robust guidance for parents, policymakers and other stakeholders on the effects of day care cannot currently be offered on the basis of evidence from randomised controlled trials. Some trials included co-interventions that are unlikely to be found in normal day care centres. Effectiveness studies of centre-based day care without these co-interventions are few, and the need for such studies is significant. Comparisons might include home visits or alternative day care arrangements that provide special attention to children from low-income families while exploring possible mechanisms of effect.

Mixed-age grouping in early childhood – creating the outdoor learning environment

Children attending centre-based early childhood care and education programmes across Australia are most likely to be grouped according to age and development. While multi- or mixed-age grouping has been seen to have positive benefits on young children's learning and pro-social behaviours, this approach is not usually adopted in the organisation of children's grouping in most long day care settings across the county. This paper reports on a case study which explored one urban children's setting where the outdoor learning space has been specifically designed to enable a mixed-age approach for children. The findings suggest that while the educators see many benefits across the age groups in engaging in this approach, there is still a preference to segregate the very young children arising from concerns for their safety. The study also found that planning for learning especially in regards pro-social learning with the older children has been problematic.

Time spent in different types of childcare and children's development at school entry: an Australian longitudinal study

ObjectiveTo investigate whether the total amount of time in childcare through the first 3 years of life was associated with children's receptive vocabulary, externalising and internalising problem behaviours at age...

Child care subsidies and the school readiness of children of immigrants.

This study is the first to test whether receipt of a federal child care subsidy is associated with children of immigrants' school readiness skills. Using nationally representative data (n≈2,900), this study estimates the associations between subsidy receipt at age 4 and kindergarten cognitive and social outcomes, for children of immigrant versus native-born parents. Among children of immigrants, subsidized center-based care (vs. subsidized and unsubsidized home-based care) was positively linked with reading. Among children of native-born parents, those in subsidized center care displayed poorer math skills than those in unsubsidized centers, and more externalizing problems than those in unsubsidized home-based care.

The association between early care arrangements, quality, and emergent bilingual Latino American children's math and literacy skills in English

Drawing on a sample of Latino American children from the Early Childhood Longitudinal Study-Birth cohort (ECLS-B), this paper uses propensity score matching to examine the relation between care arrangements the year before kindergarten and math and literacy outcomes, in English, at kindergarten entry. Care arrangements included: Head Start (federally-funded center-based care for young children from low-income families), pre-kindergarten (state-funded center-based care), other-center care, parental care, and other-home care (care provided in a home, by relatives other than a parent or non-relatives). For literacy, results revealed that (1) Latino children in center-based care (Head Start, pre-kindergarten, and other-center) scored higher than Latino children in other-home care and (2) Latino children in Head Start (but not pre-kindergarten or other-center) scored higher than Latino children in parental care. For math, Latino children in other-center care outperformed Latino children in other-home care and Head Start. No significant differences emerged among Head Start, pre-kindergarten, or other-center for math or literacy outcomes. Follow-up analyses indicate that quality of care helps to explain the significant differences. Policy implications are discussed.

Clinical mentorship to improve pediatric quality of care at the health centers in rural Rwanda: a qualitative study of perceptions and acceptability of health care workers.

BackgroundDespite evidence supporting Integrated Management of Childhood Illness (IMCI) as a strategy to improve pediatric care in countries with high child mortality, its implementation faces challenges related to lack of or poor post-didactic training supervision and gaps in necessary supporting systems. These constraints lead to health care workers’ inability to consistently translate IMCI knowledge and skills into practice. A program providing mentoring and enhanced supervision at health centers (MESH), focusing on clinical and systems improvement was implemented in rural Rwanda as a strategy to address these issues, with the ultimate goal of improving the quality of pediatric care at rural health centers. We explored perceptions of MESH from the perspective of IMCI clinical mentors, mentees, and district clinical leadership.MethodsWe conducted focus group discussions with 40 health care workers from 21 MESH-supported health centers. Two FGDs in each district were carried out, including one for nurses and one for director of health centers. District medical directors and clinical mentors had individual in-depth interviews. We performed a hermeneutic analysis using Atlas.ti v5.2.ResultsStudy participants highlighted program components in five key areas that contributed to acceptability and impact, including: 1) Interactive, collaborative capacity-building, 2) active listening and relationships, 3) supporting not policing, 4) systems improvement, and 5) real-time feedback. Staff turn-over, stock-outs, and other facility/systems gaps were identified as barriers to MESH and IMCI implementation.ConclusionHealth care workers reported high acceptance and positive perceptions of the MESH model as an effective strategy to build their capacity, bridge the gap between knowledge and practice in pediatric care, and address facility and systems issues. This approach also improved relationships between the district supervisory team and health center-based care providers. Despite some challenges, many perceived a strong benefit on clinical performance and outcomes. This study can inform program implementers and policy makers of key components needed for developing similar health facility-based mentorship interventions and potential barriers and resistance which can be proactively addressed to ensure success.

After-School Center-Based Care and Children’s Development

Abstract What is the impact of after-school center-based care on the development of primary school-aged children? Answering this question is challenging due to non-random selection of children into after-school center-based care. We tackle this challenge using detailed data of the German Child Panel and employing a value-added method. While we do not find significant effects on average, our analysis provides evidence for beneficial returns to after-school center-based care attendance for more disadvantaged children. To be more precise, children of less educated mothers and low-income families benefit from attending after-school care centers in terms of their socio-behavioral development.

Child Care Subsidy Use and Child Care Quality in Low-Wealth, Rural Communities

Child care subsidy programs serve to reduce the number of families for whom child care is a barrier to work. Child care is essential to economic self-sufficiency, and it can also support child development, particularly for low-income children. However, most research has an urban focus so little is known about rural settings where formal programs are limited and of lower quality. In this paper we examine the subsidy use of rural families, the care arrangements they make, and the quality of care received. We utilized data collected between 2004 and 2007 from the Family Life Project, a representative, longitudinal study of non-metro families in low-wealth counties (n = 1,292), oversampled for low-income and African-American families. Families who used subsidies were more likely to select center-based care, typically of higher quality. Further, these families were also more likely to receive higher quality care, regardless of the type chosen, even after accounting for a host of family and community factors. Findings suggest that subsidy programs have successfully moved low-income children into higher quality care beneficial for development. These findings point to the need to maintain subsidy programs and encourage eligible families to take advantage of such resources.

Assessing Quality in Toddler Classrooms Using the CLASS-Toddler and the ITERS-R

Many very young children attend early care and education programs, but current information about the quality of center-based care for toddlers is scarce. Using 2 observation instruments, the Infant/Toddler Environment Rating Scale–Revised (ITERS-R) and the Classroom Assessment Scoring System, Toddler Version (CLASS-Toddler), 93 child care classrooms for toddlers across the state of North Carolina, representing a range of quality, were assessed to determine overall quality, and associations between observed quality and teachers' ratings of child behavior problems and competence outcomes using the Brief Infant Toddler Social Emotional Assessment. Research Findings: Findings indicated that overall, toddler classrooms were rated as being of moderate quality. Associations between observed quality and teacher-reported child behavior problems and competence outcomes indicated that CLASS-Toddler ratings were positively associated with fewer behavior problems; specifically, children in classrooms with higher levels on the CLASS-Toddler domains of Emotional and Behavioral Support as well as Engaged Support for Learning were reported to have fewer behavior problems. Similarly, the ITERS-R subscales of Interaction and Listening and Talking were positively related to fewer reported behavior problems. Regression models showed that the CLASS-Toddler Emotional and Behavioral Support domain predicted differences in child behavior problems. Practice or Policy: Findings suggest the need for additional research related to very young children's experiences in center-based child care to examine associations between quality and child experiences and outcomes. Children's experiences over time need to be examined to understand how these early child care experiences are related to children's later school adjustment and performance. On a related note, professional development for teachers in toddler classrooms needs to be addressed in terms of preparing effective teachers for young children during the toddler developmental period.

Are We Experts?: Perspectives of Korean Teachers on their Careers in Infant and Toddler Care

THE PRESENT STUDY INVESTIGATES how Korean infant/toddler teachers define their role in centre-based childcare settings and how their attitudes and perspectives influence their professional identities and relationships with parents. The study utilised the interpretive science paradigm and individual interviews for data collection, and the qualitative data analysis method explored the experiences of 19 infant/toddler teachers. Participants defined their role as ‘teacher as mother’ and placed more emphasis on nurturing than educating despite their acknowledgement of the importance of the educational aspects of centre-based care. The consensus among infant/toddler teachers that it is best for mothers to care for children at home derives from 1) teachers' consideration of infants/toddlers' developmental characteristics, and 2) the limitations of centre-based programs to fulfill the developmental needs of infants and toddlers. This perspective affects their sense of professionalism and job satisfaction and can lower the quality of overall infant and toddler care.

Does Early Child Care Help or Hurt Children's Development?

More children than ever attend center-based care early in life. We study whether children who attend center-based care before age 3 have better or worse language and motor skills, socio-emotional maturity, and school readiness just before entering primary school. In data covering about 36,000 children in one West German state, we use a marginal treatment effects framework to show how causal effects vary with observed characteristics of children, parents, and care centers and with unobserved preferences for center-based care. Early center-based care benefits children with less educated mothers or foreign parents. Benefits increase when parents have a preference for center-based care. Centers with small playgroups and with experienced, trained, or full-time working staff produce the best effects. A modest expansion of the number of places in early care centers improves children's development, whereas a strong expansion has no significant effects.