Child Care Programs Research Articles

How Professionals Collaborate to Support Infants and Toddlers with Disabilities in Child Care

As it is common for infants and toddlers with disabilities to receive their early intervention (EI) services in child care programs, this mixed method study examined the experiences of child care and EI providers (e.g., occupational therapists, physical therapists, speech-language pathologists) in collaborating to support infants and toddlers with disabilities in child care settings. Through an online survey and in-person focus groups across a large state, findings indicated that although professionals may interact with each other during EI visits at child care, meaningful collaboration such as including child care providers in Individualized Family Service Plans and embedding intervention strategies into daily routines was minimal. Participants noted many barriers including liability concerns; information sharing; funding and time for collaboration; and minimal training and understanding of child care and EI programming. Participants provided suggestions to support future collaboration including building relationships through shared training, substitute staffing to attend meetings, and clear program and state policies.

Oral Manifestations in HIV-Positive Children: A Systematic Review.

Background: The number of pediatric patients affected by HIV still remains high, mainly in developing countries, where the main cause of infection is vertical transmission from the mother. Even today, a large number of these children do not have access to treatment, and, without proper care, they die in the first few years of life. Objective: The aim of our review was to assess the prevalence of oral hard and soft tissue lesions in HIV-positive pediatric patients by identifying the most common manifestations and the overall impact that they may have on the children’s quality of life. Study design: A systematic review of the articles in the English language in PubMed and Scopus was conducted in March 2019 in order to identify the main epidemiological and cross-sectional studies on the topic. Results: Oral diseases are still one of the most common manifestations in HIV-positive pediatric patients, and they often represent the first form in which immunosuppression shows itself. An analysis of the literature shows that candidiasis is the most common oral lesion found in HIV-positive children. A significant incidence of gingivitis and gingival disease is also evident, though not strictly correlated to HIV infection. However, thanks to the introduction of new antiretroviral therapies, the incidence of HIV-related oral lesions is decreasing. Conclusions: An HIV-positive children care program should also include dental protocols, as oral disease negatively influences the quality of life, affecting both functional and social aspects.

Early Childhood Professional Well-Being as a Predictor of the Risk of Turnover in Child Care: A Matter of Quality

ABSTRACT Annually, approximately 27% of early childhood care and education professionals turnover, or leave their positions or the field, which may negatively impact quality in two ways. First, continuity is disrupted when teachers leave, severing important relationship bonds among teachers, children, and families. Second, professionals who are considering leaving may be unhappy and distracted, which may impact their capacity to care mindfully and appropriately for young children. This quantitative study examined the relationship of Early Childhood Professional Well-being (ECPW) to “risk of turnover” (perceived job dissatisfaction and consideration of leaving one’s position and/or the field) using the Early Childhood Professional Well-being Questionnaire (ECPW-Q) with a sample of 281 caregivers/teachers and administrators of child-care programs. Three factors of well-being were identified through factor analysis: Supportive Structures – environment and climate; Collegial Relationships – between/among adults; and Professional Beliefs & Values – autonomy, choices, participation in decision-making. Regression results show average ECPW predictive of risk of turnover, with Path Analysis showing specific relationships among variables. Implications for further analyses are considered along with practices and policies that decrease the risk of turnover and increase well-being to support professionals’ capacity to care optimally and appropriately in their work with young children and families.

Improving Post-Transplant Outcomes Following Allogeneic Hematopoietic Stem Cell Transplant for Sickle Cell Disease in a Low Resource Setting: Experience from a Dedicated Post-Transplant Clinic in Nigeria

<h3>Background</h3> Allogeneic hematopoietic stem cell transplantation (Allo-HCT) is potentially curative in eligible patients with sickle cell disease (SCD). Improved transplant technology coupled with low transplant-related mortality has resulted in the development of a cottage industry in most of Africa, where 85% of all SCD births world-wide occurs. Families are seeking curative options primarily outside their country of residence, only to return back to a low-resource setting like Nigeria where long-term programs for the management of patient's post-transplant are lacking. <h3>Methods</h3> To address this perceived care gap, a dedicated post-transplant care clinic was developed. Patients were seen at various time points post-transplant (Days+112- 415). Most patients, (7/8), received haploidentical peripheral blood stem cell transplant from parental donors, while one patient received matched related bone marrow transplant. Three patients received myeloablative conditioning and five received non-myeloablative conditioning as well as preconditioning with hydroxyurea, azathioprine and chronic blood transfusion therapy. All patients who underwent haploidentical HCT received post-transplant Cytoxan as part of their GVHD prophylaxis. <h3>Result</h3> All patients had sickle cell anemia (HbSS), ages ranged from 2-18 years, all were considered asymptomatic (Figure 1). Main life-threatening health complications encountered include EBV reactivation in 38% (3/8), chronic GVHD 63% (5/8), others included febrile illnesses, pseudomembranous colitis, renal tubular acidosis, malnutrition and mixed chimerism (Figure 2). About 50% of the patients self-discontinued immunosuppression therapy without adequate guidance and most had delayed health maintenance measures such as routine immunizations and appropriate antimicrobial prophylaxis (Figure 3). Other logistical challenges encountered include delayed timely reporting of diagnostic tests (Chimerism: 14 to 21 days turnaround time; viral studies: 14 to 21 days turnaround time; drug trough levels: 14 to 21 days turnaround time), unavailability of irradiated blood products and lack of cost-effective medications. <h3>Conclusion</h3> A dedicated comprehensive, long-term care program for children with SCD residing in a low income setting who have undergone Allo-HCT, can improve their post-transplant outcomes. Locally adapted supportive care strategies can address the unique challenges encountered by these patients.

Early Childhood Education and Child Care in Arizona : Is Availability Alone Sufficient?

With many states increasingly adopting Quality Rating and Improvement Systems (QRIS) to rate their early childhood education (ECE) and child care programs, researchers question the use of these systems. Specifically, they are trying to understand the value of information provided by QRIS ratings and the implications QRIS ratings have on the quality of and access to ECE and child care programs for families. In this study, we attempt to understand the value of QRIS ratings when they are provided for families at the household level. To do so we take a close look at the relationship between availability of programs rated by the Quality Improvement and Rating System (QIRS) in Arizona and demographics of the communities they serve, and compare the utilization of the programs in communities with varying demographic compositions. While we find that more high-quality ECE and child care programs are available for children that are Hispanic, Black, and eligible for free and reduced-price lunch, we also find that families underutilized those programs. We argue that this underutilization might be due to a variety of barriers that the families are experiencing and believe that efforts should be directed to work with families and assist them in understanding their enrollment options.

A systematic review of domestic oral health care programs for elementary school children

A systematic review of domestic oral health care programs for elementary school children

Inside the classroom door: Understanding early care and education workforce and classroom characteristics experienced by children in subsidized center-based care

The federal child care subsidy program is the nation’s largest public early care and education (ECE) program for low-income children, yet little research has documented the workforce and classroom characteristics that affect children’s experiences in subsidized classrooms. Moreover, no existing study has compared the workforce and classroom characteristics in subsidized classrooms to those in classrooms across the range of alternative center-based settings available to low-income children. To fill this knowledge gap, the present study uses data from the newest national survey of child care available – the National Survey of Early Care and Education (NSECE), collected in 2012 – to describe subsidized classrooms on a broad set of workforce and classroom characteristics. Classrooms serving children with child care subsidies are compared to other classrooms serving low-income children, with a distinction between those that receive other public funds (Head Start or school-based pre-k), and those that do not (non-publicly-funded centers). Consistent with prior research, which finds classrooms serving subsidized children to have lower observed global quality than Head Start or pre-k classrooms, our findings reveal that classrooms serving children receiving subsidies typically have a more disadvantaged workforce and fewer classroom characteristics indicative of higher quality and believed to promote child development. Compared to non-publicly-funded center-based classrooms, classrooms serving subsidized children scored lower on several desirable workforce characteristics such as hourly pay and receipt of coaching, but did not differ on classroom characteristics.

Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening.

Early identification and intervention for developmental disorders are critical to the well-being of children and are the responsibility of pediatric professionals as an integral function of the medical home. This report models a universal system of developmental surveillance and screening for the early identification of conditions that affect children's early and long-term development and achievement, followed by ongoing care. These conditions include autism, deafness/hard-of-hearing, intellectual and motor disabilities, behavioral conditions, and those seen in other medical conditions. Developmental surveillance is supported at every health supervision visit, as is as the administration of standardized screening tests at the 9-, 18-, and 30-month visits. Developmental concerns elicited on surveillance at any visit should be followed by standardized developmental screening testing or direct referral to intervention and specialty medical care. Special attention to surveillance is recommended at the 4- to 5-year well-child visit, prior to entry into elementary education, with screening completed if there are any concerns. Developmental surveillance includes bidirectional communication with early childhood professionals in child care, preschools, Head Start, and other programs, including home visitation and parenting, particularly around developmental screening. The identification of problems should lead to developmental and medical evaluations, diagnosis, counseling, and treatment, in addition to early developmental intervention. Children with diagnosed developmental disorders are identified as having special health care needs, with initiation of chronic condition management in the pediatric medical home.

What do parents value in a child care provider? Evidence from Yelp consumer reviews

This paper exploits novel data and empirical methods to examine parental preferences for child care. Specifically, we analyze consumer reviews of child care businesses posted on the website Yelp.com. A key advantage of Yelp is that it contains a large volume of unstructured information about a broad set of child care programs located in demographically and economically diverse communities. Thus our analysis relies on a combination of theory- and data-driven methodologies to organize and classify the characteristics of child care that are assessed by parents. We also use natural language processing techniques to examine the affect and psychological tones expressed in the reviews. Our main results are threefold. First, conditional on contributing a Yelp review, consumers overall are highly satisfied with their child care provider, although those in higher-income markets are substantially more satisfied than their counterparts in lower-income markets. Second, the program characteristics most commonly evaluated by consumers relate to safety, quality of the learning environment, and child-teacher interactions. However, those in lower- and higher-income markets evaluate different characteristics in their reviews. The former is more likely to comment on a program’s practical features, such as its pricing and accessibility, while the latter is more likely to focus on the learning environment. Finally, we find that consumers in lower-income markets are more likely to display negative psychological tones such as anxiety and anger in their reviews, especially when discussing the nature of their interactions with program managers and their child’s interactions with teachers.

Early access to biological neonatal screening: coordination among child care action programs.

Objective:To verify factors associated with early newborn access to biological neonatal screening.Method:A cross-sectional quantitative study was carried out with all newborns who underwent tests in healthcare units, hospitals, and laboratories of a city in the state of São Paulo, Brazil, with programs linking healthcare information. The following variables were investigated: child’s age at collection (dependent); place of collection; date of collection; and type of user (independent). Descriptive and inferential statistics were applied.Results:Records of 15,652 screenings were found in the two years analyzed. In the first year analyzed, 7,955 births and 7,640 (96.0%) tests were recorded, of which 5,586 (73.1%) were undertaken with newborns between three and five days old. In the next year analyzed, 8,316 births and 8,012 (96.3%) screenings were recorded, of which 7,025 (87.6%) were undertaken with newborns in the same age group. A statistically significant association was found between the variables “child’s age” and “type of user” in one year, and between the variables “child’s age” and “place of collection” in both years.Conclusion:Early access to these tests enables the screening of diseases and referral for treatment. The present study contributes to the management of child care programs by presenting strategies linking data and actions to improve access to biological neonatal screening.

Effect of childcare programs that promote social interaction children with autism spectrum disorder in kindergarten

Effect of childcare programs that promote social interaction children with autism spectrum disorder in kindergarten

Acompañamiento terapéutico a un bebé desprovisto de lazos familiares desde su nacimiento e institucionalizado

En Chile, la mayor parte de los recién nacidos que no son reclamados por sus familias de origen al nacer, son derivados al sistema de protección y sometidos a una institucionalización temprana, careciendo el bebé de una figura de afecto exclusiva y estable. Las condiciones institucionales producen y sostienen muchas veces dinámicas de funcionamiento deshumanizadas, realizando así una oferta vacía de identidad para cada niño/a. El presente trabajo, relata la experiencia de acompañamiento terapéutico a un bebé desprovisto de lazos familiares desde su nacimiento e institucionalizado, abriendo preguntas sobre el trabajo terapéutico a realizar en dichos contextos de sufrimiento.

Assessing Inclusion Quality

Recent advances in policy development and professional practice in the field of early learning and child care have led to the expectation that it is appropriate and advantageous to include children with disabilities and extra support needs in early child care and learning programs. Yet, to date, evidence-based research on the effects of experiences in inclusive programs has been hampered by the lack of appropriate measures to assess inclusion quality that are reliable, valid, and relatively easy to administer. The purpose of the current study was to examine a newer measure, the SpeciaLink Early Childhood Inclusion Quality Scale (SECIQS), using data from 588 classrooms in child care centres and preschool programs across Canada. Through examination of inter-item consistency and reliability, along with exploratory and confirmatory factor analyses, evidence is provided for the utility and reliability of the measure. In addition, the validity of using both subscales is supported. Implications for policy and practice include recommending the use of all items in the SECIQS and scoring for all three factors in research studies. Further, separate subscale scores for the Inclusion Principles and Inclusion Practices subscales are recommended as useful for centre assessments, quality improvement initiatives, and for educating the field about the contributors to inclusion effectiveness.

Influenza Vaccine Requirements in United States Child Care Centers.

Influenza vaccine is the most effective means to prevent influenza for the high-risk population of child care attendees. This national survey assessed child care center directors' reports of seasonal influenza vaccine requirements for children and adult caregivers. This was a 2016 telephone-based survey of child care center directors randomly selected from a national database of licensed United States child care centers and queried about influenza vaccine requirements. Conceptually related items were grouped into 4 indexes: general infection control, use of health consultants, quality of child care, and pandemic influenza preparedness. These indexes, along with other center and director characteristics, were used to predict director-reported influenza vaccine requirements. Of 518 child care center directors, only 24.5% and 13.1% reported an influenza vaccine requirement for children and adult caregivers, respectively. Center and director characteristics and the indexes were not associated with a director-reported influenza vaccine requirement. After adjusting for covariates, only having a state influenza vaccine law for children and an adult influenza vaccine requirement predicted having a child influenza vaccine requirement. Only having a child influenza vaccine requirement predicted having an adult vaccine requirement. Director-reported influenza vaccine requirements for children and adult caregivers were influenced primarily by state influenza vaccine laws. Given the high risk of children in child care and low director-reported influenza vaccine requirements, more states should pass laws requiring influenza vaccine for children and adult caregivers at child care programs.

Supporting Families Exposed to Adverse Childhood Experiences Within Child Care Settings: A Feasibility Pilot

Childhood adversity is strongly associated with poor health and well-being in childhood and adulthood. Young children are at greatest risk during their developmental years. Child care providers can participate in preventing the impact of adversity on children by becoming communities of support for families in need. This project aimed to explore the feasibility and acceptability of identifying childhood adversity and strengthening family protective factors by incorporating professional development and both universal and targeted interventions that included screening, motivational interviewing, parent cafes, and parenting workshops within ten family and center-based child care programs. A total of 159 caregivers completed the screen about their experiences of adversity, with 60% disclosing adversity during their childhood and 53% disclosing current risk for adversity for their child. An intergenerational association was found between caregivers’ past exposure to adversity and their child’s current risk (p = 0.023). However, this association was no longer significant (p = 0.14) when accounting for their current protective factors (p = 0.002). Most families (77%) who disclosed moderate to high adversity or risk on the screen participated in a brief interview with their child care provider. Eleven parent events were also conducted with an attendance of 91. Child care providers reported that these interventions were both feasible and beneficial. Caregivers showed significant improvements in protective factors (p = 0.013) over the course of the project.

The impact of basic vs. enhanced Go NAPSACC on child care centers\u2019 healthy eating and physical activity practices: protocol for a type 3 hybrid effectiveness-implementation cluster-randomized trial

BackgroundTo prevent childhood obesity and promote healthy development, health authorities recommend that child care programs use the evidence-based practices that foster healthy eating and physical habits in children. Go NAPSACC is an intervention shown to improve use of these recommended practices, but it is known to encounter barriers that limit its impact and widespread use.MethodsThis study will use a type 3 hybrid effectiveness-implementation cluster-randomized trial to compare effectiveness and implementation outcomes achieved from Go NAPSACC delivered with a basic or enhanced implementation approach. Participants will include approximately 25 coaches from Child Care Aware of Kentucky (serving four geographic regions), 97 child care centers with a director and teacher from each and two cross-sectional samples of 485 3–4-year-old children (one recruitment at baseline, another at follow-up). Coaches will be randomly assigned to deliver Go NAPSACC using either the basic or enhanced implementation approach. “Basic Go NAPSACC” represents the traditional way of delivering Go NAPSACC. “Enhanced Go NAPSACC” incorporates preparatory and support activities before and during their Go NAPSACC work, which are guided by the Quality Implementation Framework and the Consolidated Framework for Implementation Research. Data will be collected primarily at baseline and post-intervention, with select measures continuing through 6, 12, and 24 months post-intervention. Guided largely by RE-AIM, outcomes will assess change in centers’ use of evidence-based nutrition and physical activity practices (primary, measured via observation); centers’ adoption, implementation, and maintenance of the Go NAPSACC program (assessed via website use); center directors’, teachers’, and coaches’ perceptions of contextual factors (assessed via self-report surveys); children’s eating and physical activity behaviors at child care (measured via observation and accelerometers); and cost-effectiveness (assessed via logs and expense tracking). The hypotheses anticipate that “Enhanced Go NAPSACC” will have greater effects than “Basic Go NAPSACC.”DiscussionThis study incorporates many lessons gleaned from the growing implementation science field, but also offers opportunities to address the field’s research priorities, including applying a systematic method to tailor implementation strategies, examining the processes and mechanisms through which implementation strategies produce their effects, and conducting an economic evaluation of implementation strategies.Trial RegistrationClinicalTrials.gov, NCT03938103, Registered April 8, 2019

Effect of Postoperative Immobility on Children with Musculoskeletal Injuries

Background: Immobility has serious consequences physical, social and psychological for a child. Aim of the study: A study aimed to assess the effect of postoperative immobility on children with musculoskeletal injuries. Design: A descriptive design was used to conduct this study. Setting: the study was conducted at pediatric orthopedic surgical Inpatient and outpatient clinic at children's Hospitals affiliated to Ain Shams Hospital and El-Helal Hospital affiliated to Ministry of Health. Subjects: A purposive sample including 80 children exposed to musculoskeletal injuries. Tools of data collection: Part I structured interview format to assess characteristics and medical history of children. Part II-1 assessment of physical postoperative immobility. Part II-2 assessment of psychologically postoperative immobility. Results: more than half of the studied sample had physical effect, low self-esteem and severe anxiety. Conclusion: The current study concluded that the main cause of musculoskeletal injuries was traumatic injuries. Children stayed in cast for long period, so that the effect of postoperative immobility had negative effects on physical and psychological wellbeing of children with musculoskeletal injuries. Recommendations: Emphasize on the importance of implementing nursing care program for children in postoperative period for minimizing the physical and psychological effects of immobility on children with musculoskeletal injuries.

Policy levers to promote cultural competence in early childhood programs in the USA: recommendations from system specialists

The purpose of the study was to investigate ways in which early childhood systems that rate and license child care programs, known as Quality Rating and Improvement Systems (QRISs), might incorporate requirements related to cultural competence into the system, including incentives, supports, and rewards for programs that foster cultural competence of the early care and education (ECE) workforce. The study employed a focus group design to consider the research problem from the vantage point of key informants such as coaches and other system staff who routinely support ECE programs to meet system requirements and to engage in quality improvement work. Three focus groups were convened, with a total of N = 28 participants. The meetings were audio-recorded, transcribed, and analyzed using the constant comparative method. Emergent themes were noted and grouped into four categories: QRIS requirements; system alignment; ECE progrm administrator training; and ECE teacher training and technical assistance. Focus group members advocated for incorporation of system-level requirements related to cultural competence as well as program supports to ensure that ECE providers could succeed in meeting new requirements. Policy recommendations to support cultural competence development in the ECE workforce and to embed cultural competence in ECE systems are discussed.

Nonpharmaceutical Interventions for Pandemic Influenza: Communication, Training, and Guidance Needs of Public Health Officials.

The aim of this study was to identify the needs of state, tribal, local, and territorial (STLT) public health officials in communicating, implementing, and monitoring nonpharmaceutical interventions (NPIs) during an influenza pandemic. A Web-based survey collected data from a nonrandom sample of STLT health departments. A total of 267 of 346 public health officials responded (77.2% response rate). STLTs identified the general public, families, childcare programs, K-12 schools, and workplaces as their priority audiences for NPI communication. Training needs included NPI decision-making strategies, triggers for implementing NPIs, and communicating NPI recommendations to families and communities, as well as a more practical orientation and real-world examples of how to incorporate NPI guidance into preparedness and response activities. Information is needed on health messaging for various populations and settings and on the legal authority for implementing specific NPIs. Future NPI recommendations by CDC should continue to be based on feedback solicited from STLT health departments. To fill identified gaps, CDC used these findings to create NPI guidance and materials to assist in prepandemic planning and preparedness for STLTs and various community settings.

The relationship between culturally relevant materials, emotional climate, ethnic composition and peer play in preschools for children of color

PurposeThis study aims to examine the interplay between culturally relevant materials, child racial ethnic classroom composition and positive emotional climate in regard to high levels of peer play in low-income, urban preschools located in African-American and Mexican immigrant/Mexican-American communities in the USA.Design/methodology/approachThe sample includes state or city subsidized child care programs in the USA which were traditionally African-American programs that experienced an influx of Latino immigrant enrollment. Instruments included structured observations of classroom peer play and cultural artifacts. Hierarchical multiple regression was run to determine whether cultural artifacts and child ethnic composition within classrooms contributed to the prediction of high-peer play over positive emotional climate alone.FindingsThe final model indicates that cultural artifacts reflective of African-American culture positively predict high levels of peer play, while Mexican-American cultural items are negatively predictive. In classrooms with a majority African-American population, predicted high-peer play is 7.994 greater than that predicted for majority of Latino classrooms.Research limitations/implicationsPositive emotional climate in these programs was not very high, and it is not clear whether the findings discussed in this report would hold in contexts that exhibit much higher levels of positive emotional climate. It is also not clear that the inclusion of cultural artifacts in contexts in which African-American children are the minority or in racial-ethnically heterogeneous classrooms would lead to the same findings.Practical implicationsECE classroom should make specific choices as to what culturally relevant materials to include in early childhood classrooms. Teachers of young children of color must facilitate children’s engagement with these materials by ensuring that they are representative of the children’s cultural experiences and by supporting children’s engagement with peers through the formation of emotionally positive classroom climates.Social implicationsThis study points to interesting relationships between what teachers have in classrooms and children’s engagement with each other within those contexts. The findings from this study also exemplify that a one-size-fits-all approach toward childhood development may be counterproductive. Children bring with them ethnic and cultural heritages, which when combined with the preschool culture, create unique experiences for them that should not be ignored or controlled for analysis, but rather, understood.Originality/valueThis study provides a unique analysis of seldom considered contexts by examining the use of culturally relevant materials in urban, early childhood contexts. Teachers of young children have been found to consider a focus on race and ethnicity as unnecessary or to engage in a colorblind approach with young children. This study demonstrates how paying careful consideration to the cultural environment in classrooms also supports children’s exploration and play quality.