Child Care Programs Research Articles

An ecological perspective on early educator well-being at the start of the COVID-19 pandemic

Early educator well-being is increasingly understood as a critical ingredient of high-quality early education and care. The COVID-19 pandemic has threatened educator well-being by exacerbating existing stressors and introducing novel stressors to all aspects of early educators’ lives, and early educators have had differential access to resources to cope with these new circumstances. Using survey data collected between April and June 2020 with a sample of 666 early educators in community-based center, family child care, Head Start, and public school prekindergarten programs across Massachusetts, we document the pandemic's initial influence on educators’ sense of well-being. Adopting an ecological perspective, we consider educator-, program-, and community-level factors that may be associated with reported changes in well-being. Most educators indicated that their mental and financial well-being had been affected. These changes were not systematically associated with most contextual factors, although there was clear evidence of variability in reported impacts by provider type. These findings underscore the need to support educator well-being, as well as to create policy solutions that meet the heterogeneous needs of this essential workforce.

Применение программы ранней помощи на основе Денверской модели раннего вмешательства для детей с РАС

Currently, there are no standards for early care in Russia, and therefore the introduction of successful foreign practices of work with young children is relevant. The article presents the experience of implementing an early care program for children with ASD. Presented program developed and tested during 6 months of 2020 in the Center for Mental Health of the Privolzhsky Research Medical University in 2020. The program was established on the basis of the Early Start Denver Model program for children with ASD. The study involved 19 children from 1 to 4 years old with a diagnosis of autism. For 6 months, all children were engaged in the developed program. Frequency of the program — 2—3 hours in a week, parents were also trained. As a result of the dynamic assessment of skills according to the RCDI-2000, the rates of target skills in the Denver model showed improvement in all areas of child development. For example, as a result of classes, 9 children (47.4%) demonstrated positive dynamics in the development of social skills, their “age” in this area improved by the end of the project from 3 to more than 20 months. 12 children (63.2%) showed an improvement in the development of speech skills in the range from 1 to more than 28 months. The results of the dynamic assessment based on repeated diagnostics of the list of target skills of the Denver model demonstrate an improvement in children’s skills in all areas of age development. The greatest changes in indicators are detected in the areas of receptive communication (improvement of skills by an average of 40%), games (an increase of 30%), cognitive skills (an increase of 30.5%), household skills (an increase of 33%). That is, the effectiveness of the developed training program has been proven. A low-intensity early care program based on the Denver model is promising for use in public educational and social institutions involved in the early care system.

A specialized multi-disciplinary care program for children with sepsis and multiple organ dysfunction-associated immune dysregulation.

The complex physiology and medical requirements of children with sepsis and multiple organ dysfunction syndrome (MODS) challenge traditional care coordination models. While the involvement of multiple clinical subspecialty services is often necessary to support different care processes and individual organ system dysfunctions, it can also delay the diagnostic process, monitoring, and treatment. The logistics of coordinating with many specialty providers for critically ill patients are challenging and time consuming, and often can result in fragmented communication. To address these and other related issues, we developed a new multi-disciplinary consult service focused on streamlining diagnostics, management, and communication for patients with sepsis and MODS-associated immune dysregulation. The service, called the Program in Inflammation, Immunity, and the Microbiome (PrIIMe), is now a hospital-wide clinical consult service at our institution caring for a broad group of patients with immune dysregulation, particularly focusing on patients with sepsis and MODS. In this paper, we summarize the development, structure, and function of the program, as well as the initial impact. This information may be helpful to clinicians and healthcare leaders who are developing multi-disciplinary consult services for children with complex care needs, especially those with sepsis and MODS-associated immune dysregulation.Impact The care of children with sepsis and multiple organ dysfunction-associated immune dysregulation requires rapid and flexible involvement of multiple clinical subspecialists that is difficult to achieve without fragmented care and delayed decision making.In this narrative review we describe the development, structure, and function of a multi-disciplinary consult service at a children’s hospital dedicated to helping coordinate management and provide continuity of care for patients with sepsis and multiple organ dysfunction-associated immune dysregulation.This information may be helpful to clinicians and healthcare leaders who are developing multi-disciplinary consult services for children with complex care needs, especially those with sepsis and MODS-associated immune dysregulation.

Panel Probit Models with Time‐Varying Individual Effects: Reestimating the Effects of Fertility on Female Labour Participation*

AbstractThis paper considers a probit model for panel data in which the individual effects vary over time by interacting with unobserved factors. In estimation we adopt a correlated random effects approach for individual effects to get around the incidental parameter problem. This allows us to construct (asymptotically) unbiased estimators for average marginal effects (AMEs), which are often the ultimate quantities of interest in many empirical studies. We derive the asymptotic distributions for the AME estimators as well as provide the consistent estimators for their asymptotic variances. Next, we design a specification test for detecting whether individual effects are time‐varying or not, and establish the asymptotic distribution for the proposed test statistic under the null hypothesis of no time variation of individual effects. Monte Carlo simulations demonstrate satisfactory finite sample performance of our proposed method. An empirical application to study the effect of fertility on labour force participation (LFP) is provided. We find that fertility has a larger impact on female LFP in Germany than in the US during the 1980s. We also provide some new empirical evidence of a even stronger effect of fertility on LFP during the 2010s in Germany, which might call for a reconsideration of relevant policies recently enacted such as the subsidized child care programme.

Pangea – The Emergence of Self


 
 
 
 
 This is my story and my journey of the healing power of an arts-based child and youth care self-portrait assignment. My name is Jordan Grant, and I am about to enter my final year in the Bachelor of Child and Youth Care (CYC) program at MacEwan University in Edmonton, Alberta. In my early life, I struggled to find self-acceptance and was unwilling to move into the vulnerable spaces of self-repair, as I felt overwhelmed by my perceived flaws and insecurity regarding my innate worth as a human being. The CYC program provided an uncomfortable yet safe place in which to overcome my self-doubt and experience personal growth. One third-year assignment was especially important in my personal development that I have decided to share this assignment with you.
 
 
 
 

The Goldilocks problem: Healthcare delivery models for children with medical complexity

Health systems have increasingly adapted elements of the medical home model in designing complex care programs for children with medical complexity (CMC). In recent years, several key complex care program designs have emerged. These programs have been shown to be effective in improving the quality and cost of care for CMC. In designing and implementing a complex care model, there are many variables a health system must consider to ensure program viability. To address CMC across the continuum of care, tertiary care systems should implement a portfolio of complex care models to accommodate the population's diverse needs. Further study is needed to establish 'gold standards' for complex care delivery models, but a major factor affecting program innovation is reimbursement, as the fee for service model does not adequately support the enhanced services required to ensure high value, high quality care for CMC. It is thus critical that stakeholders from health systems and payers align to engage in innovation in complex care delivery design and implementation. Without this partnership, advances in care delivery for CMC will be limited.

Vplivi na obisk gozda v splošnih in gozdnih vrtcih

Preschool children spend a large part of their everyday life in kindergartens, so it is necessary to include visits to the forest, which is the most extensive natural environment in Slovenia, in preschool childcare programs. Based on surveys with preschool teachers of public kindergartens in Slovenia (N = 133), we analysed the habits, purposes, barriers and concerns associated with visiting the forest. The frequency and duration of forest visits largely depend on the distance of the forest from the kindergarten. The habits of forest visits among forest kindergartens which are included in the Network of Forest Kindergartens organized by the Institute of Forest Pedagogy do not differ significantly from that of general public kindergartens. They differ mainly with respect to the frequency of visitation in bad weather and the purpose of visitation. The main concerns when visiting the forest are ticks, fear of injury, and the children having inappropriate equipment. The reasons for less frequent forest visitation include different pedagogical priorities of the kindergartens and lack of support from the management and parents, which highlight the need for the strategic promotion and implementation of forest visitation in preschool education.

Swarna Prashana - faith in the embrace of research.

Childhood needs diverse nutritional requirements. Poor appetite, lifestyle changes, and poor digestion affects child immunity and make them prone to diseases. Kaumarabhritya, a branch of Ayurveda which deals in child and adolescent health care, has a unique concept of Swarna Prashana (SP) to promote generalized immunity and intellect. SP is commonly recommended to children between 0 and 12 years of age and given as a general health promoter to improve intellect, digestion, strength, immunity, longevity, and complexion. Multiple benefits of SP are mentioned in different Samhitas which needs to be explored on scientific background. Authors have highlighted content variabilities, plausible mechanisms, research tasks and potentials, lacunae, and future prospects about SP. This manuscript is a spotlight on current social, clinical, marketing, and scientific information of Swarna Prashana. SP can be a cost-effective, safe, infrastructure compatible, and prevention-centric approach to improve children's overall health status and has the potential to serve as a positive health care program for children.

The effects of COVID-19-related stress among parents and children in Ohio child care programs: a mixed-methods study

ABSTRACT COVID-19-related stress effects on the caregiver and child are largely unexplored. Caregivers (N = 114) of children between the ages of 3 months and 10 years accessing Ohio child care completed a parent survey (fall 2020), and additional caregivers (N = 20) completed an interview. Caregivers reported a mean of 70 (SD = 19; scale 1–100) on COVID-19-related stress. In adjusted regression models, higher caregiver-reported COVID-19-related stress was associated with increased odds of child aggression and poor social skills. Exploratory analyses indicated that these associations may be partly mediated by the caregiver working from home and losing their temper. Qualitative findings reflect caregiver COVID-19 stress and complement quantitative findings. Caregivers and children who experience COVID-19 stress should be monitored for persistent problems.

COVID-19 Vaccine Uptake Among US Child Care Providers.

Ensuring high coronavirus disease-2019 (COVID-19) vaccine uptake among US child care providers is crucial to mitigating the public health implications of child-staff and staff-child transmission of severe acute respiratory syndrome coronavirus 2; however, the vaccination rate among this group was previously unknown. To characterize vaccine uptake among US child care providers, we conducted a multistate cross-sectional survey of the child care workforce. Providers were identified through various national databases and state registries. A link to the survey was sent via e-mail between May 26 and June 23, 2021. A 37.8% response yielded 21 663 respondents, with 20 013 satisfying inclusion criteria. Overall COVID-19 vaccine uptake among US child care providers (78.2%, 90% confidence interval: 77.5% to 78.9%) was higher than the US general adult population (65%). Vaccination rates varied between states from 53.5% to 89.4%. Vaccine uptake among respondents differed significantly (P < .01) based on respondent age (70.0% for ages 25-34, 91.6% for ages 75-84), race (70.0% for Black or African Americans, 92.5% for Asian Americans), annual household income (70.8% for <$35 000, 85.1% for >$75 000), and child care setting (73.0% for home-based, 79.7% for center-based). COVID-19 vaccine uptake among US child care providers was higher than the general US adult population. Those who were younger, lower income, Black or African American, resided in states either in the Mountain West or the South, and/or worked in home-based child care programs reported the lowest rates of vaccination. State public health leaders and lawmakers should prioritize these subgroups to realize the largest gains in vaccine uptake among providers.

Designing of a Parenting Education Web Program in Overcoming Students' Learning Difficulties at Home during the COVID-19 Pandemic

This is the result of the research entitled Web Design of Parenting Education Programs in Overcoming Students' Learning Difficulties at Home during the Covid-19 Pandemic. This research was conducted in FIP-UMJ Labs. Elementary School in South Tangerang, Indonesia. The research method was model development, with a qualitative descriptive approach, a prototype model. The number of respondents was 397 elementary school students. The purpose of the study was to determine the problems faced by parents, so far in an effort to help their children study at home. The results of this study were proven based on the results of the analysis of respondent data, where only 79% of parents understand the child's parenting education web program at home, while the implementation of child care programs at school where 82% have been implemented properly. The effectiveness to overcome their children's learning difficulties at home is 65%, while for parents who have good communication between teachers and parents, the figure is 64%. The highest percentage gain of 91% is parents who accompany their children to study at home, while as many as 42% of parents prepare special time, to accompany their children to study at home. Difficulties in assisting children to study at home yielded a percentage of 47% and regarding concentration on learning for children, to overcome this, a percentage 72% was obtained. The parents who studied their children's learning materials was as much as 66%. Regarding the parents who prepared study time for their children at home according to the schedule given by the school, the obstacles faced by them in accompanying learning at home, were due to the busyness of parents and was reflected by a percentage rate of 53%.

Chronic pain among children with cerebral palsy attending a Ugandan tertiary hospital: a cross-sectional study

BackgroundChildren with cerebral palsy (CP) frequently experience chronic pain. The burden and severity of such pain is often underestimated in relation to their other impairments. Recognition and awareness of this chronic pain among children with CP constitute the cornerstone for caretakers and clinicians to improve the quality of life of those children. This study aimed to determine the prevalence of chronic pain among children with CP, and the factors associated.MethodsA cross-sectional study of children with CP, aged 2–12 years, attending the CP rehabilitation clinic and Pediatric Neurology Clinic at Mulago Hospital, Uganda from November 2017 to May 2018. A detailed history and clinical examination were performed and the co-morbidities were determined. CP was classified using the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System, Communication Function Classification System (CFCS), and the Eating and Drinking Ability Classification System (EDACS) and documented with the level of impairment in the different domains. Pain was assessed by using the revised Face, Legs, Activity, Consolability, Cry pain scale.ResultsA total of 224 children with CP were enrolled. The prevalence of chronic pain was 64.3%. The majority had spastic bilateral CP (77.8%), moderate pain lasting over 6 months, and none of them was on long-term pain management. Epilepsy (60.9%), behavioral problem (63.2%), hearing impairment (66,7%), learning problem (67,6%), dental caries (75%), gastro-esophageal reflux (75%), sleep disorders (79.5%), vision impairment (80%), and malnutrition (90%) were co- morbid conditions of chronic pain in children with CP in this study. The factors independently associated with chronic pain among children with CP were the GMFCS level IV & V, CFCS level IV & V, EDACS level IV & V, female children, and caretaker aged more than 30 years.ConclusionsTwo-thirds of children with CP attending rehabilitation in this hospital had chronic pain. None was receiving pain management. Chronic pain was associated with the presence of multiple co-morbidities and more severe disability. Rehabilitation and care programs for children with CP should include assessment of pain in routine care and provide interventions for pain relief in children with CP even at an early age.

Can Policies Stall the Fertility Fall? A Systematic Review of the (Quasi‐) Experimental Literature

AbstractIn the course of the twentieth century, social scientists and policy analysts have produced a large volume of literature on whether policies boost fertility. This paper describes the results of a systematic review of the literature on the effects of policy on fertility since 1970 in Europe, the United States, Canada, and Australia. Empirical studies were selected through extensive systematic searches, including studies using an experimental or quasi‐experimental design. Thirty‐five studies were included, covering reforms of parental leave, childcare, health services, and universal child transfers. In line with previous reviews, we find that childcare expansions increase completed fertility, while increased cash transfers have temporary effects. New evidence on parental leave expansions, particularly from Central Europe, suggests larger effects than previously established. High‐earning couples benefit more from parental leave expansions, while expanding childcare programs can reduce social inequalities on other domains. Subsidizing assisted reproductive treatments shows some promise of increasing birth rates for women over the age of 35. Countries that to date have limited support for families can build on solid evidence if they choose to expand these programs.

Suspension and expulsion in Colorado early care and education settings: Child, program, and community-level predictors.

Expulsion presents a significant risk in Early Care and Education (ECE) settings due to its association with early disadvantage and frequency of use. A statewide survey was conducted to characterize ECE suspension and expulsion (S/E) in Colorado. Child, program, and community-level factors were examined as predictors of S/E, alongside preventative intervention supports capable of reducing S/E. Six hundred and sixty three licensed child care programs participated in the survey, providing information on 19,848 enrolled children, 312 suspensions, and 74 expulsions. A series of multilevel hierarchical regressions were conducted, examining predictors for S/E. Children with IEPs/IFSPs were disproportionately suspended; 2-3-year-olds were disproportionately expelled; and boys, 5-6-year-olds, and children with disabilities were disproportionately suspended and expelled. Center-based programs, lower quality ratings, and "zero tolerance" policies predicted greater use of suspension. In contrast, school-district affiliation and knowledge of how to access infant and early childhood mental health consultation (IECMHC) decreased suspension. Lower levels of regional child poverty predicted higher use of expulsion. Affiliation with a school-district, IECMH consultant-led training, and use of quality coaches predicted decreased expulsion. This study identifies the need for ongoing protection for children with IEPs/ IFSPs and the preventative interventions that mitigate risk for S/E.

Gaps in Nutrition Policy Implementation in Childcare Centres in The Edmonton Metropolitan Region: A Cross-Sectional Survey

Purpose: To describe (i) nutrition policies in childcare centres, (ii) the resources and processes used to enable policy implementation, and (iii) the association between policy implementation and childcare centres' or administrators' characteristics.Methods: Between October 2018 and June 2019 a web-based survey that addressed nutrition policy, policy implementation, and sociodemographic characteristics was sent to eligible childcare programs (centre-based and provided meals) in the Edmonton (Alberta) metropolitan region. The survey was pretested and pilot tested. Statistical tests examined the relationship between policy implementation with centres' and administrators' characteristics.Results: Of 312 childcare centres that received the survey invitation, 43 completed it. The majority of centres had a nutrition policy in place (94%). On average, centres had about 9 of the 17 implementation resources and processes assessed. Most often administrators reported actively encouraging the implementation of the nutrition policy (n = 35; 87%) and least often writing evaluation reports of the implementation of the nutrition policy (n = 9; 22%). Administrator's education level was associated with implementation total score (p = 0.009; Kruskal-Wallis).Conclusion: Most childcare centres had a nutrition policy in place, but many lacked resources and processes to enable policy implementation. Additional support is required to improve nutrition policy development and implementation.

Need for and concerns about non-parental childcare programs for infants and toddlers in Hong Kong: Voices of parents

This study examined Hong Kong parents’ need for, and concerns about, the quality of non-parental childcare programs for infants and toddlers. A total of 266 Hong Kong parents whose children were enrolled in center-based childcare programs for infants and toddlers participated in a quantitative survey, and 22 parents participated in qualitative interviews. The results showed that there was a large demand for childcare programs for infants and toddlers in Hong Kong, due mainly to the number of dual working parents. Parents considered location to be the most important determinant of their program selection and also expected an upward adjustment to the teacher-child ratio in their children’s programs. Finally, parents considered mealtime (e.g., bottle feeding), self-care training (e.g., toileting), and cognitive development activities to be the three most important aspects of their children’s educational and care activities. The findings are discussed in light of the importance of developing non-parental childcare programs for infants and toddlers that address parents’ needs and concerns. This study can inform both research and policy concerning center-based childcare programs in Hong Kong.

Household catastrophic health expenditure and its effective factors: a case of Iran

BackgroundThe World Health Organization (WHO) has placed special emphasis on protecting households from health care expenditures. Many households face catastrophic health expenditures (CHEs) from a combination of economic poverty and financing the treatment of medical conditions. The present study aimed to measure the percentage of households facing catastrophic CHEs and the factors associated with the occurrence of CHEs in Shiraz, Iran in 2018.MethodsThe present cross-sectional study was performed on 740 randomly selected households from different districts of Shiraz, Iran in 2018 using a multi-stage sampling method. Data were collected using the Persian version of the “WHO Global Health Survey” questionnaire. CHEs were defined as health expenditures exceeding 40% of households’ capacity to pay. Households living below the poverty line before paying for health services were excluded from the study. The associations between the households’ characteristics and facing CHEs were determined using the Chi-Square test as well as multiple logistic regression modeling in SPSS 23.0 at the significance level of 5%.ResultsThe results showed that 16.48% of studied households had faced CHEs. The higher odds of facing CHEs were observed in the households living in rented houses (OR = 3.14, P-value < 0.001), households with disabled members (OR = 27.98, P-value < 0.001), households with children under 5 years old (OR = 2.718, P-value = 0.02), and those without supplementary health insurance coverage (OR = 1.87, P-value = 0.01).ConclusionCHEs may be reduced by increasing the use of supplementary health insurance coverage by individuals and households, increasing the support of the Social Security and the State Welfare Organizations for households with disabled members, developing programs such as the Integrated Child Care Programs, and setting home rental policies and housing policies for tenants.

Implications of labour market on career development in the early childhood care programme in Adamawa state, Nigeria

Introduction: The issues of job type and career choice are always controversial and more demanding as they require careful act and guidance to make the right decisions; career choice and the factor of the labour market is one major element in every society that influences the standard of living. Purpose: This study investigated the implication of the labour market on career development in the Early Childhood Care Program (ECCE) in Adamawa state. The study explored various factors of career choice in relation to the labour market norms and values as well as its implication towards sustaining a satisfactory career choice and development in ECCE Design: The study adopted survey research design. The population of this study consists of parents, teachers and other members of the respective communities in Adamawa State. A sample of 175 was randomly selected in five educational zones in Adamawa State. Structured questionnaire was used for data collection and data were analysed descriptively using frequency table, percentage and weighted average. Results: The finding revealed that factors such as the decline in ECCE certificates, favoritism toward other professions, low remuneration, lack of society acceptance, and inadequate counseling services make the labour market hinder career development in ECCE among career seekers. However, it is established in this paper that opportunities are still in abundance for career seekers in ECCE. Recommendations: The study recommended among other that there should be campaign awareness as well as services of counseling for career seeker in ECCE.

Dietary Intakes of Children Enrolled in US Early Child-Care Programs During Child-Care and Non-Child-Care Days

BackgroundEarly-child-care (ECE) programs may substantially influence child diet quality. ObjectiveThe Study of Nutrition and Activity in Child Care Settings describes the usual food group intake of preschool-aged children attending ECE programs relative to Dietary Guidelines for Americans (DGA) recommendations, comparing intakes during child-care and non-child-care days. DesignMeal observations and parent-completed food diaries in a cross-sectional nationally representative multistage cluster sample of Child and Adult Care Food Program-participating ECE programs. Participants/settingOne thousand four hundred sixty-eight children aged 3 to 5 years attending 217 Child and Adult Care Food Program-participating ECE programs (eg, child-care centers and Head Start) during 2017. Main outcome measuresDaily energy intake, daily US Department of Agriculture Food Pattern Food Group intakes, and percentage of daily intakes meeting 2015-2020 DGA Food Pattern recommendations. Statistical analyses performedRegression-adjusted usual intakes and percentage of children meeting recommendations were estimated using the National Cancer Institute method. Single-day mean intakes were used to test for statistical differences between child-care and non-child-care days. ResultsMean usual energy intake was 1,524 ± 19.3 kcal during child-care days and exceeded the recommended range at 1,702 ± 30.2 kcal during non-child-care days; single-day means indicated significantly lower energy intake on child-care days (P < 0.001). The percent of children meeting DGA recommendations on a child-care day varied by DGA food group: fruits (51.4%), grains (50.1%), dairy (42.5%), vegetables (6.5%), whole grains (4.6%), and protein foods (0.1%). Recommended limits on calories from added sugar and solid fats were met by 28.2% and 14.6% of children, respectively. Compared with mean food group intakes during a single child-care day, non-child-care day intakes were similar for fruits and vegetables, lower for dairy and whole grains, and higher for total grains, protein foods, and calories from added sugars and solid fats. ConclusionsAlthough there is room to increase nutrient density inside and outside of child care, intakes on child-care days more closely align to DGAs.

A 26-Year Study of Restraint Fatalities Among Children and Adolescents in the United States: A Failure of Organizational Structures and Processes

BackgroundPhysical and mechanical restraints used in treatment, care, education, and corrections programs for children are high-risk interventions primarily due to their adverse physical, emotional, and fatal consequences.ObjectiveThis study explores the conditions and circumstances of restraint-related fatalities in the United States by asking (1) Who are the children that died due to physical restraint? and (2) How did they die?MethodThe study employs internet search systems to discover and compile information about restraint-related fatalities of children and youth up to 18 years of age from reputable journalism sources, advocacy groups, activists, and governmental and non-governmental agencies. The child cohort from a published study of restraint fatalities in the United States from 1993 to 2003 is combined with restraint fatalities from 2004 to 2018. This study’s scope has expanded to include restraint deaths in community schools, as well as undiscovered restraint deaths from 1993 to 2003 not in the 2006 study.ResultsSeventy-nine restraint-related fatalities occurred over the 26-year period from across a spectrum of children’s out-of-home child welfare, corrections, mental health and disability services. The research provides a data snapshot and examples of how fatalities unfold and their consequences for staff and agencies. Practice recommendations are offered to increase safety and transparency.ConclusionsThe study postulates that restraint fatalities result from a confluence of medical, psychological, and organizational causes; such as cultures prioritizing control, ignoring risk, using dangerous techniques, as well as agencies that lack structures, processes, procedures, and resources to promote learning and to ensure physical and psychological safety.