Nonrelative Care Research Articles

Parental care and cognitive skill development in early childhood

ABSTRACT This paper looks at the relationship between child care choices and children’s cognitive skills at an early age. The care choices include parental care, center care, relative care and non-relative care. I use children’s motor and mental scores at 9 months as a baseline control for their innate ability and their reading and maths scores in kindergarten as outcome measures of cognitive development. My estimates show that non-parental care is related to better scores for children from less-educated households. Further analysis on some parenting activity and parenting style measures shows that reading to children more frequently and a healthy parenting approach have the potential to reduce the parental and non-parental care gap.

“I hope my voice is heard.”: A mixed-methods study of youths’ perceptions of residential care

There are a lack of studies examining youth’s perspective on their experiences in residential care. Such studies may yield important contributions to quality improvement and, hence, outcomes of youth in residential care. In this mixed-methods study, we aimed to evaluate youths’ perspectives of the quality of care and experiences in residential group care. The sample (N = 450) was comprised of 50.9% females and 48.6% males with a mean age of 14.77 (±2.27). The majority were white (36.3%) and black (36.0%). The sample was drawn from 127 residential care programs in Florida. This study was approved by an Institutional Review Board. Data were collected as part of a larger statewide pilot of the Quality Standards Assessment (QSA). We used univariate analyses to describe quality ratings and a multilevel model to examine associations between QSA scores and youth and program characteristics. Youths’ care experiences were categorized using a content-analysis of their open-ended responses. Overall, youth rated the quality of their placements highly. The multilevel model revealed that quality ratings were higher among youth with family reunification as their discharge plan versus non-relative care. Youths’ open-ended responses supported positive views on their placements and connections with staff. Negative comments focused on environmental restrictions and staff/peer relations. The inclusion of youth perspectives can contribute to improved service experiences and outcomes.

Type of Child Care Setting Is Associated With Child Care Constraints and Food Insecurity Among Families With Low-Incomes.

High quality child care positively affects long-term development in children and is a necessary support for parents who work or are in school. We assessed the association between child care setting and parents' report of difficulties with ability to work and/or further their education ("child care constraints") or material hardships among families with low incomes. Cross-sectional data were analyzed from families in Minneapolis, MN with children aged six weeks to 48 months in child care from 2004 to 2017. Associations between child care setting (formal, informal relative, informal non-relative) and child care constraints or material hardships (household/child food insecurity, housing instability, energy instability) were examined. Among 1580 families, 73.8% used informal care. Child care subsidy and public assistance program participation were higher among families utilizing formal care. Compared to formal care, families using informal relative or non-relative care had 2.44 and 4.18 greater adjusted odds of child care constraints, respectively. Families with children in informal non-relative care had 1.51 greater adjusted odds of household food insecurity. There were no statistically significant associations between informal relative care and household or child food insecurity, and no associations between child care setting and housing instability or energy insecurity. Informal care settings-relative and non-relative-were associated with child care constraints, and informal non-relative care with household food insecurity. Investment to expand equitable access to affordable, high-quality child care is necessary to enable parents to pursue desired employment and education and reduce food insecurity.

The incredible years parenting program for foster carers and biological parents of children in foster care: A mixed methods study

Trauma-related social, emotional and behavioral difficulties (SEBD) are common among children in foster care and are the primary reason for placement breakdown. SEBD in foster children – and especially in the context of unstable and troubled relationships with both foster and biological parents - affects the child’s future functioning and has substantial cost implications in terms of public service utilization. The aim of this study was to assess the utility and perceived effectiveness of the 18-week Incredible Years parenting program (IYPP) which was delivered, on an exploratory basis, to both biological and foster parents (including kinship and non-relative care) of 23 foster children (aged 3–10 years). Biological and foster parent pairs (n = 46) were assessed at pre-intervention and at 6-month follow up, using measures of child SEBD, parenting stress, competencies, and quality of child-parent/carer relationships. One-to-one interviews and a focus group were also undertaken with a subset of biological parents (n = 12), foster carers (n = 11) and Social Work clinicians (n = 5) who delivered the program; the findings were analyzed using grounded theory. Both biological and foster parents reported statistically significant improvements in child SEBD, parent–child relationships, and in parenting stress and competencies. The qualitative findings highlighted further benefits for families, such as an increased number of access visits between biological parents and children and improved relationships with Social Work clinicians. Several factors were identified as important when implementing the IYPP with foster children, including: potential difficulties in engaging both foster and biological parents within the Social Work infrastructure; making appropriate adaptations to program principles, and integrating delivery with a trauma-informed approach. These findings contribute to the growing body of evidence that the IYPP could add value to the standard training and supports for foster parents, children and biological parents.

Maternal and non-maternal care in infancy and later child cognitive, language and motor development in Chile: Does type of care matter?

Growing numbers of children across the world start non-maternal care in the first year of life. However, few studies have described how different infant care experiences may relate to later child cognitive, language and motor functioning, and most analyses have focused on samples from historically industrialized regions. Cognitive, language and motor subscores (TEPSI) and receptive vocabulary scores (TVIP) obtained through direct testing of 24-to-48-month-old children (n = 7564) from the Chilean Longitudinal Survey of Early Childhood were compared based on retrospective reports of care received as infants. Children who, as infants, had received one of four types of non-maternal care — center-based, grandparent, other relative, and non-relative care — were compared to those who had exclusively experienced maternal care (71.8%). Series of regressions with propensity score models (PSM) were performed. Compared to maternal care, children in center-based care and grandparent care had higher total TEPSI scores (d = .19, p < 0.05) (d = .19, p < 0.01) and TEPSI language subscores (d = .20, p < 0.05) (d = .20, p < 0.01), while those in grandparent care also had higher TEPSI motor subscores (d = .08, p < 0.05). In contrast, children in non-relative care had lower TVIP receptive vocabulary scores (d = −.38, p < 0.01). These findings contribute to the debate on national policies supporting specific types of non-maternal care and their impact on child development.

Association of childcare arrangement with overweight and obesity in preschool-aged children: a narrative review of literature.

The time children spend in childcare overlaps with daily meals and opportunities to be active. Thus these environments have the opportunity to promote-or hinder-healthy weight gain among children who attend them. The purpose of this narrative review was to compile findings from studies examining childcare type and weight outcomes among preschool-age children. A literature search was conducted using PubMed, PsychInfo and ERIC. Inclusion criteria were infant- to 5-year-old children exposed to any type of childcare with a cross-sectional or longitudinal weight outcome. Among 385 studies screened, 18 were included. For comparison across studies, type of childcare was categorized as: childcare center, Head Start, nanny/babysitter, non-relative care/family childcare home and relative care. Four studies found no association with childcare type and obesity, and 10 studies reported mixed results by type of care or subpopulation analyses. Two studies found an overall positive association, and two reported an inverse association. There were differences in direction of associations and findings by type of care arrangement. For Head Start, three of eight studies demonstrated a negative relationship with obesity; none demonstrated a positive association. No other childcare type demonstrated this inverse association. Informal types of care (relative and non-relative care in a home) were positively associated with child obesity in 3 of 10 studies. This association was less commonly reported among formal childcare centers (2 of 15 studies). The majority of studies, however, reported mixed findings or no association by childcare type. Results suggested no consistent evidence for a relationship between childcare and obesity risk, except Head Start. This review exposed the need for a consistent definition of childcare type and the exploration of unmeasured confounders, such as the nutrition and physical activity environment of childcare settings, to understand how they contribute to or protect against the development of overweight/obesity among children.

Foster home licensing and risk of reentry to out-of-home care following family reunification

Family reunification without subsequent reentry is the primary permanency goal for children placed in foster care. While a number of placement-level factors have been examined for their effect on subsequent reentry to care, no study to date has considered foster care licensing. The current study uses statewide administrative data to construct a cohort of foster care youth who entered care between 2009 and 2012 and were reunified by the start of 2013 (N=7752) to investigate the association between types of foster care and the probability of reentry to foster care up to two years following reunification. We focus specifically on the licensing status of foster homes, and employ propensity score analysis to address selection bias in placement type. A propensity-weighted cox proportional hazard model revealed that youth placed in licensed relative care (LRC) homes and licensed non-relative care (LNC) homes were more likely to reenter foster care than those youth placed in unlicensed relative care (URC) homes during their first spell of foster care.

Foster home placements and the probability of family reunification: Does licensing matter?

The concept of foster care has been widely studied in child welfare. The literature is well developed with regard to the risk of initial placement, length of stay in care, placement stability, exits to permanency, and emancipation. Yet, the literature is woefully underdeveloped when it comes to understanding if variations in the types and characteristics of foster homes impact important child welfare outcomes. The current study utilizes entry cohorts pulled from statewide administrative data (N=17,960) to investigate the association between types of foster care and the probability of reunification. We focus specifically on the licensing status of foster homes. Reflecting federal benchmarks, we examined the odds of reunification at one- and two-year intervals. Propensity score analysis was used to reduce selection bias. Adjusted logistic regression models revealed that youth placed in licensed relative care (LRC) homes were the least likely to achieve reunification compared with youth placed in licensed non-relative care (LNC) homes and unlicensed relative care (URC) homes. Conversely, youth placed in URC homes were more likely to achieve reunification as compared with youth placed in LRC and LNC homes. These findings will help states to efficiently target scarce resources to specific types of foster homes that may be impacting federal reunification benchmarks.

Foster care placement change: The role of family dynamics and household composition

Sibling co-placement and kinship care have each been shown to protect against the occurrence of placement change for youth in substitute care. However, little is known about the effects of different combinations of sibling placement and relative caregiver status on placement change. Nor does the field fully understand how family dynamics may differ in these households. Utilizing data from the Supporting Siblings in Foster Care study, this paper examines family dynamics across four typologies of living composition, and tests the effects of living composition membership on the odds of experiencing a placement change over an 18-month period of time. Findings suggest that across living composition typologies, children who were placed separately from their siblings in non-relative care were more likely to be older, have more extensive placement histories, and experience more placement changes both prior to and during the study than were children in other living composition groups. Family living composition was found to influence the occurrence of placement change. Specifically, children co-placed in kinship care were least likely to experience movement; however, sibling co-placement in non-relative care was also protective. Results reveal the need to conduct additional research into the experiences of children in different family living arrangements, and tailor case management services and supports to children in substitute care accordingly. Implications and future directions are discussed.

Is higher placement stability in kinship foster care by virtue or design?

Prior research has repeatedly documented higher placement stability for children who enter kinship care rather than non-relative foster care. However, little is known about why, and under what circumstances, kinship care is more stable. This study uses longitudinal state administrative data to explore possible explanations. Results suggest that, while children in non-relative foster care are indeed at higher risk of any placement move than their peers in kinship care, this appears to be partly driven by child selection factors and policy preferences for kinship care. That is, the gap is not explained primarily by different rates of caregiver-requested moves. However, the gap was sizably smaller among select high-risk subgroups of foster children, suggesting that higher stability in kinship care may be partly explained by differences in the characteristics of children entering kinship care (versus non-relative foster care). Moreover, a large portion of the gap is explained by children in non-relative care being moved into kinship care; a move that is likely the result of policy preferences for kinship care rather than a defect in the initial placement. In sum, these results suggest that kinship care provides only a limited stability advantage, and the reasons for that advantage are not well understood.

Examining the relationship between immigrant status and after-school care usage of young children in the US

Using the 2005 National Household Education Survey, this study examines the relationship between parental nativity and the after-school care use patterns of U.S. children. Results indicate that child-care usage patterns vary across households by parental nativity as well as by immigrant generational status. That is, immigrants are less likely to use nonparental care than natives. Among immigrants who use nonparental care, first-generation immigrant children were more likely to be placed in nonrelative care or activities, while second-generation immigrant children were more likely to be cared for by relatives. In terms of the time use pattern of youths in such nonparental care settings, second-generation immigrants were less likely to play sports and more likely to watch television or listen to music than natives. Lastly, the study found significant moderation effects of maternal employment status on the association between parental nativity and the type of child care used.

Associations between Birth Health, Maternal Employment, and Child Care Arrangement among a Community Sample of Mothers with Young Children

Although a large body of literature exists on how different types of child care arrangements affect a child's subsequent health and sociocognitive development, little is known about the relationship between birth health and subsequent decisions regarding type of nonparental child care as well as how this relationship might be influenced by maternal employment. This study used data from the Los Angeles Families and Neighborhoods Survey (L.A.FANS). Mothers of 864 children (ages 0–5) provided information regarding birth weight, maternal evaluation of a child's birth health, child's current health, maternal employment, type of child care arrangement chosen, and a variety of socioeconomic variables. Child care options included parental care, relative care, nonrelative care, and daycare center. Multivariate analyses found that birth weight and subjective rating of birth health had similar effects on child care arrangement. After controlling for a child's age and current health condition, multinomial logit analyses found that mothers with children with poorer birth health are more likely to use nonrelative and daycare centers than parental care when compared to mothers with children with better birth health. The magnitude of these relationships diminished when adjusting for maternal employment. Working mothers were significantly more likely to use nonparental child care than nonemployed mothers. Results suggest that a child's health early in life is significantly but indirectly related to subsequent decisions regarding child care arrangements, and this association is influenced by maternal employment. Development of social policy aimed at improving child care service should take maternal and family backgrounds into consideration.

The Frequency of Outdoor Play for Preschool Age Children Cared for at Home-Based Child Care Settings

ObjectiveGiven that more than 34% of U.S. children are cared for in home-based child care settings and outdoor play is associated with physical activity and other health benefits, we sought to characterize the outdoor play frequency of preschoolers cared for at home-based child care settings and factors associated with outdoor play. MethodsCross-sectional study of 1900 preschoolers (representing approximately 862,800 children) cared for in home-based child care settings (including relative and nonrelative care) using the nationally representative Early Childhood Longitudinal Study, Birth Cohort. ResultsOnly 50% of home-based child care providers reported taking the child outside to walk or play at least once/day. More than one-third of all children did not go outside to play daily with either their parent(s) or home-based child care provider. There were increased odds of going outside daily for children cared for by nonrelatives in the child's home compared with care from a relative. Children with ≥3 regular playmates had greater odds of being taken outdoors by either the parents or child care provider. We did not find statistically significant associations between other child level (age, sex, screen-time), family level (highest education in household, mother's race, employment, exercise frequency), and child care level (hours in care, provider's educational attainment, perception of neighborhood safety) factors and frequency of outdoor play. ConclusionsAt a national level, the frequency of outdoor play for preschoolers cared for in home-based child care settings is suboptimal. Further study and efforts to increase outdoor playtime for children in home-based child care settings are needed.

Multiple Childcare Arrangements and Health Outcomes in Early Childhood

This study examined the associations between multiple childcare arrangements and young children's health problems. This study used three waves of the Early Childhood Longitudinal Study-Birth Cohort, collected from a nationally representative sample of children when they were 9 months old, 2 years old, and 4 years old (N = 7,150). 'Multiple childcare arrangements' was defined and measured by the number of non-parental childcare arrangements that occurred on a regular basis. During each wave of the data collection, the mother reported the number of regular childcare arrangements by three types: relative care, non-relative care, and center-based care. These numbers were summed to calculate the total number of arrangements. The mother also reported the incidence of ear infections, gastrointestinal illnesses, asthma diagnosis, and unintentional injuries of the child. Random effects and fixed effects regression models were used to estimate the association between the number of childcare arrangements and measures of early childhood health problems. Increases in the total number of childcare arrangements were associated with an elevated risk of ear infections, gastrointestinal illnesses, and diagnosed asthma in children. Further analysis indicates that increases in both the number of center-based care and non-relative care (but not relative care) arrangements can lead to a greater chance of health problems in young children. Multiple childcare arrangements are associated with communicable illness and diagnosed asthma in early childhood and appear to be a risk factor for health problems in early childhood.

Physical Activity Levels of Children attending Family Child Care Homes

Family Child Care Homes (FCCH's) are the second largest provider of non-relative care in the U.S. However, despite providing care for nearly 1.9 million children under the age of 5, little is known about the physical activity (PA) levels of children attending FCCHs. PURPOSE: The purpose of this study was to objectively measure PA levels in 2- to 5-year-old children attending FCCHs in 5 counties in western Oregon. METHODS: 205 children (50.2% male) between the ages of 2 and 5 (mean age = 3.4 ± 1.2 yrs) from 53 FCCHs wore an ActiGraph GT1M accelerometer for the duration of their time in care for 1-week. Accelerometers were removed during naptime and providers noted the times monitors were put on and taken off throughout the day. Time spent in sedentary (SED), light (LPA), moderate-to-vigorous PA (MVPA), and light- moderate-vigorous PA (LMVPA) was calculated using the intensity-related cut-points developed by Pate et al. (2006). Resp RESULTS: Physical activity levels per hour of child attendance (excluding nap time), were as follows: 26.3 ± 6.2 min of SED (male = 24.9 ± 1.0 and female = 27.4 ± 0.9), 24.2 ± 3.8 min of LPA (male = 24.1 ± 0.6 and female = 23.6 ± 0.5), 9.4 ± 4.3 min of MVPA (male = 11.2 ± 0.7 and female = 8.9 ± 0.6), and 33.7 ± 6.2 min of LMVPA (male = 35.1 ± 0.9 and female = 32.6 ± 0.9). 25.7% (23.8% female and 27.4% male) of children met the physical activity recommendation of 60 minutes of MVPA per day. Overweight (OW) and non-overweight (N-OW) children exhibited similar levels of MVPA, with the exception of OW 4 y olds, for whom MVPA were significantly lower than their N-OW counterparts. Among N-OW children, MVPA levels were significantly higher among children age 4 y than children aged 2, 3, or 5 y. No age-related differences in MVPA were observed among overweight children. (OW: 2y = 9.7 ± 1.4, 3y = 9.8 ± 1.5, 4y = 8.5 ± 1.3, 5y = 10.7 ± 1.7; N-OW: 2y = 7.9 ± 0.9, 3y = 10.5 ± 0.8, 4y = 12.4 ± 0.9, 5y = 11.0 ± 1.7) CONCLUSIONS: The results suggest that a significant percentage of children attending FCCH do not meet PA guidelines for preschool children. Interventions are needed to increase physical activity in this population. National Institute of Food and Agriculture Grant 2008-04423

Center-based childcare use by Hispanic families: Reasons and predictors

This study explored the reasons and factors associated with childcare use for Hispanic children of preschool age with working and nonworking mothers. National Household Education Survey/Early Childhood Program Participation 2005 data were used. The data suggested that use of center-based childcare is more frequent than use of parental care, relative care, or nonrelative care. In general, family poverty status, mother's education, household composition, mother's work status, and acculturation are all significant predictors of center-based childcare use. The importance of the educational and pragmatic characteristics of childcare plays a significant role in childcare selection for parents of Hispanic preschool-age children. Mothers who put greater value on socialization are more likely and mothers who put greater value on location and reliability are less likely to use a center-based childcare. Nevertheless, the relationship between family characteristics and center-based childcare use, and the relationship between the importance of childcare characteristics and center-based childcare use, depends on the mother's working status.

Do Effects of Early Child Care Extend to Age 15 Years? Results From the NICHD Study of Early Child Care and Youth Development

Relations between nonrelative child care (birth to 4(1/2) years) and functioning at age 15 were examined (N = 1,364). Both quality and quantity of child care were linked to adolescent functioning. Effects were similar in size as those observed at younger ages. Higher quality care predicted higher cognitive-academic achievement at age 15, with escalating positive effects at higher levels of quality. The association between quality and achievement was mediated, in part, by earlier child-care effects on achievement. High-quality early child care also predicted youth reports of less externalizing behavior. More hours of nonrelative care predicted greater risk taking and impulsivity at age 15, relations that were partially mediated by earlier child-care effects on externalizing behaviors.

Nutrition and Physical Activity Policies and Practices in Family Child Care Homes

Family child care homes (FCCHs) are the second-largest provider of nonrelative care in the U.S. However, despite providing care for nearly 1.9 million children aged <5 years, little is known about the nutrition and physical activity practices of FCCHs. To address this gap, this study aims to describe policies and practices related to nutrition and physical activity in a representative sample of FCCHs. A stratified random sample of registered FCCHs operating in Kansas (N=297) completed the Nutrition and Physical Activity Self Assessment for Child Care (NAPSACC) instrument. Prevalence estimates and 95% CIs for meeting or exceeding accepted child care standards were calculated using SAS PROC SURVEYFREQ. Most providers either met or exceeded child care standards related to serving fruit and vegetables and provision of daily physical activity. Very few providers reported serving fried meats or vegetables or unhealthy snack foods on a regular basis. Areas of concern included infrequent servings of low-fat milk, frequent use of unhealthy foods for celebrations, widespread use of TV and video games throughout the day, restricting physical activity for children who misbehave, and lack of appropriate indoor spaces for physical activity. Only a small percentage of providers reported receiving regular training in nutrition or physical activity. Relatively few providers had written guidelines on nutrition or physical activity. Some strengths were exhibited by FCCHs, but substantial weaknesses were shown with respect to meeting established child care standards for nutrition and physical activity. Interventions to promote healthy eating and regular physical activity in FCCHs are thus warranted.

Kinship Foster Care: Protection or Risk?

The data reported in this article by Jesús Palacios and Jesús M Jiménez come from a study of foster care in Andalusia, southern Spain. In Andalusia, as in the rest of Spain, kinship care is far more frequent than non-relative foster care. The authors explore the differences between these two types of foster care arrangement in a number of areas: socio-demographic profiles; children's stimulation and patterns of rearing; stress, informal support and needs; formal support and relationships with child protection services; evaluation of the experiences of carers; contact between birth parents and children; and foster children's development and behavioural difficulties. Although, compared with non-relative care, there are some clear advantages to kinship foster care (eg placement at an early age and fewer transitions), there are also a number of risk factors in all areas studied that must be considered to avoid what should be a protective placement becoming a risk situation for both carers and children.

Profiles of choice: Parents’ patterns of priority in child care decision-making

Abstract Responding adequately to parental priorities for child care is important for shaping children’s early experiences and development, and for facilitating parenting at the nexus of work and caregiving roles. Although much research on child care choice has relied on variable-centered approaches that treat parental priorities as distinct and isolated, this article aims to understand parents’ care choices from a person-centered, holistic perspective. Using data from the National Household Education Survey of Early Childhood Program Participation of 2005 (n = 4570), we conduct latent class and multinomial logistic regression analyses, identifying four empirically and substantively distinctive classes of parents based on their scores on seven indicators of child care priority. Class 1 parents (35%) rank all seven indicators as very important. Class 2 parents (18%) prioritize practicality factors. Class 3 parents (9%) do not, on average, rank any of the indicators as highly important. Class 4 parents (37%) emphasize learning and quality-focused factors. Class membership is associated with child’s age, race/ethnicity, and parent respondent’s gender, age, employment status, and socio-economic status. After controlling for socio-demographic factors, parents in the learning-focused class are more likely to choose center-based cares whereas practicality-focused parents prefer home-based relative or non-relative care arrangements.