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What lies behind day-care stress: No easy answers for parents worried by studies [US]

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Gilbert, Susan
Publication Date: 
25 Jul 2003

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Two studies published last week added fuel to the long-standing controversy over the effects of child care on children's health and well-being.

A study by the National Institute of Child and Human Development found that the more time children spent in child care, the more likely they were to be aggressive and have other behaviour problems.

While some factors, like a mother's sensitivity and the quality of the child care, can help offset the negative effects, they do not erase them entirely, the study concluded. The findings are significant because they are from the largest long-term study of child care in the United States.

The other study, by researchers at the University of Minnesota, reported that children had higher levels of cortisol, a stress hormone, on the days when they were in child-care centres than on the days when they were home. Cortisol, considered a marker for the amount of stress a child was feeling, was highest in the shy children.

Recognizing that these findings were likely to disturb working parents and spark public furor, the editors of the journal Child Development published them with nine commentaries from child development experts.

Some of the commentaries supported the findings, but others were considerably more hopeful, giving more credit to quality child care, as well as quality time at home, than the studies did.

In interviews, four commentators offered advice for parents. Some went beyond the checklist of what to look for in high-quality child care and recommended that parents consider their child's temperament when making child-care decisions. Others discussed the importance of parental sensitivity, especially at the times of day when many parents find this a great challenge.

The bottom line is that the best option is for the child to have more than half of his time in the care of a parent. Where it's possible emotionally and financially, there's enough evidence that parents should provide the majority of care themselves. One way to do this is for one parent to work full time and the other to work part time. But this is not an easy choice, and certain careers lend themselves more than others to this kind of flexibility.

If you have to elect full-time day care, there are things to look for. First, is the setting safe and secure? Parents need to observe and talk to other parents.

Second, is the staff warm and nurturing? Picking the people who will care for your child is as important as picking your spouse.

Third, do the people know how to interact with children your child's age? Do you see them engaged in lots of back-and-forth preverbal signalling with 8-month-olds? Do you see 16-month-olds taking staff members by the hand and walking over to the toy area? With 24-month-olds, do you see staff on the floor engaging in shared pretend play?

Fourth, how well does the staff tailor their interaction to individual differences in the children? If a child is in the corner, is anyone wooing that child to engage him?

Finally, what's the staff-to-child ratio? If there are four babies per caregiver, which is typical, it's hard to give them the individual attention they need. It's better to have two babies or toddlers per caregiver and three to four preschoolers per caregiver. My hunch is that if we had these ratios, we wouldn't have seen the stress patterns and behaviour problems found in the studies.

The National Institute for Child and Human Development study has been reporting for several years that more time in child care results in more aggressive behaviour in children. This wasn't ringing right to me based on our research on Early Head Start.

We had a large sample of 17 communities around the United States, and we found that at ages 2 and 3 the aggressive behaviour problems were lower in the Early Head Start children than in a control group of children in other child care.

The children in the Early Head Start centre programs got significantly higher quality child care than the control group. We had parents rate their children's behaviour and observers go into the child-care programs. The children in Early Head Start had higher cognitive and language development and fewer behaviour problems.

We're confident that the differences we see are due to the quality of the program. Within Early Head Start families, we found that spending more time in child care improved language and cognitive development, but had no effect on aggressive behaviour. We conclude that when the care is of high quality, we don't see the detriment.

The two main differences between the studies is that all of our families had incomes below the poverty line, whereas the institute families had incomes on average three times the poverty level. The second difference is quality. Head Start had lower child-to-caregiver ratios.

- Michael Lamb, director of the section on social and emotional development at the National Institute of Child and Human Development. He was not involved in the institute's study.

It's what's happening both in day care and at home that affect a child's behaviour. Being in child care can be stressful for kids. But when parents come home from work, they might not be as attentive to their children as they are at other times, because they've got dinner to prepare and other responsibilities.

You have the child needing comforting and the parent not providing the child with an adequate degree of buffering and support. So the child carries forward this unresolved stress, which ultimately might increase the level of behaviour problems emphasized in the institute's study.

The message for parents is to see if you can provide your child with focused attention when you first come home. One way is to try to sequence activities. Give the child attention and comfort before trying to make supper. I also think - and here I'm speaking as a parent rather than on the basis of research - that the time right before bed is important to provide the emotional support the child needs.

The evidence is clear that sensitive parenting can mitigate behaviour problems in children. In the institute's study, behaviour problems were related to levels of maternal sensitivity. I would argue that the study would have found sensitivity to be even more important if it had looked at sensitivity particularly at dinner time and at bedtime.

If you really want to see how parents and children get along, watch them around the dinner hour, when the demands are high paced and everybody's a bit cranky. A sensitive parent can figure out what the child needs and try to provide it.

- Eleanor Maccoby, emerita professor of developmental psychology at Stanford University and author most recently of "The Two Sexes: Growing up Apart, Coming Together" (Belknap).

I don't think this is panic time for parents. There are very many children who are doing just fine in their day-care centres. However, the two articles do point to some risk for some children spending extended time in some day-care settings as they're now organized.

It looks as though there are some children under 3 who find it stressful when they are in day-care centres. That does suggest that if parents can keep their children home, there could be some virtues, especially if they have a shy, anxious child.

But we're still doing research to see if that would be a better alternative. Instead of taking their children out of day care, parents might first want to see how their children react to the day-care centres they are in, if they're anxious and unable to settle in and play with

Parents could also shorten the time their child is in day care by starting it later, after the first 18 months.

But there are many parents who must work, and we in our public welfare policy are insisting that they do work. So we must turn our attention to what we're doing in day care that causes the behaviour problems that the institute study found.

We're focusing so much on academic readiness. What we haven't done enough is to help children with group work. There's no trade-off: The research is clear that you don't hurt academic development if you focus on social skills and not just on the numbers and letters side at ages 3 and 4.

In cross-cultural comparisons, academic programs in other countries that have the social element that I'm talking about do somewhat better academically in Grade 1 than our children do.

One idea is to have the children and teachers meet at the end of the day to discuss what happened during the day. When all the children have input, this helps their social development.

Another idea is to divide a class of preschoolers into groups that sit together for snacks and lunch, and then assign them responsibilities that rotate. This generates a kind of group spirit, which helps prevent bullying.

-Reprinted in the Toronto Star.