EXCERPTS
It may be tomorrow, it may be next week, or perhaps next month but it will happen — another child will die in an unlicensed child-care setting.
Deaths in child care occur with such alarming frequency in the United States and Canada that they tend to resonate in the news for only a short period of time.
A disproportionate number of these deaths occur in unlicensed home child care, where a woman will care for a number of children in her home for a fee. Many countries, including the U.S., Canada and Ireland, allow for these businesses to operate legally but without any real government oversight.
Because of this lack of oversight, we have no idea how many children are cared for or by how many unlicensed providers. We know virtually nothing about what is going on in these homes.
Our research at the University of Toronto aims to understand why governments continue to let these businesses — which care for one of our most vulnerable populations — operate without any real oversight.
In some parts of Canada, dog walkers and hot dog vendors require more permits than some child care providers.
The safety of dogs, and of the food we eat from street vendors, is of course important. And so is the safety of our babies and children.
Prioritizing ‘parent choice’ over quality
Given the risks unlicensed care poses to children, it is puzzling that governments continue to allow these businesses to operate without any review or assessment of quality and safety.
Research that we have just published in the Journal of Risk Research examines this question in the case of Ontario, which reviewed its legislation shortly after four young children (all under the age of two) died in unlicensed home child care within a seven month period in 2013 and 2014.
There was significant media attention and subsequent public outcry at these deaths.
Yet when the government developed the new Ontario Child Care and Early Years Act (CCEYA), which came into effect on August 31, 2015, it chose to allow a portion of the home child care sector to remain unlicensed.
Our research suggests a unique set of circumstances have resulted in a serious lack of oversight to ensure that our youngest citizens are in safe and nurturing environments.
Despite the recent deaths in care, we found that the policy debate — in legislative and subcommittee discussions — prioritized concerns of “access” and “parent choice” over evaluation of “quality” and “risk.”
A flawed logic
In worrying about access, policymakers and the attentive public expressed concern that if government increased oversight of unlicensed providers, some of them would fail to meet basic standards and would have to close.
Access to child care is, of course, a major concern for many parents. But shying away from licensing because it might force unsafe or poorly functioning providers to close seems very misguided, to say the least.
When it comes to “parent choice,” the logic runs something like this: Parents know what’s best for their families and should have the option to choose from a full range of options, including unlicensed care.
This logic is flawed in a number of ways.
For starters, it’s a very different logic to that which the government applies to pretty much all other services. Parents don’t have the choice (at least legally) to take their child to an unlicensed dentist or pediatrician, or out to dinner at a restaurant that hasn’t passed health and safety inspections.
There are a couple of factors specific to this sector that need to be attended to. One is that — due to the high cost and frequent shortages of child care — parents across North America often have no choice at all but to take whatever space they can find, regardless of quality concerns. Lower income parents who work irregular hours are really in this bind and use unlicensed care more often.
The other is that “quality” in child care is very difficult to see and assess.
Parents misjudge quality
Experts agree that one of the most important aspects of care is the way that caregivers interact with children.
But identifying quality in interactions is very difficult and generally requires training. Research studies show that parents tend to assess the quality of their child care much more favourably than do trained observers.
In the U.S. a large-scale policy effort has been made to measure quality and make those quality ratings available to parents. While this does put parents in a better position to make informed choices, it does not replace the need for regulations and oversight to ensure that basic quality standards are met.
Within the content of the hearings and debates we analyzed in Ontario, we did find some discussion of quality and risk.
But these were less frequent than discussions of choice and access to begin with and they decreased as more time passed after the deaths of the four children.
Government oversight will reduce risks
The other part of the problem for policymakers is that it’s hard to quantify just how risky unlicensed care is.
For example, in Ontario we don’t have accurate numbers of child care deaths as coroners do not note the context when deaths in unlicensed child care occur.
What we do know is that while unlicensed care can be of good quality, licensed providers are generally rated as providing higher quality care on standardized measures.
Licensed providers are also required to undergo criminal record checks, fire safety inspections and have up-to-date first aid certifications.
Parents going the unlicensed child care route must do the research, inspect their potential or current care providers, and ask all the right questions. This places a big burden on parents and, arguably, it’s not a task that most parents are well-equipped to take on.
Bringing unlicensed home child care providers out of the cold and into the light of government oversight will go a long way to addressing these gaps in parent information and reducing the risks for children in care.
This policy action is doable. And it will only bring this sector up to the standard of any other sector that matters.