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Child day care center or home care for children 12–40 months of age – what is best for the child?

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A systematic literature review
The Swedish National Institute of Public Health
Publication Date: 
1 Sep 2009



Swedish family policy reforms are world-leading in regard to meeting internationally recommended standards for early childhood care and education (e.g., policy regarding parental leave, child poverty rate, minimum staff-to-children ratio in preschool education, education and training of staff, etc.) that are set to improve children’s health. This is crucial, since many Swedish children attend day care centers. Statistics from the Swedish National Agency for Education show that in 2008, 46 percent of all 12–23 month old children, 85.8 percent of all 24–35 month old children, and 88.8 percent of all 36–48 month old children were enrolled in day care centers. In 2008, the Swedish government introduced a new family policy called the “child-raising allowance”. The purpose of this reform is to enable parents with children aged 12–36 months to stay at home with their children after the end of the standard paid parental leave period. On account of this new family policy reform, the Swedish National Institute of Public Health conducted a systematic overview of disquisitions to present research evidence on the impact of day care centers versus home care on children exposed to these types of care between the ages 12 and 40 months. Child outcomes were captured using measures of cognitive and socioemotional development. 

Prerequisites to be included in the review were that studies must distinguish between child care centers and home care (i.e., parental care) and other types of child care in the statistical analyses, and that the children had some day care experience between ages of 12 and 40 months. International studies were included if the quality of day care centers was comparable to features found in Swedish day care centers. 

Four studies that measured cognitive and socio-emotional development fulfilled the quality requirements. In two of these studies, the findings show that day care centers benefit young children’s cognitive development in comparison to home care children. The day care children demonstrated higher cognitive and language skills at age 36 months. Long-term effects of day care centers were demonstrated in both verbal ability and mathematical ability in 8-year old children. In the other two studies, no such effects were detected. In addition to cognitive development, no certain conclusion can be drawn regarding the effect of day care centers on children’s socioemotional development. One study shows that day care centers increase problem behaviors, and have a negative effect on children’s social skills, at age 36 months. The same study also reports, however, that more time in day care centers is associated with more positive interactions with peers at 54 months of age. In the remaining study, neither center-based day care nor home care was found to be better than the other with respect to personality development.

The overall conclusion is that day care centers enhance children’s cognitive development. 

From a public health perspective, it can be argued that children at risk, and especially children from poor families, benefit from day care centers. There is a relation between child poverty and poor developmental outcomes that can be reduced with high quality day care centers.