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Including relationship-based care practices in infant-toddler care: Implications for practice and policy

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Sosinsky, L., Ruprecht, K., Horm, D., Kriener-Althen, K., Vogel, C. & Halle, T..
Publication Date: 
30 Apr 2016


Approximately half of all children under the age of three in the United States have a regular child care arrangement (nearly 44 percent of infants from birth to 12 months, 52 percent from 12 to 24 months, and 56 percent from 24 to 36 months; NSECE Project Team, 2015). The percentages of infants and toddlers in center-based care increases with age, with nearly nine percent of infants from birth to 12 months, thirteen percent of infants from 12 to 24 months, and twenty percent of toddlers 24 to 36 months of age in center-based care (NSECE Project Team, 2015). Research suggests high-quality care and learning programs that begin early in life have the potential to improve developmental outcomes as well as close gaps in educational achievement for young children (Mayoral, 2013; NICHD, 2005; Yazejian, Bryant, Freel, Burchinal, & the Educare Learning Network Investigative Team, 2015). However, observed quality in infant and toddler settings is low in general (Phillips & Lowenstein, 2011; Vogel et al., 2011) and often lower than in preschool settings (NICHD, 2005).

Quality in infant and toddler settings includes various features such as low child to staff ratios, small group size, and specialized teacher education and training. However, given the unique developmental characteristics of infants and toddlers, a specific focus by practitioners and policymakers on developing and supporting relationships between young children and their teachers is needed (Horm et al., 2016). (See Text Box 1) Relationships are critical for positive, healthy infant development and help provide a framework for exploration and future learning(Shonkoff & Phillips, 2000). When an infant is able to establish a relationship with a sensitive and responsive caregiver, the infant learns who to trust and turn to when needing support (Howes & Spieker, 2008). Additionally, a secure relationship provides a base from which the infant can explore the world and build knowledge. Sensitive and responsive caregiving can also impact child outcomes. When infants have sensitive and responsive caregivers, they are more likely to show greater language development and greater levels of peer play (NICHD, 2005).

Thus, relationship-based care practices are a priority area for practice and policy initiatives designed to strengthen quality standards in infant and toddler early care and education settings (Schmit & Matthews, 2013). This brief describes relationship-based care practices and the research support for a focus on relationships in infant and toddler care. We emphasize two specific relationship-based care supports – primary caregiving and continuity of care. We then present practice considerations for child care directors and owners regarding adopting or enhancing relationship-based care practices, and discuss the implications of state standards for incorporating these practices into programs that serve infants and toddlers.

This brief focuses on implementation and standards in center-based settings because family child care homes are already structured to support relationship-based care practices from infancy through age three due to small numbers of children and caregivers. However, considerations for implementation of relationship-based care practices in centers may also be relevant to group child care homes serving infants and toddlers.