1. Child Care, Early Learning, and Children’s Development Cathryn Booth-LaForce, PhD, FAPS Charles & Gerda Spence Professor of Nursing Conference on Early Learning September 24, 2007

2. Media Reports

3. Some Recent Headlines “Poor Behavior is Linked to Time in Day Care” “Poor Behavior is Linked to Time in Day Care” ---New York Times “Study Links Child Care to Acting Out” “Study Links Child Care to Acting Out” ---Associated Press “How nurseries ‘still breed aggression’” “How nurseries ‘still breed aggression’” ---London Times

4. “Day Care is Linked to Behavior Lasting Through 6 th Grade” “Day Care is Linked to Behavior Lasting Through 6 th Grade” ---The Wall Street Journal “Few Effects of Poor Daycare Last Past Age 11” “Few Effects of Poor Daycare Last Past Age 11” ---Reuters

5. “Quality of Early Child Care Makes a Difference But Good Parenting Matters More, US Study Finds” “Quality of Early Child Care Makes a Difference But Good Parenting Matters More, US Study Finds” ---Medical News Today “Day Care News: Parents, You Count Most” “Day Care News: Parents, You Count Most” ---Newsday

6. “A day care center, the sort of place in which bullies are bred, according to a new study” ---New York Times, 2001

8. Some statistics….

9. National Maternal Employment Statistics (2005) 60% of married mothers of preschool children are in the work force 60% of married mothers of preschool children are in the work force 53.5% of married mothers of infants are in the work force 53.5% of married mothers of infants are in the work force ---Monthly Labor Review, Feb, 2007

10. Child-Care Statistics Each year, parents + government spend roughly $50 billion on child care Each year, parents + government spend roughly $50 billion on child care ---Univ. MD, 2006 About 12 million children are in child care in the U.S. (9.8 million under 5 years in 40+ hours) About 12 million children are in child care in the U.S. (9.8 million under 5 years in 40+ hours) ---U.S. Census Bureau, 1999

11. Why are young children spending so much time in child care? National trends—maternal employment National trends—maternal employment Families need two incomes Families need two incomes Work preference Work preference

12. Costs to Women of the “Off Ramp” Short (1-2 year) time out—lose 18% of earning power (28% in business and banking/finance) Short (1-2 year) time out—lose 18% of earning power (28% in business and banking/finance) 3 or more years—lose 37% of earning power 3 or more years—lose 37% of earning power ---Center for Work-Life Policy, 2005

13. What are the effects of childcare on children and families?

14. Science

15. NICHD Study of Early Child Care and Youth Development

16. NICHD Early Child Care Research Network Virginia Allhusen Mark Appelbaum Jay Belsky Cathryn Booth-LaForce Robert Bradley Celia Brownell Peg Burchinal Bettye Caldwell Susan Campbell Alison Clarke-Stewart Martha Cox Sarah L. Friedman Willard Hartup Ty Hartwell Kathryn Hirsh-Pasek Aletha Huston University of California: Irvine University of California: San Diego Birkbeck College, University of London University of Washington University of Arkansas at Little Rock University of Pittsburgh University of North Carolina at Chapel Hill University of Arkansas at Little Rock University of Pittsburgh University of California: Irvine University of North Carolina at Chapel Hill NICHD University of Minnesota Research Triangle Institute Temple University University of Texas-Austin Lyz Jaeger Deborah Johnson Jean Kelly Bonnie Knoke Nancy Marshall Kathleen McCartney Fred Morrison Phil Nader Marion O’Brien Margaret Owen Ross Parke Chris Payne Deborah Phillips Robert Pianta Suzanne Randolph Wendy Robeson Susan Spieker Deborah Vandell Marsha Weinraub St. Joseph’s University Michigan State University University of Washington Research Triangle Institute Wellesley College Harvard University Loyola University Chicago University of California: San Diego University of Kansas University of Texas-Dallas University of California: Riverside University of North Carolina at Greensboro Georgetown University University of Virginia University of Maryland, College Park Wellesley College University of Washington University of Wisconsin- Madison Temple University

17. Acknowledgements NICHD Grant #HD25447 NICHD Grant #HD25447 Susan J. Spieker, Co-PI Susan J. Spieker, Co-PI Jean F. Kelly, Co-PI Jean F. Kelly, Co-PI Sumi Hayashi, Site Coordinator Sumi Hayashi, Site Coordinator Participating families Participating families

18. …and a small army of data collectors

19. Purpose of the NICHD Study Purpose of the NICHD Study To examine how variations in child-rearing contexts (childcare, home, school, etc.) are related to children’s social, emotional, cognitive, and language development and health.

20. Ecological Model: Concurrent and Longitudinal Relations Family and maternal characteristics Demographic characteristics Home environment Childcare and school environments Child characteristics Child Outcomes: Social, emotional, cognitive, language, health

21. Families in the Study 1,364 eligible births occurring during 1991 1,364 eligible births occurring during 1991 Sampling designed to assure adequate representation of major socio- demographic niches Sampling designed to assure adequate representation of major socio- demographic niches Ten data collection sites Ten data collection sites 24 hospitals 24 hospitals Recruited in these locations

22. Exclusion Criteria Mother younger than 18 years Mother younger than 18 years Family planned to move Family planned to move Multiple birth Multiple birth Infant had disability Infant had disability Infant stayed in hospital > 7 days Infant stayed in hospital > 7 days Substance abuse—mother Substance abuse—mother Mother did not speak English Mother did not speak English > 1 hour from lab site > 1 hour from lab site Extremely unsafe neighborhood Extremely unsafe neighborhood

23. Current Locations of the 1009 Study Families

24. Who are the Families in the Study? Maternal Education 10% no HS degree 21% HS degree or GED 33% some college 21% college degree 15% postgrad education Income-to-Needs (1 m) 13% poverty 18% near-poverty 69% non-poor Marital Status (1 m) 14% single

25. Race/Ethnicity (%) StudyUSA StudyUSA White, non-Hispanic 75 65 Black, non-Hispanic 13 16 Hispanic 6 15 Asian 1 3 Native American 1 1 Other 4 NA

26. Work/School Plans at Birth Employment/School Plans--child’s first year: Yes79% No18% Don’t know 3%

27. Planned Hours of Work/School < 10 4% 10-2929% 30+67%

28. Early Entry into Many Hours of Childcare Median age at entry—3 months Median age at entry—3 months Mean hrs per week (1-54 months)—31 hrs Mean hrs per week (1-54 months)—31 hrs “Informal” care arrangements most common during first year “Informal” care arrangements most common during first year

29. Study Assessment Ages 1, 6, 15, 24, 36, 54 months 1, 6, 15, 24, 36, 54 months K, Grades 1, 2, 3, 4, 5, 6 K, Grades 1, 2, 3, 4, 5, 6 Age 15 Age 15

30. Types of Assessments Interviews Interviews Questionnaires Questionnaires Observations Observations Direct Assessments Direct Assessments Records Records

31. Informants Mothers Mothers Fathers/Partners Fathers/Partners Child-care Providers Child-care Providers After-school Care Providers After-school Care Providers Teachers Teachers Principals Principals Children Children Best Friends Best Friends Mothers and Teachers of Best Friends Mothers and Teachers of Best Friends Nurse Practitioners Nurse Practitioners

32. Contexts Home Home Child-care arrangements Child-care arrangements School School After-school settings After-school settings Neighborhood Neighborhood

33. Number of Variables (birth to Grade 6) Raw data—70,000 variables Raw data—70,000 variables Analysis data sets—8,700 variables Analysis data sets—8,700 variables Data are available to other investigators Data are available to other investigators

34. What did we measure in the child-care setting?

35. Child-Care Measures Quantity : Hours/week Quantity : Hours/week Observed Quality (ORCE) Observed Quality (ORCE) Type : Type : Relative/ In Home Care Relative/ In Home Care Child-care Home Child-care Home Child-care Center Child-care Center

36. Quality of Care ORCE (Observational Record of the Caregiving Environment) 6, 15, 24, 36, 54 months of age

37. ORCE Behaviors Shared positive affect Shared positive affect Positive physical contact Positive physical contact Responds to vocalization/child’s talk Responds to vocalization/child’s talk Speaks positively to child Speaks positively to child Asks questions of child Asks questions of child Other talk to child Other talk to child Stimulates cognitive development/teaches academic skill Stimulates cognitive development/teaches academic skill Facilitates behavior Facilitates behavior Mutual exchange Mutual exchange Negative/restricting actions (reversed) Negative/restricting actions (reversed) Speaks negatively to child (reversed) Speaks negatively to child (reversed)

38. ORCE Ratings Stimulation Stimulation Sensitivity/responsiveness Sensitivity/responsiveness Positive regard Positive regard Detachment/disengagement Detachment/disengagement Flat affect Flat affect Intrusiveness (at 36, 54 months) Intrusiveness (at 36, 54 months) Fosters exploration (at 36, 54 months) Fosters exploration (at 36, 54 months)

39. ORCE is related to… Quality of the physical environment Quality of the physical environment “Regulable” features of child care “Regulable” features of child care

40. Type of Care: Child Care Centers Larger groups of children Larger groups of children More toys More toys More structured activities More structured activities More children per adult More children per adult Children grouped by age Children grouped by age

41. Child-Care Homes More informal care More informal care More time in free play More time in free play Varying ages of children; often siblings Varying ages of children; often siblings Activities are more “home-like” Activities are more “home-like”

42. Relative/In-Home Care Most informal Most informal Care provider follows usual routine and incorporates child Care provider follows usual routine and incorporates child Little structure Little structure May be just caregiver and child or other related children May be just caregiver and child or other related children

43. …including Fathers

44. Quality of Care by Type Full range of quality in every type of care. Full range of quality in every type of care. Especially during the first two years, the average quality of care was higher in less formal care with fewer children. Especially during the first two years, the average quality of care was higher in less formal care with fewer children. ---NICHD ECCRN, 1996

45. What did we measure in the home setting?

46. Parenting Quality

47. Quality of Mother-child Interaction Ratings from 15 minute videotaped structured play interactions: Ratings from 15 minute videotaped structured play interactions: Sensitivity to distress Sensitivity to distress Sensitivity to nondistress Sensitivity to nondistress Detachment Detachment Intrusiveness Intrusiveness Cognitive stimulation Cognitive stimulation Positive regard Positive regard Negative regard Negative regard Flat affect Flat affect

48. Home Observation for Measurement of the Environment (HOME) Checklist of quantity and quality of support and stimulation available to the child in the home environment (e.g., books, age-appropriate play materials, appropriate responses to child, affection) Checklist of quantity and quality of support and stimulation available to the child in the home environment (e.g., books, age-appropriate play materials, appropriate responses to child, affection) Based on interview of mother with child present Based on interview of mother with child present

49. Is early, extensive participation in childcare a risk factor for insecure attachment?

50. A 30-sec introduction to attachment… Secure attachment—”comfortable sense of trust in the primary caregiver” Secure attachment—”comfortable sense of trust in the primary caregiver” Security is predicted by warm, sensitive, responsive parenting from primary caregiver Security is predicted by warm, sensitive, responsive parenting from primary caregiver Insecurity is predicted by detached, uninvolved, unresponsive, intrusive parenting Insecurity is predicted by detached, uninvolved, unresponsive, intrusive parenting Insecurity is a risk factor for subsequent behavior problems, problems with peers, relationships, poor social competence Insecurity is a risk factor for subsequent behavior problems, problems with peers, relationships, poor social competence

51. Attachment Results Security/insecurity was related to the quality of parenting. Security/insecurity was related to the quality of parenting. Security/insecurity was not related to the quality, quantity, or age of entry into childcare. Security/insecurity was not related to the quality, quantity, or age of entry into childcare. Dual-risk effect: Very insensitive parenting plus poor quality childcare, or many hours in childcare—greater proportion of insecure infants. Dual-risk effect: Very insensitive parenting plus poor quality childcare, or many hours in childcare—greater proportion of insecure infants. ---NICHD ECCRN, 1997

52. Child Care and Child Outcomes: More Questions  Is child care related to child cognitive, language and social outcomes at language and social outcomes at 4.5 years? 4.5 years?  If so, how? What are the specific effects of quality, quantity of care, and type of of quality, quantity of care, and type of care on child outcomes? care on child outcomes?  How big are these effects?

53. Statistical Controls Site, gender, ethnicity, maternal education, proportion time mother had partner in household, maternal depression, income, maternal sensitivity

54. I. Quality of Early Child Care For preschoolers, higher quality care over the first 4.5 years is associated with For preschoolers, higher quality care over the first 4.5 years is associated with better pre-academic skills better pre-academic skills better language skills better language skills

55. Differences in Child Care Quality vs. Differences in Parenting Quality: Language Competence Language Competence Parenting Quality d =.87 Child Care Quality d =.29 Language Competence 0 85 90 95 100 105 LowHigh m=95.3 m=97.6 0 85 90 95 100 105 LowHigh m=88.8 m=102.5

56. II. Type of Child Care More experience in child care centers is associated with More experience in child care centers is associated with better language skills better language skills more problem behaviors more problem behaviors

57. III. Quantity of Child Care (all types of care) More hours of child care over the first 4.5 years is associated with more problem behaviors more problem behaviors (aggression, disobedience)

58. All types of care All types of care Not a function of quality Not a function of quality No threshold No threshold Not just assertive behavior Not just assertive behavior Not clinical levels of aggression Not clinical levels of aggression

59. Differences in Amount of Child Care vs Differences in Parenting Quality: Behavior Problems at 54 Months Caregiver Reported Behavior Problems Parenting Quality d =.23 Quantity of Care d =.38 <10 hrs/wk30>hrs/wk 0 45 50 55 m=48.1 m=51.7 0 45 50 55 LowHigh m=51.0 m=48.8

60. Grade 5/6 Results

61. Statistical Controls Site, gender, ethnicity, maternal education, proportion time mother had partner in household, maternal depression, income, maternal sensitivity, classroom quality, after-school hours.

62. I. Quality of Early Child Care Higher quality care over the first 4.5 years is associated with: Higher quality care over the first 4.5 years is associated with: higher vocabulary scores in Grade 5 higher vocabulary scores in Grade 5

63. II. Type of Child Care More experience in child care centers is associated with More experience in child care centers is associated with more behavior problems in Grade 6 more behavior problems in Grade 6

64. Comparison of Effect Sizes Vocabulary: Vocabulary: Child-care quality--.06 Child-care quality--.06 Parenting quality--.25-.33 Parenting quality--.25-.33 Behavior Problems Behavior Problems Prop. center care--.08-.12 Prop. center care--.08-.12 Parenting quality--.11-.19 Parenting quality--.11-.19

65. Behavior-Problem Mean Scores Average score 50.0 Average score 50.0 “At-risk” score 60.0 “At-risk” score 60.0 No time in child care: 49.6 No time in child care: 49.6 1-2 years in center care: 50.0 1-2 years in center care: 50.0 3 years in center care: 51.4 3 years in center care: 51.4 (10% of sample) 4 years in center care: 52.0 4 years in center care: 52.0 (5% of sample)

66. Effect Size Considerations… Length of time between measurements Length of time between measurements Parenting—genetic and environmental influences? Parenting—genetic and environmental influences? Childcare—cumulative societal effects? Childcare—cumulative societal effects?

67. Classroom effects?

68. Are the effects of child care contagious? Dmitrieva, Steinberg, & Belsky (in press) Dmitrieva, Steinberg, & Belsky (in press) 3440 children in 282 Kindergarten classrooms—ECLS-K study 3440 children in 282 Kindergarten classrooms—ECLS-K study Beginning and end of Kindergarten year Beginning and end of Kindergarten year Externalizing problems (teacher report) Externalizing problems (teacher report) Achievement (teacher report + testing) Achievement (teacher report + testing)

69. Question: What are classroom composition effects, beyond demographic variables and effects of the child’s individual child-care history on her/his development? What are classroom composition effects, beyond demographic variables and effects of the child’s individual child-care history on her/his development?

70. For children with limited child- care experience….. Those in classrooms with many children with extensive center-based child-care experience had better academic growth than did children in classrooms with few children with extensive center-based experience. Those in classrooms with many children with extensive center-based child-care experience had better academic growth than did children in classrooms with few children with extensive center-based experience.

71. For children with limited child- care experience….. Those in classrooms with many children with extensive child-care experience were more aggressive and disobedient than were children in classrooms with few children with extensive child-care experience. Those in classrooms with many children with extensive child-care experience were more aggressive and disobedient than were children in classrooms with few children with extensive child-care experience.

72. Back to the NICHD Study…

73. What are the limitations of the study? It is not nationally representative It is not nationally representative We did not include the most high-risk disadvantaged families We did not include the most high-risk disadvantaged families It is not an “experiment” It is not an “experiment” Therefore, we cannot claim that child care causes child outcomes. Therefore, we cannot claim that child care causes child outcomes.

74. What are the strengths of the study? Largest, longest-term study of child care in relation to child development Largest, longest-term study of child care in relation to child development Prospective study Prospective study Began at birth Began at birth “Ecological” model – included data about “Ecological” model – included data about the family, home, school, neighborhood the family, home, school, neighborhood Multiple aspects of child development & health Multiple aspects of child development & health Exceptionally high-quality data Exceptionally high-quality data Diversity of investigators’ views Diversity of investigators’ views

75. Summing up: What do these results mean?

76. Parent(s) Matter!

77. Parents are spending more time with their children 1965--mothers spent 10.2 hrs per week tending to their children 1965--mothers spent 10.2 hrs per week tending to their children 2003--mothers spent 14.1 hrs per week 2003--mothers spent 14.1 hrs per week 1965—fathers spent 2.5 hrs per week 1965—fathers spent 2.5 hrs per week 2003—fathers spent 7 hrs per week 2003—fathers spent 7 hrs per week 2003 paid work + time spent with child = 65 hrs/wk for mothers, 64 for fathers. 2003 paid work + time spent with child = 65 hrs/wk for mothers, 64 for fathers. ---Bianchi et al., 2006

78. In our study at 7 months of age… Compared families in which the infant was in 30 or more hours of childcare vs. at home with mom since birth. Time interacting with mother—only 12 hours difference per week. Time interacting with mother—only 12 hours difference per week. Time not related to quality of mother- infant interaction or child outcomes. Time not related to quality of mother- infant interaction or child outcomes. ---Booth et al., 2002

79. A conservative politician… Our study “…proves what has long been obvious, that kids do better if nurtured by their own parents.”

80. Is there a developmental advantage to staying home with mom?

81. “Thank goodness I’m a stay-at- home mom!”

82. No evidence that exclusive maternal care is best Only 52 children with exclusive maternal care, birth to 60 months Only 52 children with exclusive maternal care, birth to 60 months Not different from child-care children in cognitive, language, social development Not different from child-care children in cognitive, language, social development High-quality child care > exclusive maternal care > low-quality child care— cognitive and language development. High-quality child care > exclusive maternal care > low-quality child care— cognitive and language development.

83. Are childcare quality and quantity important?

84. Results of other studies… Importance of child-care quality for lower-income and at-risk children (correlational and experimental studies) Importance of child-care quality for lower-income and at-risk children (correlational and experimental studies) Quantity findings consistent with those from ECLS and from a study in England Quantity findings consistent with those from ECLS and from a study in England

85. Consider child-care quantity and quality from the perspective of the child’s everyday experiences…

86. Quality of Care in the U.S. Poor 8% Fair53% Good30% Excellent 9% ---Booth et al., 1999

87. “Ira’s Discount Day Care”

88. My Recommendations Let’s stop making parents feel guilty and focus on supporting them Let’s stop making parents feel guilty and focus on supporting them Let’s stop thinking that staying at home with mom is the “gold standard” Let’s stop thinking that staying at home with mom is the “gold standard”

89. More recommendations… Family leave policies Family leave policies Flexible employment; re-entry strategies Flexible employment; re-entry strategies Improve child-care quality and choices Improve child-care quality and choices Educate parents about their importance; practical strategies Educate parents about their importance; practical strategies Pay attention to what is going on in child care Pay attention to what is going on in child care

90. More science… What is the role of stress? What is the role of stress? Given the small effect sizes for childcare quality, weighing of costs and benefits of specific improvements Given the small effect sizes for childcare quality, weighing of costs and benefits of specific improvements More data about “daily life” More data about “daily life” Classroom effects Classroom effects Age 15 results Age 15 results Relationship study—Age 17.5 Relationship study—Age 17.5