Relationship-Focused Child Care Practices: Quality of Care and Child Outcomes for Children in Poverty

Research Findings: Child care delivery practices promoting continuous, primary caregiver–child relationships (relationship-focused child care) were evaluated for 223 preschool-age children (45% African American, 55% Latino) attending child care centers serving low-income children. Both relationship-focused and non-relationship-focused centers were accredited by the National Association for the Education of Young Children. Children in relationship-focused programs received more sensitive, involved, and affectionate caregiving and were more engaged with their caregivers than children in comparison centers, but some differences were greater for African American children. Outcomes associated with relationship-focused care included greater parent-reported child compliance and closer parent–caregiver relations, but no consistent benefits for cognitive school readiness, receptive language, or child behavior problems were found. Follow-up assessments were completed 1 year later for 119 children who remained in their programs. Social and cognitive outcomes improved over time, but some changes were moderated by child race/ethnicity and center type. Over time, parents reported greater child compliance and caregivers reported better parent–caregiver relationships in relationship-focused programs. Practice or Policy: Some social benefits of continuous, primary caregivers were found, but children's cognitive competencies improved with sustained attendance at these accredited programs regardless of the relationship-focused practices.     

Continuity of Care,Caregiver–Child Interactions,and Toddler Social Competence and Problem Behaviors

ABSTRACT

Research Findings: Continuity of care is a recommended practice in child care intended to promote secure and supportive relationships between infants and toddlers and their caregivers. Toddlers (N = 115) between 12 and 24 months were observed in 30 continuity and 29 noncontinuity classrooms. The average duration of care for toddlers with caregivers was 14 months in the continuity rooms and 5 months in noncontinuity rooms. Toddlers observed in continuity rooms experienced higher levels of interactive involvement with their caregivers and were rated by their caregivers as having fewer problem behaviors compared with the toddlers in noncontinuity rooms. Toddlers in rooms with higher staff–child ratios also experienced more involved caregiving. We did not find evidence that the level of involved caregiving mediated the association between continuity of care and toddlers’ social competence or problem behaviors. Practice or Policy: Continuity of care may be a promising practice for programs that strive to provide high-quality care for infants and toddlers.     

Early Head Start Relationships: Association with Program Outcomes

Research Findings: Interpersonal relationships among staff caregivers, parents, and children have been recommended as essential aspects of early childhood intervention. This study explored the associations of these relationships with program outcomes for children and parents in 3 Early Head Start programs. A total of 71 children (8–35 months, M = 20), their parents, and 33 program caregivers participated. The results showed that caregiver–child relationships were moderately positive, secure, and interactive and improved in quality over 6 months, whereas caregiver–parent relationships were generally positive and temporally stable. Caregiver–child relationships were more positive for girls, younger children, and those in home-visiting programs. Caregiver–parent relationships were more positive when parents had higher education levels and when staff had more years of experience, had more positive work environments, or had attained a Child Development Associate credential or associate's level of education rather than a 4-year academic degree. Hierarchical linear modeling analysis suggested that the quality of the caregiver–parent relationship was a stronger predictor of both child and parent outcomes than was the quality of the caregiver–child relationship. There were also moderation effects: Stronger associations of caregiver–parent relationships with observed positive parenting were seen in parents with lower education levels and when program caregivers had higher levels of education. Practice or Policy: The results support the importance of caregiver–family relationships in early intervention programs and suggest that staff need to be prepared to build relationships with children and families in individualized ways. Limitations of this study and implications for program improvements and future research are discussed.     

The crucial role of the micro caregiving environment: Factors associated with attachment styles in alternative care in Chile

The distribution of attachment styles has been shown to differ between groups of children living with their parents and children placed in alternative care (AC), defined as residential or foster. However, this is the first study in Latin America to explore possible factors affecting the quality of attachment in children living in both residential and foster care. Two groups of children (N = 57) were compared: one group living in Residential Homes (RC) and the other in Foster Care (FC) in Chile. Children’s, caregivers’ and structural factors (e.g., child: caregiver ratios) and their links with attachment styles were investigated. The micro caregiving environment (i.e., the specific individual child caregiver relationship), especially the caregivers’ engagement, sensitivity, disciplinary control and affection, as well as some structural factors (i.e., child: caregiver ratios), were linked to attachment security in children. Specifically, better emotional caregiving and lower child-caregiver ratios were associated with higher rates of secure attachment. The association between quality of care (as measured by the HOME inventory) and attachment styles seems to be influenced by caregiver relationships (as measured by CCSERSS). Caregiver relationship factors (i.e., affection, engagement and sensitivity) directly impact the quality of the attachment children establish with them while living in AC. However, the relationships that caregivers establish with children under their care can be facilitated by good quality structural factors, particularly child-caregiver ratios.     

Who cares for the child in day care? An examination of caregivers from three types of care

As part of a larger study, the Victoria Day Care Research Project, caregivers representing three different types of caregiving arrangements (licensed center-based day care, licensed family day care homes, and unlicensed family day care homes) were interviewed. The structured interviews of approximately 1 hour covered the following caregiver-related areas: caregiver personal, socioeconomic status (SES), and support system factors; caregiver relationships with the chldren's mothers and general attitudes towards maternal employment; caregivers' perceptions of their own programs and children they care for; and caregivers' satisfaction with their employment. From the interview data, distinctive profiles emerged for each of the three caregiving groups. The data on the three caregiver groups and their composite profiles are presented in the article.     

Multiple determinants of caregiver behavior in child care centers

In this study of the multiple determinants of professional caregiving, 237 caregivers (age range: 18–56 years) from 64 Dutch child care centers were extensively observed during their interactions with the children (0–4 years) in their usual care group. The choice of potential determinants of the caregiving quality was guided by Belsky's [Belsky, J. (1984). The determinants of parenting: A process model. Child Development, 55, 83–96] model of the determinants of parenting. Consistent with Belsky's model, quality of caregiving was found to be multiply determined by characteristics of the caregiver, the children and the caregiving context. More specifically, lower-quality care was provided by younger caregivers, to younger children, and by caregivers reporting higher physical occupational workloads. The differences between the participating child care centers proved to explain more variance in the quality of professional caregiving than the differences between the individual caregivers.     

Assessment of Early Childcare Programs in Jordan

Research Findings: Forty-five child caregivers and 120 parents participated in this study to examine perceptions of childcare programs in Jordan. The researchers developed a questionnaire that consisted of 6 dimensions: health, education, parent–caregiver relationship, facilities, building/landscape, and playground. Moreover, interviews with 10 child caregivers and 20 parents were conducted. Results indicated that child caregivers expressed moderate satisfaction with the programs. In contrast, parents expressed lower satisfaction with the childcare programs. The results also revealed that caregivers and parents perceived the playground area as effective but found health and the parent–caregiver relationship ineffective. Practice or Policy: This study highlights the need to supervise childcare programs effectively and the importance of fostering a strong partnership between child caregivers and parents.     

Is Caregiver Gender Important for Boys and Girls? Gender-Specific Child–Caregiver Interactions and Attachment Relationships

Outcomes of studies with exclusively or predominantly female caregivers suggest that boys in child care are involved with interactions, attachment relationships, and care of lower quality than girls. We investigated to what extent child gender (N = 38, 19 boys) and caregiver gender (N = 38, 19 males) is associated with child–caregiver interactions and attachment relationships. Children’s involvement and caregivers’ sensitive and stimulation behaviors were observed using systematic observations of semistructured play. Children’s secure attachment with caregivers was observed using the Attachment Q-Sort. Research Findings: Male and female caregivers showed similar sensitive behaviors toward boys and girls, and children had similar levels of secure attachment with male and female caregivers. Female caregivers had a tendency to stimulate boys more than girls, and this behavior was associated with a lower secure attachment in boys. Girls’ involvement with the caregiver was associated with male and female caregivers’ sensitive behavior and with male but not female caregivers’ stimulation. Conversely, boys’ involvement with the caregiver was elicited by sensitive but not stimulating behavior of male caregivers but not by female caregivers. Practice or Policy: Boys and girls can have equally positive interactions and attachment relationships with both male and female caregivers.     

Relationship-Focused Child Care Practices: Quality of Care and Child Outcomes for Children in Poverty

Research Findings: Child care delivery practices promoting continuous, primary caregiver-child relationships (relationship-focused child care) were evaluated for 223 preschool-age children (45% African American, 55% Latino) attending child care centers serving low-income children. Both relationship-focused and non-relationship-focused centers were accredited by the National Association for the Education of Young Children. Children in relationship-focused programs received more sensitive, involved, and affectionate caregiving and were more engaged with their caregivers than children in comparison centers, but some differences were greater for African American children. Outcomes associated with relationship-focused care included greater parent-reported child compliance and closer parent-caregiver relations, but no consistent benefits for cognitive school readiness, receptive language, or child behavior problems were found. Follow-up assessments were completed 1 year later for 119 children who remained in their programs. Social and cognitive outcomes improved over time, but some changes were moderated by child race/ethnicity and center type. Over time, parents reported greater child compliance and caregivers reported better parent-caregiver relationships in relationship-focused programs. Practice or Policy: Some social benefits of continuous, primary caregivers were found, but children's cognitive competencies improved with sustained attendance at these accredited programs regardless of the relationship-focused practices.     

Who's minding the kids? Experimental evidence on the demand for child care quality

Despite the well-documented benefits of high-quality child care, many preschool-age children in the U.S. attend low-quality programs. Accordingly, improving the quality of child care is increasingly an explicit goal of government policy. However, accomplishing this goal requires a thorough understanding of the factors that influence parents’ child care decisions. This paper provides the first evidence on the demand for child care characteristics in the market for home-based care. Using a randomized audit design, we study three dimensions of caregiving: affordability (i.e., the hourly price of child care), quality (i.e., caregiver education and experience), and convenience (i.e., caregiver car ownership and availability). We find that while parents are extremely sensitive to the cost of child care, they also have strong preferences for quality, particularly caregivers’ educational attainment. Furthermore, we obtain mixed results on the convenience dimensions of child care, with parents valuing those owning a car but not those with more availability. Finally, we find significant heterogeneity in child care preferences according to families’ age of youngest child, race and ethnicity, and willingness-to-pay. Our findings are consistent with the notion that the problem of low-quality in the U.S. child care market may be explained by lack of affordability or the informational resources to identify high-quality care, rather than an undervaluation of such care by parents.     

Child sexual abuse by nonrelated caregivers

This study examined the social contexts in which sexually abusive child care providers came into contact with children and parents. Content analysis of 325 case records resulted in the identification of seven main child care arrangements in which sexual abuse occurred. These arrangements varied by the routinization and formality of the caregiving relationship, as well as the methods of caregiver selection and reimbursement. The main finding was that the vast majority of female perpetrators were adolescents whose abusive behavior took place in the caregiving arrangement in which she is selected by parents, engaged on a routine basis, and paid a sum of money for her child care. In contrast, sexually abusive male caregivers represented a wide range of ages and committed sexual abuse over a significantly broader range of situations than female caregivers.     

The Role of Parent,Provider, and Child Characteristics in Parent–Provider Relationships in Infant and Toddler Classrooms

Research Findings: This study examined how characteristics of parents, providers, and children contribute to the quality of parent–provider relationships in infant and toddler classrooms. Parents (n = 192) and providers (n = 95) from 14 child care centers in a large metropolitan area participated by completing questionnaires about the nature of their relationships and communication, as well as other aspects of the child care experience. Although the study did not examine causal relations between variables, characteristics of parent–provider relationships were correlated with parents’ anxiety about placing their children in care, with providers’ knowledge of child development, and with whether parents and providers had worked together in the past. Parents’ views of their relationships with providers were more positive when they had worked with them before and when they were less anxious about placing their children in care. Providers who had worked with parents before had less favorable views of their relationships when parents were more anxious about placing their children in care; however, this was not the case when providers and parents were in more recent relationships. Providers who had never worked with parents before viewed relationships more positively when they had more knowledge of child development. The opposite was true for providers who had worked with parents before. Providers with more knowledge of child development reported communicating more frequently with parents. Providers reported communicating more frequently with parents of children with easier temperaments. Practice or Policy: Implications for transition practices in early care and education settings, in-service training, and teacher education programs are discussed.     

Child Care Quality in The Netherlands Over the Years: A Closer Look

Research Findings: We assessed the quality of child care in a nationally representative sample of 200 Dutch child care centers using the Infant/Toddler Environment Rating Scale–Revised and/or Early Childhood Environment Rating Scale–Revised and compared it with a previous assessment in 2005. The Caregiver Interaction Profile (CIP) scales were used to rate the quality of caregiver–child interactions. Results showed a significant and substantial decline in quality compared to 2005, with 49% of the groups now scoring below the minimal level. The CIP scales showed relatively high scores for the basic caregiver interactive skills of sensitive responsiveness, respect for autonomy, and structuring and limit setting but much lower scores for the more educational skills of verbal communication, developmental stimulation, and fostering positive peer interactions. Caregiver sensitive responsiveness was significantly lower in infant groups (0–2 years) than in preschool groups (2–4 years); caregiver respect for autonomy, verbal communication, developmental stimulation, and fostering positive peer interactions were significantly lower in infant groups than in preschool groups and mixed-age groups (0–4 years). Practice or Policy: Quality of child care is not stable across the years, and regular quality assessments are therefore needed to monitor child care quality. The low scores on the more educational versus the more basic caregiver interactive skills indicate that these skills deserve more attention in caregiver education and training. Training programs should be attuned to the individual interaction skill profile of caregivers.     

Barriers to the implementation of continuity-of-care practices in child care centers

This study examined barriers to the implementation of continuity-of-care practices in child care centers. We collected qualitative and quantitative data for 52 children at four centers that advertise their programs as continuity programs. Of the 52 children, only 7 of the children had been cared for in a single child–caregiver dyad between the time of their entry into child care and either their third birthday or the time of data collection. During their infant–toddler period, the remaining 45 children had experienced 71 cumulative transitions to new child–caregiver dyads. We found that the barrier frequently suggested in the literature and by practitioners, caregiver turnover, was not a significant cause for the non-continuity transitions. The primary barrier that we found was infant caregiver unwillingness or inability to care for children who had developed toddler abilities. A secondary barrier was directors’ reluctance to replace unwilling or unable caregivers with willing and able ones.     

Cortisol levels of caregivers in child care centers as related to the quality of their caregiving

The present study examined whether stress in professional caregivers – as reflected in salivary cortisol levels – is related to the quality of their caregiving behavior. The 221 professional female caregivers in 64 child care centers were observed in three different situations and saliva samples were taken three times during the morning. Results showed that higher levels of cortisol, particularly at the beginning of the workday, predicted lower-quality caregiver behavior beyond the contribution of three other predictors, namely a higher self-reported physical workload, more children under age two in the care group, and lower caregiver age. Contrary to the expectation, higher cortisol levels did not mediate the relation between higher self-reported physical workload and more children under age two on the one hand and lower-quality caregiving behavior on the other.     

Improving caregivers’ confidence with the Powerful Tools for Caregivers program

ABSTRACT

The Powerful Tools for Caregivers (PTC) program is designed to help caregivers develop skills to improve their self-efficacy in caregiving. To demonstrate the effectiveness of the PTC program in Boise, Idaho, the program’s pre-survey (n = 277), end-of-program survey (n = 131), and 6-month follow-up post-survey data (n = 100) collected between 2011 and 2017 were analyzed in this study. The end-of-program survey data indicated that caregivers viewed the quality of the program to be excellent and that all of them felt more confident as a caregiver. Factor analysis and reliability testing on the pre-survey data confirmed that seven questions included in the pre- and 6-month follow-up post-survey instruments reliably measured a single factor named as caregiver confidence. A paired samples t-test on 76 complete sets of pre- and 6-month follow-up post-survey data on the seven questions revealed that caregivers improved their confidence in caregiving to a statistically significant level (p < .001, d = 45). Additional paired samples t-tests on each of the seven questions with the Bonferroni correction showed statistically significant improvements in three areas: making tough decisions (p < .001, d = .53), coping with emotions (p < .001, d = .54), and using stress-reducing activities (p < .007, d = .33). Caregivers experienced the greatest improvement in their confidence in making tough decisions. Despite these significant improvements, caregivers still struggled with finding ways to reduce stress and manage their emotions associated with caregiving as shown by the lowest pre- and 6-month follow-up post-survey scores. In addition to the study results, several considerations when synthesizing PTC research results are discussed.     

Caregiver Responsiveness During Preschool Supports Cooperation in Kindergarten: Moderation by Children’s Early Compliance

Research Findings: The current study examined how children’s parent-reported compliance at age 3 (36 months) moderated the effects of 2 dimensions of directly observed early care and education (ECE) process quality (positivity/responsivity and cognitive stimulation) during the prekindergarten year (54 months) on teacher reports of children’s classroom cooperation in the fall of kindergarten. Compliance at 36 months and cooperation in kindergarten are operationalized as overt, behavioral aspects of self-regulation as appraised by parents and teachers. The sample consisted of 996 children from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development who attended formal or informal ECE settings during the prekindergarten year. Results indicated that children with low compliance at age 3 tend to demonstrate stronger cooperation skills by kindergarten when they experience more positivity/responsivity from their ECE caregivers. Main effects of positivity/responsivity and cognitive stimulation on classroom cooperation were not detected for the overall sample. Practice or Policy: The discussion addresses the importance of preparing and empowering ECE providers to help young children who enter the preschool period struggling with behavioral aspects of self-regulation, such as compliance, to improve these skills through positive and responsive caregiving.     

Adaptation in the transition to school: perspectives of parents,preschool and primary school teachers

Background: Transition to school is a highly demanding phase at an intellectual, social and emotional level and is, therefore, an opportunity for growth and development. Despite the greater emphasis given to school transition in Portugal over recent years, namely by means of new educational policies, studies on the adaptation processes involved in the transition to primary school are still scarce.

Purpose: The present qualitative study sets out to contribute to the knowledge on the adaptation process of children to school transition (around age 6) in Portugal, by comparing preschool teachers’, primary school teachers’, and parents’ perceptions about success indicators and relevant factors in the transition to school.

Design and method: In order to collect data, 14 focus group interviews with different participants were conducted, three with preschool teachers (N = 18), three with primary school teachers (N = 13), four with parents conducted before the child’s transition to primary school (N = 14) and four with parents conducted after the child’s transition to primary school (N = 20).

Results: While the preschool and primary school teachers stressed factors of a family nature, such as parental involvement and parental support of children, the parents referred more frequently to the overall running of the school and the characteristics and methodology of the teacher as being relevant to the adaptation process in the first year of primary education.

Conclusions: The findings suggest different factors associated with adaptation to school and also offer clues for designing strategies to facilitate such adaptation. New strategies are needed to facilitate the construction of a robust educational family–school partnership.     

Measuring the Interactive Skills of Caregivers in Child Care Centers: Development and Validation of the Caregiver Interaction Profile Scales

Research Findings: High-quality caregiver–child interactions constitute the core of high-quality child care for young children. This article describes the background and development of the Caregiver Interaction Profile (CIP) scales to rate 6 key skills of caregivers for interacting with 0- to 4-year-old children in child care centers: sensitive responsiveness, respect for autonomy, structuring and limit setting, verbal communication, developmental stimulation, and fostering positive peer interactions. Each interactive skill is rated on a 7-point scale based on observation of video-recorded caregiver–child interactions. Together, the 6 scale scores constitute an Interaction Profile for individual caregivers that may serve as a starting point for education and training to improve the quality of caregiver–child interactions. This article also presents the results of a 1st study with the CIP scales, in a sample of 145 caregivers from 75 child care groups in 47 child care centers in The Netherlands. Practice or Policy: Results provide promising preliminary evidence supporting the reliability and validity of the CIP scales.