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5 Effects of Child Care O ne by-product of the increase in women's employment in the United States has been a transformation in how children are cared for. This transformation has affected children of all ages--from the youngest infants to adolescents. Children in the United States typically begin full-time (i.e., 40 hours a week) nonmaternal care during their first year and this often lasts through elementary school, since the regular school day is typically shorter than parents' workdays. A critical issue for parents, educators, and policy makers is whether these care experiences are a source of enrichment that contributes positively to children's developmental out- comes or are a source of risk that undermines development. Substantial progress has been made in the past 15 years in determining the effects of child care on children's cognitive and social functioning. This progress reflects a convergence of conceptual and methodological advances and the availability of several large-scale research projects (see Box 5-1). From this research base, it is possible to specify the effects of nonmaternal care on children's development with greater confidence and precision than was possible when the National Academies published the 1990 report en- titled Who Cares for America's Children? (NRC, 1990). This chapter reviews the conceptual and methodological advances that have informed recent research. Then we evaluate the research evidence pertaining to the effects of three aspects of early child care--quality, type of care, and quantity--on a wide range of child developmental outcomes. Included in this review is consideration of experimental studies of center- based early education programs, which fulfill both child care and educa- 99

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100 WORKING FAMILIES AND GROWING KIDS BOX 5-1 Multisite Child Care Studies 1. National Institute of Child Health and Human Development (NICHD) Study of Early Child Care The Study of Early Child Care (SECC) is a prospective longitudinal study of 1,364 children recruited at birth from 10 research sites: Little Rock, Arkansas; Irvine, California; Lawrence, Kansas; Boston, Massachusetts; Morganton, North Carolina; Philadelphia, Pennsylvania; Pittsburgh, Pennsylvania; Charlottesville, Virginia; Seattle, Washington; and Madison, Wisconsin. The sample includes eth- nic minority children (24 percent), mothers without a high school diploma (10 per- cent), and single mothers (14 percent). The recruited families did not differ from the eligible families on any of a substantial number of variables, except that moth- ers in the study were more likely to plan to be employed in their infant's first year. Of the 1,364 families who began the study, 1,216 continued through 36 months, 1,062 continued through 1st grade, and 1,033 continued through 3rd grade. Extensive information was collected about child care, families, and child functioning (see Annex Table A5-4). Extended observations of children's primary child care arrangements were conducted at 6, 15, 24, 36, and 54 months. Mothers reported amount and types of care during phone interviews every three to four months. In addition, extensive information about the children's families and homes was obtained during home and lab visits at 1, 6, 15, 24, 36, and 54 months. Child developmental (cognitive, social, academic, and health) outcomes were assessed using multiple methods (standardized tests, observations, questionnaires) and multiple respondents (mother, father, teacher). The study's design has made it possible to examine quality, quantity, and type of child care in the same analyses in order to estimate the unique contribu- tions of each factor. It also is possible to examine effects of timing (see Brooks- Gunn et al., 2002) and trajectories of care (see NICHD Early Child Care Research Network, 2002c). Another strength is that it is possible to include extensive con- trols for family factors, including controls for such observed factors as mother-child interaction and the home environment. The longitudinal data have permitted ex- aminations of changes in scores (NICHD Early Child Care Research Network and Duncan, 2002). Although it is a remarkably rich dataset, the NICHD study is limited in some important respects. The sample is not nationally representative. Compared with Census Bureau figures from all births in the United States in 1991, white, non- Hispanic children are somewhat overrepresented in the sample and children from ethnic minority groups are somewhat underrepresented (NICHD Early Child Care Research Network, 2001c). Mean household income and maternal education also were higher than the U.S. average. There also are indications (NICHD Early Child Care Research Network, 2000a) that poorer quality child care settings were less likely to have been observed, meaning that effects associated with quality of child care may be underestimated. 2. Cost, Quality, and Outcome Study The Cost, Quality, and Outcomes Study (CQO; Peisner-Feinberg et al., 1999) was conducted in four states (California, Colorado, Connecticut, and North Carolina) that varied in the stringency of their child care regulations. The initial sample was recruited in 1993 and consisted of 579 children (30 percent ethnic minority) who were enrolled in 183 preschool classrooms. At the start of the study, the children were in their next-to-last year of preschool before entering school. Classrooms were observed and rated for quality of the classroom environment, teacher sensitivity, and teaching style. These quality indicators were combined

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EFFECTS OF CHILD CARE 101 into a single process quality composite. Children were followed through two years of child care and the first three years of school (kindergarten through 2nd grade) and completed tests of receptive language ability, reading ability, and math skills. Child care staff and schoolteachers rated the children's cognitive and attention skills, sociability, and problem behaviors yearly. 3. The Three-State Study The Three-State Study (Scarr et al., 1994) was conducted in Georgia, Mas- sachusetts, and Virginia, three states that varied in child care regulations. The sample consisted of 120 centers that included randomly selected programs from national chains, with nearby nonprofit programs, local for-profit centers, and church sponsored centers situated. Each program was observed during a single full-day visit that included observations of an infant classroom, a toddler classroom, and a preschool classroom. A total of 718 children (176 infants, 291 toddlers, and 251 preschoolers) were observed at the centers. Mothers and fathers completed ques- tionnaires about the study child's problem behaviors, as well as information about family income, education, parenting attitudes, and parenting stress. 4. The National Day Care Study The National Day Care Study (Ruopp et al., 1979) included a quasi-experi- ment that was conducted at 49 publicly funded centers in three cities (Atlanta, Geor- gia; Detroit, Michigan; and Seattle, Washington) and a random assignment experi- ment that was conducted in eight centers (29 classrooms). In the quasi-experiment, ratios were improved in some centers, high ratios were maintained in some centers, and low ratios were maintained in other centers. In the experiment, classrooms were assigned to one of three levels of staff education (master's degree, completed 2-year training program, had not completed 2-year training) and one of two ratios (5:1 versus 7:1). Outcomes included observed teacher and child behavior at the centers and child performance on standardized cognitive assessments. 5. Family and Relative Care Study This study was conducted in three communities (San Fernando Valley, Cali- fornia; Charlotte, North Carolina; and Dallas, Texas) that differed in the stringency of their child care home licensing regulations (Kontos et al., 1995). Participants were identified from random digit phone calls, birth records, and referrals for child care providers. A total of 820 families and 226 child care homes and providers of relative care were contacted. The final sample of children consisted of 145 cases (35 per- cent ethnic minority, 54.7 percent low or very low income) in which both mother and provider agreed to participate. Three-hour observations were conducted at each home by trained field staff, and quality of care was assessed using the Family Day Care Rating Scale (FDCRS). 6. The National Child Care Staffing Study (NCCSS) The National Child Care Staffing Study (NCCSS) was conducted in 1988 in 227 centers in five metropolitan areas in the United States (Atlanta, Georgia; Bos- ton, Massachusetts; Detroit, Michigan; Phoenix, Arizona; and Seattle, Washing- ton). Approximately 45 centers were randomly selected from the licensed full-day programs in each city. In each center, an infant, toddler, and preschool classroom was randomly selected, and two teachers in these classrooms (six per center; total number of teachers = 1,309) were interviewed about their training, education, wages, experience, and personal background. The selected classrooms also were observed by the research staff, who rated process quality using the Early Child- hood Environment Rating Scale (ECERS), the Infant/Toddler Environment Rating Scale (ITERS), and the Arnett Scale of teacher sensitivity.

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102 WORKING FAMILIES AND GROWING KIDS tional functions. We then examine the effects of different types of child care during middle childhood. CONCEPTUAL AND METHODOLOGICAL ADVANCES Various aspects of child care have informed the advances of researchers working to understand the effects of child care on the cognitive and social functioning of children. Relationship Among Contextual Factors Bronfenbrenner's ecological systems theory (1979, 1989; Brofenbrenner and Morris, 1998) has guided much of the research by developmental psychologists who study child care effects (see NICHD Early Child Care Research Network, 1994; Vandell and Posner, 1999). A key element of the theory is a framework of nested relations among contextual factors, which are conceptualized as microsystems, mesosystems, and exosystems. A microsystem is described as "a pattern of activities, roles, and interpersonal relations experienced by the developing person in a given setting with par- ticular physical and material characteristics" (Bronfenbrenner, 1979:22). Consistent with the formulation, child care researchers have developed detailed descriptions of children's activities, roles, and interpersonal rela- tions at centers and day care homes, and with nannies and grandparents (see Clarke-Stewart, Gruber, and Fitzgerald, 1994; Howes, 1983; NICHD Early Child Care Research Network, 1996, 2000a). These descriptions proved instrumental in the development of measures that distinguish high- quality and low-quality care. Bronfenbrenner conceptualizes the mesosystem as "the interrelations among two or more settings in which the developing person actively partici- pates, such as, for a child, the relations among home, school, and neighbor- hood peer group" (1979:25), and this also has influenced research in this area. One child care and family linkage that has been extensively investi- gated is families' selection of care arrangements. In some cases, selection reflects active decision making, which occurs when parents visit several providers and then select one. In other cases, parents may use an arrange- ment because it is the only one that they can afford, even if they have concerns about it. The critical point is that family preferences and circum- stances influence the particular care that children receive. Child care and the family also are interconnected because child care may affect family functioning. An example of such effects was reported in the Wisconsin Family and Work Project. Early and extensive child care was related to maternal and paternal emotional well-being (Vandell et al., 1997). Increases in maternal and paternal depression, anger, and anxiety were

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EFFECTS OF CHILD CARE 103 found in parents whose infants were in full-time child care during the first four months, but not in parents whose children were not in early and extensive child care. These associations between child care and the family highlight a chal- lenge for child care research, namely, to distinguish between aspects of the family that influence placement into care and aspects of the family that change in response to child care. Only the former reflect selection differ- ences, whereas the latter may be indicative of changes in family functioning that mediate child care effects. Longitudinal studies have begun to track the interplay between child care and the family over time. Bronfenbrenner conceptualizes the exosystem as "one or more set- tings that do not involve the developing person as an active participant, but in which events occur that affect, or are affected by, what happens in the setting containing the developing person" (1979:25), and this also has guided research about child care. For example, as discussed earlier, the mother's work environment (her schedule, working conditions, etc.) has implications for the child's development even if the child is not typically cared for at the mother's work site (Hoffman and Youngblade, 1999). Such effects are consistent with the conceptualization of the exosystem. Multidimensional Aspects of Child Care A second advance that has occurred in child care research since the mid-1980s is the move from simple comparisons of day care versus no day care to studies that focused on quality, quantity, and type of child care (see Lamb, 1998, for a comprehensive review). Studies of child care quality have asked whether structural and caregiver characteristics as well as more process-oriented indicators of caregiving are related to child developmental outcomes. Studies of child care quantity have asked if cumulative hours in child care as well as when care begins are related to child outcomes. Type- of-care studies have primarily focused on the effects of center care, al- though some research has considered the effects of child care homes, nan- nies, and relatives on child outcomes. A limitation of much of the research in this area is that these three aspects of care (quality, type, and quantity) have been studied in isolation, that is, without consideration of the other aspects. Thus, quantity of care has been investigated without consideration of the quality of care, and quality of care was studied without consideration of quantity. Findings in these studies are sometimes difficult to interpret because it is not possible to rule out alternative explanations for purported effects (Phillips et al., 1987a; Vandell and Corasaniti, 1990). Several recent projects, described below, have sought to disentangle effects associated with quality, amount, and

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104 WORKING FAMILIES AND GROWING KIDS type of care by including measures of all three aspects of care in their design and analyses. Multiplicity of Child Care Arrangements A third advance is the recognition that children in the United States often have multiple child care arrangements, both simultaneously and se- quentially (see Chapter 3). This multiplicity of arrangements means that researchers have needed to collect information about child care over time and include secondary and tertiary arrangements as well as the primary arrangement. Otherwise, key aspects of these arrangements may not be measured adequately. Surveys such as the National Child Care Survey and the National Household Education Survey have asked parents to report both primary and secondary arrangements, and the Survey of Income and Program Par- ticipation (SIPP) asks parents to report all child care arrangements used by each child. The NICHD Study of Early Child Care obtained reports from mothers every three to four months to document the types and amount of care that were used. Correlational Versus Experimental Designs Although research examining the effects of high-quality center-based interventions on children from low-income families (e.g., Ramey et al., in press) has relied on experimental and quasi-experimental designs, most of the research examining the effects of child care quality and quantity has used correlational designs. As is the case with any correlational study, there are important concerns that unmeasured factors may account for reported effects (Blau, 2001). In some cases, child care researchers have sought to address possible selection bias by including multiple controls for family and child characteristics (examples of such studies appear in the annex at the end of this chapter, see Tables A5-1, A5-2, A5-3). In other cases, investiga- tors (Blau, 2000; NICHD Early Child Care Research Network and Duncan, 2003, discussed below) have considered the robustness of findings using other statistical methods to control for biases introduced by unobserved factors. Characteristics of the Child A final advance reflected in much of the recent research is the recogni- tion that child characteristics also may influence placement in child care. A long line of scholarship has shown that children (and parents) actively seek out environments that are consistent with children's maturity, interests, and

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EFFECTS OF CHILD CARE 105 skills (Scarr and McCartney, 1983). For child care researchers, the issue is whether children with particular characteristics, dispositions, or skills are more likely to be placed in some settings and not others, and if these selection differences account for the observed findings. In some instances, it is relatively easy to identify child characteristics that affect placement. Placement based on age, for example, is easy to determine; infants are more likely to be placed in relative care, whereas preschoolers are more likely to be placed in centers. Identifying child dispositions and compe- tencies that influence placement in early child care is more difficult, because of the absence of reliable and robust measures of social and cognitive func- tioning for young infants that can be obtained before they begin child care. In several reports, the NICHD investigators used maternal reports of child temperament collected at 6 months of age as an indicator of child disposition, but by 6 months, 75 percent of the children had already been in care for 3 months (or half their lifetime). Measures of child functioning obtained after care begins may reflect the effects of that care and thus may not be measures of child selection. Measuring child adjustment and functioning for older children is more feasible because there are numerous psychometrically strong measures of social and cognitive functioning that are appropriate for preschoolers and young school-age children. QUALITY OF EARLY CHILD CARE In this section, we consider the research evidence pertaining to the effects of child care quality on developmental outcomes. First, we describe how quality is measured, focusing on measures of process quality, struc- tural characteristics, and caregiver characteristics. Next, a model is pre- sented that describes the interactions among various dimensions of child care experiences. This model has guided much research on the effects of child care quality on children's developmental outcomes. Three sets of research findings related to this model are explored. These include: (1) relations between structural characteristics and process quality, (2) rela- tions between process quality and child outcomes, and (3) relations be- tween structural measures and child outcomes. Both concurrent and longer term associations are presented. Measuring Child Care Quality Process quality refers to the kinds of experiences that children have with caregivers and other children, opportunities for cognitive, linguistic, and social stimulation, and opportunities to use interesting and varied ma- terials. Process quality is typically assessed by trained personnel who observe the arrangement for an extended period of time. Particular expe-

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106 WORKING FAMILIES AND GROWING KIDS riences are evaluated because developmental theory and research have iden- tified them as important for children's healthy development. There are several robust measures of process quality that have been used by research- ers. Each of these measures is designed to serve somewhat different pur- poses. All of these measures are strong measures that have particular uses and strengths. One of the most commonly used measures of process quality is the Early Childhood Environment Rating Scale (ECERS) (Harms and Clifford, 1989), an instrument used to assess center-based care for preschool-age children. It consists of 37 items and evaluates 7 areas: personal care rou- tines, furnishings, language reasoning experiences, motor activities, creative activities, social development, and staff needs. Detailed descriptors are provided for each item, which is rated on a scale from 1 to 7 in which 1 = inadequate, 3 = minimal, 5 = good, and 7 = excellent. Ratings are com- pleted after at least two hours of observation in a classroom. The Infant/Toddler Environment Rating Scale (ITERS) (Harms et al., 1990) is a related measure for use in classrooms serving children under the age of 21/2 years. The Family Day Care Rating Scale (FDCRS) rates process quality in child care homes (Harms and Clifford, 1989), and the School- Aged Care Environment Rating Scale (SACERS) is appropriate for before- school and after-school programs serving school-age children. All of these measures have good internal consistency, and field staff can be trained to use them fairly easily The Observational Record of the Caregiving Environment (ORCE) was developed by the NICHD Early Child Care Research Network (1996, 2000a) to assess all types of child care settings. Age-appropriate versions are available for children ages 6 months to 5 years.1 Observers complete both time-sample behavioral counts and qualitative ratings during a series of 44-minute observation cycles collected over a 2-day period. The ob- server records the frequency or amount of specific caregiver behaviors, such as responds to child vocalization and asks questions, and makes qualitative four-point ratings of caregiver sensitivity to the child's needs, cognitive stimulation, positive regard for the child, emotional detachment, and nega- tive regard. The positive caregiving composite score is the mean of the qualitative scales, after reflecting the ratings of detachment and negative regard. Annex Table A5-4 provides the distribution of child care quality (cat- egorized as poor, fair, good, excellent) that was derived from positive caregiving composite scores of the ORCE in the NICHD Study of Early Child Care. In these analyses, poor quality care was defined as a composite 1 Coding manuals, including detailed descriptions of scales at each age, can be found at http://secc.rti.org.

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EFFECTS OF CHILD CARE 107 score of less than 2, fair quality care as a score of 2 or more, but less than 3, good quality care was a score between 3 and 3.5, and excellent quality care was a score of 3.5 or higher. Because there is no nationally represen- tative study that has assessed process quality in the United States, the observations from the NICHD study and other multisite studies (described in Annex Table A5-2) are the only available estimates of process quality in the United States. In the NICHD study, 7 percent of the settings observed were of poor quality and 12 percent were of excellent quality. Most of the settings provided care that was only of fair quality. In Chapter 3 we estimated the process quality of child care from these studies. As shown in Annex Table A5-4, children in low-income families were more likely than children in high-income families to receive poor-quality child care: 11 percent of the low-income children compared with 4 percent of the high-income children. Children in low-income families also were less likely than children in high-income families to receive excellent quality child care: 8 percent of low-income children compared with 15 percent of high-income children. Disparities in quality associated with family income were more evident in child care homes and informal care arrangements than in centers, perhaps because children in low-income families have ac- cess to publicly supported programs such as Head Start. It is likely that these observations overestimate the amount of high- quality care and underestimate the amount of poor-quality care. Informal care settings and settings that serve children from low-income families were more likely to refuse to participate in the observations, and outcomes are lower for children whose care was not observed even after controlling for an extensive array of family covariates (NICHD Early Child Care Research Network and Duncan, 2003). The sample in the NICHD Study also did not include some groups of children (e.g., children of adolescent mothers, mothers who do not speak English, and mothers who were known sub- stance abusers). Other measures of process quality are the Caregiver Interaction Scale (Arnett, 1989), which focuses on teachers' sensitivity during interactions with children, and the CC-HOME scale, which assesses overall quality of child care homes (Clarke-Stewart et al., 2002). All of these measures have excel- lent psychometric properties and predict child developmental outcomes. Another approach to the assessment of child care quality is consider- ation of structural characteristics, such as child-adult ratio, and caregiver characteristics, such as caregivers' specialized training as indicators of child care quality. Structural-caregiver characteristics are the only indicators of quality in studies such as the National Longitudinal Survey of Youth, the National Child Care Survey (Hofferth et al., 1991), and the National House- hold Education Survey (Hofferth et al., 1998). Both structural-caregiver characteristics and process quality measures were collected in the NICHD

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108 WORKING FAMILIES AND GROWING KIDS Study of Early Child Care, in the Cost, Quality and Outcome Study, and the Child Care Staffing Study. Structural-Caregiver Characteristics, Process Quality, and Child Outcomes The conceptual model that has guided much of the research on the effects of child care quality on children's developmental outcomes is shown in Figure 5-1 (Blau, 2001; Lamb, 1998; NICHD Early Child Care Research Network, 2002b; Vandell and Wolfe, 2000). This schema posits that pro- cess quality is directly related to child developmental outcomes, whereas structural-caregiver characteristics are posited to affect child outcomes in- directly through their impact on process quality. In this model, appropriate structural-caregiver characteristics are seen as providing necessary, but not sufficient, conditions for high-quality care. Also reflected in the model is the recognition of the importance of family factors for child developmental outcomes and selection into child care. For the most part, individual studies (see Annex Tables 5-1, 5-2, and 5- 3) have focused on one or another component of the overall model, while positing that the other pathways exist. One report, however, has formally tested the overall model (NICHD Early Child Care Research Network, 2002b). In that study, structural equation modeling (SEM) was used to test relations between structural-caregiver characteristics and process quality as predictors of child developmental outcomes. Two main findings were found: (1) process quality measured by the ORCE predicted children's cognitive competence and social competence at 41/2 years, controlling for Family Structure Family Process Child Outcome Structural-Caregiver Process Quality Characteristics FIGURE 5-1 A conceptual model of relations among structural-caregiver chateris- tics, process quality, and child outcomes. SOURCE: Blau (2001).

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EFFECTS OF CHILD CARE 109 family income, maternal education, and parenting quality; and (2) there was a connection between structural qualities such as caregiver training and child-staff ratio and cognitive competence and social competence that was not accounted for by family variables. As noted above, other research studies have focused on one or another pathway in the overall model. In the following sections, we review these studies, starting with studies that consider relations between structural-caregiver characteristics and process quality. Then we examine research pertaining to process quality and child developmental outcomes. Finally, we consider relations between struc- tural-caregiver characteristics and child developmental outcomes. Structural-Caregiver Characteristics and Process Quality Blau (2001) and Vandell and Wolfe (2000) reviewed the research ex- amining associations between structural-caregiver characteristics and pro- cess quality. (These studies also are summarized in Annex Table A5-1.) Four structural-caregiver characteristics--child-adult ratio, group size, spe- cialized training, and general education level--have been the focus of much of the research. Although early research studies were criticized for various methodological limitations (small samples, single site, simple bivariate analyses), recent research (Burchinal et al., 2002; NICHD Early Child Care Research Network, 1997b, 2000a) has examined relations between struc- tural-caregiver characteristics and process quality using multivariate tech- niques, multiple study sites, and large samples. As shown in Annex Table A5-1, many studies have reported associa- tions between child-adult ratios and process quality. When child-adult ratios are lower, caregivers spend less time managing children in their classrooms, children are less apathetic and distressed (Ruopp et al., 1979), and caregivers are more stimulating, responsive, warm, and supportive (Clarke-Stewart et al., 1994; NICHD Early Child Care Research Network, 1996, 2000a; Phillipsen et al., 1997). Lower child-adult ratios also are associated with higher process quality scores on the ECERS and the ORCE (NICHD Early Child Care Research Network, 1996, 2002b,c). For the most part, these findings are derived from correlational research designs, although one study (Ruopp et al., 1979) used a random assignment experi- mental design to assess the effects of varying child-adult ratios. The number of children in the group (or group size) also is associated with process quality. In multivariate analyses that included ratio, group size, caregiver training, and caregiver education, caregivers appeared more responsive, more socially stimulating, and less restrictive when there were fewer children in the group (NICHD Early Child Care Research Network, 1996, 2000a; Ruopp et al., 1979). Process quality is higher in child care

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EFFECTS OF CHILD CARE 167 Other Child Family Child Developmental Care Measures Controls Outcomesc Quality Findings Age of entry, Maternal education, Academic progress Controlling for family length of day, family structure, (1st grade characteristics, higher number of maternal CG report) quality predicted better different employment CBP: (behavior academic skills (for boys), arrangements problems, school better social skills for both skills) girls and boys, and fewer behavior problems in both girls and boys. Smaller number of arrangements better academic skills for boys and girls. Family social, family CBCL Process quality structure, child age CBI (longitudinal), age partialled out. Preschool: CG involvement/investment observed social play, social pretend play, positive affect, less CG rate difficult and hesitant. Kindergarten: CG involvement less parent ratings of internalizing and externalizing; less CG rate of distract, hostile, higher rate verbal IQ, consideration. SES PPVT-R: (receptive MANOVAs (same results language) with no covar and with SES SSC: (social) and PPVT cov). Children in center care higher on interest- participation than children in no care; no difference between high- and low- quality care. No care effect on cooperation-compliance. Children in high-quality center highest on receptive language, followed by no care and then low quality. Quantity, entry Income/needs, Mother-reported Children in higher-quality age, stability, psychological behavior problems child care during first 3 group type adjustment, child's and social years more compliant and gender, child's competence; cooperative during temperament caregiver report of observations; CG reported (continued)

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168 WORKING FAMILIES AND GROWING KIDS TABLE A5-3 Continued Process Quality Structural Citationa N Age Measureb Quality Measureb NICHD Early 6, 15, 24, 36 Positive CG Child Care months composite, Research language Network stimulation (2000b) NICHD Early 669 24 and 36 Positive Child Care 612 months caregiving Research (ORCE) Network (2001c) Peisner- CQO Study: n = Preschool to ECERS Feinberg et al. 733 in year 1; 2nd grade CIS (2001) 499 in year 2; ECOF 399 in AIF kindergarten, 345 in 2nd grade

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EFFECTS OF CHILD CARE 169 Other Child Family Child Developmental Care Measures Controls Outcomesc Quality Findings problems; laboratory fewer behavior problems. observations of compliance and negativity Quantity, type Maternal PPVT-R, Bayley MDI , Process quality significantly child gender, HOME Bracken School related to cognitive and and maternal Readiness, language outcomes at 24 stimulation Macarthur CDI; and 36 months, controlling Reynell for family factors. Developmental Language Amount of time Maternal education, Mother and More positive caregiving in CC, maternal attitude caregiver report of child more positive available other toward employment, peer competencies; sociability at 24 months, children child gender, observed peer lower proportion negative cognitive/ linguistic interaction in child interaction with peers performance at 24 care and structured observed. and 36 months, task maternal sensitivity in play, maternal psychological adjustment, family structure, number of children in home Family income, PPVT-R Higher ECERS scores education, marital WJ-R predicted higher language status, child's gender, CBI (classroom and math scores, but the child's ethnicity behavior inventory) magnitude of the STRS (teacher-child association declined over relationship) time. A significant interaction between maternal education and quality of classrooms indicated that better quality child care had stronger association when mothers had less education. Higher quality practices were significantly associated with fewer problem behaviors in Year 1, but this association declined in subsequent years. (continued)

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170 WORKING FAMILIES AND GROWING KIDS TABLE A5-3 Continued Process Quality Structural Citationa N Age Measureb Quality Measureb Pierrehumbert 47 Swiss 1-5, recruited Positive contact None et al. (1996) 3-9 months (Ainsworth interactive scale) Vandell et al. 20 Observed at 4 None C:A ratio, group (1988) and 8 years size, space, materials available, CG education Vernon-Feagans, 67 Recruited Adults present Emanuel, and before age 1, (C:A ratio), Blood (1997) followed until 4 group size a For full references see the report reference list. b Quality measures alphabetized by acronym: AIS: Adult Involvement Scale; CIS: Caregiver Interaction Scale; ECOF: UCLA Early Childhood Observation Form; ECERS: Early Childhood Environment Rating Scale; ECOI: Early Childhood Observation Instrument; IEOS: Instructional Environment Observation Scales; ITERS: Infant-Toddler Environmental Scale; ORCE: Observational Record of the Caregiving Environment; STRS: Student-Teacher Relationship Scale. c Child developmental outcome measures alphabetized by acronym: ASBI: Adaptive Social Behavior Inventory; ASB: Teacher Assessment of Social Behavior; BCL: Behavior Checklist; Boehm: Test of Basic Skills; BPI: Behavior Problems Index; BRS: Behavior Rating Scale; BSQ: Behavior Screening Questionnaire; Buck I/E Scale: Buck Internalizer/Externalizer Scale; CBCL: Child Behavior Checklist; CBI: Child Behavior Inventory; CBP: Child Behavior Profile; CTBS: Comprehensive Test of Basic Skills; MacArthur CDI:

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EFFECTS OF CHILD CARE 171 Other Child Family Child Developmental Care Measures Controls Outcomesc Quality Findings SES, child gender, Developmental Attach security, SES, and attachment with Quotients positive contact with CG mother, positive WPPSI predicted increase in contact with mother CBCL cognitive index between 2 and 5 years. Family structure, age PRS Controlling for social class, of entry in full-time Harter PCS positive interaction with care, family social Parent ratings adults at 4 years was class socioemotional related to more competent adjust (Santrock behavior at 8 years. and Warshak) Aimless wandering at 4 years was related to less social competence at 8 years. SICD: (receptive and Children in high-quality expressive language) centers better expressive language and receptive language. Communication Development Inventory; MDI: Mental Development Index (Bayley II); MSCA: McCartney Scale of Children's Abilities; ORCE: Observational Record of the Caregiving Environment; PBQ: Pre- school Behavior Questionnaire; PEI: Parent as Educator Interview; PIAT: Peabody Individual Achievement Test; PPS: Peer Play Scale; PPVT-R: Peabody Picture Vocabulary Test-Revised; PRS: Peer Relations Scale; RCSA: Rutter Child Scales (A and B); SCS: Social Competence Scale; SICD: Sequence Inventory of Com- munication Development; SRA: Science Research Associates Achievement Battery; TBQ: Toddler Behavior Questionnaire; WJ-R: Woodcock-Johnson Tests of Achievement-Revised; CG = caregiver; ECE = early childhood education; C:A ratio = child:adult ratio; CC: child care; DC = day care; SES = socioeconomic status. NOTE: Vandell and Wolfe (2000) was the source for articles published prior to 2000.

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172 WORKING FAMILIES AND GROWING KIDS TABLE A5-4 Distribution of Child Care Quality by Type of Care and Family Income For All Low Income Moderate Income High Income Overall Nonparental Care N (%) N (%) N (%) N (%) 6 months (n = 471) Poor quality 11 (13) 14 (9) 12 (5) 37 (8) Fair quality 39 (44) 67 (41) 89 (40) 195 (41) Good quality 31 (35) 60 (37) 74 (33) 165 (35) Excellent quality 7 (8) 21 (13) 46 (21) 74 (16) 15 months (n = 494) Poor quality 10 (9) 15 (9) 14 (6) 39 (8) Fair quality 59 (55) 74 (45) 96 (43) 229 (46) Good quality 27 (25) 55 (34) 76 (34) 158 (32) Excellent quality 11 (10) 19 (12) 38 (17) 68 (14) 24 months (n = 537) Poor quality 13 (13) 30 (15) 10 (4) 53 (10) Fair quality 62 (63) 99 (51) 126 (52) 287 (53) Good quality 19 (19) 49 (25) 76 (31) 144 (27) Excellent quality 5 (5) 17 (9) 31 (13) 53 (10) 36 months (n = 587) Poor quality 11 (7) 9 (5) 6 (2) 26 (4) Fair quality 102 (67) 122 (65) 134 (54) 358 (61) Good quality 36 (24) 50 (26) 87 (35) 173 (29) Excellent quality 3 (2) 8 (4) 19 (7) 30 (5) 54 months (n = 795) Poor quality 25 (12) 21 (7) 12 (4) 58 (7) Fair quality 90 (44) 142 (46) 112 (40) 344 (43) Good quality 65 (32) 96 (31) 113 (40) 274 (34) Excellent quality 26 (13) 48 (16) 45 (16) 119 (15) Overall (n = 2,884) Poor quality 70 (11) 89 (9) 54 (4) 213 (7) Fair quality 352 (54) 504 (50) 557 (46) 1,413 (49) Good quality 178 (27) 310 (31) 426 (35) 914 (32) Excellent quality 52 (8) 113 (11) 179 (15) 344 (12) TOTAL 652 1,016 1,216 2,884 Low Income Moderate Income High Income Overall For Father Care N (%) N (%) N (%) N (%) 6 months (n = 87) Poor quality 1 (6) 1 (2) 0 2 (2) Fair quality 5 (29) 18 (38) 4 (18) 27 (31)

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EFFECTS OF CHILD CARE 173 TABLE A5-4 Continued Low Income Moderate Income High Income Overall For Father Care N (%) N (%) N (%) N (%) Good quality 8 (47) 18 (38) 13 (59) 39 (45) Excellent quality 3 (18) 11 (23) 5 (23) 19 (22) 15 months (n = 107) Poor quality 1 (3) 5 (11) 0 6 (6) Fair quality 15 (45) 13 (28) 11 (41) 39 (36) Good quality 12 (36) 18 (38) 7 (26) 37 (35) Excellent quality 5 (15) 11 (23) 9 (33) 25 (23) 24 months (n = 89) Poor quality 2 (8) 2 (6) 0 4 (4) Fair quality 15 (60) 16 (44) 10 (36) 41 (46) Good quality 4 (16) 13 (36) 11 (39) 28 (31) Excellent quality 4 (16) 5 (14) 7 (25) 16 (18) 36 months (n = 83) Poor quality 3 (9) 2 (6) 0 5 (6) Fair quality 21 (62) 12 (36) 8 (50) 41 (49) Good quality 10 (29) 16 (49) 3 (19) 29 (35) Excellent quality 0 3 (9) 5 (31) 8 (10) 54 months (n = 36) Poor quality 4 (27) 2 (13) 1 (20) 7 (19) Fair quality 8 (53) 7 (44) 1 (20) 16 (44) Good quality 2 (13) 6 (38) 3 (60) 11 (31) Excellent quality 1 (7) 1 ( 6) 0 2 (6) Overall (n = 402) Poor quality 11 (9) 12 (7) 1 (1) 24 (6) Fair quality 64 (52) 66 (37) 34 (35) 164 (41) Good quality 36 (29) 71 (39) 37 (38) 144 (36) Excellent quality 13 (10) 31 (17) 26 (27) 70 (17) TOTAL 124 180 98 402 Low Income Moderate Income High Income Overall For Grandparents N (%) N (%) N (%) N (%) 6 months (n = 94) Poor quality 0 0 0 0 Fair quality 7 (33) 6 (16) 6 (17) 19 (20) Good quality 10 (48) 22 (59) 15 (42) 47 (50) Excellent quality 4 (19) 9 (24) 15 (42) 28 (30) (continued)

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174 WORKING FAMILIES AND GROWING KIDS TABLE A5-4 Continued Low Income Moderate Income High Income Overall For Grandparents N (%) N (%) N (%) N (%) 15 months (n = 77) Poor quality 1 (4) 2 (7) 1 (4) 4 (5) Fair quality 12 (48) 6 (21) 3 (13) 21 (27) Good quality 9 (36) 14 (48) 10 (43) 33 (43) Excellent quality 3 (12) 7 (24) 9 (39) 19 (25) 24 months (n = 66) Poor quality 1 (5) 2 (8) 0 3 (5) Fair quality 13 (68) 6 (23) 5 (24) 24 (36) Good quality 3 (16) 14 (54) 13 (62) 30 (45) Excellent quality 2 (11) 4 (15) 3 (14) 9 (14) 36 months (n = 61) Poor quality 3 (12) 0 0 3 (5) Fair quality 15 (58) 8 (44) 12 (71) 35 (57) Good quality 7 (27) 8 (44) 3 (18) 18 (30) Excellent quality 1 (4) 2 (11) 2 (12) 5 (8) 54 months (n = 34) Poor quality 1 (6) 0 1 (14) 2 (6) Fair quality 8 (50) 8 (73) 2 (29) 18 (53) Good quality 6 (38) 2 (18) 3 (43) 11 (32) Excellent quality 1 (6) 1 (9) 1 (14) 3 (9) Overall (n = 332) Poor quality 6 (6) 4 (3) 2 (2) 12 (4) Fair quality 55 (51) 34 (28) 28 (27) 117 (35) Good quality 35 (33) 60 (50) 44 (42) 139 (42) Excellent quality 11 (10) 23 (19) 30 (29) 64 (19) TOTAL 107 121 104 332 For in-Home Care (not parents or Low Income Moderate Income High Income Overall grandparents) N (%) N (%) N (%) N (%) 6 months (n = 83) Poor quality 1 (6) 1 (8) 3 (6) 5 (6) Fair quality 9 (56) 5 (38) 13 (24) 27 (33) Good quality 5 (31) 4 (31) 22 (41) 31 (37) Excellent quality 1 (6) 3 (23) 16 (30) 20 (24) 15 months (n = 95) Poor quality 1 (7) 0 2 (3) 3 (3) Fair quality 11 (73) 10 (48) 17 (29) 38 (40)

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EFFECTS OF CHILD CARE 175 TABLE A5-4 Continued For in-Home Care (not parents or Low Income Moderate Income High Income Overall grandparents) N (%) N (%) N (%) N (%) Good quality 2 (13) 7 (33) 25 (42) 34 (36) Excellent quality 1 (7) 4 (19) 15 (25) 20 (21) 24 months (n = 78) Poor quality 3 (23) 3 (19) 0 6 (8) Fair quality 7 (54) 6 (38) 16 (33) 29 (37) Good quality 2 (15) 4 (25) 19 (39) 25 (32) Excellent quality 1 (8) 3 (19) 14 (29) 18 (23) 36 months (n = 66) Poor quality 2 (18) 0 1 (2) 3 (5) Fair quality 8 (73) 6 (50) 14 (33) 28 (42) Good quality 1 (9 ) 5 (42) 21 (49) 27 (41) Excellent quality 0 1 (8) 7 (16) 8 (12) 54 months (n = 16) Poor quality 1 (20) 0 1 (13) 2 (13) Fair quality 3 (60) 3 (10) 5 (63) 11 (69) Good quality 0 0 2 (25) 2 (13) Excellent quality 1 (20) 0 0 1 (6) Overall (n = 338) Poor quality 8 (13) 4 (6) 7 (3) 19 (6) Fair quality 38 (63) 30 (46) 65 (31) 133 (39) Good quality 10 (17) 20 (31) 89 (42) 119 (35) Excellent quality 4 (7) 11 (17) 52 (24) 67 (20) TOTAL 60 65 213 338 For Child Care Low Income Moderate Income High Income Overall Homes N (%) N (%) N (%) N (%) 6 months (n = 192) Poor quality 7 (18) 5 (7) 7 (9) 19 (10) Fair quality 19 (48) 34 (46) 37 (47) 90 (47) Good quality 13 (33) 26 (35) 23 (30) 62 (32) Excellent quality 1 (3) 9 (12) 11 (14) 21 (11) 15 months (n = 197) Poor quality 5 (11) 5 (7) 5 (6) 15 (8) Fair quality 23 (51) 34 (47) 33 (41) 90 (46) Good quality 13 (29) 26 (36) 29 (36) 68 (35) Excellent quality 4 (9) 7 (10) 13 (16) 24 (12) (continued)

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176 WORKING FAMILIES AND GROWING KIDS TABLE A5-4 Continued For Child Care Low Income Moderate Income High Income Overall Homes N (%) N (%) N (%) N (%) 24 months (n = 210) Poor quality 5 (14) 10 (12) 4 (5) 19 (9) Fair quality 21 (57) 44 (52) 45 (51) 110 (52) Good quality 9 (24) 23 (27) 29 (33) 61 (29) Excellent quality 2 (5) 8 (9) 10 (11) 20 (10) 36 months (n = 168) Poor quality 3 (7) 1 (2) 1 (2) 5 (3) Fair quality 31 (72) 47 (76) 30 (48) 108 (64) Good quality 7 (16) 12 (19) 28 (44) 47 (28) Excellent quality 2 (5) 2 (3) 4 (6) 8 (5) 54 months (n = 76) Poor quality 9 (41) 3 (9) 1 (5) 13 (17) Fair quality 7 (32) 20 (57) 13 (68) 40 (53) Good quality 4 (18) 7 (20) 3 (16) 14 (18) Excellent quality 2 (9) 5 (14) 2 (11) 9 (12) Overall (n = 843) Poor quality 29 (16) 24 (7) 18 (5) 71 (8) Fair quality 101 (54) 179 (55) 158 (48) 438 (52) Good quality 46 (25) 94 (29) 112 (34) 252 (30) Excellent quality 11 (6) 31 (9) 40 (12) 82 (10) TOTAL 187 328 328 843 For Low Income Moderate Income High Income Overall Centers N (%) N (%) N (%) N (%) 6 months (n = 102) Poor quality 3 (27) 8 (21) 2 (4) 13 (13) Fair quality 4 (36) 22 (58) 33 (62) 59 (58) Good quality 3 (27) 8 (21) 14 (26) 25 (25) Excellent quality 1 (9) 0 4 (8) 5 (5) 15 months (n = 125) Poor quality 3 (14) 8 (20) 6 (10) 17 (14) Fair quality 13 (59) 24 (59) 43 (69) 80 (64) Good quality 3 (14) 8 (20) 12 (19) 23 (18) Excellent quality 3 (14) 1 (2) 1 (2) 5 (4) 24 months (n = 183) Poor quality 4 (13) 15 (22) 6 (7) 25 (14) Fair quality 21 (70) 43 (63) 60 (71) 124 (68) Good quality 5 (17) 8 (12) 15 (18) 28 (15) Excellent quality 0 2 (3) 4 (5) 6 (3)

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EFFECTS OF CHILD CARE 177 TABLE A5-4 Continued For Low Income Moderate Income High Income Overall Centers N (%) N (%) N (%) N (%) 36 months (n = 292) Poor quality 3 (4) 8 (8) 4 (3) 15 (5) Fair quality 48 (67) 61 (63) 78 (63) 187 (64) Good quality 21 (29) 25 (26) 35 (28) 81 (28) Excellent quality 0 3 (3) 6 (5) 9 (3) 54 months (n = 669) Poor quality 14 (9) 18 (7) 9 (4) 41 (6) Fair quality 72 (44) 111 (43) 92 (37) 275 (41) Good quality 55 (34) 87 (34) 10 (42) 247 (37) Excellent quality 22 (14) 42 (16) 42 (17) 106 (16) Overall (n = 1371) Poor quality 27 (9) 57 (11) 27 (5) 111 (8) Fair quality 158 (53) 261 (52) 306 (54) 725 (53) Good quality 87 (29) 136 (27) 181 (32) 404 (29) Excellent quality 26 (9) 48 (10) 57 (10) 131 (10) TOTAL 298 502 571 1,371 xx