II
Improving Quality



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Caring for America's Children II Improving Quality

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Caring for America's Children This page in the original is blank.

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Caring for America's Children Enactment of the 1990 child care legislation refocuses the child care debate at state and local levels. Although it does not set any guidelines on quality, the new law does provide financial incentives, in the form of federal grants, for states and localities to set or revise standards related to health and safety, and it also specifies spending for improving the quality of care. This part summarizes the panel's information related to quality child care. This information provides criteria for evaluating standards and regulations based on specific indicators of quality. Although this material is directed primarily toward those who will regulate or promulgate professional standards, it can also be used to educate parents about how to recognize and assess child care quality. An informed consumer movement might have a far more powerful effect on quality child care than regulatory efforts alone.

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Caring for America's Children CHARACTERISTICS OF QUALITY CHILD CARE The Panel on Child Care and Policy drew on both academic research and standards of professional practice to define criteria for judging quality child care. Most of the research has concentrated on center-based care, although more recent studies have also looked at family day care settings. In addition, some research has looked at factors particularly relevant to home-based care, including alternative methods of regulation and mixed-age groupings of children. The Panel on Child Care Policy concentrated on two research approaches that have been taken to identify particular qualitative dimensions in child care settings. The first focuses on specific structural features of the child care environment, such as group size, child/staff ratio, caregivers' qualifications, stability and continuity of caregivers, structure and content of daily activities, and organization of space. The second approach links children's development more closely with their daily experiences in child care, particularly with the interactions between caregivers and children. Structural features appear to support and facilitate desirable interactions, but they cannot ensure optimal patterns of interaction. For example, even when staff/child ratios are satisfactory, caregivers may spend their time talking to one another and merely watching the children, rather than interacting with them. However, good structural features increase the likelihood of responsive and stimulating interactions and, thus, promote children's development. The distinction between structural and interactive dimensions of quality is useful in differentiating between two of the major avenues for improving the quality of child care: government regulations and professional standards. Regulations are usually dichotomous (pass/fail), and experience in many fields has shown that minimum requirements often become the norm. Yet tough regulations may lead to higher costs that price many people

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Caring for America's Children out of the market or into illegal ''black market" arrangements. Nonetheless, when public funds subsidize care, regulating at least minimal health and safety conditions is generally recognized as essential. In contrast with regulations, professional standards are scalable and hence more useful in relating price and quality. Since many characteristics of quality are not appropriate for pass/fail regulations, professional standards may be most useful in educating parents about how to recognize quality care. Regulations establish minimum requirements that are enforceable by state licensing authorities. Most regulations concern the structural dimensions of quality. All states, for example, regulate the square footage per child of indoor space in child care centers, and almost all regulate staff/child ratios. Many states also specify training requirements for staff and the square footage that must be available per child outdoors. Although many state regulations address such factors as the nature of potential disciplinary interactions, such as corporal punishment, the regulations generally do not focus on the interactive aspects of quality. Professional standards address both structural features and interactions between caregivers and children. Moreover, unlike regulations, professional standards spell out goals for high-quality child care. The accreditation criteria of the National Academy of Early Childhood Programs of the National Association for the Education of Young Children (NAEYC), for example, go beyond structural features to include criteria for interactions between staff and children and between staff and parents. These criteria describe qualitative aspects of interactions, such as: Staff interact frequently with children. Staff express respect for and affection toward children by smiling, holding, touching, and speaking to children at their eye level throughout the day. . . . Staff are available and responsive to children; encourage them to share experiences, ideas, and feelings; and listen to them with attention and respect. Research with NAEYC's accreditation program has supported the reliability and validity of the assessment of interactions in early childhood settings

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Caring for America's Children and has underscored the importance of interactive features in assessing a program's quality. The NAEYC accreditation program has shown that it is possible to delineate well-grounded and attainable guidelines for constructive interactions in early childhood programs. An additional advantage of these criteria is their utility for parents in evaluating trade-offs between price and quality. STRUCTURAL ASPECTS OF QUALITY Regulatory efforts to promote quality in child care centers and family day care homes have primarily addressed the structural aspects of child care. This section summarizes the evidence regarding those aspects. Group Size Group size has the most consistent and pervasive effects on the behavior of children in child care settings. In both centers and family day care homes, patterns of interaction are less positive and development is less advanced for those in large groups than for those in small groups. Research and professional practice suggest the following ranges for group size: 6 to 8 infants; 6 to 12 1-year-olds or 2-year-olds; 14 to 20 3-year-olds; and 16 to 20 4- or 5-year-olds. Despite research showing the importance of group size, the 1979 National Day Care Study pointed out that group size is not consistently regulated by the states. The report urged wider inclusion of group size in child care regulations, but a decade later a survey by the Panel on Child Care Policy found that only 20 states and the District of Columbia regulate group size

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Caring for America's Children for all ages in child care centers. Five other states regulate group size only for infants. All but three states, however, regulate group size in family day care. Group size is one aspect of quality in which research findings have not influenced policy. Many of the studies of child care are not methodologically strong, perhaps because it is difficult to do this research: there remains a need for further research, particularly on the differing implications of staff/child ratios in groups of different sizes. Staff/Child Ratio Because ratio is usually synonymous with group size in family day care, research findings on ratio focus on center care. The National Day Care Study found higher ratios of children per adult caregiver to be associated with more distress in infants and toddlers. Higher ratios were also linked with apathy in infants and with situations that were potentially dangerous for infants. Research has found that lower ratios for toddlers enabled care-givers to facilitate positive social interactions and to foster more positive emotional climates. In groups with more children per adult, toddlers talked and played significantly less. Although studies of staff/child ratios for children of preschool age have produced inconsistent research findings and further studies are warranted, current wisdom suggests the following ranges: 4 infants or 1-year-olds for each caregiver; 4 to 6 2-year-olds for each caregiver; 5 to 10 3-year-olds for each caregiver; and 7 to 10 4- or 5-year-olds for each caregiver. The Panel on Child Care Policy found that every state except Nevada specifies staff/child ratios. There is substantial variation, however, in what states view as acceptable ratios for children of different ages. For example, California and the District of Columbia require a caregiver for each four infants; Georgia requires one for each seven infants. For 3-year-olds, North

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Caring for America's Children Dakota requires a ratio of one caregiver for each seven children; Arizona, North Carolina, and Texas permit one caregiver per fifteen children. Table 1 presents the state regulations covering several features of family day care settings, including group size. (The data in this table and the other tables in this section are based on G. Morgan, The National State of Child Care Regulation, 1986 [Watertown, Mass.: Work/Family Directions, 1986] and the panel's 1988 survey; some regulations may have changed since the survey.) What is most striking about the regulations is the disparity on what is regulated and what the regulations are. Table 2 presents the state regulations covering several features of center care, including group size and staff/child ratio. Again, the wide variety is striking, and it is also notable that many of the regulations do not appear to be based on what research and professional practice suggest. Caregivers' Qualifications Both research and professional standards recognize caregivers' training in child development, and perhaps their overall years of education, as important to children's experiences and development in child care. Professional standards address the need for stability and continuity of caregivers by recommending the long-term assignment of specific caregivers to particular groups of children in order to promote affectionate relationships between individual caregivers and children. The National Day Care Study concluded that, for preschoolers, the key variable in caregivers' qualifications was child-related training, which is associated with more social interactions between caregivers and children, more cooperation and persistence with tasks among children, and less time spent by children uninvolved in activities. For infants and toddlers, however, the amount of caregivers' overall education also showed positive effects. Research has shown that caregivers' training has strong and positive effects in all three types of family day care homes that have been studied: sponsored

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Caring for America's Children (homes that are members of networks), regulated, and unregulated. For example, in sponsored and regulated family day care homes, training was associated with more teaching, helping, and dramatic play and with less activity that did not involve interacting with children. Other studies have found that caregivers' overall education is the most important predictor of how caregivers communicate with children. The evidence, then, points to positive effects of both education and training specifically related to child development. In contrast, there is little indication that experience alone is positively related to caregivers' interactions with children or to children's behavior or development. Although the research affirms the importance of caregivers' qualifications, the Panel on Child Care Policy found that only 27 states and the District of Columbia require preservice training for teachers in child care centers, and only about one-quarter of the states require such training for family day care providers. Table 3 presents the state regulations covering caregiver qualifications and protective features for family day care. Table 4 presents the same data for center care. For these features, too, there is noticeable difference among the states in what they regulate. Stability and Continuity of Caregivers In both family day care and center care, children's needs for enduring relationships with particular caregivers are more adequately fulfilled if the children do not experience frequent changes of caregivers resulting from staff turnover or families' changing their child care arrangements. The ability of a child care center to fulfill these needs is enhanced when the children can become involved with particular caregivers among the several to whom they are exposed. Although states cannot directly regulate staff stability for child care providers, such stability is a structural feature of quality that could probably be affected by higher salaries for caregivers.

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Caring for America's Children TABLE 1 State Regulation of Family Day Care: General Features and Group Size   General Features Group Size State Type of Regulationa Inspections per Year Minimum Size Coveredb Square Feet Indoorsc Square Feet Outdoorsc No. of Children Under 2 Years Per Caregiver Maximum Group Size Permitted Alabama Lic. 1 1 NS NS NS 6 Alaska Lic. 1 per 2 yrs. 5 NS NS 2 < 30 mos. 6 Arizona None — — — — — — Arkansas Lic. 3–4 7 35 75 3 10 California Lic. 10% sample 2 NS NS 3 6 Colorado Lic. 33% sample 2 35 75 2 6 Connecticut Mand. Reg. 1 per 2 yrs. 1 NS NS 2 6 Delaware Mand. Cert. 1 1 NS NS 4 6 District of Columbia Lic. 1 1 NS NS 2 5 Florida Lic. (County) Reg. (State) 2 2 NS NS NS 5 Georgia Reg. 3% sample 3 35 NS NS 6 Hawaii Reg. 1 3 35 75 2 5 Idaho Vol. Reg. 1 1 NS NS NS 6 Illinois Lic. 1 4 NS NS 3 8 Indiana Lic. 1 6 35 50 6 10 Iowa Vol. Reg. 20% sample 1 35 50 4 6 Kansas Lic. NA 1 25 NS 1 < 18 mos. 10 Kentucky Lic. 1 4 35 60 NS 12 Louisiana None — — — — — — Maine Lic. or Reg. 1 3 35 NS NS 10 Maryland Reg. 1 1 NS NS 2 6 Massachusetts Lic. NA 1 NS 75 2 6 Michigan Lic. 0 1 35 400 total NS 6 Minnesota Lic. NA 2 35 50 NS 6 Mississippi None — — — — — — Missouri Lic. 2 4 35 75 2 10 Montana Reg. 15% sample 3 NS 0 3 6

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Caring for America's Children   General Features Group Size State Type of Regulationa Inspections per Year Minimum Size Coveredb Square Feet Indoorsc Square Feet Outdoorsc No. of Children Under 2 Years Per Caregiver Maximum Group Size Permitted Nebraska Reg. 5% per month 4 35 50 2 < 18 mos. 8 Nevada Lic. 4 5 35 37.5 2 < 13 mos. 6 New Hampshire Lic. 3 per 2 yrs. 4 35 50 2 6 New Jersey Vol. Reg. 1 per 3 yrs. 3 NS 1 NS 8 New Mexico Lic. 2 5 35 60 2 6 New York Lic. 1 3 NS NS 2 6 North Carolina Reg. NA 1 NS NS NS 5 North Dakota Lic. 2 6 35 75 NS 7; 4 < 2 yrs. Ohio Cert. 2 1 NS NS NS 12 Oklahoma Lic. 4 1 35 75 NS 5 Oregon Vol. Reg. 0 1 35 NS 2 5 Pennsylvania Reg. 20% sample 4 NS NS 4 < 3 yrs. 6 Rhode Island Cert. 1 per 2 yrs. 4 NS NS NS 6 South Carolina Reg. 0 2 NS NS NS 6 South Dakota Reg. 1–12 1 NS NS NS NR Tennessee Lic. 2 5 NS NS 4 7 Texas Reg. 0 4 NS NS 4 < 18 mos. 12 Utah Lic. 1 per 2 yrs. 4 35 40 2 8 Vermont Lic. 2 3 35 75 2 6 Virginia Lic. 2 6 NS NS 4 9 Washington Lic. 0 1 35 1 2 6 West Virginia Vol. Reg. 1 1 NS 0 NS NR Wisconsin Lic. Varies 4 35 75 4 8 Wyoming Lic. Varies 3 35 75 2 6 a Cert., certificate; Lic., license; Mand., mandatory; Reg., registration; Vol., voluntary b Number of children c Per child Abbreviations: NA, not ascertained NR, not regulated: not mentioned in regulations NS, not specified: mentioned, but not quantified (e.g., "adequate")

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Caring for America's Children Structure and Content of Daily Activities Research points to the importance of providing a mix of daily learning activities and unstructured time in child care settings, rather than providing purely custodial care. Permitting children to make choices and to initiate and set the pace of learning activities is also beneficial. Professional standards emphasize the need for a daily routine that is both structured and flexible, that incorporates activities to foster both cognitive and social development, and that allows children to make choices and to set their own pace. Research has shown that, although unstructured time is not inherently negative, child care programs that offer nothing else do not contribute to children's cognitive development. Some emphasis on planned teaching activities appears to benefit children. There is also some evidence that a range of high-quality preschool curricula can facilitate intellectual development, particularly among children in "high risk" groups. Thus, for example, one study found that "a variety of curricula are effective in preparing children for school and that any of the tested curricula is better than no program at all." When social development is considered, however, research indicates that different curricula do have differing implications. Long-term studies found that children in a teacher-directed preschool program demonstrated less adequate social adaptation than children assigned to preschool programs in which children initiated and paced their own learning activities in environments prepared by teachers. This finding points to the importance not only of the content a curriculum attempts to convey, but also of the process through which learning occurs. Children's active initiation and pacing of their learning activities appears to have positive implications for their social development. Research on learning processes also points to the need for curricula to allow for individual differences in learning styles and to the importance of learning through interactions.

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Caring for America's Children Space and Facilities Research and professional standards agree that children's experiences in child care are generally more positive when the space is well organized, differentiated, orderly, and designed for children's use. The adequacy of space as a qualitative dimension differs for family day care and center care. In family day care, the issue is whether children are cared for in a space that remains designed primarily for adults or whether adaptations have been made to orient the space for children. In center care, where space is oriented for children, the relevant issues are sufficiency and organization of space and equipment. When family day care space is not child oriented (for example, children are in a family's unadapted living room or kitchen), care-givers tend to be more restrictive and less responsive to children, and positive emotional climates and positive social relations are more difficult to achieve. In centers, some research indicates that children's social problem-solving skills are influenced by whether the center has a variety of age-appropriate materials and is arranged to accommodate groups of varying sizes. Children demonstrate better cognitive and social skills in orderly centers with more varied and stimulating materials and with space organized into activity areas. Regulation of Family Day Care Homes Although virtually all child care centers are licensed, a majority of family day care homes are not. Available studies suggest that the regulatory status of family day care homes is predictive of caregivers' behavior and children's experiences and development. In 1981 the National Day Care Home Study considered three types of care: sponsored family day care, in which homes are organized into networks; regulated family day care; and unregulated family day care. Unregulated family day care homes showed the lowest levels of interactions between caregivers and 1- to 5-year-olds and sponsored homes the

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Caring for America's Children highest. Caregivers in unregulated family day care homes also spent substantially more time uninvolved with children. Observations in sponsored family day care homes revealed more teaching activities by caregivers, more facilitation of language development, and more structured activities for fine-motor skills and for music and dancing. Although caregivers in centers have opportunities for regular contact with colleagues, sharing of tasks, and the possibility of relief from difficult interactions with children, caregivers in family day care settings do not. It is possible that the frequency with which family day care providers receive individual supervision significantly affects the quality of their interactions with children. The research suggests that membership in a network of family day care providers may benefit caregivers, perhaps alleviating their isolation. Thus, collegial contacts through a network or through supervision may improve the quality of daily experiences for children in family day care. Despite the fact that the regulatory status of family day care programs appears linked to the quality of care provided, an estimated 60 percent of family day care homes are unregulated. Other Features Several structural features of child care settings may influence the quality of care. Little is known, for example, about the role of overall center size, parental involvement, and sensitivity to children's ethnic, racial, and cultural backgrounds, although some research suggests that these factors may be significant. For example, in 1970 one researcher found that teachers spent more time managing behavior and emphasizing rules in centers with more than 60 children than in smaller centers. Furthermore, in the smaller centers, teachers were more often rated as sensitive, and children were more often rated as highly interested and enthusiastically involved in activities.

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Caring for America's Children Child development professionals view two other structural aspects of child care as important components of quality: parental involvement and the recognition and active appreciation of children's cultures. For example, the National Black Child Development Institute and the National Association for the Education of Young Children recommend that programs encourage the involvement of parents and other family members, and parental involvement is a key feature of Head Start programs. Head Start has also played a pioneering role in making multicultural sensitivity an integral part of its program. Developmental research underscores the importance of providing a child care environment that builds and sustains the self-esteem of children from minority cultures. Some studies show links between minority children's academic competence and their identification with their own culture, which suggests that cultural affirmation may be an important component in the quality of child care. Professional Guidelines for Quality Although research helps in identifying which structural dimensions of quality are important in child care, program evaluations and professional expertise are more useful in identifying the ranges and limits for specific dimensions of quality. The Panel on Child Care Policy identified four sets of standards for professional practice and two sets of requirements for receipt of federal funding: Accreditation Criteria and Procedures of the National Academy of Early Childhood Programs, National Association for the Education of Young Children (NAEYC)—developed in 1984 to "improve the quality of life for young children" and were designed for programs serving 10 or more children.

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Caring for America's Children Safeguards: Guidelines for Establishing Programs for Four Year Olds in the Public Schools, National Black Child Development Institute (NBCDI)—developed in 1987 as suggestions for ensuring that early education programs in the public schools create productive and effective learning environments for black children and produce long-lasting benefits in the children's development. Early Childhood Environment Rating Scale (ECERS)—developed in 1980 "to provide a basis for evaluation and planning" of programs serving children at least 9 months of age in child care centers. Standards for Day Care Service, Child Welfare League of America (CWLA)—developed in 1960 and revised in 1984 "to be goals for continual improvement of services to children and families. They represent practices considered to be most desirable . . . These are therefore standards for social welfare services for children, regardless of auspices or setting," including agencies, center-based programs, and family day care homes. The standards are designed for comprehensive programs and urge planning of services to meet children's needs. The standards for center-based programs are designed primarily for programs serving children aged 3 and older, and the standards note that "family day care is suitable for all children and may be preferable for infants." Federal Interagency Day Care Requirements (FIDCR)—developed in 1968 and revised in 1980 in an effort to standardize the requirements of federally funded programs providing comprehensive services to children; suspended in 1981. Designed for family day care homes, group day care homes, and child care centers, the requirements addressed the needs of children from infancy through age 14 (although no requirements were set for center-based care of children under age 3). Head Start Performance Standards promulgated in 1975 to cover all Head Start programs, which are limited to those children between the age of 3 and the age of compulsory school attendance, unless the agency's approved grant provides otherwise.

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Caring for America's Children Compliance with professional standards is voluntary. Compliance with FIDCR was mandatory for programs receiving federal funds, and compliance with the performance standards is a condition of federal Head Start funding. Child care providers generally must evaluate their own programs, with the help of parents and professionals. Because standards of quality specific to family day care programs have been lacking until the recent program of accreditation for family day care homes, launched by the National Association for Family Day Care, the standards discussed here pertain almost entirely to care in centers. Table 5 provides an overview of how the different sets of professional standards and federal requirements address various indicators of quality. The guidelines do not always agree precisely, but they can be combined to define an acceptable range for each dimension. For example, three professional organizations set guidelines for maximum ratios and group sizes, although only NAEYC does so for group sizes for infants and toddlers. For ratios, all the standards agree that there should be at least one caregiver for every four children from birth to age 2. The standards identify a range of acceptable ratios for older children: one caregiver for every four to six 2-year-olds, five to ten 3-year-olds, or seven to ten 4-year-olds and 5-year-olds. For group size, the professional standards identify the ranges at fourteen to twenty 3-year-olds, sixteen to twenty 4-year-olds, or sixteen to twenty 5-year-olds. NAEYC's recommendation for maximum group size for younger children in child care centers is eight infants or twelve toddlers. Four of the organizations provide guidelines for professional qualifications of child care staff. The standards agree that full teachers in centers should have training in early childhood education or development, but they disagree as to whether such training should be part of professional education, such as a college degree. The professional standards specify that child care programs should provide a daily organization that is both structured and flexible, that curricula should encompass social as well as cognitive components, and that there

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Caring for America's Children TABLE 5 Indicators of Quality Addressed by Professional Standards and Federal Requirements INDICATOR NAEYC NBCDI ECERS CWLA FIDCR Head Start Caregiver Qualifications and Roles Potential for forming affectionate relationship with familiar care-giver X     X     Frequent positive interaction between caregiver and children; caregivers responsive, positive, accepting and comforting X   X     X Caregiver training related to child development X X   X X   Opportunities for caregiver training X X X   X X Group Sizes and Ratios Maximum group size X     X X   Staff/Child ratio   X   X X   Curriculum Content and Structure Curriculum encompassing both  socioemotional and cognitive development X X   X X X Children selecting some activities X X X     X Experience with cooperative group process X           Curriculum structured but not overly rigid X X X X     Children's culture recognized, appreciated X X X       Physical Characteristics of Program Child-oriented environment X   X X X X Orderly, differentiated setting X   X X   X Parental Participation Parental involvement X X X   X   Parent-staff conferences and communication   X   X X  

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Caring for America's Children should be options for children to select and pace their own activities from among several possibilities provided by caregivers. In addition, professional standards specify the need for an orderly, differentiated physical environment that is designed for children. The standards not only recommend parental involvement and the affirmation of cultural diversity, but they also describe how to address such dimensions of quality in actual practice. For further information about professional standards and federal requirements, see: Accreditation Criteria and Procedures of the National Academy of Early Childhood Programs, National Association for the Education of Young Children (NAEYC) (S. Bredekamp, ed. Washington, D.C.: National Association for the Education of Young Children, 1984). Safeguards: Guidelines for Establishing Programs for Four Year Olds in the Public Schools, National Black Child Development Institute (NBCDI) (Washington, D.C.: National Black Child Development Institute, 1987). Early Childhood Environment Rating Scale (ECERS) (T. Harms and R.M. Clifford. New York: Teachers College Press, 1980). Standards for Day Care Service, Child Welfare League of America (CWLA) (New York: Child Welfare League of America, 1984). Federal Interagency Day Care Requirements (FIDCR) (Washington, D.C.: U.S. Department of Health, Education, and Welfare, U.S. Office of Economic Opportunity, and U.S. Department of Labor [DHEW Publ. No. OHDS 78-31081], 1968). Head Start Performance Standards (Washington, D.C.: U.S. Department of Health and Human Services [45-CFRR-1304], 1984). For a detailed review of the research on child development and of the current status of child care in the United States, see the report of the Panel on Child Care Policy: Who Cares for America's Children? (Washington, D.C.: National Academy Press, 1990).

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Caring for America's Children THE UNFINISHED AGENDA Despite the fact that research and practice have uncovered key elements for improving quality, much still must be done in order for the majority of our children to receive safe, health and developmentally stimulating child care. The enactment of P.L. 101-508 provides incentives for state and local policy makers to use the information in this booklet as they evaluate and revise their policies and regulations to promote high-quality child care. The Panel on Child Care and Policy urges policy makers to consider both the structural and interactive dimensions of quality implied by their regulations and standards. The panel further suggests that in order to ensure the best possible experiences for our children, child care policies must address: group size, child/staff ratios, caregiver qualifications, stability and continuity of caregivers, structure and content of daily activities, and organization of space. When all the dimensions of quality are addressed, a good program results; conversely, when various features of quality are ignored, a poor program results: see box on opposite page. The combined perspectives of academic research and professional practice provide a picture of the key features of high-quality child care. Although further research is needed about some of the dimensions of quality, the current state of knowledge is significant, and should influence policy and practice. State regulations, however, very often paint a different picture, as can be seen in Tables 1–4. For example, only a minority of states regulate group size for all age groups. Nearly 75 percent of the states do not require any

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Caring for America's Children In ''Child Care and Early Childhood Programs" (in Conditions of Children in California, Berkeley, Calif: Policy Analysis for California Education, 1989), Professor Norton Grubb of the School of Education at the University of California at Berkeley painted a picture of a good program: The physical space is carefully arranged to provide a variety of activities so that children in one area will not interfere with those in another; areas for active play are separated from those for quieter activities and privacy. Activities are carefully paced throughout the day and are geared to the rhythms of children coming and going and to fluctuating levels of children's and teacher's energy. Although most good centers devote some time to relatively formal cognitive development, most of the "curriculum" is embedded in games, toys, and different activity centers within classrooms, and is designed to allow children to initiate activities. In such settings, teachers circulate constantly, interacting with children, engaging nonparticipating children in activities, and anticipating problems before they develop . . . The best teachers are warm and loving, but warmth alone is insufficient; an effective teacher . . . understands the developmental stages and thoughts of young children and responds to them intelligently as well as lovingly. A well-run child care class, bustling with activity, seems to be running itself, but in fact the influence of the teacher is pervasive though hidden. And he painted a picture of a poor program: . . . many children spend large amounts of time unfocused, drifting among activities in ways that leave them both bored and frazzled. Without constant monitoring, some children may become wild, especially if they are bored, and they may respond in a dangerous or violent manner. Under these circumstances untrained teachers . . . may be pushed to the limits of their patience. . . . If the center has cut corners on adult/child ratios—not difficult to do, especially with lax enforcement of licensing—then the chaos, inattention of teachers, management problems, and harsh direction and punishment become even more serious.

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Caring for America's Children preservice training for family day care providers, and in general state regulations do not address issues of daily structure or curriculum in child care. A substantial number of states do not set space requirements—either square footage or design—for family day care homes. And staff/child ratios vary widely, with some states permitting six 3-year-olds per caregiver and others permitting as many as fifteen. Although the evidence underscores children's need for enduring relationships with caregivers, the turnover rate in child care settings is extremely high in the United States. In some localities and among some types of providers, for example, turnover rates are as high as 41 percent annually. Research suggests a link between caregivers' low wages and benefits and the high turnover rates. States cannot directly regulate child care staff stability, but they could influence it indirectly through requirements that enhance caregivers' working conditions, wages, and benefits. Improving pay and benefits for caregivers will increase the cost of care, however. Without significantly larger public subsidies than are now available, many families will be unable to afford the higher quality of care and may be forced to place their children in even less adequate arrangements. State regulators are thus left with an ongoing dilemma of how to balance the competing goals of quality and financial access. With the available knowledge and the impetus for change, the time is right for redirecting child care policy toward safe, healthy, and high-quality experiences for all of America's children. It is hoped that the information provided in this publication will aid in that effort.