Who Cares for America's Children? (1990) / Chapter Skim
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5 Supporting Physical and Psychological Development in Child Care Settings
5 Supporting Physical and Psychological Development in Child Care Settings
Pages 108-144
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From page 108... ...
We ask whether and to what extent participation in child care is associated with risk for infectious diseases, injury, abuse, or neglect; and we point to practices that protect children's health and safety in child care settings. We turn next to the psychological outcomes and examine practices supportive of specific developmental processes in child care.
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From page 109... ...
reviewed more than 200 studies for the panel; they concluded that, despite a bewildering array of methodological obstacles and gaps in the research, the findings on several issues converge and lead to conclusions that have significant implications for policy and practice. Infectious Diseases Respiratory Pact Infections Respiratory tract infections (colds, ear infections, sore throats, laryngitis, croup, epiglottitis, bronchiolitis, bronchitis, pneumonia, and flu)
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From page 110... ...
However, there is no agreement across studies as to the extent of the risk to children in child care, once a primary case has occurred: some studies indicate a substantial risk of secondary disease and some do not (Band et al., 1984; Fleming et al., 1985; Ginsburg et al., 1977; Osterholm et al., 1987~. The evidence on the household contacts of primary cases more consistently documents increased risk than the evidence for child care contacts of primary cases (Filice et al., 1978; Granoff and Basden, 1980; Ward et al., 1979)
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From page 111... ...
Human Immunodeficiency Virus (HIV) The risk of transmission of HIV infection in a group care setting appears to be extremely low, and to date there is no report of a child or a caregiver becoming seropositive for HIV because of exposure in a child care center or family day care home.
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From page 112... ...
CMV transmission in child care settings can be limited by standard hygienic practices because the virus is inactivated by soaps, detergents, and alcohols (Adler, 1988a)
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From page 113... ...
The most important conclusion regarding injuries is the need for rigorous prospective studies that contrast children in family day care and center care with home-reared children and document the circumstances associated with injuries. Abuse and Neglect There is only one major study of sexual abuse in child care settings.
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From page 114... ...
6. The restrictive guidelines for exclusion of children diagnosed with HIV infection reflect the consequences associated with infection rather than the theoretical risk of transmission in child care settings (American Academy of Pediatrics, 1987; Centers for Disease Control, 1985~.
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From page 115... ...
Four models for such care have been identified (Rodgers et al., 1986) , though none is widely available: a "get-well room" within a child care center for a mildly ill child; a satellite family day care home to which a sick child is transferred; care in the child's own home by a trained worker from an agency or a caregiver from the child's own center; and an infirmary or independent facility that cares for mildly ill children.
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From page 116... ...
Existing scientific evidence and best professional practice from the fields of pediatrics and public health suggest a number of practices for safeguarding the health and safety of children in child care settings: · limiting group size; separating groups of children according to age; · strictly adhering to hand-washing practices particularly after diapering and before food preparation; regularly cleaning and disinfecting diaper changing surfaces and communal objects and toys; excluding children presenting with bloody stool and children younger than age 2 with fever, as well as other selected infectious diseases; Rifampin therapy following the identification of an index case of Hib meningitis; and immunoglobulin prophylaxis following identification of an index case of viral hepatitis. There is little documentation of specific measures that can reduce injury, abuse, and neglect among children in child care.
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From page 117... ...
An issue that remains clouded with some uncertainty concerns the nature of the effects of full-time child care during the first year of life on infant-mother attachment. Although research has consistently shown that children of working mothers are attached to their mothers (Clarke-Stewart and Fein, 1983; see also Chapter 3)
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From page 118... ...
I-here are only a few indications from research of the child care circumstances that foster the development of secure attachments to caregivers. Findings indicate that those attachments are more likely to occur in child care settings with fewer children per caregiver, in contexts in which children are less often ignored by caregivers (Howes et al., 1988)
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From page 119... ...
Findings from the National Day Care Study (Ruopp et al., 1979) point also to group size and caregiver training as correlates of child cooperativeness.
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From page 120... ...
There is every reason to conclude that poor peer relations are centrally involved in the etiology of a variety of emotional and social maladjustments. Some of the factors that foster positive relations with peers among day care children and, conversely, those that foster antisocial behaviors have been identified.
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From page 121... ...
notes that moderate-sized groups simultaneously permit a choice of partners and protect children from overstimulation, which in turn promotes positive peer relations. In summary, the child care practices that foster the development of positive peer relations appear to be circumstances permitting secure attachment to caregivers, peer group stability, guidance by adults in interactions with peers, and moderate group size.
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From page 122... ...
on the Bilingual/Multicultural Curriculum Development Effort; National Head Start Multicultural Task Force (1987~; and Phillips (1989~. Second, it is important to build on rather than negate the diverse learning and interaction styles of children (and parents)
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From page 123... ...
Verbal interactions with caregivers rather than with peers appear to be important. Fine-grained examination of language development of children in child care centers suggests that the amount of speech that caregivers direct toward children is an important developmental predictor.
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From page 124... ...
In child care, caregivers' speech involving information exchange promotes language development. Particular child care features that may make opportunities for such caregiver-child interaction more feasible include smaller group size, more extensive caregiver training, and possibly a broader age range of children in family day care groups.
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From page 125... ...
The Balance of Emphasis in Children's Psychological Development There has been a tendency in the United States to conceive of highquality child care, and particularly intervention programs for high-risk children, solely in terms of cognitive stimulation. But researchers in the area of early intervention are now sounding a cautionary note.
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From page 126... ...
In contrast with the American experience with cognitive enrichment through child care, which suggests that there are social implications of cognitive programs, the Japanese preschool experience suggests that emphasis on social behaviors in preschool settings may have positive implications for cognitive development. In Japanese preschools, small groups are formed and assigned group projects, and the groups are composed so that children's individual qualities will complement one another.
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From page 127... ...
Children's language development in child care settings is fostered through frequent verbal interactions with caregiving adults that involve informational content and shared focus. Other aspects of cognitive development are supported by some (though not excessive focus on)
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From page 128... ...
The latter act may have a specific impact on the use of child care by families of young children with disabilities through its Individualized Family Service Plan component (see Chapter 7~. Development of Children With Developmental Disabilities Research on mainstreaming and integrating3 children with special needs into preschool settings with their normally developing peers indicates a number of potential benefits to both groups.
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From page 129... ...
found that without planning and teacher training in the child care setting, children with handicapping conditions showed fewer significant developmental gains over an academic year than their counterparts who remained in a special education setting. With teacher training or special curriculum, children with handicapping conditions in integrated preschool settings show positive changes in social behaviors, and, to some extent, in language behaviors that generalize to situations beyond the training or treatment context.
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From page 130... ...
Staff training and curriculum have been identified as the key components of integrated child care settings. Teacher Draining Model projects described by Rule and colleagues (1985)
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From page 131... ...
Yet developmental benefits occur only when child care staff receive initial and ongoing training in the care of particular children with special needs, and techniques are used to encourage social interaction among children with and without disabilities. Research shows possible deleterious effects to children with disabilities of simply introducing them into child care settings without necessary staff training and appropriate programming.
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From page 132... ...
; and the character of the surrounding neighborhood. Contradictory results concerning latchkey children may well be clarified by ongoing longitudinal research that takes contextual factors into account (e.g., the work in progress by D
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From page 133... ...
found that the children in the high-quality after-school program received more peer nominations as friends than did children from kindergartens not in the program. Vandell and Corasaniti reported that children who attended the child care centers after school received more negative peer nominations than mother-care children.
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From page 134... ...
Similarly, language development in child care can be fostered by particular kinds of verbal interactions between children and caregivers, namely, those that involve shared focus and informational content. Child care settings also present unique opportunities to enhance particular aspects of social and cognitive development.
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From page 135... ...
Molecular epidemiology of cytomegalovirus: Evidence for viral transmission to parents from children infected at a day care center. Pediatric Infectious Disease Journal 5:315-318.
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From page 136... ...
Erben, and B.A. Meredith 1985 Diarrheal illness among infants and toddlers in day care centers: 1.
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From page 137... ...
Armstrong, and G Kelso 1978 Management of Day Care Children During Episodes of Illness: Parent Attitudes to a Sick Child Care Center.
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From page 138... ...
Hawkins 1983 Transmission dynamics of enteric bacteria in day care centers. American Joumal of Epidemiology 118:562-572.
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From page 139... ...
Maynard 1982 Risk factors for hepatitis in day care centers. Joumal of Infectious Diseases 145:255-261.
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From page 140... ...
Sheehan 1987 Stab development: A key issue in meeting the needs of young handicapped children in day care settings. Topics in Early Childhood Special Education 7:13-27.
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From page 141... ...
Grajek, and J.C. Schwarz 1982 Environmental differences among day care centers and their effects on children's development.
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From page 142... ...
Pichichero 1984 Haernophi~s ingenue type b disease: Epidemiologic study with special reference to day care centers.
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From page 143... ...
Greenberg 1981 Step by step integration of handicapped preschool children in a day care center for nonhandicapped children. Journal of the Division for Early Childhood 2:96-101.
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From page 144... ...
Gangorosa, A Schmerler, R.L" Marier, and J.N. Lewis 1975 Shigellosis in day care centers.
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