Every day, millions of infants, toddlers, and preschoolers leave home to spend part or most of their day in some type of child care setting. According to Healthy Child Care America: Blueprint for Action, the percentage of children, up to age five, who were enrolled in child care soared from 30 percent in 1970 to 70 percent in 1993 (U.S. Department of Health and Human Services, 1996). In 1999, the National Household Education Survey, which asked all families about nonparental child care, reported that 61 percent of children under four were in regularly scheduled child care, including 44 percent of infants under one year, 53 percent of one-year-olds, and 57 percent of two-year-olds (National Research Council and Institute of Medicine, 2000).
Many observers believe the nation is at a turning point in its thinking about the care and early education of young children. First, an explosion of knowledge from the neurosciences and the behavioral and social sciences has documented the remarkable pace of development and accomplishments of the early childhood period, and the critical importance of early relationships and nurturing environments in helping children realize their full potential.
Second, child care has become a fact of life for American families at all income levels. Today, many young children are cared for in a number and variety of out-of-home environments. Trends for parental employment suggest that early reliance on child care in both informal (by relatives or friends)
and formal (licensed day care family homes and center-based settings) care is likely to grow (National Research Council and Institute of Medicine, 2000).
Third, the use of public funds for early childhood care and education, as well as concerns about preparing young children to enter school ready to learn, have prompted demands for objective and quantifiable information on such programs and growing concern about the effects of early care and education on children's development (e.g., The Government Performance and Results Act of 1993, the National Education Goals Panel of 1998, Head Start Performance Standards and Measures). Child care also figures in other policy debates, such as welfare reform and the requirements of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996.
As a result of the heightened public and political attention and the movement toward standards and accountability, performance measurement has emerged as an important concern in the early childhood care and education field. At the request of the Department of Health and Human Services' Administration for Children and Families, the Board on Children, Youth, and Families convened two workshops to learn from existing efforts to develop performance measures for early childhood care and education, to consider what would be involved in developing and implementing an effective performance measurement system for this field, and to delineate some critical next steps for moving such an effort forward.
Of necessity, this report captures only some of the range and richness of the four days of discussion. The report is organized in three sections. Chapter 2 provides an overview of the workshops, summarizing the key issues addressed, the themes that emerged from discussions, and participants' ideas for next steps. Chapter 3 provides lessons learned from other policy domains that have implemented performance measures. Chapter 4 provides capsule summaries of selected presentations that detailed specific experiences with performance measurement and indicators at national and state levels. (Also see Assessment of Performance Measures for Public Health, Substance Abuse and Mental Health, National Research Council, 1997.) An appendix includes workshop agendas and participant lists.
Throughout the report, the terms “child care” and “early childhood programs” are used to encompass the variety of services provided, including care and early education (see Box 1-1). The term “early childhood field” includes child development experts, child care providers, early childhood
educators, and advocates for children. Definitions of terms related to performance measures used in the report appear in Box 1-2.
This report reflects some of the key issues and tensions that are inherent in efforts to develop performance measures and improve the quality of child care. Many other issues important to policy and practice are not covered here and deserve ongoing consideration and examination. The Board on Children, Youth, and Families hopes the workshops and this summary will serve as a stimulus to all those working to meet the needs of children who are in the care of others.
What Is Child Care?
Historically, child care traces its roots in two traditions: social welfare and early childhood education. Programs such as charitable day nurseries served poor and dependent children and those of working parents, providing primarily custodial or protective services. Middle-class parents seeking academic and social enrichment for their children initiated nursery schools and kindergartens that offered comprehensive services focused on cognitive and social development.
During World War II, labor needs required the services of women, and the number of working mothers with children under age six grew dramatically. Both the federal government and some industries provided support for day care centers in war-disrupted areas. Such support ended after the war, but many mothers with preschool children continued to work outside the home (Cahan, 1989).
In the wake of broad social, cultural, and economic changes beginning in the 1960s, more women with children joined the work force—out of choice or necessity—with significant implications for the care of children. Many working parents care for children themselves or rely on grandparents and other relatives, nannies, and babysitters to provide care at home. Others have turned to settings outside the home including day care centers (both profit and non-profit); family day care and group homes; public and private nursery schools, employer-provided care, prekindergartens, and kindergartens, operated as part- or full-day school programs; and beforeand after-school programs.
While parents and relatives continue to provide vast amounts of child care, there has been a rapid growth in the reliance on paid care by nonrelatives, on center-based settings, and on public subsidies for child care. In 1965, the United States instituted a federally sponsored program, known as Head Start, intended to provide care for the “whole child”—physical health as well as cognitive, social, and emotional development. The Child Care and Development Block Grant (CCDBG) provides funds for low-income families and to help states provide child care (National Research Council and Institute of Medicine, 1995). The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 established the Child Care and Development Fund (CCDF) to assist working low-income families to achieve and maintain economic self-sufficiency. Currently, child care funding is now administered under the Child Care and Development Block Grant Act rules, including CCDF.
Today, child care increasingly is seen to provide a range of services, including nurturance and learning opportunities for children, preparation for school, support for working parents, and reduction of poverty and access to supplemental services. Although many of these purposes are complementary, distinctions between child care as a developmental program or as a service for working parents continue to influence policy debates. The early childhood field has developed in this mixed tradition, which some observers have described as a “two-tiered system” that hampers planning, coordination, and advocacy (Cahan, 1989; National Research Council, 1990). While divisions may be easing, they are still apparent with respect to issues of quality in publicly supported programs. For example, 25 percent of all new funds for Head Start are set aside for quality improvements, while only 4 percent of funds for the Child Care and Development Fund are earmarked for quality improvements (National Research Council and Institute of Medicine, 2000). The discussions at the workshops reflected some of these issues and tensions about the goals and performance of child care and appropriate measurement approaches.
What Do We Mean by Performance Measures, Benchmarks, Indicators, and Other Terms?
As noted throughout the workshop, the term “performance measures,” and other terms such as “indicators” and “outcomes,” are used in various contexts and definitions vary. Lack of agreement across the country on terms such as outcomes, measures, indicators, and benchmark make discussions unwieldy and somewhat frustrating. Definitional issues are important and complex, and the workshop addressed but could not resolve these. This report generally uses the following definitions for terms: