1. Children in Daycare: Science, the Media, and Public Opinion Cathryn Booth-LaForce, PhD, FAPS Charles & Gerda Spence Professor of Nursing Early Childhood Development Lecture Series May 2, 2007

2. Public Opinion

3. Examples of things I have heard… Any family can get along without two incomes—they just have to make sacrifices. Any family can get along without two incomes—they just have to make sacrifices. Women shouldn’t have children if they’re going to have strangers raise them. Women shouldn’t have children if they’re going to have strangers raise them. Anyone who puts their baby in daycare doesn’t have good family values. Anyone who puts their baby in daycare doesn’t have good family values. Children learn bad habits in daycare. Children learn bad habits in daycare. Children learn how to get along with other children in daycare. Children learn how to get along with other children in daycare. The right (high quality, expensive) daycare will make my child smarter. The right (high quality, expensive) daycare will make my child smarter. I raised my child myself and he/she is smarter/better behaved/more socially skilled than children raised in daycare. I raised my child myself and he/she is smarter/better behaved/more socially skilled than children raised in daycare.

4. Media Reports

5. Some Recent Headlines “Poor Behavior is Linked to Time in Day Care” “Poor Behavior is Linked to Time in Day Care” ---New York Times “Study Links Child Care to Acting Out” “Study Links Child Care to Acting Out” ---Associated Press “How nurseries ‘still breed aggression’” “How nurseries ‘still breed aggression’” ---London Times

6. “Day Care is Linked to Behavior Lasting Through 6 th Grade” “Day Care is Linked to Behavior Lasting Through 6 th Grade” ---The Wall Street Journal “Few Effects of Poor Daycare Last Past Age 11” “Few Effects of Poor Daycare Last Past Age 11” ---Reuters

7. “Quality of Early Child Care Makes a Difference But Good Parenting Matters More, US Study Finds” “Quality of Early Child Care Makes a Difference But Good Parenting Matters More, US Study Finds” ---Medical News Today “Day Care News: Parents, You Count Most” “Day Care News: Parents, You Count Most” ---Newsday

8. “A day care center, the sort of place in which bullies are bred, according to a new study” ---New York Times, 2001

10. Some statistics….

11. National Maternal Employment Statistics (2005) 60% of married mothers of preschool children are in the work force 60% of married mothers of preschool children are in the work force 53.5% of married mothers of infants are in the work force 53.5% of married mothers of infants are in the work force ---Monthly Labor Review, Feb, 2007

12. Child-Care Statistics Each year, parents + government spend roughly $50 billion on child care Each year, parents + government spend roughly $50 billion on child care ---Univ. MD, 2006 About 12 million children are in child care in the U.S. (9.8 million under 5 years in 40+ hours) About 12 million children are in child care in the U.S. (9.8 million under 5 years in 40+ hours) ---U.S. Census Bureau, 1999

13. Why are young children spending so much time in daycare? National trends—maternal employment National trends—maternal employment Families need two incomes Families need two incomes Work preference Work preference

14. Costs to Women of the “Off Ramp” Short (1-2 year) time out—lose 18% of earning power (28% in business and banking/finance) Short (1-2 year) time out—lose 18% of earning power (28% in business and banking/finance) 3 or more years—lose 37% of earning power 3 or more years—lose 37% of earning power ---Center for Work-Life Policy, 2005

15. What are the effects of childcare on children and families?

16. Science

17. NICHD Study of Early Child Care and Youth Development

18. NICHD Early Child Care Research Network Virginia Allhusen Mark Appelbaum Jay Belsky Cathryn Booth-LaForce Robert Bradley Celia Brownell Peg Burchinal Bettye Caldwell Susan Campbell Alison Clarke-Stewart Martha Cox Sarah L. Friedman Willard Hartup Ty Hartwell Kathryn Hirsh-Pasek Aletha Huston University of California: Irvine University of California: San Diego Birkbeck College, University of London University of Washington University of Arkansas at Little Rock University of Pittsburgh University of North Carolina at Chapel Hill University of Arkansas at Little Rock University of Pittsburgh University of California: Irvine University of North Carolina at Chapel Hill NICHD University of Minnesota Research Triangle Institute Temple University University of Texas-Austin Lyz Jaeger Deborah Johnson Jean Kelly Bonnie Knoke Nancy Marshall Kathleen McCartney Fred Morrison Phil Nader Marion O’Brien Margaret Owen Ross Parke Chris Payne Deborah Phillips Robert Pianta Suzanne Randolph Wendy Robeson Susan Spieker Deborah Vandell Marsha Weinraub St. Joseph’s University Michigan State University University of Washington Research Triangle Institute Wellesley College Harvard University Loyola University Chicago University of California: San Diego University of Kansas University of Texas-Dallas University of California: Riverside University of North Carolina at Greensboro Georgetown University University of Virginia University of Maryland, College Park Wellesley College University of Washington University of Wisconsin- Madison Temple University

19. Acknowledgements NICHD Grant #HD25447 NICHD Grant #HD25447 Susan J. Spieker, Co-PI Susan J. Spieker, Co-PI Jean F. Kelly, Co-PI Jean F. Kelly, Co-PI Sumi Hayashi, Site Coordinator Sumi Hayashi, Site Coordinator Participating families Participating families

20. …and a small army of data collectors

21. Purpose of the NICHD Study Purpose of the NICHD Study To examine how variations in child-rearing contexts (childcare, home, school, etc.) are related to children’s social, emotional, cognitive, and language development and health.

22. Ecological Model: Concurrent and Longitudinal Relations Family and maternal characteristics Demographic characteristics Home environment Childcare and school environments Child characteristics Child Outcomes: Social, emotional, cognitive, language, health

23. Families in the Study 1,364 eligible births occurring during 1991 1,364 eligible births occurring during 1991 Sampling designed to assure adequate representation of major socio- demographic niches Sampling designed to assure adequate representation of major socio- demographic niches Ten data collection sites Ten data collection sites 24 hospitals 24 hospitals Recruited in these locations

24. Exclusion Criteria Mother younger than 18 years Mother younger than 18 years Family planned to move Family planned to move Multiple birth Multiple birth Infant had disability Infant had disability Infant stayed in hospital > 7 days Infant stayed in hospital > 7 days Substance abuse—mother Substance abuse—mother Mother did not speak English Mother did not speak English > 1 hour from lab site > 1 hour from lab site Extremely unsafe neighborhood Extremely unsafe neighborhood

25. Current Locations of the 1009 Study Families

26. Who are the Families in the Study? Maternal Education 10% no HS degree 21% HS degree or GED 33% some college 21% college degree 15% postgrad education Income-to-Needs (1 m) 13% poverty 18% near-poverty 69% non-poor Marital Status (1 m) 14% single

27. Race/Ethnicity (%) StudyUSA StudyUSA White, non-Hispanic 75 65 Black, non-Hispanic 13 16 Hispanic 6 15 Asian 1 3 Native American 1 1 Other 4 NA

28. Work/School Plans at Birth Employment/School Plans--child’s first year: Yes79% No18% Don’t know 3%

29. Planned Hours of Work/School < 10 4% 10-2929% 30+67%

30. Early Entry into Many Hours of Childcare Median age at entry—3 months Median age at entry—3 months Mean hrs per week (1-54 months)—31 hrs Mean hrs per week (1-54 months)—31 hrs “Informal” care arrangements most common during first year “Informal” care arrangements most common during first year

31. Study Assessment Ages 1, 6, 15, 24, 36, 54 months 1, 6, 15, 24, 36, 54 months K, Grades 1, 2, 3, 4, 5, 6 K, Grades 1, 2, 3, 4, 5, 6 Age 15 Age 15

32. Types of Assessments Interviews Interviews Questionnaires Questionnaires Observations Observations Direct Assessments Direct Assessments Records Records

33. Informants Mothers Mothers Fathers/Partners Fathers/Partners Child-care Providers Child-care Providers After-school Care Providers After-school Care Providers Teachers Teachers Principals Principals Children Children Best Friends Best Friends Mothers and Teachers of Best Friends Mothers and Teachers of Best Friends Nurse Practitioners Nurse Practitioners

34. Contexts Home Home Child-care arrangements Child-care arrangements School School After-school settings After-school settings Neighborhood Neighborhood

35. Number of Variables (birth to Grade 6) Raw data—70,000 variables Raw data—70,000 variables Analysis data sets—8,700 variables Analysis data sets—8,700 variables Data are available to other investigators Data are available to other investigators

36. What did we measure in the child-care setting?

37. Child-Care Measures Quantity : Hours/week Quantity : Hours/week Observed Quality (ORCE) Observed Quality (ORCE) Type : Type : Relative/ In Home Care Relative/ In Home Care Child-care Home Child-care Home Child-care Center Child-care Center

38. Quality of Care ORCE (Observational Record of the Caregiving Environment) 6, 15, 24, 36, 54 months of age

39. ORCE Behaviors Shared positive affect Shared positive affect Positive physical contact Positive physical contact Responds to vocalization/child’s talk Responds to vocalization/child’s talk Speaks positively to child Speaks positively to child Asks questions of child Asks questions of child Other talk to child Other talk to child Stimulates cognitive development/teaches academic skill Stimulates cognitive development/teaches academic skill Facilitates behavior Facilitates behavior Mutual exchange Mutual exchange Negative/restricting actions (reversed) Negative/restricting actions (reversed) Speaks negatively to child (reversed) Speaks negatively to child (reversed)

40. ORCE Ratings Stimulation Stimulation Sensitivity/responsiveness Sensitivity/responsiveness Positive regard Positive regard Detachment/disengagement Detachment/disengagement Flat affect Flat affect Intrusiveness (at 36, 54 months) Intrusiveness (at 36, 54 months) Fosters exploration (at 36, 54 months) Fosters exploration (at 36, 54 months)

41. ORCE is related to… Quality of the physical environment Quality of the physical environment “Regulable” features of daycare “Regulable” features of daycare

42. Type of Care: Child Care Centers Larger groups of children Larger groups of children More toys More toys More structured activities More structured activities More children per adult More children per adult Children grouped by age Children grouped by age

43. Child-Care Homes More informal care More informal care More time in free play More time in free play Varying ages of children; often siblings Varying ages of children; often siblings Activities are more “home-like” Activities are more “home-like”

44. Relative/In-Home Care Most informal Most informal Care provider follows usual routine and incorporates child Care provider follows usual routine and incorporates child Little structure Little structure May be just caregiver and child or other related children May be just caregiver and child or other related children

45. …including Fathers

46. Quality of Care by Type Full range of quality in every type of care. Full range of quality in every type of care. Especially during the first two years, the average quality of care was higher in less formal care with fewer children. Especially during the first two years, the average quality of care was higher in less formal care with fewer children. ---NICHD ECCRN, 1996

47. What did we measure in the home setting?

48. Parenting Quality

49. Quality of Mother-child Interaction Ratings from 15 minute videotaped structured play interactions: Ratings from 15 minute videotaped structured play interactions: Sensitivity to distress Sensitivity to distress Sensitivity to nondistress Sensitivity to nondistress Detachment Detachment Intrusiveness Intrusiveness Cognitive stimulation Cognitive stimulation Positive regard Positive regard Negative regard Negative regard Flat affect Flat affect

50. Home Observation for Measurement of the Environment (HOME) Checklist of quantity and quality of support and stimulation available to the child in the home environment (e.g., books, age-appropriate play materials, appropriate responses to child, affection) Checklist of quantity and quality of support and stimulation available to the child in the home environment (e.g., books, age-appropriate play materials, appropriate responses to child, affection) Based on interview of mother with child present Based on interview of mother with child present

51. Is early, extensive participation in childcare a risk factor for insecure attachment?

52. A 30-sec introduction to attachment… Secure attachment—”comfortable sense of trust in the primary caregiver” Secure attachment—”comfortable sense of trust in the primary caregiver” Security is predicted by warm, sensitive, responsive parenting from primary caregiver Security is predicted by warm, sensitive, responsive parenting from primary caregiver Insecurity is predicted by detached, uninvolved, unresponsive, intrusive parenting Insecurity is predicted by detached, uninvolved, unresponsive, intrusive parenting Insecurity is a risk factor for subsequent behavior problems, problems with peers, relationships, poor social competence Insecurity is a risk factor for subsequent behavior problems, problems with peers, relationships, poor social competence

53. Attachment Results Security/insecurity was related to the quality of parenting. Security/insecurity was related to the quality of parenting. Security/insecurity was not related to the quality, quantity, or age of entry into childcare. Security/insecurity was not related to the quality, quantity, or age of entry into childcare. Dual-risk effect: Very insensitive parenting plus poor quality childcare, or many hours in childcare—greater proportion of insecure infants. Dual-risk effect: Very insensitive parenting plus poor quality childcare, or many hours in childcare—greater proportion of insecure infants. ---NICHD ECCRN, 1997

54. Child Care and Child Outcomes: More Questions  Is child care related to child cognitive, language and social outcomes at language and social outcomes at 4.5 years? 4.5 years?  If so, how? What are the specific effects of quality, quantity of care, and type of of quality, quantity of care, and type of care on child outcomes? care on child outcomes?  How big are these effects?

55. Statistical Controls Site, gender, ethnicity, maternal education, proportion time mother had partner in household, maternal depression, income, maternal sensitivity

56. I. Quality of Early Child Care For preschoolers, higher quality care over the first 4.5 years is associated with For preschoolers, higher quality care over the first 4.5 years is associated with better pre-academic skills better pre-academic skills better language skills better language skills

57. Differences in Child Care Quality vs. Differences in Parenting Quality: Language Competence Language Competence Parenting Quality d =.87 Child Care Quality d =.29 Language Competence 0 85 90 95 100 105 LowHigh m=95.3 m=97.6 0 85 90 95 100 105 LowHigh m=88.8 m=102.5

58. II. Type of Child Care More experience in child care centers is associated with More experience in child care centers is associated with better language skills better language skills more problem behaviors more problem behaviors

59. III. Quantity of Child Care (all types of care) More hours of child care over the first 4.5 years is associated with more problem behaviors more problem behaviors (aggression, disobedience)

60. All types of care All types of care Not a function of quality Not a function of quality No threshold No threshold Not just assertive behavior Not just assertive behavior Not clinical levels of aggression Not clinical levels of aggression

61. Differences in Amount of Child Care vs Differences in Parenting Quality: Behavior Problems at 54 Months Caregiver Reported Behavior Problems Parenting Quality d =.23 Quantity of Care d =.38 <10 hrs/wk30>hrs/wk 0 45 50 55 m=48.1 m=51.7 0 45 50 55 LowHigh m=51.0 m=48.8

62. Grade 5/6 Results

63. Statistical Controls Site, gender, ethnicity, maternal education, proportion time mother had partner in household, maternal depression, income, maternal sensitivity, classroom quality, after-school hours.

64. I. Quality of Early Child Care Higher quality care over the first 4.5 years is associated with: Higher quality care over the first 4.5 years is associated with: higher vocabulary scores in Grade 5 higher vocabulary scores in Grade 5

65. II. Type of Child Care More experience in child care centers is associated with More experience in child care centers is associated with more behavior problems in Grade 6 more behavior problems in Grade 6

66. Comparison of Effect Sizes Vocabulary: Vocabulary: Child-care quality--.06 Child-care quality--.06 Parenting quality--.25-.33 Parenting quality--.25-.33 Behavior Problems Behavior Problems Prop. center care--.08-.12 Prop. center care--.08-.12 Parenting quality--.11-.19 Parenting quality--.11-.19

67. Behavior-Problem Mean Scores Average score 50.0 Average score 50.0 “At-risk” score 60.0 “At-risk” score 60.0 No time in child care: 49.6 No time in child care: 49.6 1-2 years in center care: 50.0 1-2 years in center care: 50.0 3 years in center care: 51.4 3 years in center care: 51.4 (10% of sample) 4 years in center care: 52.0 4 years in center care: 52.0 (5% of sample)

68. Effect Size Considerations… Length of time between measurements Length of time between measurements Parenting—genetic and environmental influences? Parenting—genetic and environmental influences? Childcare—cumulative societal effects? Childcare—cumulative societal effects?

69. Classroom effects?

70. “ONCE MORE, THE HORRORS OF DAY CARE” ---Philadelphia Daily News

71. “THERE ARE some things that should just... DIE already: * Photos of Brad and Angelina holding their many children. (Mine could walk by age 1 - didn't yours?) * Tube tops, particularly on anyone over the age of 25 and with a BMI of more than 25. * Women who are the fourth wife of a billionaire saying the two of them are soulmates. * Studies that purport to demonstrate that day care will irreversibly damage your children. Especially poorly designed studies of limited usefulness being trotted out by people who can't really grasp the limitations of the study but put screaming headlines on them designed to sell newspapers and scare the stuffing out of working parents.”

72. So, what are the limitations of the study? It is not nationally representative It is not nationally representative We did not include the most high-risk disadvantaged families We did not include the most high-risk disadvantaged families It is not an “experiment” It is not an “experiment” Therefore, we cannot claim that child care causes child outcomes. Therefore, we cannot claim that child care causes child outcomes.

73. What are the strengths of the study? Largest, longest-term study of child care in relation to child development Largest, longest-term study of child care in relation to child development Prospective study Prospective study Began at birth Began at birth “Ecological” model – included data about “Ecological” model – included data about the family, home, school, neighborhood the family, home, school, neighborhood Multiple aspects of child development & health Multiple aspects of child development & health Exceptionally high-quality data Exceptionally high-quality data Diversity of investigators’ views Diversity of investigators’ views

74. Summing up: What do these results mean?

75. Parent(s) Matter!

76. Parents are spending more time with their children 1965--mothers spent 10.2 hrs per week tending to their children 1965--mothers spent 10.2 hrs per week tending to their children 2003--mothers spent 14.1 hrs per week 2003--mothers spent 14.1 hrs per week 1965—fathers spent 2.5 hrs per week 1965—fathers spent 2.5 hrs per week 2003—fathers spent 7 hrs per week 2003—fathers spent 7 hrs per week 2003 paid work + time spent with child = 65 hrs/wk for mothers, 64 for fathers. 2003 paid work + time spent with child = 65 hrs/wk for mothers, 64 for fathers. ---Bianchi et al., 2006

77. In our study at 7 months of age… Compared families in which the infant was in 30 or more hours of childcare vs. at home with mom since birth. Time interacting with mother—only 12 hours difference per week. Time interacting with mother—only 12 hours difference per week. Time not related to quality of mother- infant interaction or child outcomes. Time not related to quality of mother- infant interaction or child outcomes. ---Booth et al., 2002

78. A conservative politician… Our study “…proves what has long been obvious, that kids do better if nurtured by their own parents.”

79. Is there a developmental advantage to staying home with mom?

80. “Thank goodness I’m a stay-at- home mom!”

81. No evidence that exclusive maternal care is best Only 52 children with exclusive maternal care, birth to 60 months Only 52 children with exclusive maternal care, birth to 60 months Not different from daycare children in cognitive, language, social development Not different from daycare children in cognitive, language, social development High-quality daycare > exclusive maternal care > low-quality daycare—cognitive and language development. High-quality daycare > exclusive maternal care > low-quality daycare—cognitive and language development.

82. Are childcare quality and quantity important?

83. Results of other studies… Importance of child-care quality for lower- income and at-risk children (correlational and experimental studies) Importance of child-care quality for lower- income and at-risk children (correlational and experimental studies) Quantity findings consistent with those from ECLS and from a study in England Quantity findings consistent with those from ECLS and from a study in England

84. Consider child-care quantity and quality from the perspective of the child’s everyday experiences…

85. Quality of Care in the U.S. Poor 8% Fair53% Good30% Excellent 9% ---Booth et al., 1999

86. “Ira’s Discount Day Care”

87. My Recommendations Let’s stop making parents feel guilty and focus on supporting them Let’s stop making parents feel guilty and focus on supporting them Let’s stop thinking that staying at home with mom is the “gold standard” Let’s stop thinking that staying at home with mom is the “gold standard”

88. More recommendations… Family leave policies Family leave policies Flexible employment; re-entry strategies Flexible employment; re-entry strategies Improve daycare quality and choices Improve daycare quality and choices Educate parents about their importance; practical strategies Educate parents about their importance; practical strategies Pay attention to what is going on in daycare Pay attention to what is going on in daycare

89. More science… What is the role of stress? What is the role of stress? Given the small effect sizes for childcare quality, weighing of costs and benefits of specific improvements Given the small effect sizes for childcare quality, weighing of costs and benefits of specific improvements More data about “daily life” More data about “daily life” Classroom effects Classroom effects Age 15 results Age 15 results Relationship study—Age 17.5 Relationship study—Age 17.5