1. CHAPTER 11: Responsive Programs Quality, Health, Safety, and Nutrition
Infant and Toddler Development and Responsive Program Planning: A Relationship-Based Approach
Third Edition
Donna S. Wittmer
Sandy Petersen
© 2014, 2010, 2006 by Pearson Education, Inc. All Rights Reserved

2. What Is Quality . . . At a minimum, Safety of the child
Communication between the family and the teacher about the child
A warm, responsive relationship between the teacher and the child
(Kontos, Howes, Shinn, & Galinsky, 1995)

3. What Is Quality . . .
Plus:
Low ratios, small group sizes, and well-trained teachers
Focused, warm, enriched relationships
The well-being of the children

4. … and Why Does It Matter?
Nearly 2 million children younger than age 1 are in out-of-home care at least part of the week
Early experiences form the architecture of the brain
Poor quality child care produces stress hormones in children’s brains

5. Structural variables Measurable aspects that affect quality:
Ratios: 1 adult to 3-4 infants/toddlers
Group sizes: No larger than 8
Primary caregiving: 1 adult provides most of the care and communication with family
Continuity of care: Child stays with caregiver and group birth to 3.
Teacher characteristics: warm, capable of closeness, age-specific training, compensation, supervision

6. Actual experiences that occur
Process variables
Actual experiences that occur
within child care:
Responsive interactions: understanding the child’s experience and knowing how to respond appropriately
Cultural and linguistic continuity: use of home language
Meeting the needs of the individual within the context of the group: temperament, moods, preferences, and routines of each child

7. Process variables Physical environment: safe, clean, engaging
Communication with families: ongoing, reciprocal, respectful (See chapter 2, chapter 12)

8. 7 gifts of caregiving Nurturance Support Security Predictability Focus
Encouragement
Expansion
(Lally, 2001)

9. National health and safety performance standards
Staffing
Program activities
Health
Nutrition
Facilities, supplies, equipment, transportation
Infectious diseases
IDEA
Administration
Licensing

10. Health involves more than the absence of illness and injury.
To stay healthy, children depend on adults to make healthy choices for them and to teach them to make such choices for themselves over the course of a lifetime. (Chang & Aronson, 2002)

11. An Emphasis on Health and Safety Sanitation and Preventing the Spread of Disease
Programs need policies and training for:
Hand washing
Diapering
Sanitizing toys, furniture and bedding
Excluding children who are ill
Medication administration

12. An Emphasis on Health and Safety Promoting Safety and Preventing Injuries
Accident prevention
Vigilant scanning for hazards
Formal safety checks
Visual access to all children at all times
Furniture stability
Outlets covered
Choking hazards: foods, toys over 1 ½ inches diameter
Cleaning supplies and medication locked up
First aid and CPR training

13. Policies that promote and protect health
Programs need clear policies addressing issues such as sleeping positions and abuse and neglect
Infant/toddler teachers are mandated to report suspected abuse or neglect.

14. SIDS prevention Place infants on their backs to sleep.
Use a firm sleep surface.
Keep soft objects and loose bedding out of the crib.
Do not smoke during pregnancy.
Provide a separate nearby sleeping environment (recommended).
Offer a pacifier at naptime and bedtime.
Avoid overheating.
(American Academy of Pediatrics, 2013)

15. Abuse
“non-accidental injury or pattern of injuries to a child for which there is no ‘reasonable’ explanation.” (NCCIC, 2009)
Non-accidental injury
Neglect
Sexual molestation
Emotional abuse

16. Nutritional needs of infants and toddlers
Value of breast milk and policies that support the use of breast milk in group care
Holding during bottle feeding
Essential micronutrients: iron, iodine, zinc
Healthy calories: fat but no sugar or salt
Introduce variety – but slowly
Allow for individual patterns

17. Child development and education programs Supporting safe and healthy nutrition
Social environment of feeding:
Being held
Conversation
Never force or prevent eating or use food as rewards or punishment

18. Child development and education programs Supporting safe and healthy nutrition
Safe handling of food and utensils:
Seating arrangements during meals
Safe and sanitary tables, utensils
Separate food preparation areas
Storage of foods
Handling of breast milk

19. Evaluating quality in child care programs
Infant Toddler Environmental Rating Scale (ITERS)
Observational record of the Caregiving Environment (ORCE)
Teacher Interaction Scale
PITC Program Assessment Rating Scale (PARS)
The Head Start Program Monitoring Review Protocol

20. Infant/Toddler Earmark
Policies, Laws, and Systems that Support Quality Programs Child Care Development Fund
Child Care Bureau, Administration for Children and Families, U.S. Department of Health and Human Services
Subsidize cost of care
Infant/Toddler Earmark
$100,000,000 annually
Quality improvements
Access

21. Policies, Laws, and Systems that Support Quality Programs Licensing
State requirements
Safety
Staffing – age, training & experience
Group sizes, ratios, space
Each state’s licensing requirements are available at:

22. Policies, Laws, and Systems that Support Quality Programs Quality Rating Systems and Tiered Reimbursement
State-wide systems describing levels of quality
May be tied to higher CCDF subsidy reimbursement
Items may include:
Environmental rating scales
Family involvement
Teacher training
Accreditation

23. Policies, Laws, and Systems that Support Quality Programs Accreditation
National Organizations system of recognizing quality
NAEYC – center-based
NAFCC -- family child care
Established criteria
Self –study
Peer review