Children's cortisol levels and quality of child care provision

Macro-structural predictors of Australian family day care quality

Introduction

This study explores the predictive power of macro-structural characteristics on quality rating and improvement system (QRIS) outcomes of Family Day Care (FDC) services in Australia.

Methods

The dataset consisted of 441 FDC National Quality Standard (NQS) ratings from all Australian states and territories, with overall ratings of Exceeding NQS, Meeting NQS, Working Towards NQS, or Significant Improvement Required.

Results

Multinomial logistic regressions confirmed that management type, community socioeconomic status (SES), level of urbanization, and government jurisdiction explained 6.9 to 19.3% of the variation in QRIS outcomes. Results indicated that lower FDC NQS ratings were more likely for (1) private for-profit vs. not-for-profit; (2) low-SES vs. high-SES area; and (3) regional or remote area vs. metropolitan. State/territory jurisdiction also influenced NQS ratings.

Discussion

These findings imply the need for policy attention to inequalities in FDC quality associated with systemic and organizational differences. Greater effort is needed to promote equality and equity in FDC services.

The Effect of an Alternative Swimming Learning Program on Skills, Technique, Performance, and Salivary Cortisol Concentration at Primary School Ages Novice Swimmers

The playful training method shows positive effects on sports learning, thus the aim of the present study was to compare the effect of two different swimming learning programs. In an 8-week intervention with a training frequency of three times per week, 23 healthy primary school-aged novice swimmers (13 boys, 10 girls) aged 9.0 ± 0.9 participated. They were split into control (CG) and alternative (AG) groups and evaluated on skills (Start, Sink), backstroke (BK) and breaststroke (BR) technique, performance (Skills time, Kicks Time), and salivary cortisol concentration. According to the results, "Start" had a greater percentage of success in AG, at the first (CG = 9.1% vs. AG = 58.3%, p = 0.027) and third (CG = 63.6% vs. AG = 100%, p = 0.037) measurement. Additionally, greater scores were found in technique for AG in both BK (p = 0.009, η² = 0.283) and BR (p = 0.020, η² = 0.231). Salivary cortisol concentration was decreased for both groups (p < 0.001) and greater in CG at the second measurement (p < 0.001). The alternative swimming learning program was found to be more efficient or equally effective, compared with the standardized method in-water skills, swimming technique and performance, and in salivary cortisol concentration.

Poverty, Caregiving, and HPA-Axis Activity in Early Childhood

The association between poverty and the activity of the hypothalamic pituitary adrenal (HPA) axis in early childhood is well established. Both ecological and transactional theories suggest that one way in which poverty may influence children's HPA-axis activity is through its effects on parents' behaviors, and over the past three decades a substantial literature has accumulated indicating that variations in these behaviors are associated with individual differences in young children's HPA-axis activity. More recent research suggests that non-parental caregiving behaviors are associated with HPA-axis activity in early childhood as well. Here we systematically review the literature on the association between both parental and non-parental caregiving behaviors in the context of poverty and the activity of the HPA-axis in early childhood. We conclude by noting commonalities across these two literatures and their implications for future research.

Neurohormones and temperament interact during infant development

The infant's psycho-physiological regulatory system begins to develop prenatally and continues to mature during the postnatal period. Temperament is a construct comprising tonic individual differences in dispositional physiological and behavioural reactions as well as an evolving ability to regulate to environmental conditions. Theoretical models and research have shown that neurohormonal and -physiological factors contribute to individual development and impact infant behaviours as well as the developing regulatory system. Moreover, prenatal maternal risks such as stress and depression are thought to programme fetal regulatory tendencies and that influences neural and behavioural functioning in infancy. The purpose of this review is to examine the theories and research that link infant temperament to neurohormonal and -physiological development in typically developing infants and in those exposed to environmental risk. Research has demonstrated associations between individual variation in physiological stress responses and regulation (measured with cortisol). Moreover, studies have noted an association with physiological regulation and socio-emotional interaction (as measured by the touch-oxytocin link) that may buffer emotional dysregulation. The interaction between individual differences in temperamental tendencies, neurohormonal and -physiological patterns will be discussed by presenting data from studies that have shown that infant neurohormonal and -physiological functioning sets an important trajectory for the development of the individual.This article is part of the theme issue 'Diverse perspectives on diversity: multi-disciplinary approaches to taxonomies of individual differences'.

The Effects of a Humor Intervention on the Physiological, Physical, and Psychological Responses of School-aged Children With Atopic Dermatitis in South Korea: A Pilot Study

PURPOSE

We examined the effects of a humor intervention on the physiological, physical, and psychological responses of school-aged children with atopic dermatitis.

DESIGN AND METHODS

This quasi-experimental study used a nonequivalent control group and a pre- and post-test design. Forty-five schoolchildren participated.

RESULTS

Children in the experimental group (n=26) received a humor intervention and reported significant differences in physiological response, which was evidenced by heightened salivary immunoglobulin A levels as compared to the control group (n=19). Additionally, the psychological response of the experimental group was significantly different from that of the control group as evidenced by decreased stress levels.

CONCLUSION

Humor intervention may be an effective nursing intervention for children with atopic dermatitis.

Transition to Kindergarten: Negative Associations between the Emotional Availability in Mother-Child Relationships and Elevated Cortisol Levels in Children with an Immigrant Background

Background: The transition to child care is a challenging time in a child's life and leads to elevated levels of cortisol. These elevations may be influenced by the quality of the mother-child relationship. However, remarkably little is known about cortisol production in response to the beginning of child care among children-at-risk such as children with an immigrant background. However, attending kindergarten or any other child day-care institution can for example have a compensating effect on potential language deficits thus improving the educational opportunities of these children. Method: Data of a subsample of N = 24 "hard-to-reach" mother-child dyads was collected in the context of the psychoanalytic early prevention project FIRST STEPS. The project focuses on the earliest integration of children with an immigrant background by supporting parenting capacities in the critical phase of migration and early parenthood. Children's hair cortisol concentration (HCC) was assessed 1 week before (mean age = 38.77 months) and 3 months after kindergarten entry (mean age = 42.26 months). Hair analysis was conducted for both times of measurement, reflecting the first 3 months after kindergarten entry and 3 months prior. Furthermore, the emotional quality of the mother-child relationship was assessed with the help of the Emotional Availability Scales (EAS; Biringen, 2008) shortly before kindergarten entry when the children were about 3 years old (mean age = 37.2). Results and Conclusion: Children's mean cumulated HCC was higher after kindergarten entry than before. The increase correlated negatively with several dimensions of the EAS. Repeated measures ANCOVA revealed that particularly responsive children and children who had experienced less intrusive mother-child relationships demonstrated lower elevations in HCC after kindergarten entry. Furthermore, a decreased EA score was found in all EA dimensions, besides the dimension "mother's non-hostility," indicating problematic EA within the mother-child relationships of the sample. The results suggest that children with an immigrant background who experience more emotional available mother-child relationships seem to regulate stress induced by kindergarten entry more effectively, indicated by lower cortisol elevations after entry. This implicates that supporting early mother-child relationships by intervention may have a positive effect on the children's ability to regulate stress induced by kindergarten entry thus promoting child development.

Children's physiological responses to childcare

This review focuses on children's physiological responses to out-of-home childcare. The finding that children's cortisol levels are higher at childcare than at home has been well-replicated. Here we summarize recent evidence examining possible correlates of elevated cortisol levels. Reviewed studies suggest that childcare quality matters, whereas group sizes and type of care do not. As for child characteristics, elevated cortisol at childcare is more pronounced in toddlers than in infants, and in inhibited and aggressive children. We discuss recent advances focusing on hair cortisol analysis and immunomarkers of stress, and suggest that there is a need for experimental and longitudinal studies to examine causal relations and possible negative long-term consequences for children's health and development.

Child Care and Cortisol Across Infancy and Toddlerhood: Poverty, Peers, and Developmental Timing

Evidence suggests that relations between child care and children's development-behaviorally and physiologically-likely differ between children from high-versus low-risk contexts. Using data from the Family Life Project (N = 1,155), the authors tested (a) whether within- and between-child differences in children's child care experiences (i.e., quantity, type, caregiver responsivity, and peer exposure) were predictive of their cortisol levels across infancy and toddlerhood and (b) whether these relations differed for children experiencing different levels of environmental risk. They found some evidence of such interactive effects. For children from high-risk contexts, within-child increases in child care hours were predictive of cortisol decreases. The inverse was evident for children from low-risk contexts. This relation grew across toddlerhood. Whereas a history of greater center-based child care was predictive of heightened cortisol levels for low-risk families, this was not the case for children from high-risk families. Irrespective of risk, greater peer exposure (between children) was associated with lower cortisol levels.

Cortisol levels of infants in center care across the first year of life: links with quality of care and infant temperament

Cortisol concentrations of older children in childcare centers have been found to be higher than at home. This study focuses on infant cortisol in childcare centers throughout the first year of life, and aims to investigate whether inter-individual differences can be explained by temperament, the quality of maternal behavior, and the quality of center care. Sixty-four infants were followed for 9 months after entering care at 3 months of age. Salivary samples were taken at 10.00 h and 16.00 h in center care (in post-entry weeks 1, 2, 3, 4, 8, 12, 16, 24, and 36) and at home (in post-entry weeks 1, 24, and 36). Prior to entry, mothers completed a temperament questionnaire and the quality of maternal behavior (sensitivity and cooperation) was observed during routine bathing sessions. Subsequently, the infants were visited three times at center care to observe the quality of infant's interactive experiences with their professional caregiver. Longitudinal regression models showed that both morning and afternoon cortisol were higher in center care compared to home. Longitudinal regression models showed that infants receiving higher quality of maternal behavior displayed higher morning cortisol in center care, compared to infants receiving lower quality of maternal behavior. Higher quality of maternal behavior was also related to higher afternoon cortisol in center care, but only in infants high in negative emotionality. Center care quality was not related to cortisol. In sum, young infants show higher cortisol concentrations in center care that are related to infant temperament and quality of maternal behavior at home.

The Impact of Program Structure on Cortisol Patterning in Children Attending Out-of-Home Child Care

Full-day center-based child care has repeatedly been associated with rising levels of cortisol, a hormone that helps the body manage challenge, across the day at child care. This article presents findings from two studies examining the relationship between child care program structure (number of days per week, and hours per day) and cortisol production across the day. Study 1 presents findings comparing cortisol production in 3- to 5-year-old children enrolled in either full-day (N = 55) or half-day (N = 63) Head-Start-funded programs. Study 2 presents findings comparing young children enrolled in either full-day full-time (5 days per week; N = 37) or full-day part-time (2-3days/week; N = 41) primarily tuition-funded programs. Using multilevel modeling and controlling for a number of child factors, attending full-day, full-time programs (as compared to either half-day or part-time programs) was associated with increased cortisol production across the day on child care and home days. Implications for early childhood educators are discussed.

Examining change in cortisol patterns during the 10-week transition to a new child-care setting

The transition to out-of-home child care brings a number of challenges for children, including complex peer interactions and extended separations from parents. Children often show a midmorning to afternoon rise in cortisol on child-care days, compared to the typical diurnal decline seen at home. Changes in cortisol were examined in a wide age range of children (N = 168; 1.2 months to 8 years, M = 3.27 years) during the 10-week transition to a new child-care setting. Structural equation modeling using latent change scores showed that children experienced an increase in the cortisol rise at child care across the 10-week transition. Furthermore, child age moderated the difference between home- and child-care cortisol patterns. Findings are placed in a developmental context, and potential implications and future directions are discussed.

Gene-environment interaction between DRD4 7-repeat VNTR and early child-care experiences predicts self-regulation abilities in prekindergarten

Intervention studies indicate that children's early child-care experiences can be leveraged to foster their development of effective self-regulation skills. It is less clear whether typical child-care experiences play a similar role. In addition, evidence suggests that children with a common variant of the DRD4 gene (48-bp VNTR, 7-repeat) may be more sensitive to their experiences than those without this variant. Using data from the NICHD Study of Early Child Care and Youth Development, we considered the degree to which children's early child-care experiences-quantity, quality, and type-were associated with their attention and self-regulation abilities in prekindergarten, and, in particular, whether these relations were conditional on DRD4 genotype. G × E interactions were evident across multiple neuropsychological and observational measures of children's attention and self-regulation abilities. Across most outcome measures, DRD4 7+ children spending fewer hours in child care showed more effective attention/self-regulation abilities. For those without a copy of the DRD4 7-repeat allele, such associations were typically null. The results for child-care quality and type indicated no interactions with genotype; the main-effect associations were somewhat inconsistent.

Understanding Cortisol Reactivity across the Day at Child Care: The Potential Buffering Role of Secure Attachments to Caregivers

Full-day center-based child care has been repeatedly associated with rising cortisol across the child care day. This study addressed the potential buffering role of attachment to mothers and lead teachers in 110 preschoolers while at child care. Using multi-level modeling and controlling for a number of child, family, and child care factors, children with more secure attachments to teachers were more likely to show falling cortisol across the child care day. Attachment to mothers interacted with child care quality, with buffering effects found for children with secure attachments attending higher quality child care. Implications for early childhood educators are discussed.

Differential susceptibility to long-term effects of quality of child care on externalizing behavior in adolescence?

Much research on the quality of child care reveals it —in the case of low-quality child care—to be related to poorer child functioning, net of confounding factors, perhaps especially in the case of cognitive-linguistic performance. Recent work using data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (USA) makes clear that when children’s early negative emotionality/difficult temperament is taken into account, it also predicts externalizing problems reported by teachers through the primary school years. More negatively emotional infants are more affected—for better and for worse—by child care quality than less difficult ones, such that the latter appear unaffected by it but the former benefit from good quality care and are adversely affected by poor quality care. Here we determine whether the same is true when children are restudied in adolescence and the focus is their own reports of externalizing problems, impulsivity and risk taking. Results prove more consistent with a diathesis-stress model of environmental action than a differential-susceptibility-related one, in that 15-year-olds who were highly negative as infants report more externalizing behavior (but not risk taking or impulsivity) if they experienced low-quality child care, but not fewer problems if they experienced high-quality care relative to their counterparts with less difficult temperaments in infancy. Results are discussed in relation to physiological stress, with possible explanations offered as to why the predictive nature of child care experience might change over time.

Two-to-three-year-old children's interactions with peers in child-care centres: Effects of spatial distance to caregivers

In child-care centres, the influence of caregivers on the development of peer interactions seems ambivalent and mixed results are reported in the literature. Adopting an environmental approach, we examined the effects of the caregivers' spatial proximity on children's social behaviour. The study was carried out with 175 children (18-40 months) in 12 child-care-centre groups. Children's behaviours were observed during free plays, and both children and caregivers' locations were recorded. When peers were nearby, children's social behaviours were compared when they were in the immediate proximity (within 2m) and out of the immediate proximity of a caregiver. Results show that in the latter situation children spend substantially more time addressing social overture to peers and interacting with them; positive interactions with peers show a particularly marked difference. This pattern of results is exhibited by the greater part of the children. Whatever the child-care-centre group, the age subgroup or the gender considered similar results are found. Results also demonstrate that when children are in the immediate proximity of caregivers they are socially oriented towards the attractive adult partners rather than towards peers.

The rise in cortisol in family day care: associations with aspects of care quality, child behavior, and child sex

This study examined the increase in salivary cortisol from midmorning to midafternoon in 151 children (3.0-4.5 years) in full-time home-based day care. Compared to cortisol levels at home, increases were noted in the majority of children (63%) at day care, with 40% classified as a stress response. Observations at day care revealed that intrusive, overcontrolling care was associated with the cortisol rise. For girls, the cortisol rise was associated with anxious, vigilant behavior, while for boys the rise was associated with angry, aggressive behavior. Child behavior did not mediate or moderate relations between care quality and the cortisol rise, except for evidence that boys scoring low on angry, aggressive behavior were more sensitive to variations in warm, supportive care than boys scoring high on this behavior.

Associations among child care, family, and behavior outcomes in a nation-wide sample of preschool-aged children

Canadian data based on maternal reports for a nationally representative sample of 4,521 4—5-year-olds were used to examine associations among child care, family factors, and behaviors in preschool-aged children. Linear regressions testing for direct and moderated associations indicated that regulated home-based care was associated with less physical aggression and less prosocial behavior while high process quality in home-based care was associated with greater prosocial behavior. Among children in home-based settings, being in at least one additional current child care arrangement was linked with greater physical aggression, and low child care stability was linked to greater hyperactivity-inattention, internalizing behavior, and prosocial behaviors. For family factors, parenting behaviors and maternal depression were associated with greater behavioral problems while low household income was linked with greater hyperactivity-inattention among children in home-based care. There was a significant interaction between process quality and household income for physical aggression and internalizing behavior and between structure quality and parenting consistency for prosocial behavior for children in home-based care. Results suggest that child care matters for preschool behavioral outcomes, even after controlling for socio-demographic factors. High quality care appears particularly important for children in home-based care from low-income families so issues around child care quality and regulation should be considered. Findings also underscore the importance of family factors on young children’s behaviors and show that child care and family influences work together to impact child outcomes.

Measurement and meaning of salivary cortisol: a focus on health and disease in children

Measurement of salivary cortisol can provide important information about hypothalamic-pituitary-adrenal (HPA) axis activity under normal conditions and in response to stress. However, there are many variables relating to the measurement of cortisol in saliva which may introduce error and therefore may render difficult the comparison and interpretation of data between, and within, laboratories. This review addresses the effects of gender, age, time and location of sampling, units of measurement, assay conditions and compliance with the protocol, all of which have the potential to impact upon the precision, accuracy and reliability of salivary cortisol measurements in the literature. Some of these factors are applicable to both adults and children, but the measurement of salivary cortisol in children introduces aspects of unique variability which demand special attention. The specific focus of this review is upon the somewhat neglected area of methodological variability of salivary cortisol measurement in children. In addition to these methodological issues, the review highlights the use of salivary cortisol measurements to provide information about HPA axis dysfunction associated with psycho- and patho-physiological conditions in children. Novel applications for salivary cortisol measurements in future research into HPA axis activity in children are also discussed.