Stability in Center Day Care: Relations with Children's Well-being and Problem Behavior in Day Care1

Change in toddlers' cortisol activity during a year in childcare. Associations with childcare quality, child temperament, well-being and maternal education

Elevated levels of the stress hormone cortisol have been found in toddlers in childcare. Measuring cortisol may provide an indication of children's experiences in childcare and help to adjust practices better to their needs. To the best of our knowledge, toddlers' cortisol levels in childcare have not yet been investigated longitudinally. Furthermore, it is unclear which child and childcare factors contribute to cortisol elevation in toddlers. Using linear mixed model analyses, we investigated the full-day cortisol activity (10.00 h, 15.00 h, 18.00 h) of 156 toddlers (81 female, 56 male) during a year in childcare (September, January, June). We also investigated child cortisol levels at home in January. In addition, we tested the relation between cortisol activity and changes in cortisol activity across the year and childcare quality, temperament, well-being in childcare, and maternal education. We found increasing evening cortisol levels through the year while controlling for age. Afternoon cortisol levels were stable, but above morning cortisol levels in September and January and only slightly below morning cortisol levels in June. At home in January, afternoon levels were significantly below morning levels. Higher well-being in childcare was associated with lower overall cortisol levels and less increase in evening cortisol levels through the year in childcare. Further, less active toddlers seemed to accumulate some stress during the childcare day, indicated by higher evening cortisol levels. Rising evening cortisol levels may indicate accumulating stress across the year. Results point toward childcare being demanding for toddlers and their need for consideration from caregivers and parents, also after a longer period of childcare attendance. The findings underline the importance of observing, promoting, and further researching children's well-being in childcare.

Validation of the Leiden Inventory for the Child's Well-Being in Daycare (LICW-D) Questionnaire in Norwegian Early Childhood Education and Care Centers

The promotion of children's development and well-being is a core concept in Early Childhood Education and Care (ECEC) quality frameworks. Yet, few validated instruments measuring young children's well-being exist. This study examined the validity of The Leiden Inventory for the Child's Well-being in Daycare (LICW-D) (De Schipper et al., 2004b) in a sample of toddlers (n = 1,472) attending ECEC centers in Norway, using confirmatory factor analysis. Factorial invariance across gender and concurrent validity were also investigated. Indicators of concurrent validity were problem behaviors and difficult temperament, as rated by professional caregivers. Results showed a marginally acceptable fit for the hypothesized one-factor model, when allowing the measurement error of four item pairs to be correlated. This slightly modified model showed satisfactory concurrent validity, and factorial invariance across gender was confirmed.

A Model of Intervention and Implementation of Quality Building and Quality Control in Childcare Centers to Strengthen the Mental Health and Development of 1-3-Year Olds: Protocol for a Randomized Controlled Trial of Thrive by Three

BACKGROUND

Universal, high-quality childcare offers a unique opportunity to prevent developmental trajectories leading to mental health problems. Yet, growing evidence has shown that the process quality of Norwegian childcare centers varies considerably, and that research-based models for quality building are significantly lacking.

OBJECTIVE

To examine whether a model for quality building in childcare centers, Thrive by Three, increases the quality of child-caregiver interactions, and promotes child development, well-being, and mental health.

METHODS

The Thrive by Three study is a clustered randomized controlled trial involving 187 toddler groups in childcare centers across 7 municipalities within southern and central Norway. Each center is randomly allocated to the intervention or wait-list control group. Data are collected at 4 points: preintervention (T1), midway (T2), postintervention (T3), and 1-year postintervention (T4). Primary outcomes are changes in childcare quality measured by the Classroom Assessment Scoring System toddler version (CLASS), Student-Teacher Relationship Scale, Short Form (STRS-SF), and Life in Early Childhood Programs (LECP), as well as child development and mental health measured by The Brief Infant Toddler Social and Emotional Assessment (BITSEA, parent and teacher report), the Caregiver-Teacher Report Form (C-TRF), and Child Behavior Checklist (parent report) from the Achenbach System of Empirically Based Assessment (ASEBA) from 1.5 to 5 years, and child well-being measured by the Leiden Inventory for Child's Well-Being in Day Care (LICW-D). Secondary outcomes are child cortisol levels, assessed in a subsample of 372 children.

RESULTS

As of August 2020, a total of 1531 children and 769 staff from 187 toddler groups were recruited. Because of turnover, the recruitment of staff will be ongoing until August 2020. As of January 2020, the intervention group has been working with Thrive by Three for 1.5 years. Data at T1, T2, and T3 from both the intervention and control groups have been completed and T4 will be completed in August 2020.

CONCLUSIONS

This study makes an important contribution to the field of quality building in childcare centers. The results will provide greater insight into how high quality can be obtained and the effects of high-quality early childcare on child mental health. This in turn will be significant for policymakers and to the Norwegian society at large.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03879733; https://clinicaltrials.gov/ct2/show/NCT03879733 and Norwegian Research Council 260624/H10; https://prosjektbanken.forskningsradet.no/#/project/NFR/260624/Sprak=en.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/17726.

Family Childcare Types and Conduct Problem Behaviors in Young Children: The Mediation Role of Caregiver-Child Interaction

Background: Previous studies have demonstrated the impacts of genetic, family, and community factors on child conduct problems (CPs). However, little is understood regarding the association between family childcare types and child conduct problem behaviors, as well as whether and to what extent caregiver-child interaction mediates the above association. Methods: 9,289 children first entering kindergartens in the Longhua New District of Shenzhen, China were enrolled in this cross-sectional study. Primary caregivers were invited to fulfill a self-administered structured questionnaire containing data regarding socio-demographics, family childcare types, caregiver-child interaction, and child conduct problem behaviors (measured by the Conners' Conduct Problem Subscale). A series of multiple logistic and linear regression models were employed to assess the associations among family childcare, caregiver-child interaction, and child conduct problem behaviors. Results: Family childcare types other than by parents together (i.e., mother alone, mother with others, grandparents, or changing caregivers) were all significantly associated with higher risks of conduct problem behaviors in young children (adjusted ORs ranged from 2.18 to 2.55, and adjusted βs ranged from 0.043 to 0.073; all p < 0.05), after adjusting for confounders including child age, gender, parental education level, parental age at pregnancy, marital status, and family income. The following family childcare types (mother alone, or grandparents, or changing caregivers) vs. the childcare by parents together showed significant relative indirect effects on conduct problem behaviors through caregiver-child interaction, indicating the significant mediation effect of caregiver-child interaction on the above associations. Mediation of caregiver-child interaction on the effect of being cared by mother with others relative to care by parents together on child conduct problem behaviors was yet non-significant. Conclusions: Family childcare types other than by parents together are associated with increased risks for conduct problem behaviors in young children. Caregiver-child interaction may function as a potential mediator for the above association.

Child-Care Instability and Behavior Problems: Does Parenting Stress Mediate the Relationship?

Child care instability is associated with more behavior problems in young children, but the mechanisms of this relationship are not well understood. Theoretically, this relationship is likely to emerge, at least in part, because care instability leads to increased parenting stress. Moreover, low socioeconomic status and single-mother families may be more vulnerable to the effects of instability. This study tested these hypotheses using data from the Fragile Families and Child Wellbeing study (n=1,675) and structural equation modeling. Three types of child care instability were examined: long-term instability, multiplicity, and needing to use back-up arrangements. Overall, findings showed little evidence that parenting stress mediated the associations between care instability and child behavior problems among the full sample. Among single-mother and low-income families, however, needing to use back-up arrangements had small positive associations with parenting stress, which partially mediated the relationship between that type of care instability and child externalizing behavior problems.

Randomized Video-Feedback Intervention in Home-Based Childcare: Improvement of Children's Wellbeing Dependent on Time Spent with Trusted Caregiver

Background

The childcare environment offers a wide array of developmental opportunities for children. Providing children with a feeling of security to explore this environment is one of the most fundamental goals of childcare.

Objective

In the current study the effectiveness of Video-feedback Intervention to promote Positive Parenting-Child Care (VIPP-CC) was tested on children’s wellbeing in home-based childcare in a randomized controlled trial.

Methods

Forty-seven children and their caregivers were randomly assigned to the intervention group or control group. Children’s wellbeing, caregiver sensitivity, and global childcare quality were observed during a pretest and a posttest.

Results

We did not find an overall intervention effect on child wellbeing, but a significant interaction effect with months spent with a trusted caregiver was present. Children who were less familiar with the caregiver showed an increase in wellbeing scores in both the intervention and control group, but for the group of children who were more familiar with the caregiver, wellbeing increased only in the intervention group.

Conclusions

Although there was no overall effect of the VIPP-CC on children’s wellbeing, the VIPP-CC seems effective in children who have been cared for by the same trusted caregiver for a longer period of time.

Unstable and Multiple Child Care Arrangements and Young Children's Behavior

Growing evidence suggests that child care instability is associated with child behavior problems, but existing studies confound different types of instability; use small, convenience samples; and/or control insufficiently for selection into child care arrangements. This study uses survey and calendar data from the Fragile Families and Child Well-Being Study to estimate the associations between three different types of child care instability-long-term instability, multiplicity, and the use of back-up arrangements-and children's internalizing, externalizing, and prosocial behaviors at age 3, controlling for a large number of child and family background characteristics. Long-term instability between birth and age 3, as measured in both the survey and calendar data, is associated with higher levels of externalizing behavior problems. Current multiplicity at age 3 (as measured by survey data) is associated with higher levels of both externalizing and internalizing behavior problems, but stable multiplicity over time (as measured using calendar data) is not. Finally, the use of back-up arrangements at age 3 is associated with higher levels of internalizing behaviors. We find no consistent differences in these results by the timing of instability, child gender, family income, or type of care.

Fatores associados à não adaptação do bebê na creche: da gestação ao ingresso na instituição

Buscou-se identificar fatores associados à não adaptação do bebê na creche, tais como, temperamento do bebê, relações pais-bebê e crenças e práticas ligadas aos cuidados alternativos. Participaram quatro famílias, cujos bebês entraram na creche entre 10 e 12 meses de idade e foram retirados por não adaptação segundo avaliação dos pais. Realizou-se entrevistas na gestação, 3, 8 e 12 meses do bebê. Análise de conteúdo qualitativa revelou que os fatores mais relevantes na compreensão da não adaptação relacionaram-se à dinâmica da interação pais-bebê, a saber: sentimentos ligados à separação e forma com que os pais vivenciaram o ingresso na creche. Os resultados sugerem a importância de ações que promovam acolhimento à situação de separação pais-bebê na transição para a creche.

Multiple child care arrangements and common communicable illnesses in children aged 3 to 54 months

The study examined the relationship between the number of concurrent child care arrangements and children's incidence of communicable illnesses throughout the first 4½ years of life, and whether this association is mediated by the total number of children across care settings. Within-child fixed effects regression models were used to relate changes in the numbers of concurrent nonparental arrangements to changes in children's illnesses using longitudinal data from the NICHD's Study of Early Child Care and Youth Development (N = 1,265). 52 % of children attended multiple child care arrangements at least once from 3 to 54 months. Increases in the number of arrangements were associated with a 15 % increase in respiratory problems among children 3-54 months of age, and a 25 % increase in otitis media among children 36-54 months. Associations were smaller among African American children compared to European American and other-race children. Findings suggest that the number of peers with which a child comes into contact at child care mediates the association between increases in number of arrangements and increases in reported respiratory problems. Children attending multiple child care arrangements prior to kindergarten entry experience slightly more contemporaneous communicable diseases, relative to attending single nonparental arrangements, through exposure to more peers.

Accounting for Movement between Childcare Classrooms: Does it Change Teacher Effects Interpretations?

Child care studies that have examined links between teachers' qualifications and children's outcomes often ignore teachers' and children's transitions between classrooms at a center throughout the day and only take into account head teacher qualifications. The objective of this investigation was to examine these traditional assumptions and to compare inferences made from these traditional models to methods accounting for transitions between classrooms and multiple teachers in a classroom. The study examined the receptive language, letter-word identification, and passage comprehension skills of 307 children enrolled in 49 community-based childcare centers serving primarily low-income families in Colorado. Results suggest that nearly one-third of children and over 80% of teachers moved daily between classrooms. Findings also reveal that failure to account for daily transitions between classrooms can affect interpretations of the relationship between teacher qualifications and child outcomes, with the model accounting for movement providing significant improvements in model fit and inference.

Nonparental care and infant health: do number of hours and number of concurrent arrangements matter?

OBJECTIVES

Previous research found that centre-based childcare is related to more illnesses early in life. The goal of this longitudinal study is to determine whether infant health in the first year of life is also related to the amount of time spent in non-parental care and the number of concurrent non-parental care arrangements.

METHODS

Information on infant health and non-parental care was obtained through monthly maternal interviews across the first year of life. The occurrences of respiratory, digestive, general, and skin illnesses and complaints were used as dependent variables, while the number of hours and the number of arrangements per week were used as predictors. Analyses were done separately in infants for whom centre-based childcare is included in their arrangements (n=107), and for those which it is not (n=61).

RESULTS

Infants spending more hours in non-parental care had more respiratory and general illnesses. Infants who were cared for in more concurrent arrangements had fewer respiratory and general, but more skin illnesses. These results only applied to infants that included centre-based childcare in their arrangements. In the group of infants that did not attend centre-based childcare, health was not related to either the number of hours or the number of arrangements.

CONCLUSIONS

Number of hours and number of arrangements do matter in relation to infant health early in life, but only for infants who attend centre-based childcare. While more hours were related to more illnesses, more arrangements were related to both fewer and more illnesses, depending on the type of illnesses.

Multiple child-care arrangements and young children's behavioral outcomes

Nationally, 15% of children younger than 5 years regularly attend more than 1 child-care arrangement. An association between arrangement multiplicity and children's behavior problems has been identified, but previous research may be susceptible to measurement or omitted variable bias. This study used within-child fixed effects models to examine associations between changes in the number of concurrent, nonparental child-care arrangements and changes in mother- and caregiver-reported behavior among 2- and 3-year-old children in the National Institute for Child Health and Human Development Study of Early Child Care and Youth Development (N= 850). Increases in the number of arrangements were related to increases in children's concurrent behavior problems and decreases in prosocial behaviors, particularly among girls and younger children. Implications for policy and research are discussed.