Child care centres: solution or stopgap?

"Imangine a country in which nearly all children between the ages of three and five attend pre-school in sparkling classrooms, with teachers recruited and trained as child care professionals. Imagine a country that conceives of child care as a programme to welcome children into the larger community and awaken their potential for learning and growing". Hillary Clinton, wife of the former US President, begins one of the chapters of her book It Takes a Village (2003), with this vision.

The Ministry for the Family and Social Solidarity and the Ministry for Education, Youth and Employment have just issued a consultation document entitled Early Childhood Development and Care. This document shares the same vision as that of Senator Clinton, only that it speaks of children as young as six weeks.

From the outset, under the signatures of Ministers Dolores Cristina and Louis Galea, the aim of the document and consultation are clearly set and focused: "To promote and ensure good quality day service for children" (p. 4). This means that the document intends to discuss childhood development and care only in the context of day service. And throughout the document, day service refers solely to services outside the child's family home.

Basic statements

The two ministers make a number of fundamental statements. But some of these are open to discussion, especially when placed in the context of child care services. These statements are:

"Research demonstrates that the first few years of a child's life are crucial in his/her development..."

"Children hailing from disadvantaged backgrounds are known to benefit particularly from exposure to activities specifically provided to enhance their development..."

"Early childhood education and care services provide children with the stimulation which they may not be receiving at home..."

"Early childhood education is a crucial building block in the concept of lifelong learning..."

Later, the ministers' introduction seems, to my mind, to get quite muddled about what is the real rationale for child care services. Is it for the development of the child, as expressed in the statements reported above? Or is it because of "parents who, for whatever reason, opt to take on employment which is incompatible with full-time care..."? (p. 4).

One might argue that there is no need for this distinction. Child care services might serve the two objectives concurrently. So much so that the very first article of this document (par. 1.1) includes the third stakeholder, the community. It states: "(this) document demonstrates the Government's commitment to ensure that maximum benefit is acquired by children, parents and the community." This would be excellent had not research pointed out to quite different conclusions.

I quote just two examples. Burton White, a psychologist and author of The First Three Years of Life (1991), writes: "We haven't moved to day care because we were seeking a better way of raising children, but to meet the needs of the parent, mostly the mother. My concern is that this trend constitutes a disastrous effect on the child."

Another very impressive quote is by E. F. Ziglar of Yale University. He bluntly says: "When parents pick a day care centre, they are essentially picking what their child will become."

Priority

And if the three stakeholders cannot at the same time get the maximum benefit from this arrangement, the very same document addresses to us a very popular axiom to follow: "the best interests of the child shall be a primary consideration" (par. 1.3). This is very important and this is not universal. The Swedish Social Democrats have a different priority which they call "the priority of the workline". We need to monitor where we are actually heading.

I am putting forward some of the research available which shows that child day services as proposed in this document is not as heartening as the document describes it. I do not intend to go into the important detailed technicalities in the document. I feel that before that, more fundamental issues have to be debated. Some of the most important issues that affect the child are the psychological, social costs and the medical costs.

In short, one needs to establish whether day care centres really are in "the best interest of the child." As in many other instances, we are lucky that we can learn from the experiences of other countries.

Fundamental needs

Child psychologist Stanley I. Greenspan of George Washington University, co-author of The Irreducible Needs of Children (2000), gives a list of six of what he terms "irreducible needs". Even this phrase needs to bother the community. It is a disgrace for our society that we have trimmed ourselves to speak of the minimum instead of the optimum we invest in our children.

The first one of these needs is "ongoing nurturing relationships ... which must be provided by one, or at most, two adults who are deeply attached to, even crazy about, the child." Greenspan's brain research indicates that an infant needs this in its first three years of life to achieve optimal intellectual, physical, and emotional development.

Even if, for the sake of argument, one is to concede, contrary to what Dr Greenspan holds, that this one or two caregivers are apart from the parents, in day care centres, given the number of hours this service is made available and given the normal conditions of employment (shifts, breaks, optional leave, sick leave, staff turnover, etc.) of the caregivers, the infant is going to face quite a number of different caregivers.

In his earlier book, The Growth of the Mind and the Endangered Origins of Intelligence (1996), Dr Greenspan is more outspoken and states that by their very nature, day care centres, even good ones, do not meet four of these six irreducible needs.

Bond with mother

Jean Piaget has shown that young children are incapable of reflective thinking. They are unable to keep an image of an object that does not remain present to them. For example, if one hides a ball, after some time, the infant stops searching for it because it has ceased to exist in the child's mind.

Likewise, one can say that when the mother leaves her child in the day care centre, she has ceased to exist in the mind of the child. The mother may reflect on her child all day while at work, but the child has erased her from his or her mind.

Professor Jay Belsky, a child care expert at Penn State's College of Health and Human Development, author of Clinical Implications of Attachment, reports that children who, in their first year of life, attend 20 or more hours weekly of non-parental care are more likely to look insecure in their relationships to their mothers, in particular at the end of their first year of life.

A study published in the November 1999 issue of Developmental Psychology, a publication of the American Psychological Association, comes to the conclusion that daycare weakens the mother-child bond. The study was conducted on 1,274 mothers and their children. It examined parent-child interaction at six, 15, 24, and 36 months and found that "more hours of child care predicted less maternal sensitivity and less positive child engagement". This study positively confirms that the more time a mother spends with her child, the more responsive that child will be to her. It might sound obvious, but needs to be spelt out.

Similar results are obtained from another study conducted by the National Institute for Child Health and Development (NICHD) based on three years observation of 900 European-American children born in 1991 (Child Development 73 [2002]:1052-1072).

The conclusion is that children whose mothers worked at all by the ninth month of their life have lower scores on a standard test of child cognitive development. at 36 months than did children whose mothers did not work by that time.

The researchers claim that they have statistically controlled child care and home environment. Although only the effect of maternal employment initiated by the ninth month reach the threshold of statistical significance, the researchers note the the effects of any maternal employment by one, three, six or 12 months are also negative. The negative effect is most pronounced for children whose mothers worked 30 hours or more per week in the first year.

Another disturbing finding found repeatedly in this research is that children with mothers employed for more than 30 hours per week, by nine months, receive less sensitive care at 36 months from their mothers than children whose mother is not employed during the first year of their lives. This finding also put in question the assertion often made about parents who can do much for their children with a little "quality time".

A very interesting twist in this line of thought is provided by the study conducted by Nina Koren-Karie of the University of Haifa (Infant and Child Development 10 [2001]: 117-127). She has set out from a hypothesis that the weak bonds between children in day care and their mothers reflect not the effects of day care, but rather "the emotional make-up of mothers choosing day care as opposed to mothers who choose to remain at home with their infants."

To test this hypothesis, Koren-Karie has analysed the maternal attachment of 76 mothers, half of whom have placed their infants in day care centres while the other half have left their employment to be at home with their babies. The results of this analysis tend to confirm her hypothesis: 83% of home care mothers and 61% of care centres mothers are classified as secure.

Aggressiveness

Bryna Siegel, a psychologist at Stanford University, reports in her nine-year study that day care children are "15 times more aggressive... a tendency toward more physical and verbal attacks on other children."

J.C. Schwartz has shown that children who frequent day care before they are 12 months old are more physically and verbally abusive when they are older. Together with his colleagues he has found that this abuse is aimed at adults, and also have found that these children are less co-operative with grown ups and less tolerant of frustration than children cared for by their mothers.

The most important study in this field is the one conducted for many years by NICHD. It is a study, sponsored by the government, involving some 25 researchers and costing hundreds of thousands of dollars. In April 2001, it has released an aspect of this study. It reveals that children who are separated from their mothers for more than ten hours a week early in life, whether they are with nannies in their own homes or quality day care centres, once they reach kindergarten, are more aggressive as rated by their mothers and by their teachers.

In The Wall Street Journal (July 16, 2003), Professor Jay Belsky, a world-renowned child development researcher who has been involved with the NICHD study from the beginning (1989), has published other aspects of this study conducted by NICHD. It results that the more time children spend in non-parental day care arrangements before they are 4.5 years old, the more likely they were to display aggression, disobedience, and conflict with adults.

In the context of this research, "aggressive" is a term covering a range of behaviour from "demands a lot of attention" through "gets in lots of fights" all the way up to "cruelty". Of the children who were not in maternal care for less than ten hours a week, six per cent were classified as aggressive; 10 per cent of those between ten and 29 hours and 17 per cent of those in care for 30 or more hours.

Professor Belsky states that this increased risk of aggression cannot (as is often the case) be attributed to maternal depression, poverty, or poor quality day care because, he claims that this study controls for all of these.

One must add that most children participating in this study and who were affected by non parental care do not show levels of problem behaviour that need clinical treatment. Most of them do function "in the normal range."

Belsky's co-researchers have been furious at him, not because his presentation has been mistaken or lob sided but because he has not presented "the party line" (Sarah Friedman). Another colleague, Robert Pianta, confesses, "There's more caution in the group in drawing implications that might be worrisome to parents". This reasoning is disgraceful and grossly offensive! Moreover it is harmful to society at large.

Research having the same results has been conducted by child psychologist Lise M. Youngblade of the University of Florida (Journal of Child Psychology and Psychiatry 44 [2003]: 477-488). She has examined 365 Midwestern families with a third or fourth grade child. She has spotted a link between mother's employment during the first year of their children's lives and subsequent aggressive and problematic behaviour on the part of these children.

Youngblade reports more acting out, less frustration tolerance and more hitting and being mean. She emphasizes that the measured effects "do not suggest pathological outcomes." However she also makes a disturbing conclusion: "Small effects which affect a lot of people may in the end have greater societal consequences than large effects which impact only a few."

Financial and medical costs

I assume that all those who turn to day care for their children do their financial calculations before opting for it. Apart from this, there are also other additional and often hidden costs.

Among these costs are the health costs. Since toddlers are still developing their immunity to certain diseases, they are more likely to become sick when exposed more frequently. Research mention also infections that are as three or four times as prevalent in group care as compared to home care.

Medical scholars at the University of Washington have examined medical expenses for a nationally representative sample of preschool age children (Pediatrics 111 [2003]: €317-€375). Their results highlight "increased utilisation of health-care services" among children in day care centres, when compared to children cared for at home.

The former are almost three times more likely to have made at least one visit to a doctor's clinic; twice as likely to have visited an emergency room, and almost three times as likely to have received a prescription medication. The researchers estimate a difference of $343 per child annually. They also point to "higher incidence of minor communicable illness" as well as "more significant medical problems".

More interesting data that emerge from this research is that parents who use day care centres for their children seek medical help more promptly for their children than parents who care for children at home. The researchers' conjecture is that this happens so that these parents may return back to work as soon as possible.

A study by a team of child-development experts from the University of Minnesota (Child Development 74 [2003]: 1006-1020), shows a significant increase in hormonal measurements of stress among preschoolers in day care. These measurements fall for the same children on days they spend at home.

These experts have monitored the levels of cortisol (usually regarded as stress sensitive hormone) of 111 children in four full-day day care centres. It resulted that home cortisol levels were lower than day care cortisol levels. Moreover, there has been no change in cortisol over the day by age at home. However, when the same children are in day care, they have reported a pattern of rising cortisol levels over the day. Among the three-16 months, 35 per cent have shown a rise and among the 16-38 months, 71 per cent have shown a rise.

My contribution to this consultation document might sound rather negative. It is not intended to be. On the contrary, my intention is that the information I have presented, be as positive as possible in the best interest of the child, and as a consequence in the best interest of the parents and as a consequence, in the best interest of the community.