0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Review Article |

Child Care and the Well-being of Children FREE

Robert H. Bradley, PhD; Deborah Lowe Vandell, PhD
[+] Author Affiliations

Author Affiliations: Center for Applied Studies in Education, University of Arkansas at Little Rock (Dr Bradley) and Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock (Dr Bradley); and Department of Education, University of California at Irvine (Dr Vandell).


Arch Pediatr Adolesc Med. 2007;161(7):669-676. doi:10.1001/archpedi.161.7.669.
Text Size: A A A
Published online

Objective  To evaluate studies of child care with specific attention to the impact of age at entry and amount, quality, and type of care on children's adaptive functioning.

Data Sources  MEDLINE, PsychINFO, and the SAGE Full-Text Collection.

Study Selection  The review considers correlational and experimental research conducted throughout the world that includes an adequate description of the type of care provided.

Main Exposures  Amount, quality, and type of child care.

Main Outcome Measures  Language, cognitive and social competence, achievement, behavioral problems, relationships with parents, communicable illnesses, and asthma.

Results  Children who began care early in life and were in care 30 or more hours a week were at increased risk for stress-related behavioral problems. Elevated risk was more likely if they had difficulties interacting with peers or had insensitive parents. Children in day care centers had higher language scores and early school achievement, especially if they came from disadvantaged backgrounds and the centers offered high-quality care. Attending arrangements with 6 or more children increased the likelihood of communicable illnesses and ear infections, albeit those illnesses had no long-term adverse consequences.

Conclusions  Child care is a multidimensional phenomenon. Guidance on when to place a child in nonparental care and what kind of care to use is complicated because of the multiplicity of sometimes offsetting effects on children. Child care experiences interact with experiences at home and the child's own characteristics, and research indicates that the quality of child care matters.

In 2002, the US Bureau of the Census estimated that 11 596 000 children younger than 5 years routinely spend a significant amount of time in nonparental care.1 Child care arrangements vary widely in quality, amount, and type.1,2 Consequently, concerned parents and public officials wonder about the impact of child care. Several recent large-scale studies,26 in conjunction with almost 4 decades of smaller-scale studies, offer more authoritative answers to key questions about the quality, amount, and type of child care children receive.

Providing definitive information about child care is challenging because most research is correlational, with researchers identifying statistical associations rather than causal effects. In only a few studies have researchers used random assignment to study nonparental care. Even those studies had significant limitations in terms of the questions posed or samples used.4,710 In the absence of random assignment, researchers have included family and child measures as covariates to minimize selection bias. Only recently have researchers incorporated extensive covariates.11 Although using multiple covariates reduces the likelihood of drawing erroneous conclusions about child care, this strategy can yield conservative estimates of effects.12 Another problem with the child care literature is that less formal and unregulated settings are underrepresented in most studies.2 Their omission has likely resulted in conservative estimates of the effects of child care quality on children's development.11,13 Another challenge is that child care is a complex phenomenon that varies along multiple dimensions (eg, amount, type, and quality), making it difficult to isolate the effects of just 1 dimension. Recent research has attempted to segregate the impact of each dimension by controlling for the other ones, but it is not possible to fully disentangle the dimensions of care yet still provide meaningful estimates of the effects of each dimension. The most comprehensive study about this topic is the Study of Early Child Care (SECC), which is funded by the National Institute of Child Health and Human Development (NICHD).14,15 This prospective, longitudinal study includes detailed assessments of child care (amount and timing, quality, and types of care settings) for more than 1200 children who have been studied from birth through middle childhood. Children initially resided near 10 research sites but now reside in 38 states.

This review aims to provide some context to research on child care. It summarizes what is known about 3 aspects of nonparental care (age at entry and amount of care, type of care, and quality of care) and how each affects children's social, physical, and cognitive development. To identify studies of child care appropriate for this review, we searched MEDLINE, PsychINFO, and the SAGE Full-Text Collection. We then selected studies that focused on correlational and experimental research conducted throughout the world that included an adequate description of the type of care provided.

As the number of women entering the workforce increased rapidly in the 1970s, so did the number of children entering child care. Researchers, policymakers, and the public at large began to ask questions regarding the possible negative consequences of nonparental care, especially large amounts of care beginning in the first year of life.16,17 It is not easy to determine the effects of beginning care early in life or spending lots of time in care because children who enter care early also tend to spend large amounts of time there. Data from the SECC show that 84% of children experience nonmaternal care on a routine basis by age 12 months.18 Of this group, 72% enter care by age 4 months. At first entry, infants are in care for 29 hours a week on average. Once initiated, the amount of time spent in care on a weekly basis remains essentially stable throughout early childhood. However, nonparental care is anything but a consistent experience for many young children. On average, 34% of children younger than 3 years experience multiple arrangements, with 44% of 3- and 4-year-olds experiencing multiple arrangements.19 In summary, natural confounding occurs among the ages at which children begin child care, the amount of care, and the number of arrangements, making it difficult to isolate the effects of any 1 aspect of the child care experience. Granting this limitation, evidence has indicated that spending large amounts of time in child care from early infancy can have negative consequences.

Attachment

Some child care studies published in the 1980s and 1990s provided evidence of elevated rates of attachment insecurity for children who began full-time care early in life,20,21 but none of these studies controlled for child care quality, and most did not control for family factors. In the SECC,22,23 when quality and type of care were controlled for along with family background, children exposed to large amounts of care were at increased risk for attachment insecurity only if their mothers were highly insensitive.

Mother-Child Interactions

Although some studies published in the 1980s and 1990s reported the amount of early care to be related to more negative mother-infant interactions,24,25 others found positive effects26,27 or no effects.28 Much of this initial research was limited because of small sample sizes, few controls for family background, and reliance on a single time of measurement. The SECC29 addressed these concerns: mother-child interactions were observed at 6, 15, 24, and 36 months for more than 1000 families. These observations were evaluated by trained raters who were blinded to children's child care backgrounds. More hours in child care were linked to less maternal sensitivity and less positive engagement between the child and the mother, controlling for quality and type of child care, family income, maternal educational level, marital or partner status, maternal depression, maternal separation anxiety, child sex, child temperament, and ethnicity. In a follow-up report30 at 54 months and during the first grade, a higher number of hours in care was associated with less maternal sensitivity and less positive engagement in white children but greater maternal sensitivity and more positive engagement in African American and Latino children.

Behavioral Problems

Another area of investigation concerns the link between time in nonparental care and children's behavioral problems.31 The NICHD Early Child Care Research Network has reported a series of carefully controlled analyses showing that amount of time in nonparental care is associated with poor peer interactions and adjustment problems from the age of 2 years to the end of kindergarten.3234 In follow-up analyses at grades 3 and 5, relations between hours and behavioral problems were no longer statistically significant, suggesting a fade-out effect.35,36 To more precisely delineate the relation between amount of care and behavioral problems, the SECC controlled for quality of interactions with caregivers and mothers, type of care, and family background.32 These controls resulted in modest reductions in the hours effect, but the effects continued to be statistically significant.

Cortisol Levels and Peer Relationships

Several studies3739 implicate the role played by peer relationships in the observed association between amount of care and behavioral maladjustment. Salivary cortisol levels tend to increase from midmorning to midafternoon on days when children are in child care but not on days when they stay at home.39,40 Cortisol levels increased across the day, especially for children who had difficulty regulating negative emotions and behavior,36 who were more fearful,38 who were less involved in peer play, and who were less socially competent.37 Rises in cortisol levels occurred more in toddlers and preschoolers than infants and school-aged children.3840 These findings suggest that toddlers and preschoolers who are learning to negotiate with peers may experience group settings as stressful. Although less socially competent children exhibit greater increases in cortisol levels in peer group activities,4143 temperamental differences in children also appear to play a role.37,42,44 Some evidence has suggested that high-quality child care might reduce the stress induced by spending long hours in care,39,45 but much remains unclear regarding whether changes in the organization of child care programs or in caregivers' efforts might result in less stressful environments for children.46

Overall, research indicates that being in care for 30 or more hours a week is associated with small but statistically significant increases in behavioral problems. Children who had 45 or more hours of care per week from ages 3 to 54 months had the most behavioral problems as kindergartners. Interestingly, in a study performed in Japan (where the average quality of care is higher), spending many hours in care was not associated with increased behavioral maladjustment.47

Social Competence

Evidence has shown that spending time in nonparental care increases children's social knowledge and skills.48,49 Morales and Bridges50 found that children with experience in child care were more accomplished at entertaining themselves and managing challenges. A French study51 showed that children who spent time in child care manifested more self-confidence, were more outgoing, and showed less distress in new situations. Although research provides some evidence that nonparental care may enhance social competence, the evidence is mixed.5254 In the SECC, analyses performed with careful controlling for home experience and child characteristics indicated that although nonparental care was associated with more positive and skilled peer play in child care, it was not associated with improved competence in peer play in a laboratory situation or as rated by parents.34

Language and Achievement

Findings are mixed with respect to amount (and timing) of child care and children's cognitive, language, and academic performance. Analyses conducted by the NICHD Early Child Care Research Network11,34,36,55,56 found no relation between amount or timing and cognitive and language measures from infancy through the fifth grade, controlling for other aspects of care and family factors. Other researchers, however, have detected amount or timing effects with some conditions but only at some ages or only for some income or ethnic groups.5760

Communicable Illness

Not surprisingly, spending time in child care, especially in care with large numbers of other children, increases the likelihood that children will be exposed to common pathogens and experience more bouts of common communicable illnesses.6165 Studies show an increased prevalence of diarrheal illness especially in the first 2 years of life for children who attend child care. However, by the age of 3 years little difference was found between children in nonparental care and those reared at home.6163 Studies62,64,65 also show an increased prevalence of upper respiratory tract infections and otitis media in children who attend child care, with some evidence suggesting that experience in child care during the first 3 years of life might afford some immunity to colds as children reach elementary school. The major factor that contributed to respiratory infections was the number of other children present in the child care arrangement; number of hours of care was insignificant.61,62,64,65

Asthma

Research on the relation between asthma and experience in child care has been inconsistent. Some studies66,67 show that child care is associated with an increased likelihood of asthma symptoms, but these studies may reflect transient wheeze more than persistent asthma,66 especially for children with a family history of atopy.68 One of the studies66 that showed an increased risk was conducted in Norway, where children do not enter care until after the age of 1 year. Other studies6972 showed no relation or a decreased likelihood of asthma for children who attended child care, consistent with arguments that respiratory syncytial virus infections help promote the TH1 phenotype that is protective against atopic asthma.7375 Recent unpublished findings from the SECC also indicated that time in care before the age of 1 year was associated with a decreased likelihood of late-onset asthma.

Established Standards

The American Public Health Association (APHA) and the American Academy of Pediatrics (AAP) have established standards for assuring quality of out-of-home child care.76 These standards, often referred to as structural quality, address such issues as age-based caregiver-child ratios, group size, health and safety practices, and qualifications and continuing education for child care providers. Consistent with recommendations made by the APHA and AAP, research demonstrates that high caregiver-child ratios, small group size, and well-trained caregivers result in higher-quality care.5,77 In settings where child-adult ratios were lower, caregivers spent less time managing children and children were less apathetic and distressed78; caregivers were more stimulating, responsive, and supportive.2,7880 Caregivers were also more responsive, more socially stimulating, and less restrictive when fewer children were in the group.2,78,79,81 Caregivers tend to be more stimulating and supportive, organize materials better, and provide more age-appropriate experiences when they have more education and child-related training.2,7983 These findings suggest that higher structural quality increases the likelihood of higher process quality conceptualized as supportive interactions with caregivers, positive interactions with peers, and opportunities for cognitively stimulating play. Consistent with this argument, the SECC84 observed positive developmental outcomes, controlling for maternal educational level and parenting quality, when children attended centers that were in compliance with the APHA's and AAP's recommended guidelines. Children who attended centers that met child-adult ratio standards displayed fewer behavioral problems and more positive social behaviors.11 Similar relations emerged between structural or caregiver characteristics and child developmental outcomes in child care homes.81

In their review of child care studies, the Committee on Family and Work Policies of the National Academy of Sciences concluded that when process quality was higher and adult-child ratios were higher, children appeared happier and more securely attached to caregivers in care settings.77 When child-adult ratios were higher and caregivers were more sensitive and positive, children appeared more prosocial and positively engaged with peers. Children were also rated as more cognitively competent in child care settings that offered more opportunities for art, blocks, and dramatic play and in settings where caregivers had college degrees and more early-childhood training. Twenty-three studies were cited by the National Academy of Sciences77 as finding relations between process quality and children's cognitive and social-emotional development, after controlling for family and child background factors. Since the National Academy of Sciences report was prepared, other investigators8587 have also found higher-quality care to be associated with better cognitive performance and fewer behavioral problems.

Long-term Adaptive Functioning

High-quality care appears to be associated with long-term adaptive functioning as well. In the SECC,36,55,56,88 caregiver behavior predicted children's performance on standardized cognitive and language assessments through fifth grade, controlling for amount and type of care and an extensive list of family covariates. In the Cost, Quality, and Outcomes Study,3 a prospective longitudinal study of 579 children who attended 151 centers in 4 states, child care quality predicted cognitive, language, and social development during the early grade-school years. Children who had closer relationships with their preschool teachers were more sociable in kindergarten, controlling for earlier child adjustment and family factors. Children who were enrolled in higher-quality child care displayed better math skills during kindergarten and second grade. In addition, children who had closer relationships with their caregivers at the age of 4 years were reported by their second-grade teachers to be more socially competent with peers, controlling for family factors and previous child functioning.89

Stress Reduction

More positive child care environments appear to reduce stress in children.90 Children who attended high-quality child care homes showed decreases in cortisol levels from morning to afternoon, whereas children in low-quality child care homes showed increases. This rise is the opposite of the typical pattern for circadian rhythm of cortisol but similar to a rise across the workday that has been recorded in adult executives who were under high pressure.

Health Outcomes

To date, few studies have investigated the relations between quality of child care and children's physical health. Results from the SECC indicated links between group size and communicable illnesses: children who attended centers with more than 6 children in a group had more bouts of common communicable illnesses.62,63 Other studies6466 have obtained similar results. In one of the few experimental studies directed at hygiene practices, Kotch90 reported that staff from 60 randomly selected centers were trained in personal hygiene and environmental sanitation practices. They increased their hand washing, sanitary food handling, disinfection of diapering areas, and use of step cans for diaper disposal and reduced their preparation of food in diapering areas. The result was fewer cases of diarrhea.

Child Care Quality and Family Risk

Although not every study has observed significant associations between child care quality and child well-being, most have, especially those that measured quality on more than 1 occasion. The effects tend to be modest and more often observed for outcomes such as language and academic achievement.91 In some domains, poor-quality care appears to function as a risk factor. In the SECC, low-quality care, coupled with low maternal sensitivity, was associated with infant-mother attachment insecurity.23 In other cases, high-quality child care served as a protective factor for children who were otherwise at risk. For example, children of depressed mothers appeared to be more positively engaged with their mothers when they attended higher-quality child care.31 In analyses of school readiness, receptive language, and expressive language, higher-quality child care was found to buffer young children from the negative effects of poverty.92

A major limitation of studies on child care quality is that the poorest-quality child care settings have been difficult to observe; thus, the effect of quality may well be underestimated. Such an underestimation is particularly problematic given that quality estimates derived from the SECC suggest that child care quality is not high. Positive caregiving was rated as “not characteristic” in 60% of the settings that were observed, and only 10% were rated as “excellent.”2 To better understand the effects of quality, the factors that are examined as part of quality must be expanded. The quality of the peer environment in child care may be especially important to consider given the negative impact of poor peer relations on stress.39,93 The specific strategies caregivers use to promote children's social skills and to handle children's noncompliance and aggression may help to explain the effects associated with quantity of care.

Characteristics of Caregivers and Styles of Care

The advantages of having children in small, informal settings where the caregiver-child ratios are more favorable vs having them in centers where there tends to be more professionalism have long been debated. Clarke-Stewart94 found that child care centers typically had better educated caregivers with more professional orientation, larger group sizes, more time spent in “lessons” and structured activities, and more child-oriented materials. In contrast, family child care homes typically devoted more time to free exploration, casual learning, and watching television. Similar findings were obtained in the SECC.2,79 Centers had larger group sizes and higher child-adult ratios but more stimulating environments and caregivers with more training.

Cognitive and Social Outcomes

Consistent with their greater educational focus, children who attended centers scored higher on cognitive assessments, controlling for family demographics and parenting. Children in center-based care were also more competent with strangers and more independent of mothers in a laboratory playroom. Least advanced were children with caregivers in their own homes. Children with more experience in center-based care obtained higher cognitive and language scores from the age of 2 years to third grade, controlling for family background and the quality and amount of child care.56 Loeb et al85 conducted a study of 451 children in 3 sites. Children were observed in centers and child care homes and when being cared for by family members after their parents began working, in connection with Temporary Assistance to Needy Families. Children who attended centers obtained higher cognitive and school readiness scores, controlling for family background and previous child performance. Participation in centers was unrelated to behavioral problems.

Health Outcomes

Because centers generally have large numbers of children, the likelihood of contracting communicable illnesses and otitis media is greater than in care where 6 or fewer other children are present.6064,9598 However, time spent in child care centers appears to be associated with no long-term health consequences and may even provide some protection against atopic diseases.68,69

Low-Income Children

Experimental and quasi-experimental evidence indicates that high-quality center-based care confers social and academic benefits for children at risk for school failure, with evidence indicating that the benefits last into adulthood. Not only do children who receive high-quality care in centers do better in school, but they are also more likely to go to college, to avoid teenage pregnancy and criminality, and not to require governmental assistance.79,99103

Three recent nationwide studies9,10,103 of Head Start families indicate that center-based care of even modest quality can confer social and cognitive benefits to low-income children. However, the effects do not appear to be as widespread as the effects of high-quality day care centers, and it is not yet clear whether the effects will be as long lasting or apply to all children. For example, results from the Head Start Impact Study10 provide little evidence of positive impact on children from Spanish-speaking families. An effort is under way, under the auspices of the Institution for Education Sciences at the US Department of Education, to determine whether carefully constructed preschool curricula can be brought to scale with good success. Efforts to provide prekindergarten programs for all children whose parents seek it are being mounted in many states as well. A significant number of these efforts are also being evaluated to determine effectiveness. These state and federal efforts should clarify the impact of moderate-quality to high-quality center-based preschool programs.

All in all, day care centers appear to accelerate children's language and cognitive development, and for low-income children, time spent in centers of moderate to high quality appears to provide an even wider array of advantages. However, there seems to be a trade-off regarding type and quality of care. In centers, more children are present but caregivers have more professional training; therefore, these children are more likely to have structured stimulation but perhaps less likely to receive sensitive individual care.

Family Influences

In the United States, there are deeply held beliefs about the primacy of the family. Such beliefs are buttressed by psychological theories that see parents as having the principal role in shaping children's futures.104 As children have begun spending large amounts of time in nonparental care, worries have emerged about whether child care might supplant the family. As part of the SECC, information about the families was collected during face-to-face contacts at ages 1, 6, 15, 24, 36, and 54 months as well as during the first, third, and fifth grades. Information was collected about family structure and size, parental employment, income, psychosocial characteristics of the mother and father, attitudes and beliefs about parenting and child care, depression, and quality of parenting in observed interactions with the child. Physical characteristics of the home, including the opportunities it provides for social and cognitive enrichment, were assessed. In a series of analyses through grade 5, family factors were found to be consistently stronger predictors of children's cognitive, language, social-emotional, and behavioral outcomes. Family effects, on average, were 2 to 3 times as large as the effects of child care. In addition, similar-size family effects were obtained for children with extensive child care experience and those with less or no child care experience.105 In summary, the impact of the family on child behavior and development does not seem to have abated as a consequence of children spending substantial time away from their parents. That is not to say, however, that family influences may not wane as children get older and spend increasing amounts of time with the media and persons outside the family.

Although much progress has been made in understanding the effects of early child care, further research is clearly needed. Despite the uncertainties that remain, it is probably fair to conclude that it matters where children get their care, when they start care, how much care they get during infancy and early childhood, and whether the care they get meets standards of quality. Children who spend many hours in care beginning in infancy appear to be at increased risk for stress-related behavioral problems. Behavioral problems are more likely if the child struggles when interacting with peers and if parents do not provide high-quality care. Day care centers appear to confer some advantage to language development and achievement, especially for poor children and if the centers offer high-quality care. Children in arrangements that meet the standards established by the APHA and AAP tend to receive better care and to have better developmental outcomes. However, attending arrangements with 6 or more children increases the likelihood of communicable illnesses and ear infections, albeit those illnesses appear to have no long-term adverse consequences. Pediatricians can help provide guidance on child care decisions. In addition, they can provide perspective on the issues, including reminding parents that what children experience at home accounts for substantially more variance in child outcomes than does what they experience in child care.105 Thus, parents need to remain vigilant for signs of stress, ready to spend time with their children in productive and enjoyable activities, and cognizant of the child's needs for structure and routines.106

Correspondence: Robert H. Bradley, PhD, Center for Applied Studies in Education, University of Arkansas at Little Rock, 2801 S University Ave, Little Rock, AR 72204 (Rhbradley@Ualr.Edu).

Accepted for Publication: January 25, 2007.

Author Contributions:Study concept and design: Bradley. Analysis and interpretation of data: Bradley and Vandell. Drafting of the manuscript: Bradley. Critical revision of the manuscript for important intellectual content: Bradley and Vandell. Administrative, technical, and material support: Bradley and Vandell. Study supervision: Bradley and Vandell.

Financial Disclosure: None reported.

Overturf Johnson  J Who's minding the kids? child care arrangements: winter 2002. Current Population Reports, P70-101 US Census Bureau Washington, DC2005;http://www.census.gov/prod/2005pubs/p70-101.pdfAccessed April 23, 2006
NICHD Early Child Care Research Network, Characteristics and quality of child care for toddlers and preschoolers. Appl Dev Sci 2000;4 (3) 116- 135
Peisner-Feinberg  ESBurchinal  MRClifford  RM  et al.  The relation of child care quality to children's cognitive and social developmental trajectories through second grade. Child Dev 2001;72 (5) 1534- 1553
PubMed
Kontos  SCHowes  CShinn  MGalinsky  E Quality in Family Child Care and Relative Care.  New York, NY Teachers College Press1995;
Ruopp  RTravers  JGlantz  FCoelen  G Children at the Center.  Cambridge, MA Abt Associates1979;
Howes  CPhillips  DAWhitebook  M Thresholds of quality: implications for the social development of children in center-based child care. Child Dev 1992;63 (2) 449- 460
PubMed
Campbell  FARamey  CTPungello  EPSparling  JMiller-Johnson  S Early childhood education: young adult outcomes from the Abecedarian Project. Appl Dev Sci 2002;6 (1) 42- 57
Schweinhart  LJWeikart  DPLarner  MB Consequences of three preschool curriculum models through age 15. Early Child Res Q 1986;1 (3) 15- 45
Administration for Children and Families, Making a Difference in the Lives of Children and Families: The Impacts of Early Head Start Programs on Infants and Toddlers and Their Families.  Washington, DC US Dept of Health and Human Services2002;
US Department of Health and Human Services,; Administration for Children and Families, Head Start Impact Study: First Year Findings.  Washington, DC US Dept of Health and Human Services May2005;
Duncan  GJNICHD Early Child Care Research Network, Modeling the impacts of child care quality on children's preschool cognitive development. Child Dev 2003;74 ((5)) 1454- 1475
PubMed
Newcombe  NS Some controls control too much. Child Dev 2003;74 (4) 1050- 1052
PubMed
Sagi  AKoren-Karie  NGini  MZiv  YJoels  T Shedding further light on the effects of various types and quality of early child care on infant-mother attachment relationship: The Haifa Study of Early Child Care. Child Dev 2002;73 (4) 1166- 1186
PubMed
NICHD Early Child Care Research Network, Child Care and Child Development: Results From the NICHD Study of Early Child Care and Youth Development.  New York, NY Guilford2005;
NICHD Early Child Care Research Network, Nonmaternal care and family factors in early development: an overview of the NICHD Study of Early Child Care. J Appl Dev Psychol 2001;22 (4) 457- 492
Belsky  J Infant day care: a cause for concern? Zero to Three 1986;6 (1) 1- 9
Belsky  J The effects of infant day care reconsidered. Early Child Res Q 1988;3 (3) 235- 272
NICHD Early Child Care Research Network, Child care in the first year of life. Merrill Palmer Q 1997;43 (3) 340- 360
Capizzano  JAdams  G The Number of Child Care Arrangements Used by Children Under Five: Variation Across States. New Federalism. National Survey of America's Families, Series B (No. B-12).  Washington, DC Urban Institute2004;
Barglow  PVaughn  BEMolitor  N Effects of maternal absence due to employment on the quality of infant-mother attachment in a low-risk sample. Child Dev 1987;58 (4) 945- 954
PubMed
Belsky  JRovine  M Nonmaternal care in the first year of life and the security of infant-parent attachment. Child Dev 1988;59 (1) 157- 167
PubMed
NICHD Early Child Care Research Network, The effects of infant child care on infant-mother attachment: results from the NICHD Study of Early Child Care. Child Dev 1997;68 (5) 860- 879
NICHD Early Child Care Research Network, Child care and family predictors of preschool attachment and stability from infancy. Dev Psychol 2001;37 (6) 847- 862
PubMed
Campbell  SBCohn  JFMeyers  T Depression in first-time mothers: mother-infant interaction and depression chronicity. Dev Psychol 1995;31 (3) 349- 357
Owen  MTCox  MJGottfried  AEedGottfried  AWed Maternal employment and the transition to parenthood. Maternal Employment and Children's Development: Longitudinal Research. New York, NY Plenum1988;85- 119
Crockenberg  SLitman  C Effects of maternal employment on maternal and two-year-old child behavior. Child Dev 1991;62 (5) 930- 953
Vandell  DL Effects of a playgroup experience on mother-son and father-son interaction. Dev Psychol 1979;15 (4) 379- 385
Burchinal  MRBryant  DMLee  MWRamey  CT Early day care, infant-mother attachment, and maternal responsiveness in the infant's first year of life. Early Child Res Q 1992;7 (3) 383- 396
NICHD Early Child Care Research Network, Child care and mother-child interaction in the first 3 years of life. Dev Psychol 1999;35 (6) 1399- 1413
PubMed
NICHD Early Child Care Research Network, Early child care and mother-child interaction from 36 months through first grade. Infant Behav Dev 2003;26 (3) 345- 370
Geoffroy  MCCote  SMParent  SSeguin  JR Daycare attendance, stress, and mental health. Can J Psychiatry 2006;51 (9) 607- 615
PubMed
NICHD Early Child Care Research Network, Early child care and self-control, compliance, and problem behavior at twenty-four and thirty-six months. Child Dev 1998;69 (4) 1145- 1170
PubMed
NICHD Early Child Care Research Network, Child care and children's peer interaction at 24 and 36 months: the NICHD Study of Early Child Care. Child Dev 2001;72 (5) 1478- 1500
PubMed
NICHD Early Child Care Research Network, Does amount of time spent in child care predict socioemotional adjustment during the transition to kindergarten? Child Dev 2003;74 (4) 976- 1005
PubMed
NICHD Early Child Care Research Network, Early child care and children's development in the primary grades: follow-up results from the NICHD Study of Early Child Care. Am Educ Res J 2005;43 (3) 537- 570
Belsky  JVandell  DLBurchinal  MClarke-Stewart  KAMcCartney  KOwen  MTNICHD Early Child Care Research Network, Are there long-term effects of early child care? Child Dev 2007;78 (2) 681- 701
PubMed
Dettling  ACGunnar  MRDonzell  AB Cortisol levels of young children in full-day child care centers: relations with age and temperament. Psychoneuroendocrinology 1999;24 (5) 519- 536
PubMed
Tout  KDe Haan  MCampbell  EKGunnar  MR Social behavior correlates of cortisol activity in child care: gender differences and time-of-day effects. Child Dev 1998;69 (5) 1247- 1262
PubMed
Vermeer  HJvan Ijzendoorn  MH Children's elevated cortisol levels at daycare: a review and meta-analysis. Early Child Res Q 2006;21 (3) 390- 401
Watamura  SEDonzella  BAlwin  JGunnar  MR Morning-to-afternoon increases in cortisol concentrations for infants and toddlers at child care: age differences and behavioral correlates. Child Dev 2003;74 (4) 1006- 1020
PubMed
Zimmerman  LKStansbury  K The influence of emotion regulation, level of shyness, and habituation on the neuroendocrine response of three-year-old children. Psychoneuroendocrinology 2004;29 ((8)) 973- 982
PubMed
Smider  NAEssex  MJKalin  NH  et al.  Salivary cortisol as a predictor of socioemotional adjustment in kindergarten: a prospective study. Child Dev 2002;73 (1) 75- 92
PubMed
Hay  DFPayne  AChadwick  A Peer relations in childhood. J Child Psychol Psychiatry 2004;45 (1) 84- 108
PubMed
Gunnar  MRCheatham  CL Brain and behavior interface: stress and the developing brain. Infant Ment Health J 2003;24 (3) 195- 211
Dettling  ACParker  SWLane  SKSebanc  AMGunnar  MR Quality of care and temperament determine whether cortisol levels rise over the day for children in full-day child care. Psychoneuroendocrinology 2000;25 (8) 819- 836
PubMed
Maccoby  EELewis  CC Less day care or different day care? Child Dev 2003;74 (4) 1069- 1075
PubMed
Anme  TSegal  UA Implications for the development of children in over 11 hours of centre-based care. Child Care Health Dev 2004;30 (4) 345- 352
PubMed
Aureli  TColecchia  N Day care experience and free play behavior in preschool children. J Appl Dev Psychol 1996;17 (1) 1- 17
Campbell  JLamb  MEHwang  C Early child-care experiences and children's social competence between 1.5 and 15 years of age. Appl Dev Sci 2000;4 (3) 166- 175
Morales  NBridges  L Associations between nonparental care experience and preschoolers' emotion regulation in the presence of the mother. J Appl Dev Psychol 1996;17 (4) 577- 596
Balleyguier  GMelhuish  E The relationship between infant day care and socio-emotional development in French children aged 3-4 years. Eur J Psych Educ 1996;11 (2) 193- 199
Hegland  SRix  M Aggression and assertiveness in kindergarten children differing in day care experiences. Early Child Res Q 1990;5 (1) 105- 116
Holloway  SReichart-Erickson  M Child care quality, family structure, and maternal expectations: relationship to preschool children's peer relations. J Appl Dev Psychol 1989;10 (3) 281- 298
Shenk  VGrusec  J A comparison of prosocial behavior of children with and without day care experience. Merrill Palmer Q 1987;33 (2) 231- 240
NICHD Early Child Care Research Network, The relation of child care to cognitive and language development. Child Dev 2000;71 (4) 960- 980
PubMed
NICHD Early Child Care Research Network, Early child care and children's development prior to school entry. Am Educ Res J 2002;39 (1) 133- 164
Baydar  NBrooks-Gunn  J Effects of maternal employment and child care arrangements on preschoolers' cognitive and behavioral outcomes: evidence from the National Longitudinal Survey of Youth. Dev Psychol 1991;27 (6) 932- 945
Brooks-Gunn  JHan  WWaldfogel  J Maternal employment and child cognitive outcomes in the first year of life: The NICHD Study of Early Child Care. Child Dev 2002;73 (4) 1052- 1072
PubMed
Waldfogel  JHan  WBrooks-Gunn  J The effects of early maternal employment on child cognitive development. Demography 2002;39 (2) 369- 392
PubMed
Vandell  DLRamanan  J Effects of early and recent maternal employment on children from low-income families. Child Dev 1992;63 (4) 938- 949
PubMed
NICHD Early Child Care Research Network, Child care and common communicable illnesses. Arch Pediatr Adolesc Med 2001;155 (4) 481- 488
PubMed
Bradley  RHNICHD Early Child Care Research Network, Child care and common communicable illnesses in children aged 37 to 54 months. Arch Pediatr Adolesc Med 2003;157 (2) 196- 200
PubMed
Lu  NSamuels  MShi  LBaker  SGlover  SSanders  J Child day care risks of common infectious diseases revisited. Child Care Health Dev 2004;30 (4) 361- 368
PubMed
Ball  TMHolberg  CAldous  MMartinez  FWright  A Influence of attendance at day care on the common cold from birth through 13 years of age. Arch Pediatr Adolesc Med 2002;156 (2) 121- 126
PubMed
Nafstad  PHagen  JOie  LMagnus  PJaakkola  J Day care centers and respiratory health. Pediatrics 1999;103 (4, pt 1) 753- 758
PubMed
Ponsonby  ALCouper  DDwyer  TCarmichael  A Cross sectional study of the relation between sibling number and asthma, hay fever, and eczema. Arch Dis Child 1998;79 (4) 328- 333
PubMed
Celedon  JCLitonjua  AAWeiss  STGold  DR Day care attendance in the first year of life and illnesses of the upper and lower respiratory tract in children with a familial history of atopy. Pediatrics 1999;104 (3, pt 1) 495- 500
PubMed
Gilliland  FDLi  YFPeters  JM Effects of maternal smoking during pregnancy and environmental tobacco smoke on asthma and wheezing in children. Am J Respir Crit Care Med 2001;163 (2) 429- 436
PubMed
Ball  TMCastro-Rodriguez  JGriffith  K Siblings, day-care attendance, and the risk of asthma and wheezing during childhood. N Engl J Med 2000;343 (8) 538- 543
PubMed
Krämer  UHeinrich  JWjst  MWichmann  H Age of entry to day nursery and allergy in later childhood. Lancet 1999;353 (9151) 450- 454
PubMed
Backman  ABjorksten  RIlmonen  SJuntunen  KSuoniemi  I Do infections in infancy affect sensitization to airborne allergens and development of atopic disease? Allergy 1984;39 (4) 309- 315
PubMed
Maddox  LSchwartz  D The pathophysiology of asthma. Annu Rev Med 2002;53477- 498
PubMed
Martinez  FD Viral infections and the development of asthma. Am J Respir Crit Care Med 1995;151 (5) 1644- 1647
PubMed
Peden  D Development of atopy and asthma: candidate environmental influences and important periods of exposure. Environ Health Perspect 2000;108 (3(suppl 3)) 475- 482
PubMed
American Public Health Association & American Academy of Pediatrics, Caring for Our Children: National Health and Safety Performance Standards: Standards for Out-of-Home Child Care Programs.  Ann Arbor, MI American Public Health Association & American Academy of Pediatrics1992;
Committee on Family and Work Policies, Working Families and Growing Kids: Caring for Children and Adolescents.  Washington, DC National Academies Press2003;
Vandell  DLWolfe  B Child Care Quality: Does It Matter and Does It Need to Be Improved? Report prepared for the US Department of Health and Human Services, Office for Planning and Evaluation, 2000 http://aspe.hhs.gov/hsp/ccquality00/Accessed May 12, 2006
NICHD Early Child Care Research Network, Characteristics of infant child care: factors contributing to positive caregiving. Early Child Res Q 1996;11 (3) 269- 306
Phillips  DAMekow  DScarr  SMcCartney  KAbbott-Shim  M Within and beyond the classroom door: assessing quality in child care centers. Early Child Res Q 2000;15 (4) 475- 496
Clarke-Stewart  KAVandell  DLBurchinal  MO’Brien  MMcCartney  K Do regulable features of child care homes affect children's development? Early Child Res Q 2002;17 (1) 52- 86
Burchinal  MRCryer  DClifford  RMHowes  C Caregiver training and classroom quality in child care centers. Appl Dev Sci 2002;6 (1) 2- 11
Howes  C Children's experiences in center-based child care as a function of teacher background and adult:child ratio. Merrill Palmer Q 1997;43 (3) 404- 425
NICHD Early Child Care Research Network, Child outcomes when child care center classes meet recommended standards for quality. Am J Public Health 1999;89 (7) 1072- 1077
PubMed
Bornstein  MHHahn  CGist  NFHaynes  OM Long-term cumulative effects of childcare on children's mental development and socioemotional adjustment in a non-risk sample: the moderating effects of gender. Early Child Dev Care 2006;176 (2) 129- 156
Loeb  SFuller  BKagan  SLCarrol  B Child care in poor communities: early learning effects of type, quality, and stability. Child Dev 2004;75 (1) 47- 65
PubMed
Love  JMHarrison  LSagi-Schwartz  A  et al.  Child care quality matters: how conclusions may vary with context. Child Dev 2003;74 (4) 1021- 1033
PubMed
NICHD Early Child Care Research Network, Does quality of child care affect child outcomes at age 4 1/2? Dev Psychol 2003;39 (3) 451- 469
PubMed
Howes  C Social-emotional classroom climate in child care, child-teacher relationships and children's second grade peer relations. Soc Dev 2000;9 (2) 191- 204
Dettling  ACParker  SWLane  SKSebanc  MGunnar  MR Quality of care and temperament determine whether cortisol levels rise over the day for children in full-day child care. Psychoneuroendocrinology 2000;25 (8) 819- 836
PubMed
Kotch  J Reductions in Transmission of Infectious Disease in Childcare Settings (Grant No. MCJ-37111: final report submitted to Maternal and Child Health Bureau [US Dept of Health and Human Services]).  Washington, DC US Dept of Health and Human Services1990;
NICHD Early Child Care Research Network, Child care effect sizes for the NICHD Study of Early Child Care and Youth Development. Am Psychol 2006;61 (2) 99- 116
PubMed
McCartney  KDearing  ETaylor  BA Quality child care supports the achievement of low-income children: direct and indirect effects via caregiving and the home environment.  Symposium conducted at the biennial meeting of the Society for Research in Child Development Tampa, FL April 24, 2003
Fabes  RAHanish  LDMartin  CL Children at play: the role of peers in understanding the effects of child care. Child Dev 2003;74 (4) 1039- 1043
PubMed
Clarke-Stewart  KAPhillips  DAed Predicting child development from child care forms and features: the Chicago Study. Quality in Child Care: What Does Research Tell Us? Washington, DC National Association for the Education of Young Children1987;
Hardy  AMFowler  MG Child care arrangements and repeated ear infections in young children. Am J Public Health 1993;83 (9) 1321- 1325
PubMed
Hurwitz  ESGunn  WJPinsky  PFShonberger  LB Risk of respiratory illness associated with day care attendance: a nationwide study. Pediatrics 1991;87 (1) 62- 69
PubMed
Paradise  JLRockette  HEColborn  K  et al.  Otitis media in 2253 Pittsburgh-area infants: prevalence and risk factors during the first two years of life. Pediatrics 1997;99 (3) 318- 333
PubMed
Louhiala  PJJaakkola  NRuotsalainen  RJaakkola  JJ Day care centers and diarrhea: a public health perspective. J Pediatr 1997;131 (3) 476- 479
PubMed
Campbell  FARamey  CT Effects of early intervention on intellectual and academic achievement: a follow-up of children from low-income families. Child Dev 1994;65 (2 Spec No) 684- 698
PubMed
Brooks-Gunn  JMcCarton  CMCasey  PH  et al.  Early intervention in low-birth-weight premature infants: results through age 5 years from the Infant Health and Development Program. JAMA 1994;272 (16) 1257- 1262
PubMed
Reynolds  AJTemple  JA Extended early childhood intervention and school achievement: age 13 findings from the Chicago Longitudinal Study. Child Dev 1998;69 (1) 231- 246
PubMed
Reynolds  AJTemple  JARobertson  DLMann  EA Long-term effects of an early childhood intervention on educational achievement and juvenile arrest: a 15-year follow-up of low-income children in public schools. JAMA 2001;285 (18) 2339- 2346
PubMed
Zill  NResenick  GKim  K  et al.  Head Start FACES 2000: A Whole-child Perspective on Program Performance.  Washington, DC US Dept of Health and Human Services, Administration on Child & Families2003;
NICHD Early Child Care Research Network, Families matter—even for kids in child care [commentary]. J Dev Behav Pediatr 2003;24 (1) 58- 62
PubMed
NICHD Early Child Care Research Network, Relations between family predictors and child outcomes: are they weaker for children in child care? Dev Psychol 1998;34 (5) 1119- 1128
PubMed
Bradley  RHCorwyn  RFTamis-LeMonda  CTedBalter  Led The family environment. Child Psychology: A Handbook of Contemporary Issues. 2nd ed New York, NY Garland2005;493- 520

Figures

Tables

References

Overturf Johnson  J Who's minding the kids? child care arrangements: winter 2002. Current Population Reports, P70-101 US Census Bureau Washington, DC2005;http://www.census.gov/prod/2005pubs/p70-101.pdfAccessed April 23, 2006
NICHD Early Child Care Research Network, Characteristics and quality of child care for toddlers and preschoolers. Appl Dev Sci 2000;4 (3) 116- 135
Peisner-Feinberg  ESBurchinal  MRClifford  RM  et al.  The relation of child care quality to children's cognitive and social developmental trajectories through second grade. Child Dev 2001;72 (5) 1534- 1553
PubMed
Kontos  SCHowes  CShinn  MGalinsky  E Quality in Family Child Care and Relative Care.  New York, NY Teachers College Press1995;
Ruopp  RTravers  JGlantz  FCoelen  G Children at the Center.  Cambridge, MA Abt Associates1979;
Howes  CPhillips  DAWhitebook  M Thresholds of quality: implications for the social development of children in center-based child care. Child Dev 1992;63 (2) 449- 460
PubMed
Campbell  FARamey  CTPungello  EPSparling  JMiller-Johnson  S Early childhood education: young adult outcomes from the Abecedarian Project. Appl Dev Sci 2002;6 (1) 42- 57
Schweinhart  LJWeikart  DPLarner  MB Consequences of three preschool curriculum models through age 15. Early Child Res Q 1986;1 (3) 15- 45
Administration for Children and Families, Making a Difference in the Lives of Children and Families: The Impacts of Early Head Start Programs on Infants and Toddlers and Their Families.  Washington, DC US Dept of Health and Human Services2002;
US Department of Health and Human Services,; Administration for Children and Families, Head Start Impact Study: First Year Findings.  Washington, DC US Dept of Health and Human Services May2005;
Duncan  GJNICHD Early Child Care Research Network, Modeling the impacts of child care quality on children's preschool cognitive development. Child Dev 2003;74 ((5)) 1454- 1475
PubMed
Newcombe  NS Some controls control too much. Child Dev 2003;74 (4) 1050- 1052
PubMed
Sagi  AKoren-Karie  NGini  MZiv  YJoels  T Shedding further light on the effects of various types and quality of early child care on infant-mother attachment relationship: The Haifa Study of Early Child Care. Child Dev 2002;73 (4) 1166- 1186
PubMed
NICHD Early Child Care Research Network, Child Care and Child Development: Results From the NICHD Study of Early Child Care and Youth Development.  New York, NY Guilford2005;
NICHD Early Child Care Research Network, Nonmaternal care and family factors in early development: an overview of the NICHD Study of Early Child Care. J Appl Dev Psychol 2001;22 (4) 457- 492
Belsky  J Infant day care: a cause for concern? Zero to Three 1986;6 (1) 1- 9
Belsky  J The effects of infant day care reconsidered. Early Child Res Q 1988;3 (3) 235- 272
NICHD Early Child Care Research Network, Child care in the first year of life. Merrill Palmer Q 1997;43 (3) 340- 360
Capizzano  JAdams  G The Number of Child Care Arrangements Used by Children Under Five: Variation Across States. New Federalism. National Survey of America's Families, Series B (No. B-12).  Washington, DC Urban Institute2004;
Barglow  PVaughn  BEMolitor  N Effects of maternal absence due to employment on the quality of infant-mother attachment in a low-risk sample. Child Dev 1987;58 (4) 945- 954
PubMed
Belsky  JRovine  M Nonmaternal care in the first year of life and the security of infant-parent attachment. Child Dev 1988;59 (1) 157- 167
PubMed
NICHD Early Child Care Research Network, The effects of infant child care on infant-mother attachment: results from the NICHD Study of Early Child Care. Child Dev 1997;68 (5) 860- 879
NICHD Early Child Care Research Network, Child care and family predictors of preschool attachment and stability from infancy. Dev Psychol 2001;37 (6) 847- 862
PubMed
Campbell  SBCohn  JFMeyers  T Depression in first-time mothers: mother-infant interaction and depression chronicity. Dev Psychol 1995;31 (3) 349- 357
Owen  MTCox  MJGottfried  AEedGottfried  AWed Maternal employment and the transition to parenthood. Maternal Employment and Children's Development: Longitudinal Research. New York, NY Plenum1988;85- 119
Crockenberg  SLitman  C Effects of maternal employment on maternal and two-year-old child behavior. Child Dev 1991;62 (5) 930- 953
Vandell  DL Effects of a playgroup experience on mother-son and father-son interaction. Dev Psychol 1979;15 (4) 379- 385
Burchinal  MRBryant  DMLee  MWRamey  CT Early day care, infant-mother attachment, and maternal responsiveness in the infant's first year of life. Early Child Res Q 1992;7 (3) 383- 396
NICHD Early Child Care Research Network, Child care and mother-child interaction in the first 3 years of life. Dev Psychol 1999;35 (6) 1399- 1413
PubMed
NICHD Early Child Care Research Network, Early child care and mother-child interaction from 36 months through first grade. Infant Behav Dev 2003;26 (3) 345- 370
Geoffroy  MCCote  SMParent  SSeguin  JR Daycare attendance, stress, and mental health. Can J Psychiatry 2006;51 (9) 607- 615
PubMed
NICHD Early Child Care Research Network, Early child care and self-control, compliance, and problem behavior at twenty-four and thirty-six months. Child Dev 1998;69 (4) 1145- 1170
PubMed
NICHD Early Child Care Research Network, Child care and children's peer interaction at 24 and 36 months: the NICHD Study of Early Child Care. Child Dev 2001;72 (5) 1478- 1500
PubMed
NICHD Early Child Care Research Network, Does amount of time spent in child care predict socioemotional adjustment during the transition to kindergarten? Child Dev 2003;74 (4) 976- 1005
PubMed
NICHD Early Child Care Research Network, Early child care and children's development in the primary grades: follow-up results from the NICHD Study of Early Child Care. Am Educ Res J 2005;43 (3) 537- 570
Belsky  JVandell  DLBurchinal  MClarke-Stewart  KAMcCartney  KOwen  MTNICHD Early Child Care Research Network, Are there long-term effects of early child care? Child Dev 2007;78 (2) 681- 701
PubMed
Dettling  ACGunnar  MRDonzell  AB Cortisol levels of young children in full-day child care centers: relations with age and temperament. Psychoneuroendocrinology 1999;24 (5) 519- 536
PubMed
Tout  KDe Haan  MCampbell  EKGunnar  MR Social behavior correlates of cortisol activity in child care: gender differences and time-of-day effects. Child Dev 1998;69 (5) 1247- 1262
PubMed
Vermeer  HJvan Ijzendoorn  MH Children's elevated cortisol levels at daycare: a review and meta-analysis. Early Child Res Q 2006;21 (3) 390- 401
Watamura  SEDonzella  BAlwin  JGunnar  MR Morning-to-afternoon increases in cortisol concentrations for infants and toddlers at child care: age differences and behavioral correlates. Child Dev 2003;74 (4) 1006- 1020
PubMed
Zimmerman  LKStansbury  K The influence of emotion regulation, level of shyness, and habituation on the neuroendocrine response of three-year-old children. Psychoneuroendocrinology 2004;29 ((8)) 973- 982
PubMed
Smider  NAEssex  MJKalin  NH  et al.  Salivary cortisol as a predictor of socioemotional adjustment in kindergarten: a prospective study. Child Dev 2002;73 (1) 75- 92
PubMed
Hay  DFPayne  AChadwick  A Peer relations in childhood. J Child Psychol Psychiatry 2004;45 (1) 84- 108
PubMed
Gunnar  MRCheatham  CL Brain and behavior interface: stress and the developing brain. Infant Ment Health J 2003;24 (3) 195- 211
Dettling  ACParker  SWLane  SKSebanc  AMGunnar  MR Quality of care and temperament determine whether cortisol levels rise over the day for children in full-day child care. Psychoneuroendocrinology 2000;25 (8) 819- 836
PubMed
Maccoby  EELewis  CC Less day care or different day care? Child Dev 2003;74 (4) 1069- 1075
PubMed
Anme  TSegal  UA Implications for the development of children in over 11 hours of centre-based care. Child Care Health Dev 2004;30 (4) 345- 352
PubMed
Aureli  TColecchia  N Day care experience and free play behavior in preschool children. J Appl Dev Psychol 1996;17 (1) 1- 17
Campbell  JLamb  MEHwang  C Early child-care experiences and children's social competence between 1.5 and 15 years of age. Appl Dev Sci 2000;4 (3) 166- 175
Morales  NBridges  L Associations between nonparental care experience and preschoolers' emotion regulation in the presence of the mother. J Appl Dev Psychol 1996;17 (4) 577- 596
Balleyguier  GMelhuish  E The relationship between infant day care and socio-emotional development in French children aged 3-4 years. Eur J Psych Educ 1996;11 (2) 193- 199
Hegland  SRix  M Aggression and assertiveness in kindergarten children differing in day care experiences. Early Child Res Q 1990;5 (1) 105- 116
Holloway  SReichart-Erickson  M Child care quality, family structure, and maternal expectations: relationship to preschool children's peer relations. J Appl Dev Psychol 1989;10 (3) 281- 298
Shenk  VGrusec  J A comparison of prosocial behavior of children with and without day care experience. Merrill Palmer Q 1987;33 (2) 231- 240
NICHD Early Child Care Research Network, The relation of child care to cognitive and language development. Child Dev 2000;71 (4) 960- 980
PubMed
NICHD Early Child Care Research Network, Early child care and children's development prior to school entry. Am Educ Res J 2002;39 (1) 133- 164
Baydar  NBrooks-Gunn  J Effects of maternal employment and child care arrangements on preschoolers' cognitive and behavioral outcomes: evidence from the National Longitudinal Survey of Youth. Dev Psychol 1991;27 (6) 932- 945
Brooks-Gunn  JHan  WWaldfogel  J Maternal employment and child cognitive outcomes in the first year of life: The NICHD Study of Early Child Care. Child Dev 2002;73 (4) 1052- 1072
PubMed
Waldfogel  JHan  WBrooks-Gunn  J The effects of early maternal employment on child cognitive development. Demography 2002;39 (2) 369- 392
PubMed
Vandell  DLRamanan  J Effects of early and recent maternal employment on children from low-income families. Child Dev 1992;63 (4) 938- 949
PubMed
NICHD Early Child Care Research Network, Child care and common communicable illnesses. Arch Pediatr Adolesc Med 2001;155 (4) 481- 488
PubMed
Bradley  RHNICHD Early Child Care Research Network, Child care and common communicable illnesses in children aged 37 to 54 months. Arch Pediatr Adolesc Med 2003;157 (2) 196- 200
PubMed
Lu  NSamuels  MShi  LBaker  SGlover  SSanders  J Child day care risks of common infectious diseases revisited. Child Care Health Dev 2004;30 (4) 361- 368
PubMed
Ball  TMHolberg  CAldous  MMartinez  FWright  A Influence of attendance at day care on the common cold from birth through 13 years of age. Arch Pediatr Adolesc Med 2002;156 (2) 121- 126
PubMed
Nafstad  PHagen  JOie  LMagnus  PJaakkola  J Day care centers and respiratory health. Pediatrics 1999;103 (4, pt 1) 753- 758
PubMed
Ponsonby  ALCouper  DDwyer  TCarmichael  A Cross sectional study of the relation between sibling number and asthma, hay fever, and eczema. Arch Dis Child 1998;79 (4) 328- 333
PubMed
Celedon  JCLitonjua  AAWeiss  STGold  DR Day care attendance in the first year of life and illnesses of the upper and lower respiratory tract in children with a familial history of atopy. Pediatrics 1999;104 (3, pt 1) 495- 500
PubMed
Gilliland  FDLi  YFPeters  JM Effects of maternal smoking during pregnancy and environmental tobacco smoke on asthma and wheezing in children. Am J Respir Crit Care Med 2001;163 (2) 429- 436
PubMed
Ball  TMCastro-Rodriguez  JGriffith  K Siblings, day-care attendance, and the risk of asthma and wheezing during childhood. N Engl J Med 2000;343 (8) 538- 543
PubMed
Krämer  UHeinrich  JWjst  MWichmann  H Age of entry to day nursery and allergy in later childhood. Lancet 1999;353 (9151) 450- 454
PubMed
Backman  ABjorksten  RIlmonen  SJuntunen  KSuoniemi  I Do infections in infancy affect sensitization to airborne allergens and development of atopic disease? Allergy 1984;39 (4) 309- 315
PubMed
Maddox  LSchwartz  D The pathophysiology of asthma. Annu Rev Med 2002;53477- 498
PubMed
Martinez  FD Viral infections and the development of asthma. Am J Respir Crit Care Med 1995;151 (5) 1644- 1647
PubMed
Peden  D Development of atopy and asthma: candidate environmental influences and important periods of exposure. Environ Health Perspect 2000;108 (3(suppl 3)) 475- 482
PubMed
American Public Health Association & American Academy of Pediatrics, Caring for Our Children: National Health and Safety Performance Standards: Standards for Out-of-Home Child Care Programs.  Ann Arbor, MI American Public Health Association & American Academy of Pediatrics1992;
Committee on Family and Work Policies, Working Families and Growing Kids: Caring for Children and Adolescents.  Washington, DC National Academies Press2003;
Vandell  DLWolfe  B Child Care Quality: Does It Matter and Does It Need to Be Improved? Report prepared for the US Department of Health and Human Services, Office for Planning and Evaluation, 2000 http://aspe.hhs.gov/hsp/ccquality00/Accessed May 12, 2006
NICHD Early Child Care Research Network, Characteristics of infant child care: factors contributing to positive caregiving. Early Child Res Q 1996;11 (3) 269- 306
Phillips  DAMekow  DScarr  SMcCartney  KAbbott-Shim  M Within and beyond the classroom door: assessing quality in child care centers. Early Child Res Q 2000;15 (4) 475- 496
Clarke-Stewart  KAVandell  DLBurchinal  MO’Brien  MMcCartney  K Do regulable features of child care homes affect children's development? Early Child Res Q 2002;17 (1) 52- 86
Burchinal  MRCryer  DClifford  RMHowes  C Caregiver training and classroom quality in child care centers. Appl Dev Sci 2002;6 (1) 2- 11
Howes  C Children's experiences in center-based child care as a function of teacher background and adult:child ratio. Merrill Palmer Q 1997;43 (3) 404- 425
NICHD Early Child Care Research Network, Child outcomes when child care center classes meet recommended standards for quality. Am J Public Health 1999;89 (7) 1072- 1077
PubMed
Bornstein  MHHahn  CGist  NFHaynes  OM Long-term cumulative effects of childcare on children's mental development and socioemotional adjustment in a non-risk sample: the moderating effects of gender. Early Child Dev Care 2006;176 (2) 129- 156
Loeb  SFuller  BKagan  SLCarrol  B Child care in poor communities: early learning effects of type, quality, and stability. Child Dev 2004;75 (1) 47- 65
PubMed
Love  JMHarrison  LSagi-Schwartz  A  et al.  Child care quality matters: how conclusions may vary with context. Child Dev 2003;74 (4) 1021- 1033
PubMed
NICHD Early Child Care Research Network, Does quality of child care affect child outcomes at age 4 1/2? Dev Psychol 2003;39 (3) 451- 469
PubMed
Howes  C Social-emotional classroom climate in child care, child-teacher relationships and children's second grade peer relations. Soc Dev 2000;9 (2) 191- 204
Dettling  ACParker  SWLane  SKSebanc  MGunnar  MR Quality of care and temperament determine whether cortisol levels rise over the day for children in full-day child care. Psychoneuroendocrinology 2000;25 (8) 819- 836
PubMed
Kotch  J Reductions in Transmission of Infectious Disease in Childcare Settings (Grant No. MCJ-37111: final report submitted to Maternal and Child Health Bureau [US Dept of Health and Human Services]).  Washington, DC US Dept of Health and Human Services1990;
NICHD Early Child Care Research Network, Child care effect sizes for the NICHD Study of Early Child Care and Youth Development. Am Psychol 2006;61 (2) 99- 116
PubMed
McCartney  KDearing  ETaylor  BA Quality child care supports the achievement of low-income children: direct and indirect effects via caregiving and the home environment.  Symposium conducted at the biennial meeting of the Society for Research in Child Development Tampa, FL April 24, 2003
Fabes  RAHanish  LDMartin  CL Children at play: the role of peers in understanding the effects of child care. Child Dev 2003;74 (4) 1039- 1043
PubMed
Clarke-Stewart  KAPhillips  DAed Predicting child development from child care forms and features: the Chicago Study. Quality in Child Care: What Does Research Tell Us? Washington, DC National Association for the Education of Young Children1987;
Hardy  AMFowler  MG Child care arrangements and repeated ear infections in young children. Am J Public Health 1993;83 (9) 1321- 1325
PubMed
Hurwitz  ESGunn  WJPinsky  PFShonberger  LB Risk of respiratory illness associated with day care attendance: a nationwide study. Pediatrics 1991;87 (1) 62- 69
PubMed
Paradise  JLRockette  HEColborn  K  et al.  Otitis media in 2253 Pittsburgh-area infants: prevalence and risk factors during the first two years of life. Pediatrics 1997;99 (3) 318- 333
PubMed
Louhiala  PJJaakkola  NRuotsalainen  RJaakkola  JJ Day care centers and diarrhea: a public health perspective. J Pediatr 1997;131 (3) 476- 479
PubMed
Campbell  FARamey  CT Effects of early intervention on intellectual and academic achievement: a follow-up of children from low-income families. Child Dev 1994;65 (2 Spec No) 684- 698
PubMed
Brooks-Gunn  JMcCarton  CMCasey  PH  et al.  Early intervention in low-birth-weight premature infants: results through age 5 years from the Infant Health and Development Program. JAMA 1994;272 (16) 1257- 1262
PubMed
Reynolds  AJTemple  JA Extended early childhood intervention and school achievement: age 13 findings from the Chicago Longitudinal Study. Child Dev 1998;69 (1) 231- 246
PubMed
Reynolds  AJTemple  JARobertson  DLMann  EA Long-term effects of an early childhood intervention on educational achievement and juvenile arrest: a 15-year follow-up of low-income children in public schools. JAMA 2001;285 (18) 2339- 2346
PubMed
Zill  NResenick  GKim  K  et al.  Head Start FACES 2000: A Whole-child Perspective on Program Performance.  Washington, DC US Dept of Health and Human Services, Administration on Child & Families2003;
NICHD Early Child Care Research Network, Families matter—even for kids in child care [commentary]. J Dev Behav Pediatr 2003;24 (1) 58- 62
PubMed
NICHD Early Child Care Research Network, Relations between family predictors and child outcomes: are they weaker for children in child care? Dev Psychol 1998;34 (5) 1119- 1128
PubMed
Bradley  RHCorwyn  RFTamis-LeMonda  CTedBalter  Led The family environment. Child Psychology: A Handbook of Contemporary Issues. 2nd ed New York, NY Garland2005;493- 520

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 29

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles