The debate over children spending excessive time in day care is heating up again following the results of a new survey released by the National Institute of Child Health and Human Development that identifies the possible adverse effects of day care.
With three out of four preschoolers now spending at least part of their day in day care, the results might leave some parents feeling guilty.
The government-funded, ongoing study of more than 1,000 children found that very young children who spent long hours in day care were more likely to become aggressive and defiant in school, beginning in kindergarten and continuing through sixth grade. While that fact is continually highlighted, it is important to note that 83 percent of the children in the study did not display these behaviors. In addition, this is not a scientific study, and there was no evaluation of how many stay-at-home children displayed the same tendencies.
On a positive note, children placed in high-quality day care tended to have higher vocabulary scores and performed at least as well as their peers in math and reading skills. Although many parents elect to care for their children at home, those who choose quality day care should not feel they are putting their kids at risk.
When choosing day care for your child, do your homework. Parents have many options as they try to balance family, home and career. Some may choose a relative or in-home nanny; others will select a provider home or center-based care. Understanding how quality is defined will improve your search for the best available option for your family.
Massachusetts has been a leader in defining quality and in licensing day cares. When looking for day care, ask to see policies regarding the following issues:
* Infection control: Policies on hand washing by staff and children after every diaper change and bathroom visit and before touching food, immunizations for both adults and kids, regular cleaning of toys and equipment, and safe hygiene practices.
* Emergency procedures: There should be written policies for emergencies and parent contact lists. Staff should be trained for emergencies, and there should be arrangements for medical support and, if needed, transportation.
* Injury prevention: Inquire about the safety of equipment, medication administration and the positioning of infants to prevent sudden infant death syndrome.
* Caregivers: Ask about the educational level, certification, continuing education and qualifications of staff as well as the staff turnover rate.
r Staff-to-child ratio: Younger children require smaller group settings with greater adult supervision. For example, for children who are less than 1 year old, one adult should be assigned to every three kids, with groups limited to six or less children. For children who are under 2, one adult should be assigned to every four kids, with groups limited to eight children or less.
* Accreditation: Accreditation by a national organization assures that the provider has voluntarily met higher standards than those required for licensing.
Armed with this information, talk to friends and local child-care professionals to figure out what day-care options are available. Then, make appointments to visit a number of sites. Once you select a day care, drop in regularly, often unannounced, and meet with caregivers frequently. If anything happens that makes you or your child uncomfortable, ask questions and define the issues.
Good, quality day care is safe and frequently promotes social and interpersonal development. Taking the time to make the right choices reduces the need to second-guess your decision.
Excellent information is available for parents at www.AAP.org or www.childcareaware.org.
nnn
Dr. Edward Bailey is chief of pediatrics at NSMC North Shore Children's Hospital, on staff at Mass General Hospital for Children and a father of three. You can contact him at ebailey@aap.org.
