Strong opinions have been expressed about the pros and cons of out-of-home child care. In order to evaluate the actual effects, it is necessary to take account of the quantity and quality of child care, as well as many characteristics of the children and their families. A longitudinal study entitled "Welfare, Children, and Families: A Three City Study" assessed 204 2- to 4-year-olds who were regularly in child care for at least 10 hours per week. The children were drawn from household samples in low-income neighborhoods of Boston, Chicago, and San Antonio. The quality of the child care settings was assessed by standardized observations, plus interviews with child care providers. At a mean interval of 16 months, children were tested twice for cognitive achievement and their mothers completed the age-appropriate CBCL, as well as a 6-item measure of their child's positive behaviors. Children's Time 1 scores on each measure were partialed out of the Time 2 analyses of effects associated with child care. Children's cognitive achievement was not significantly associated with the quality of child care, although there was a modest tendency for children's quantitative achievement to be positively associated with weekly hours in child care. However, CBCL Internalizing, Externalizing, and Total Problems scores were associated with significant interactions between the quality and quantity of child care as follows: Children who spent many hours in high quality care had the lowest levels of Internalizing, Externalizing, and Total Problems scores. For Internalizing and Total Problems, children who were in low quality care had higher problem scores than children who were in high quality care, regardless of whether they spent few or many hours in care. For Externalizing, there was a distinct cross-over effect, whereby children who spent few hours in low quality care had lower problem scores than children who spent many hours in low quality care or children who spent few hours in high quality care. However, Externalizing scores were also affected by a significant interaction between child care quality and cognitive stimulation in the child's home, as measured by standardized observations and interviews. Children receiving low quality care who also received low cognitive stimulation at home obtained considerably higher Externalizing scores than children receiving low quality care but high cognitive stimulation at home. Children receiving high quality care obtained lower Externalizing scores, regardless of the cognitive stimulation received at home. Interactions with the children's gender were also found: Boys in high quality care had lower problem scores than boys in low quality care, especially for Externalizing problems. The authors concluded that "more extensive, high-quality child care fostered children's socioemotional functioning, as exemplified by reductions in both internalizing and externalizing problem behaviors" and "Children who experienced extensive amounts of care in low-quality arrangements showed elevated levels of externalizing behavior problems over time, including elevations that placed children in to a categorization indicating the potential need for clinical services" (p. 309).

Reference:
Votruba-Drzal, E., Coley, R.L., & Chase-Lansdale, P.L. (2004). Child care and low-income children's development: Direct and moderated effects. Child Development, 75, 296-312.

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