Professor Jacqueline Barnes is deputy director of the Institute for the Study of Children, Families and Social Issues. Here, she comments on the points raised by Oliver James’s article, Day care and the developing child
The article by Oliver James can be critiqued on many levels. First, it is useful to analyse the language used and the sequencing of ideas. The manner in which the piece begins indicates that he presents himself as a reasonable person, in favour of mothers working if they wish to do so. (No mention that childcare may also be needed because the father works.) Thus he presents himself as someone who is not biased, whose information can be trusted. However, his use of the term ‘substitute care’ is interesting, harking back to a world of governesses replacing parents. Most academic experts (and most providers of childcare) would agree that they do not aim to be ‘quasi-parents’ but they offer a different experience with individuals who may stimulate in ways that are different to the home experience with mother or father.
The piece next sets up the idea that, despite being unbiased, he will be identifying not one but many problems, so the early ‘soothing’ is immediately banished to be replaced by anxiety. Problems related to the use of childcare will be akin to those identified for children of depressed mothers. This comparison is spurious. A large body of knowledge indicates that the impact of maternal depression can be identified even when mothers are depressed prenatally, before parenting even begins, and is likely to persist throughout childhood. Also, some studies suggest that problems associated with childcare are much less severe than other problems, and much more transient. He concludes that no ‘middle class’ parent should use day care. But why then should other families use it? Is it to be a desperate measure for families struggling to survive? Perhaps he is not aware that day care is costly and in fact more often used by middle class families where parents (of both sexes) may wish to pursue careers, or take up employment for other reasons.
After setting the scene for problems, Mr James’s piece then focuses on one aspect of the childcare research, concerned with cortisol levels of children at home and in day care (a term he uses throughout as if it were synonymous with group childcare although most studies include a range or types of childcare). A biological fact or two is likely to make the writer sound more authoritative and also raise parental anxiety levels. Biological effects sound much more drastic. He tells the reader which studies are ‘definitive’, relying to a great extent on one USA study which even the study investigators (like all responsible researchers) readily agree is not definitive. While this is a large and well-reported study it does not represent experiences of families in Europe, Scandinavia or the UK. In all these societies there are more opportunities for mothers who have given birth to delay returning to work or taking up employment. There is legislation in these countries allowing them to work part-time if they wish, whereas in the USA with no paid maternity leave, many return to work by the time their infant is three months, and many more to work full-time. Findings from other countries do not replicate the NICHD (Eunice Kennedy Shriver National Institute of Child Health and Human Development) results that indicate early and extended use of centre-based care is associated with subsequent behaviour problems (eg Barnes et al., 2010 and Sammons, 2010). In addition, new evidence in the USA from different longitudinal studies fails to find any relationship between early non-maternal childcare and subsequent behaviour problems (Jaffee et al, 2011) or finds that high quality care was in fact protective against the development of behaviour problems for boys from disadvantaged background (Votruba-Drzal et al, 2010).
Now it is important to turn to the facts, and the literature on cortisol. The literature on cortisol is complex. While it is a feature of the ‘fight and flight’ response it can be a useful chemical in moderate situations. It can raise attentiveness and alertness and give an energy boost. It is also difficult to measure. Samples need to be taken several times during the day, and on average the highest levels are on waking, with a reduction by evening. It could be possible that the higher levels of cortisol found in the afternoon for children in non-parental care are linked with ongoing stimulation, rather than a drop-off in activities in the lull after lunch. It has been found in one study led by the pioneering expert in the study of cortisol that it was the popular (not the difficult) children who showed higher changes in cortisol over the day (Gunnar et al, 1997). Thus it is not a simple picture of a rise in cortisol during the day being a bad thing – or a good thing.
Next it is important to turn to the errors. The NICHD study is quoted with information that at age 15, children who had experienced more childcare had higher levels of cortisol. In fact, the study found just the opposite (Roisman et al, 2009). If a greater percentage of their early childcare (three to 36 months) had been in a centre, then their waking cortisol level at age 15 years was likely to be significantly lower – not higher. This is not to say that a low level is necessarily good. Researchers at Berkeley, California have shown that young children with depressed mothers living in extreme poverty had low levels of cortisol, which they think may be a response to chronic stress. It has also been identified in some studies of children living in Romanian orphanages where there was very little stimulation. But recall that Oliver James asserts that high levels are found in younger children who are in day care, which supports the idea that they are being stimulated rather than experiencing an adverse situation. Given that the average waking cortisol level is lower at age fifteen and not higher for the NICHD children exposed to greater amounts of centre-based day care, the paragraph listing all kinds of problem behaviours that have been associated with high cortisol and/or more early day care is rather irrelevant. It is also misleading. Children who have experienced early day care would not have all those characteristics, nor are they ‘so much more likely’ to be aggressive and disobedient. The average score for a list of questions about disobedience may be higher but NICHD study authors note that the extent of differences between groups is small in reality and does not mean that children with day care experience have definite behaviour problems requiring clinical attention. Differences related to early day care also fade by age eight. Other studies, particularly those from the UK such as the EPPE study and the FCCC study, find no effect of day care on behaviour, or small effects that are gone by school age.
Overall, while studies of biological phenomena are intriguing, the processes in question are far from clear and should not be presented to families thinking about using childcare as ‘bad news’. Instead they should be encouraged to learn from the massed and well-established evidence that good quality childcare has a range of positive benefits. Thus seeking out good quality should be their main mission.
As for quality of care, studies in the USA, UK, Europe, and Scandinavia find that high quality non-parental care is linked with a range of better child outcomes. Mr James throws out a ‘fact’ that only 9 per cent of day care in America is high quality, continuing to report that ‘something similar is true here’. Not knowing where he got his 9% fact from it is not possible to comment on its accuracy but I can comment on the fact that a UK study (EPPE; Sylva et al, 2010) initiated in 2000 found that, at that time, which was before the current system of rigorous Ofsted inspections in childcare settings, 35 per cent of the centres observed in that study had good to excellent quality. It is likely that the figure will be even higher now, with a decade of government focus on quality in early care. The EPPE study, which was nationally representative rather than only in disadvantaged areas, found that children who had exclusive maternal care during the preschool years were in fact less socially competent than those who attended some kind of group setting, especially if it was of high quality (Sylva et al, 2010). Attendance at a high quality preschool (compared to staying at home) was related to better social, emotional and intellectual development.
The comments made by Mr James on ‘attachment’ are also not to be taken seriously. Virtually all academics involved in research on childcare agree now that the early concerns (ie about 40 years ago) about parent-child attachment problems if children attend non-parental care were unfounded. Mr James’s other suggestion that day care can benefit children‘s academic attainment, though only for children from low-income homes (and only when combined with therapy) reveals that he has relied too much on a small number of US studies since his conclusion is quite contrary to the UK EPPE study’s findings. As for the idea that it is a ’myth’ that babies or toddlers need stimulation, fly in the face of decades of child development research, as is the notion that under-threes should not be ‘educated’. The whole of life is a learning experience and to say that zero to threes do not learn is simply ludicrous. Feeling loved is essential but studies from the 1960s onwards have demonstrated the impact that stimulating experiences in day care settings can have for both disadvantaged children and those from more economically advantaged homes (or middle class as Mr James would put it).
It is important for parents thinking about childcare to get to know the provider so that they can share information about their child’s day-to-day experiences at home and in childcare (Leach et al, 2006) and this can pose a particular challenge if parents believe that childcare will have a negative impact on their child (Barnes et al., 2006) so it does not make sense to add to their anxiety with over-exaggerated and inaccurate warnings about problems. When parents and childcare settings work together to stimulate learning, optimal outcomes can be expected (Hunt et al, 2011).
But what do you think? Yano would love to hear your experiences of caring for your little ones exclusively at home or by using day care.