Day Care Quality, the Great Unknown

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JONATHAN COHN NOVEMBER 17, 2011

Day Care Quality, the Great Unknown

Editor’s Note: This post is part of a series further exploring “The Two Year Window,” my feature story on babies, the brain, and poverty that appears in the new issue of TNR. Click here to access all of the supplemental material.

Ongoing abuse, neglect, and adversity early in life can have long-lasting effects, changing and potentially damaging the way the brain develops. Controlled studies of children who spent infancy and early childhood in Romania’s orphanages have shown that those children are more likely to end up with significantly diminished cognitive and emotional abilities.

OK, so what does that mean for children here in the U.S.?

Obviously, they’re not subject to the same conditions as the Romanian orphans were. But pretty much every expert I interviewed for my story agreed that large numbers of children are getting shoddy care. And by shoddy care, they meant everything from being ignored all day while strapped into a car seat to more clear-cut, and physically dangerous, forms of abuse or neglect. If you have the stomach for it, go to Google and type in “infant died locked car.” Or read the recent St. Louis Post-Dispatch series on 45 infants who died in local day cares for reasons other than disease.

In other words, there's a spectrum of shoddy care – from mediocre to poor to awful. The hard part is figuring out exactly how many kids fall into each category. And despite considerable research and consultation with experts, I came up with only two reliable sources.

One was a study of day care in four states, by researchers in Colorado. The other was a more comprehensive national survey, by the National Institute for Child Health and Human Development. The results were similar: In the Colorado study, only 8 percent of day care centers were “good” or “excellent” while 40 percent were “poor.” The NIHCD study found that three out of four infant caregivers give only minimal intellectual and cognitive stimulation. But the categories, obviously, involve some subjectivity. They tell us something, for sure, but not enough.

To be sure, measuring the quality of day care is difficult. It's hard to find good ways to measure quality, let alone collect the information. In that sense, it's the same problem that plagues efforts to measure quality of elementary and secondary education.

But the contrast between the available studies on the two age groups is revealing. Our data on the quality of grade school may not be the most reliable or insightful, but at least we have a lot of it – and are hard at work at improving both the quality and quantity. When it comes to care for children younger than 5 and, in particular, younger than 3, we have very little information and don’t seem to be generating much more. That’s indicative of the priority we put on very early childhood – or lack thereof.

By the way, it would be a mistake to take any of this as indictment of day care per se. Children can get poor care from their parents. And quality day care can be a huge plus. Based on the evidence I’ve seen, the problem isn’t that too many kids are in day care. It’s that too many kids are in lousy day care. 

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posted in: jonathan cohn, st. louis, google, post-dispatch, united states, colorado

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