Child Care Quality: Does It Matter and Does It Need to be Improved? (Full Report). What Is the Quality of Care in the United States?

05/24/2000

The evidence reviewed above indicates that child care quality has meaningful effects on children and their parents. Our next question considers the quality of the care that is available in the United States. One part of this question is a determination of whether high-quality care (of the sort that fosters positive developmental outcomes) is the norm or the exception. The flip side of this question is a determination of the likelihood that children are in poor-quality care that can impair development. Unfortunately, at the current time it is not possible to provide a definitive response to these questions, because observations of process quality have not been conducted for a nationally representative sample of children. In the absence of such a report, we must reply on existing data from multisite studies that provide suggestions about the distribution of quality of care in the United States.

The Cost, Quality, and Outcomes Study (Helburn et al., 1995) provides a perspective on center-based care. ECERS assessments were conducted in 398 centers located in four states that varied in economic health and child care regulations. In that study, 12 percent of the centers received ECERS scores lower than 3, indicating care that was less than minimal quality, and 15 percent received ECERS scores higher than 5, indicating good-quality care. The remainder of the centers were evenly divided between those receiving scores in the 3s (37 percent) and scores in the 4s (37 percent). This distribution of quality scores in the observed settings, however, may be an optimistic view. The observed centers represented only 52 percent of the eligible centers; the remainder declined to participate. It seems likely that the nonobserved settings offered care that was lower in quality.

The Relative and Family Day Care Study (Kontos, Howes, Shinn, and Galinsky, 1995) provides a perspective on quality of care in homes. FDCRS scores were obtained in 226 child care homes and relative care settings in three communities. Minority race, low-income, and nonregulated home settings were over sampled so that the investigators could study the effects of these factors on observed quality. In that study, 34 percent of the child care homes received FDCRS scores of less than 3 and were described as “inadequate,” 58 percent were “adequate/custodial,” and 8 percent were “good.” These unadjusted quality estimates are probably negatively biased, because two of the three states (Texas and North Carolina) have less stringent regulations for child care homes than other states and because nonregulated and low-income settings were over sampled.

Perhaps the best available estimate of process quality for children 3 years or younger is provided by the NICHD Study of Early Child Care. Observations were conducted in nine states (Arkansas, California, Kansas, Massachusetts, North Carolina, Pennsylvania, Virginia, Washington, Wisconsin) and included urban, suburban, and rural communities. The distribution of child care regulations in those states paralleled those in the United States. Observations were conducted in all types of nonmaternal care settings, including grandparents, in-home caregivers, child care homes, and centers. A total of 612 child care settings were assessed at 15 months, 630 child care settings at 24 months, and 674 child care settings at 36 months.

The study sample of 1,364 families was drawn from hospitals at the 10 research sites and included ethnic minorities (24 percent), mothers without a high school education (10 percent), and single-parent households (14 percent) as well as white, middle-class and two-parent households. At 15 months, 17 percent of the households had incomes below established poverty levels (income-to-needs ratio < 1.0). An additional 18 percent of the sample had incomes near poverty (income to needs ratio 1.0 –1.99) (NICHD Early Child Care Research Network, 1997). The sampling plan yielded a large and diverse sample, but it is not nationally representative. The sampling plan also did not include adolescent mothers (3.8 percent of the potential families in the hospitals), mothers who did not speak English (4.4 percent), and infants of multiple births, with obvious disabilities, or extended hospital stays postpartum (7.7 percent of the births).

Results from the NICHD Study of Early Child Care observations (NICHD Early Child Care Research Network, in press-a) are summarized in Table 9. ORCE ratings less than 2 indicate poor-quality care. Scores of 2 to less than 3 indicate fair-quality care. Scores equal to 3 but less than 3.5 indicate good-quality care, and scores of 3.5 or higher indicate excellent-quality care. Care was most often judged to be only fair in quality. Relatively little care was observed at the extremes, with 6 percent of the settings offering poor quality care and 11 percent of the settings offering excellent care. Poor-quality care was more likely in centers serving infants and toddlers than in centers serving older children (10 percent versus 4 percent).

An extrapolation to the quality of care in the United States was derived by applying NICHD observational parameters, stratified by maternal education, child age, and care type to the distribution of American families documented in the National Household Education Survey (1998).2  This stratification was needed because the NICHD investigators determined that variations in process quality were associated with these three factors. Based on the numbers of children of particular ages using specific different types of care, positive caregiving was estimated to be of poor quality for 8 percent of children under 3 years in the United States, fair quality for 53 percent, good quality for 30 percent, and excellent quality for 9 percent. These distributions suggested to the investigators that care is “neither outstanding nor terrible, but plenty of room for improvement [remains].”

The quality of child care in the United States also can be estimated based on reports of structural and caregiver characteristics. Drawing on empirical research and advice from professionals in the field, organizations such as the American Academy of Pediatrics and the American Public Health Association (1992) have established age-based guidelines for group size and child:adult ratio. For example, the recommendations for child:adult ratios are 3:1 for children from birth to 24 months, 4:1 for children from 25 to 30 months, 5:1 for children from 31 to 35 months, 7:1 for 3-year-olds, and 8:1 for 4-year-olds.

Table 10 lists regulations for child:adult ratio and group size for each of the 50 states as compiled by the Center for Career Development in Early Care and Education (1999). It is clear that very few states have regulations as strict as those recommended by professional organizations. For example, only three states have the recommended 3:1 ratio for infants, and only one state has the recommended 3:1 ratios for 18-month-olds. Two states have ratios consistent with the recommended 5:1 ratio for 3-year-olds. Some states are at substantial odds with the recommended standards. For example, eight states have child:adult ratios of 6:1 for infants. There is a similar failure to meet recommended group size standards, with 20 states having no regulations pertaining to group size.

Another way of estimating the quality of care in the United States is to consider reports of structural and caregiver characteristics. One nationally representative survey, the Profile of Child Care Settings (Kisker, Hofferth, Phillips, and Farquhar, 1991), obtained this information in 1990 from child care centers, early education programs, and licensed child care homes. According to the Profile, the average child:adult ratio was 4:1 for infants under 1 year of age, 6:1 for 1-year-olds, and 10:1 for preschoolers. This report indicates that the average center and child care home in 1990 did not meet standards for child:adult ratios that have been linked to higher quality. In contrast, the Profile of Child Care Settings found that caregivers tended to be well educated and to have specialized training pertaining to children. Nearly half of all teachers reported that they had completed college (47 percent) and an additional 13 percent reported a two-year degree. Most of the remaining teachers had a Child Development Associate (CDA) (3)credential (12 percent) or some college experience (15 percent). Only 14 percent did not have any education beyond high school. Ninety percent of the teachers in child care centers reported that they had received at least 10 hours of in-service training.

The Profile survey found that regulated child care home providers had less formal education and training than teachers in centers. Approximately 11 percent of regulated home providers reported that they had completed college; 34 percent had no schooling beyond high school. About two-thirds had received specialized in-service training. This study represents the best available information regarding structural and caregiver characteristics from nationally representative samples. The survey is dated, however, in that the data were collected in 1990, so the reports may not reflect current structural and caregiver characteristics.

Published reports from two additional national surveys are less useful for this issue. The National Child Care Survey,1990, and the National Household Education Survey, 1995, collected information from parents regarding child:adult ratios and caregiver training. The published reports from these surveys (Hofferth et al., 1991; Hofferth et al., 1998), however, did not present ratio and group size information separately by children’s age. As a result, it is not possible to use the reports to evaluate the percentage of child care settings that meet (or fail to meet) standards for infants, toddlers, and preschoolers that are set differently. A second limitation of these reports is that parents may not be accurate respondents of these quality parameters.

A third source of evidence pertaining to structural and caregiver characteristics is the NICHD Study of Early Child Care (NICHD Early Child Care Research Network, 1999a). In that study, child:adult ratios were observed at regular intervals and caregivers reported their educational background and specialized training. The percentage of center classrooms that met the AAP and APHA recommendations for child:adult ratio and group size is shown on Table 12. Also shown are the percentage of classrooms in which caregivers had at least some college and specialized training. As indicated, 36 percent of the infant classrooms were observed to have the recommended child:adult ratios of 3:1. Fifty-six percent of caregivers in infant classrooms had received specialized training during the preceding year; 65 percent of infant caregivers had some college courses. Proportions were similar for toddler care (the 15- and 24-month-olds). When compared to figures reported in the Profile of Child Care Settings, the NICHD figures suggest that there has been some decline in the educational background and training of child care staff during the 1990s.

The decrease in caregiver education and training may be related to the generally low wages in the child care field (see Figure 3).

Figure 3. Median Earnings of Highest and Lowest Paid Teachers or Assistants Relative to Full-Time Wages of Women 25+; 1992, 1997.

In 1997, child care teachers averaged $7.50–$10.85 per hour, or $13,125–$18,988 per year, when they were employed for a 35-hour week and a 50-week year. Wages for assistant teachers were $6.00 to $7.00 an hour (or $10,500–$12,250 per year). Figure 1 shows salaries for lower-paid and higher-paid child care workers relative to the median salaries of women 25+ by level of education for both 1992 and 1997. The figure shows the low salaries of child care workers relative to other occupations and indicates that there has not been any improvement in terms of the relative salaries over the 1992–1997 time period for most levels of education. While high school graduates who were child care teachers or assistants could only earn between 73 and 85 percent of the salaries they might expect to receive elsewhere, the relative salaries were far lower relative to the median for women with more schooling. A child care teacher with a B.A. degree could expect to earn between 52 and 75 percent of the median salaries across all occupations. Current child care salaries are not consistent with attracting and keeping providers who have the level of education and training that research suggests is needed to structure emotionally supportive and cognitively stimulating learning environments.

The generally low salaries earned by child care staff also appear to be a factor contributing to high staff turnover in the child care field (see Figure 4).

Figure 4. Staff Turnover by Prior Year's Wages.

In 1997, 27 percent of teachers and 39 percent of assistants left their jobs during the previous year (Figure 5 and Whitebook, Howes, and Phillips, 1998).

Figure 5. Turnover Rates, All Staff, All Centers.

Twenty percent of centers reported losing half or more of their staff. Centers that offer higher wages have lower turnover rates than centers that offer lower wages (Whitebook et al., 1998).

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