Often maltreated children have difficulty functioning in a regular daycare or preschool setting because of problem behavior. As a result, therapeutic daycare centers and preschools were created and are commonly recommended for abused infants and preschoolers (Brown, 1995). These programs offer children a supportive, nurturing environment and individualized service to address these children's emotional, developmental, and social needs through the collaboration of a multidisciplinary treatment team. Children may receive social skills training, modeling, individual therapy, group therapy, nutrition, medical referrals, and pharmacological assistance. Their parents may also receive parent training, social support, and child development education.
Despite their popularity, these programs are rarely evaluated for their efficacy by using sound methodological evaluation designs (Wolfe & Wekerle, 1993). However, one experimental study found that maltreated children in therapeutic daycare demonstrated better functioning 12 years later with respect to drug use, delinquency, and arrest for violent crime than maltreated children who received regular daycare (Moore, Armsden, & Gogerty, 1998).
Although the majority of studies use nonexperimental designs and unstandardized assessment measures, those evaluation studies that have used before and after measures (without control groups) have found that maltreated children enrolled in therapeutic preschools show improved cognitive skills, social competence, and emotion regulation (Anderson, 1981; Wolfe & Wekerle, 1993). Nonexperimental research suggests that therapeutic preschools are associated with the reduction of problem behaviors (Anderson, 1981; Whitemore, Ford, & Stack, 2003) and improved cognitive functioning (Whitemore et al., 2003). Additionally, this research has found that a majority of participants of therapeutic preschools are able to function in a regular classroom after they graduate from the therapeutic preschool (Gray, Nielson, Wood, Andresen, & Dolce, 2000; Oates, Gray, Schweitzer, & Kempe, 1995; Whitemore et al., 2003). This finding is thought to be an unlikely outcome for untreated children, although no comparison with a control group is available.
Although scientific rigor is often lacking with respect to evaluations of therapeutic daycare, nonexperimental investigation suggests that children enrolled in these programs do show improved motor, social, cognitive, and emotional functioning at the program's end. One experimental study showed that children who participate in these programs demonstrate fewer conduct problems in adolescence than their maltreated peers who did not receive therapeutic services in a daycare or preschool milieu (Moore et al., 1998). The meaningfulness of this single study on therapeutic daycare is buttressed by long-term findings for other, similar early interventions with high-risk children (albeit not children selected because they were maltreated), including the Abecederian Project (Campbell, Pungello, Miller-Johnson, Burchinal, & Ramey, 2001), the Perry Preschool Project (Brooks-Gunn, 2000), and the Chicago Child-Parent Centers (Smokowski, Mann, Reynolds, & Fraser, 2004).