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�Infant Child Care and Attachment Security: Results of the NICHD
Study of Early Child Care
1
NICHD Early Child Care Research Network
Symposium, International Conference on Infant Studies
Providence, RI, April 20,1996
This study is directed by a Steering Committee and supported by NICHD through a
cooperative agreement (U10), which calls for scientific collaboration between the
grantees and the NICHD staff. The participating investigators are listed in alphabetical
order with their institutional affiliations designated by number: Mark Appelbaum (14);
Dee Ann Batten (14); Jay Belsky (2); Cathryn Booth (12); Robert Bradley (4); Celia
Brownell (9); Bettye Caldwell (4); Susan Campbell (9); Alison Clarke-Stewart (5);
Jeffrey Cohn (9); Martha Cox (8); Kaye Fendt (1); Sarah Friedman (1); Kathryn HirshPasek (3); Aletha Huston (6); Bonnie Knoke (1); Nancy Marshall (15); Kathleen
McCartney (7); Marion O'Brien (6); Margaret Tresch Owen (10); Deborah Phillips (11);
Henry Ricciuti (1); Susan Spieker (12); Deborah Lowe Vandell (13); Marsha Weinraub
(3). The institutional affiliations, in alphabetical order, are the National Institute of Child
Health and Human Development (1); Pennsylvania State University (2); Temple
University (3); University of Arkansas at Little Rock (4); University of California, Irvine
(5); University of Kansas (6); University of New Hampshire (7); University of North
Carolina-Chapel Hill (8); University of Pittsburgh (9); University of Texas-Dallas (10);
University of Virginia (11); University of Washington (12); University of WisconsinMadison (13); Vanderbilt University (14); Wellesley College (15). We wish to express
our appreciation to the study coordinators at each site who supervised the data collection,
to the research assistants who collected the data, and especial y to the families and childcare providers who welcomed us into their home and workplaces with good grace and
cooperated willingly with our repeated requests for information.
�Infant Child Care and Attachment Security: Results of the NICHD
Study of Early Child Care
Welcome
Welcome to our symposium, "Infant Child Care and Attachment Security:
Results of the NICHD Study of Early Child Care". The author of this symposium is the
NICHD Early Child Care Research Network, comprising the following investigators
listed in alphabetical order: Mark Appelbaum, Dee Ann Batten, Jay Belsky, Cathryn
Booth, Robert Bradley, Celia Brownell, Bettye Caldwell, Susan Campbell, Alison
Clarke-Stewart, Jeffrey Cohn, Martha Cox, Kaye Fendt, Sarah Friedman, Kathryn HirshPasek, Aletha Huston, Bonnie Knoke, Nancy Marshall, Kathleen McCartney, Marion
O'Brien, Margaret Owen, Deborah Phillips, Susan Spieker, Deborah Vandell, and
Marsha Weinraub. The past chairs of our Steering Committee were Henry Ricciuti and
Bettye Caldwell, and our current chair is Lew Lipsitt.
Those of us who will be speaking represent the entire group, and the text from
which we will speak has been approved by everyone., The presenters are myself, Cathryn
Booth, Sarah Friedman, Alison Clarke-Stewart, Susan Spieker, Jay Belsky, and Kathleen
McCartney. Eleanor Maccoby is our discussant. We have allowed time for discussion at
the end, so please hold your questions and comments until then. If you would like to
receive a complete copy of this presentation, please sign up at the table in the back of the
room.
Role of NICHD and History of Study
By the time you walk out of this invited symposium you will have heard findings
about the effects of different aspects of child care on the attachment security of 1153
infants. This outcome is one of many we are measuring in the NICHD Study of Early
Child Care, which is the largest and most comprehensive ongoing longitudinal study of
child development and of the effects of child care on such development in the first seven
years of life.
The authorship list for the presentations you will hear is longer than any we are
used to in our scientific field. This calls for an explanation. Therefore, I will pose and
answer two questions: First, how did the many investigators who work collaboratively
on this study get together to form a network ?
The National Institute of Child Health and Human Development, or NICHD,
routinely supports "cooperative agreements," which are research projects that are initiated
by NICHD and are carried out by a small number of NICHD staff in collaboration with
many other investigators in the scientific community. Cooperative agreements are
established to address scientific or important public health concerns that cannot be
addressed by small studies.
Concerns about the effects of early child care on the development of children have
been addressed by scientists for many years, but no one investigator or team mounted an
investigation that could take into account all the critical family, child, and child-care
variables that are hypothesized to influence the development of young children. Dr.
Duane Alexander, the Director of NICHD has been aware of the high prevalence of early
child care and the concerns of the public regarding such care. Following a National
Academy of Science conference on the topic that pointed out the need for research, he
�asked NICHD staff to work with the scientific community to develop an NICHDsupported, comprehensive, cutting-edge study about the effects of child care.
Early in 1988, NICHD issued a request for applications calling on investigators to
participate as members of a research network. Of those interested, 10 teams of
scientifically meritorious investigators were selected. It so happens that those invited to
participate in the network included investigators who championed different
interpretations of the then available information about the effects of early child care on
the attachment of infants to their mothers.
I will now turn to question # 2: How have the many investigators managed to
collaboratively plan and implement such a large study ? The NICHD and the
participating investigators have established organizational structures and lines of
communication that made it possible to plan one study to be carried out at ten sites. All
scientific plans have been made centrally by the Steering Committee, which consists of
an independent chairperson, one representative from each of the ten grantee teams, and
representatives from NICHD, from the central Data Coordinating Center, and from the
central Data Analysis Center. In other words, the 14 members of the Steering Committee
are the collective Principal Investigator for the study.
Briefly, the response to the second question is that the many investigators manage
to collaboratively plan and implement the study thanks to their wish to work together,
thanks to the availability of centralized organizational structures established for the
purpose of coordinating important aspects of the study (including training and
certification of research assistants, coding of videotaped data, data management, and data
analysis), and thanks to extensive electronic and face-to-face communications.
So, as you listen to the results about the effects of early child care on attachment,
please remember that the findings are the product of a true collaboration of many minds.
Introduction
The prospect that routine nonmatemal care in thefirstyear of life might adversely
affect the security of the infant's attachment to mother has been a subject of much
discussion and debate over the past decade and a half, and discussion and debate continue
to this day. It began when people realized that the dangers of institutional rearing, which
were known to cause serious cognitive and emotional deficits in young children, might
apply to children in child care. And it received support when it was discovered that
children in full-time nonmatemal child care during infancy were more likely that those
cared for at home by their mothers to exhibit insecure attachments to their mothers. In
one of the first multi-study analyses of published research linking infant child care and
attachment classifications, Belsky and Rovine, in 1988, evaluated child-care effects in
five homogenous samples of maritally-intact, middle-and working-class families, with a
total N of 491. They found that infants who experienced 20 or more hours per week of
routine nonmatemal care in thefirstyear were significantly more likely to be classified as
insecurely attached to their mothers between 12 and 18 months of age than were infants
with more limited child-care experience. The difference was particularly marked for
insecure-avoidance. In a subsequent analysis of 1247 infants from a more heterogeneous
set of studies, some of them unpublished, Clarke-Stewart documented a similar
significant association in 1989. Quite consistent across these two multi-study
investigations was the extent to which early and extensive child care, defined as 20 or
more hours per week of routine nonmatemal care in thefirstyear, increased the risk of
insecure infant-mother attachment.
�A variety of explanations were advanced to account for these differences.
Barglow, Vaughn, and Molitor (1987) interpreted the elevated rates of insecure
attachment, especially insecure-avoidant attachment, as evidence that babies experience
daily separations as maternal rejection. Jaeger and Weinraub (1990) suggested that
proximal processes of mother-infant interaction might be the mediator that was affected.
Brazelton (1985) argued that time away from baby might undermine a mother's ability to
respond sensitively to the child and this would reduce the probability that a secure
relationship would develop. And Sroufe (1988) suggested that daily separations might
both cause the infant to lose confidence in the availability and responsiveness of the
parent and reduce the opportunities for "ongoing tuning of the emerging infant-caregiver
interactive system".
But the studies that demonstrated this difference in attachment security related to
hours in child care, were conducted in the late 1970's and the early 1980's, at a time
when it was less common for mothers of infants to work full time than it is today. Today,
more than half the mothers of infants under one year of age are in the labor force, and in
the NICHD Study, over half of the infants were receiving 30 or more hours of
nonmatemal care by the end of the first year. It is of interest, then, that a more recent
investigation of child care by Roggmann, Langlois, Hubbs-Tait & Rieser-Danner (1994)
revealed no significant relation between nonmatemal tare experience and attachment
security. These investigators suggested that inquiries like theirs, yielding nonsignificant
findings, are likely to succumb to the "file-drawer problem," thereby skewing the data
that find their way into the published literature in the direction of significant differences
between groups of children with and without child-care experience. However attractive
this explanation might be, the possibility must be entertained that in the arena of childcare research, the opposite problem can also occur. That is, in a field of inquiry where
the results are controversial and politically sensitive,findingsof significant differences,
too, may be relegated to the file cabinet.
The NICHD Study of Early Child Care was undertaken, in part, to establish
convincingly whether, in the 1990s, there is an association between participation in
nonmatemal infant child care and infants' attachment to mother, and if so, how such an
association might be explained. The sample of infants assessed in the NICHD Study is as
large in terms of sample size as all the studies combined in Clarke-Stewart's multi-study
meta-analysis. 1364 infants were enrolled in the study soon after birth, and 1201
continued through the first 15 months and were assessed in the Strange Situation. This
Study has the advantage of being a prospective, longitudinal investigation, in which
subjects were identified at birth, before their child care had begun. The kinds and amount
of child care the children received were determined solely by their parents and tracked
and observed by the researchers over the first three years of life.
The study design of the NICHD Study was unique in the opportunity it provided
to examine the effects of child care "in context." As the overhead (Figure 1) shows,
child outcomes were studied in the context of family and maternal characteristics, such as
maternal personality and attitudes, social stresses and supports; family demographic
characteristics, such as income and education; the home environment, including
physical, organizational and behavioral qualities; and child characteristics. This feature of
the project is an important one for trying to understand the causes of any differences
observed. The research that has demonstrated elevated rates of insecurity among infants
with early and extensive child-care experience in the past has not found insecurity among
ALL infants in early and extensive child care. In fact, according to the multi-study
analyses, the majority-about 60%-of the infants with early and extensive child-care
experience do develop secure attachments to their mothers. Thus, whether infant childcare experience leads to insecurity may depend upon the nature of the care received and
�the ecological context in which it is embedded. More specifically, the effect of child care
may depend on characteristics of the care itself, such as the type of care, the quality of
care, the amount of care, the age at which the infant entered care, and the stability of care.
In addition, the effect of care may depend on characteristics of the child, especially the
child's sex and temperament. And third, the effect of care may depend on characteristics
of the family, including the mother's social, psychological and economic resources.
These components of the child-care context may interact with one another in shaping
developmental outcomes, including attachment security. It was our goal to examine the
effects of nonmatemal care in the context of these factors. For that reason, we included
measures of multiple features of the family, the child, and the child's nonmatemal childcare experience.
Our primary aim was to test three general hypotheses about how these potentially
influential factors might operate. The first is the "main effects hypothesis," which
suggests that children in early, extensive, unstable, or poor quality care will have an
increased likelihood of insecure attachment, independent of conditions at home or in the
child. The second hypothesis is the "dual-risk hypothesis," which stipulates that large
amounts of care or poor quality of care or changes in care arrangements over time would
promote insecure attachment principally when the child is otherwise at risk, for example,
by having a difficult temperament, being a male, or residing in a home in which mother is
depressed or the quality of care she provides is relatively insensitive. The third
hypothesis is the "compensatory hypothesis." This hypothesis, in contrast to the others,
stipulates that when family or child risks are high, then nonmatemal care that is early,
extensive, or of high quality will stabilize the child's experience and thereby foster the
formation of a more secure infant-mother attachment.
Before the hypotheses were tested, however, we examined the validity of the
Strange Situation for assessing attachment in children with extensive child-care
experience. This was necessary because the argument has been made by Clarke-Stewart
(1989) and others that the observed difference in attachment security between children
with and without child care experience could be a result of the fact that children who have
experienced the multiple separations associated with child care are not especially stressed
by the Strange Situation episodes designed to elicit attachment behavior. As a
consequence, these children engage in less proximity seeking and more exploration
during the critical reunion episodes than other children, which may be mistakenly
regarded by coders as avoidance. Thus, some children who are actually securely attached
to their mothers and behave as independent explorers in the Strange Situation may be
classified erroneously as insecure-avoidant, thereby elevating the rate of insecurity among
children with child-care experience and creating the effect documented in the multi-study
meta-analyses.
Therefore, we undertook a "preliminary" set of analyses to compare a subsample
of infants who experienced extensive nonmatemal care, with a sample of infants who
experienced very little nonmatemal care during their first 15 months, in terms of their
distress during separations in the Strange Situation and the confidence with which coders
assigned them secure or insecure classifications.
In brief, then, the purpose of the work we will describe in this symposium was
four-fold: (1) first, to determine if attachment classifications were equally valid for
infants with and without extensive child care experience in the first year of life; (2)
second, to identify differences in the probability of attachment security in infants with
varying child-care experience, in terms of quality, amount, stability, age of entry, and
type of care; (3) third, to identify the combination of factors (mother/child and child-care)
under which nonmatemal care experience was associated with increased or decreased
�rates of attachment security; and (4) fourth, to determine whether early child care
experience was associated specifically with insecure-avoidant attachment.
Method
Participants in the NICHD Study of Early Child Care were recruited from 31
hospitals throughout 1991 at 10 locations around the country. Table 1 lists the
participating sites: Little Rock, Arkansas; Orange County, California; Lawrence and
Topeka, Kansas; Boston, Massachusetts; Philadelphia, Pennsylvania; Pittsburgh,
Pennsylvania; Charlottesville, Virginia; Morganton and Hickory, North Carolina; Seattle,
Washington; and Madison, Wisconsin.
Characteristics of the families for whom we have Strange Situation data, which is
84.5% of those recruited, are provided in Table 2. Participants were selected in
accordance with a conditionally-random sampling plan. The recruited families did not
differ significantly from the families in the catchment areas on the major demographic
and employment plan variables. Actual percentages for employment plans in the three
groups at the end of recruitment were 53% full time, 23% part time, and 24% in exclusive
maternal care.
>
A partial Overview of Data Collection, including only those variables used in the
present report, is depicted in Table 3.
Home visits to the families occurred when the infants were 1, 6 and 15 months
old. At all home visits mothers reported on household composition and family income.
In addition, at the 1-month visit, mothers completed the NEO Personality Inventory and a
modified Attitude Toward Maternal Employment questionnaire; at 6-months, a modified
Infant Temperament Questionnaire; and at 1, 6, and 15 months, the Center for
Epidemiologic Studies Depression Scale. At the 6 and 15 month home visits mothers and
infants were videotaped in a 15-minute semi-structured play interaction and the home
visitor completed the Infant/Toddler HOME scale.
Observations in child care arrangements were conducted when the infants were 6
and 15 months old, using the Observational Record of the Caregiving Environment, or
ORCE, which was developed for this project. Telephone interviews to update child care
information were conducted at 3, 5, 9, 12, and 14 months.
The Strange Situation assessment of infant attachment security was conducted in a
laboratory playroom visit when the infants were 15 months old.
A major challenge to all studies of child care is the fact that care experience is not
randomly assigned. In order to reduce the risk of generating spurious findings, a number
of possible selection effects variables tapping family, mother and child care
characteristics were correlated with the child care parameters under study, that is, quality,
amount, stability, age of entry, and type of care, and with attachment security. Two
variables met our criteria for covariates in that they were related to both attachment
security and child care parameters, and were not highly correlated with any other eligible
covariate. These two were an Income-To-Needs Ratio and Beliefs About Benefits Of
Maternal Employment.
An income-to-needs ratio was computed from maternal interview items collected
at each home visit. Income was divided by the appropriate poverty threshold determined
by the year in which the income was earned, total family size, and number of full-time
children in household. This variable was averaged across the three assessments to create
�an overall Average Income to Needs ratio. Higher income-to-needs ratios were found to
be associated with higher quality care, more hours in care per week, more care
arrangements started, and earlier entry into care. Families with secure infants had higher
average income-to-needs ratios compared with families of insecure infants.
The Reliefs about Benefits of Maternal Employment scale was created by
summing five 6-point items from the Attitude Toward Employment questionnaire
administered at the 1-month visit. Cronbach's alpha was .80. Higher scores reflected the
belief that maternal employment was beneficial for children. Mothers who more strongly
believed that maternal employment had benefits for children's development began care
earlier, for more hours, than the children of mothers with weaker beliefs about the
benefits of maternal employment. Mothers of secure infants had weaker beliefs about the
benefits of maternal employment for child development compared with the mothers of
insecure infants.
Mother and Child measures are listed in Table 4.
A composite measure of the mother's Psychological Adjustment was created
based on three scales of the NEO Personality Inventory: Neuroticism, reflected;
Agreeableness; and Extraversion; plus the average of the three CES-D depression scores,
reflected. Cronbach's alpha was .80.
A maternal Sensitivity In Play composite was constructed on the basis of ratings
of videotaped episodes of mother-child play. Tapes from all sites were coded by a single
team of coders, using 4-point scales. A composite was created from the sum of the
individual scales for Sensitivity to Nondistress, Positive Regard, and Intrusiveness
(reflected). Cronbach's alphas were .75 and .70, for the 6- and 15-month composites,
respectively, and interobserver agreement was .87 AND .83 respectively. These two
scores were averaged to create the overall Sensitivity in Play composite.
A maternal Sensitivity in the Home composite was also constructed. The
Infant/Toddler HOME is a structured interview/observational procedure which involves
the home visitor answering a set of binary questions based upon maternal response to
specific queries, observations of materials in the home, and observations of the mother's
behavior toward the child. A sensitivity composite was computed by summing the
Positive Involvement factor score, and the Lack of Negativity factor score. The alphas
for the 6- and 15-month scores were, respectively, .60 and .64, and interobserver
agreement with a gold standard was maintained at a minimum of .91. The 6 and 15
month scores were averaged to create the Sensitivity in the HOME score used in these
analyses.
A Difficult Temperament score was created from fifty-five 6-point items from the
ITQ. Large scores reflect a more "difficult" temperament. Cronbach's alpha was .81.
Child care variables are listed in Table 5.
Observations of the child care settings were conducted on two half-days that were
scheduled within a two-week interval. During these sessions, observers scored child care
quality using the ORCE. Because the ORCE is used to assess the quality of caregiving
for an individual child rather than what happens at the level of caregivers or classrooms,
it is an instrument that can be used in home and center settings alike.
Data collection using the ORCE consisted of four 44-minute cycles spread over
two days. Each 44 minute cycle was broken into four 10-minute observation periods.
�Observers recorded the occurrence of specific behaviors directed to the study infant for
each minute during the first three 10-minute cycles. At each age a composite variable
was created by summing three standardized variables: Positive Behavior, Responsivity,
and Stimulation, created from individual items from the ORCE behavior scales. The
composite had very good internal consistency. The average of the composite scores at 6
and 15 months resulted in the quality variable of Positive Caregiving Frequency.
At the end of the fourth cycle, observers made qualitative ratings of the observed
caregiving. A second composite was based on 4-point qualitative ratings of the same
dimensions of caregiving behavior that were rated for the mothers in the structured play
task with their infants. The qualitative rating composite was created by summing
sensitivity to nondistress, stimulation of cognitive development, positive regard, and the
reflection of detachment andflatnessof affect. This composite also had very good
internal consistency and very good interobserver reliability. The average of the
composite scores at 6 and 15 months resulted in the quality variable of Positive
Caregiving Rating. Interobserver agreement on the Positive Caregiving Frequency and
the Positive Caregiving Ratings composites ranged from .86 to .98.
Table 6 describes the child-care characteristics of the sample used in these
analyses. Mothers provided information at the telephone calls and interviews that was
used to calculate the monthly average for number of hours in care per week. A composite
for Amount of Care was created by computing the mean hours per week of the monthly
care average from 4 through 15 months. Children who received no non-maternal care
through 15 months received scores of "0". Age of Entry into child care was classified into
4 time periods. The oldest age category was also used for children not in care.
Frequency of Starts of care arrangements was the number of different arrangements the
child experienced through the first 15 months. At 5 and 14 months, information from the
ihone calls was used to classify Type of Care arrangement: mother, father, relative, inlome non-relative, child-care home, and child-care center, for the arrangements that were
observed at 6 and 15 months.
The Attachment variables arg listed in Table 7. The Strange Situation is a
25-minute procedure containing brief episodes of increasing stress for the infant,
including two mother-infant separations and reunions. On the basis of the Strange
Situation procedure, the nature of the child's attachment relationship with mother is
categorized as secure, B, or insecure, A, C, D, or U. When stressed, secure infants seek
comfort from their mothers, which is effective and permits the infant to return to play.
Insecure-avoidant, A, infants tend to show little overt distress and to turn away from or
ignore the mother on reunion. Insecure-resistant, C, infants are distressed and angry, but
ambivalent about contact, which does not effectively comfort and allow the children to
return to play. Examples of insecure-disorganized/disoriented, D, behaviors are
prolonged stilling in contact, rapid vacillation between approach and avoidance, severe
distress followed by avoidance, and expressions of fear or disorientation at the entrance
of the mother. Occasionally, a case that cannot be assigned an A, B, C, or D
classification is given the unclassifiable, or "U" code. The U classifications, comprising
3.5% of the sample have been eliminated from the major analyses in this report.
The Strange Situation was administered according to standard procedures by
research assistants who had been trained and certified according to a priori criteria to
assure that the assessments were of very high quality. The Strange Situation episodes
from all sites were shipped to a central location which was differentfromthe one
responsible for coding mother-child interaction, and rated by a team of three highly
experienced and intensely supervised coders.
�The three coders double-coded all Strange Situation assessments. A l l
disagreements were viewed by the group and discussed until a code was assigned by
consensus. Across all coder pairs, before conferencing, agreement on the 5-category AB-C-D-U classification system for the 1153 cases used in these analyses was 83% and
Kappa was .69. Agreement for the 2-category, secure/insecure classification system was
86%, and Kappa was .70.
Individual coders rated their Confidence in each classification on a 5-point scale.
Thefive-pointconfidence rating was related to inter-rater agreement in expectable ways.
When both coders' confidence ratings were 3 or higher, as they were for 87% of the
cases, agreement on A B C D U was 94%, and Kappa was .86.
Distress during each mother-absent episode was rated on a 5-point scale. Distress
ratings were summed across the three separation episodes to create a total Distress score,
which could range from 3 to 15. Cronbach's alpha was .84, and intercoder agreement
was excellent.
Results
Two sets of results will be presented, a preliminary set addressing issues of the
validity of the Strange Situation, and a primary set addressing the effects of child care.
The preliminary analyses were undertaken to evaluate both the internal and
external validity of the Strange Situation. Two analyses were conducted in order to
explore the "internal validity" of the Strange Situation for children with varying amounts
of early child care. In these analyses we examined only two extreme groups of children:
those with less than 10 hours of child care per week for every month from 0 to 15
months, the "low intensity" group, with an n of 263, and those with 30 or more hours per
week in eveiy month from 3 to 15 months, the "high intensity" group, with an n of 257.
In these preliminary analyses the 5-category classification, A B C D U, was used.
As mentioned earlier, one theoretical challenge to the validity of the Strange
Situation for children with extensive child care is the hypothesis that they are not
distressed by separation from their mothers. We examined this possibility in the first
internal validity analysis: a 2 by 5, Intensity Group by Attachment Classification
ANOVA on the Distress rating. The results are shown in Table 8. The difference
between extreme child-care groups was not significant. A significant Intensity Group by
Attachment Classification interaction resulted from the D infants in the high intensity
child care group showing more distress than their counterparts in the low intensity group .
The differential validity of the Strange Situation would be supported by finding
lower confidence ratings in the high intensity group compared with the low intensity
group. Such a finding would suggest that infants in theliigh intensity group exhibited
behavior that made judging the quality of their secure base behavior difficult. Table 8
gives the results of the second internal validity analysis: a 2 by 5, Intensity Group X
Attachment Classification ANOVA on the Confidence rating. The difference between
the two extreme groups was not significant. A significant Intensity Group by Attachment
Classification interaction resulted from the U infants in the high intensity group being
coded with higher confidence than the U infants in the low intensity group.
Neither this nor the earlier interaction regarding distress were theoretically
predicted. Therefore, we concluded that the Strange Situation was equally valid for
children with early and extensive child care, and for those without.
�10
We proposed that the "external validity" of the Strange Situation at 15 months
would be demonstrated by showing that more children whose mothers scored in the
highest quartiles for Sensitivity in Play, Sensitivity in the HOME, and Psychological
Adjustment were securely attached compared with children whose mothers were in the
lowest quartile on these three predictors .
Table 9 shows that this cross tabulation was significant for two of the three
analyses. Overall, mothers in the lowest quartiles for Sensitivity in the HOME and
Psychological Adjustment had fewer secure infants compared with mothers in the highest
quartile . Based on these analyses, we concluded that the attachment classifications in
this study were related in expectable ways to external correlates.
Having demonstrated the internal and external validity of the Strange Situation,
we proceeded with the primary analyses. Two parameterizations of attachment categories
were selected: Secure vs. Insecure, and Secure vs. Insecure-Avoidant. Use of the
Secure/Insecure dependent variable afforded the testing of child-care effects at the most
global level of adaptive versus maladaptive child outcomes. Use of the Secure/Avoidant
dependent variable parameterization afforded the testing of the proposition that infant
child-care experiences may specifically elevate the incidence of insecure-avoidant
attachment to mother.
>
In a series of logistic regression analyses, the dependent variable, either
Secure/Insecure or Secure/Avoidant, was predicted from (a) one of five characteristics of
the mother or child, (b) one of five characteristics of child care, and (c) the interaction
between the two selected variables. The mother/child variables, as shown in Table 10
were: maternal Psychological Adjustment, maternal Sensitivity in Play, maternal
Sensitivity in the HOME, child Temperament, and Sex. The child-care variables, also
shown in Table 10, were the two observational measures of quality, Positive Caregiving
Frequency and Positive Caregiving Ratings, as well as Amount of Care, Age of Entry,
and Frequency of Care Starts.
We judged this analysis plan to be preferable to one that included all 5
mother/child variables, all 5 child-care variables, and all possible interactions among
these variables in a single analysis, because of concerns about multicollinearity among
predictors. In addition, it was impossible to include all subjects in a single analysis
because some of the child-care variables, namely, age of entry, amount of care, and
stability of care, involved the total sample, whereas the positive caregiving frequency and
the positive caregiving ratings were available only for those subjects observed in
nonmatemal care.
In each regression analysis, control variables reflective of selection effects,
namely, Income-to-Needs Ratio, and Benefits of Work, were entered first and then the
"main effect" of a mother or child characteristic was tested.
In the first set of logistic regression analyses, Secure/Insecure was the dependent
variable. Among the five mother/child variables, two were significant predictors of
Secure/Insecure, as shown in Table 11, namely. Psychological Adjustment and
Sensitivity in the HOME. As expected, mothers who exhibited greater sensitivity
towards their infants and who had better psychological adjustment were more likely to
have securely-attached infants. Neither child temperament nor sex, nor maternal
sensitivity in play predicted attachment security, as main effects, once control variables
were included.
�11
As shown in Table 12, none of the five child-care variables, entered after the
mother/child variables, significantly predicted attachment security. That is, variations in
the observed quality of care, the amount of care, the age of entry, and frequency of care
starts did not, in and of themselves, increase or decrease a child's chances of being
securely- or insecurely attached to mother.
Six of the 25 interaction terms, shown in Table 13, were significant predictors of
attachment security: (a) Sensitivity in Play X Positive Caregiving Frequency, (b)
Sensitivity in Play X Positive Caregiving Ratings, (c) Sensitivity in Play X Care Starts,
(d) Sensitivity in the HOME X Positive Caregiving Ratings, (e) Sensitivity in the HOME
X Amount of Care, and (f) Sex X Amount of Care.
The nature of these significant interactions was explored in more detail by
transforming the continuous variables into discrete categories by the following procedure.
For maternal sensitivity and quality of care variables, such as the Sensitivity in Play X
Positive Caregiving Frequency interaction shown in Table 14, the continuous form of the
variable was transformed into discrete categories reflecting low, moderate, or high
sensitivity or low, moderate, or high quality. Subjects who were in the highest quartile
on any given variable (such as Sensitivity in Play) were in the "high" group, and subjects
in the lowest quartile were in the "low" group. The "moderate" group comprised the
subjects in the middle 50% of the distribution for that particular variable.
Examination of the three tables corresponding to the significant maternal
sensitivity by child-care quality interactions indicate a consistent pattern, namely, the
lowest proportion of secure attachment was obtained under "dual risk" conditions. Table
14 shows that when Sensitivity in Play was low and Positive Caregiving Frequency was
also low, the proportion of secure attachment was lowest. Table 15 shows a similar
pattern for the Sensitivity in Play X Positive Caregiving Ratings interaction, and this
pattern is repeated in Table 16 for the Sensitivity in the HOME X Positive Caregiving
Ratings interaction. Taken together, these three tables indicate that the risk of insecure
attachment is elevated when the mother is relatively insensitive and the quality of child
care is relatively poor.
For two of the remaining significant interactions, the dual-risk theme was evident
but less pronounced. Table 17 shows the Sensitivity in the HOME X Amount of Care
interaction. For Amount of Care we used cut points reflecting full time (>30 hrs/wk),
)art-time (10 - 30 hrs/wk) and minimal care (<10 hrs/wk). We found that security was
ess likely under conditions of low maternal sensitivity, coupled with 10 or more hours of
care.
Table 18 shows the Sensitivity in Play X Care Starts interaction. For Care Starts,
the discrete categories were 0,1, or >1 start. The children experiencing low maternal
sensitivity combined with relatively unstable care had among the lowest rates of secure
attachment.
A different pattern was evident in Table 19, which shows the Sex X Amount of
Care interaction. The proportion of security was lowest among boys in more than 30
hours of care per week, but was equally low for girls in less than 10 hours of care per
week.
For the Secure/Insecure analyses yielding significant two-way interactions, we
sought to determine whether consideration of additional child-care conditions would
further illuminate the dual-risk pattern of results. For example, among children
experiencing low maternal sensitivity and low-quality child care, could the increased risk
�12
of insecurity be explained by the number of hours in child care? Within the subsample of
participants at dual risk in any given analysis, attachment security was crossed with an
additional child care variable, that is, quality, amount of care, age of entry, care starts,
type of care at 5 mos, and type of care at 14 mos, grouped into the discrete categories
already described. For example, Security was crossed with Amount of Care within the
group of children at dual risk due to maternal insensitivity on the HOME and poorquality child care, as measured by positive caregiving ratings. The results indicated that
the dual-risk interpretations could not be illuminated further by the consideration of
additional child-care variables.
In addition to considering additional child care variables in the context of dual
risk, we sought to determine whether a compensatory effect of high-quality child care
was present in the group receiving low maternal sensitivity and high-quality care. One
way to look at this is that compensatory effects are simply the flip side of dual risk, that
is, among relatively insensitive mothers, the proportion secure should increase as quality
of child care increases. Another way to test for compensatory effects is to look at the
effect of number of hours spent in high-quality child care among the children
experiencing low maternal sensitivity. We reasoned that if compensatory processes were
operating, then under conditions of low maternal sensitivity, the proportion of secure
attachment would be greater in full-time high-quality ichild care than in part-time highquality care.
As shown in Table 20, for the Sensitivity in Play X Positive Caregiving
Frequency analysis, the proportion of secure attachment increased as the quality of child
care increased in the low sensitivity group. However, among the children who received
high-quality care, the proportion of security was .56 FOR children spending more than 30
hrs/wk in care and .65 FOR those spending 10-30 hrs/wk, which is the opposite of what
we expected.
For the Sensitivity in Play X Positive Caregiving Ratings analysis shown in Table
21, a linear increase in security as quality increased was not observed. However, the
proportion of security was higher in full-time care than in part-time, as expected. For the
Sensitivity in the HOME X Positive Caregiving Ratings analysis shown in Table 22,
security increased with quality, but the proportion was higher for part-time care than for
full-time care.
As a final piece of evidence, Table 23 shows that the less time children of
insensitive mothers spent apart from them in child care, the more likely they were to be
securely attached. If compensatory processes were operating, we would expect security
to be less probable in this group. In sum, data on compensatory effects were mixed and
not as consistent as those pertaining to dual risks.
Table 24 summarizes the results of the Secure/Insecure logistic regression
analyses, showing the main effects for mother/child variables, the lack of main effects for
child-care variables, and the significant interactions.
The set of logistic regression analyses used to predict Secure/Insecure were
repeated for the Secure/Avoidant dependent variable. As shown in Table 25, two of the
five mother/child predictors were significant, namely, Sensitivity in Play and Sensitivity
in the HOME. Infants whose mothers behaved in sensitive ways towards them were
more likely to be securely attached than insecure-avoidant. The main effects of
Psychological Adjustment, Temperament, and Sex were not significant.
�13
As shown in Table 26, none of the five child-care variables was significant as a
main-effect predictor of the Secure/Avoidant variable. Finally, Table 27 shows that only
one of the 25 interaction terms was significant, namely, Care Starts X Sensitivity in Play.
Examination of the data in Table 28 indicated that the group with low maternal
sensitivity and relatively unstable care had one of the lowest proportions of secure
attachment.
Table 29 summarizes the results of the Secure/Avoidant logistic regression
analyses, showing the main effects for mother/child variables, the lack of main effects for
child-care variables, and the significant interaction.
In the final set of analyses, the effects of Type of Care on attachment security
were evaluated. Chi-square analyses were performed on Attachment Security X Type of
Care at 5 months and at 14 months of age. (Table 30) The types of care used were:
mother (that is, not in nonmatemal child care), father, other relative, in-home nonrelative, child-care home, and child-care center. The results indicated that type of care
was not significantly related to Secure/Insecure or Secure/Avoidant at either age.
Additional analyses were performed to determine whether various aspects of
child-care were related to attachment security within .two types of care-relative, that is,
mother, father, or other relative; and nonrelative, that is, in-home non-relative, child-care
home, and child-care center. A logistic regression procedure was employed in which
each child-care variable was used to predict attachment security separately within the two
types of care. None of the analyses yielded significant results.
Discussion
I would like to begin by noting some of the important features of the NICHD
Study of Early Child Care. First, the participants are diverse. They come from nine
different states and vary in SES, race, and family structure. Second, the child-care
settings included all types of providers, such as fathers, other relatives, in-home
caregivers, child care home providers, and center teachers. In addition, child care settings
varied from a single child with a formally trained nanny to a center with 30 children in
the class. Third, this study included extensive observational procedures at 6 and 15 mos
to assess both child-care contexts and maternal behavior. Fourth, a large sample size was
used to provide adequate power for multivariate models that include interactions between
mother, child, and child-care factors. Fifth, and most important, this study is a
prospective, longitudinal study that began immediately following children's births. For
this reason, the meaning of these results can ultimately be considered as part of a
developmental sequence.
As i am discussing the results of the study, please refer to Table 31 which
summarizes the major points.
The first purpose of the present paper was evaluate the internal and external
validity of the Strange Situation assessment procedure. Comparison of infants
experiencing extensive child care and those experiencing very little child care during the
first 15 months of life yielded no significant differences between these two groups for
ratings of the infants' distress during mothers' absence in the Strange Situation or for
coders' ratings of their own confidence in assigning attachment classifications. Thus,
there was no evidence of differential internal validity for the Strange Situation as a
function of child-care experience. There was evidence in support of the external validity
of the Strange Situation: higher rates of attachment security were associated with higher
levels of maternal psychological adjustment and sensitivity to the child observed in the
�14
HOME assessment. These findings are consistent with a substantial theoretical and
empirical literature linking infants' attachment security to their mothers' psychological
adjustment and sensitive caregiving.
The second purpose of the study was to examine differences in the rates of
attachment security and insecurity for infants with varying child-care experiences. In all
analyses, we controlled for "selection effects" associated with child care experience and
attachment. Results were clear and consistent: There were no significant differences in
attachment classifications related to child-care participation. Rates of attachment security
were not related to variations in the observed quality of nonmatemal child care, to the
amount of care, to the age of entry into care, the stability of care, or to the type of care
used. Comparison of these results with those of previous studies in which such
differences have appeared must give substantial weight to the present findings because of
the advantages of this study, its methodological strengths, its control for family selection
effects, and its recency.
Our third purpose in this paper was to identify conditions under which child care
might be associated with increased or decreased rates of attachment security, by
examining interactions between child-care parameters and mother/child measures. Six of
the 25 two-way interactions were significant. This is consistent with Bronfenbrenner's
(1979) prediction that "in the ecology of human development the principal main effects
are likely to be interactions."
A pattern observed across five of the six significant interactions supported the
hypothesis that children's attachment is affected by "dual risk." The children who
experienced dual risks had among the highest rates of insecurity with their mothers. This
was most clearly demonstrated by children whose mothers and nonmatemal caregivers
were least sensitive to their needs and behavior. Children who received insensitive, poor
quality caregiving in child care, and insensitive, poor quality care from their mothers had
the highest rates of insecurity, ranging from .49 to .56, depending on the analysis.
Children in less risky conditions, that is, with better child care or better maternal care,
had a rate of insecurity of only .38. A similar but less pronounced effect was observed
for children who experienced the dual risks of less sensitive mothering combined with
either more time spent in child care or more child care arrangements over time, with rates
of insecurity of .46 and .44, compared, respectively, with rates of .38 and .37 under less
risky conditions. These results each support a cumulative risk model of development.
Another pattern suggested different developmental processes for boys and girls.
Whereas more time in care was associated with more insecurity for boys, it was
associated with more security for girls. These data bring to mind two sets of findings in
the developmental literature. First, there is evidence that boys tend to be more vulnerable
than girls to psychosocial stress generally. Second, there is evidence that during middle
childhood, girls benefit from having their mothers in the work force.
Efforts to illuminate further the nature of the dual-riskfindingsproved
unsuccessful. Although multiple two-way interactions were obtained, we repeatedly
failed to obtain evidence that these interactions were moderated by additional features of
child care.
The interaction analyses, also provided evidence relevant to the third hypothesis,
namely, that when children receive relatively poor caregiving from their mothers, high
quality CHILD care can foster the formation of a secure infant-mother attachment bond.
In the significant interaction tables, it appeared that the proportion of attachment security
among children with the most insensitive mothers increased as child care quality
�15
increased, in two of the three relevant analyses. In contrast, a further test of the
compensatory hypothesis provided evidence (in two of the three analyses) that children
with insensitive mothers who received a smaller amount of high quality child care were
more likely to be securely attached than children who received a greater amount of high
quality child care. Nor did these children of insensitive mothers benefit from being away
from them for longer hours in general. In sum, compensatory effects were mixed and not
as consistent as those pertaining to dual risks.
The fourth purpose of this paper was to determine whether child-care experience
was associated with an increased rate of insecure avoidance, as reported in previous
studies. Analyses of secure versus insecure-avoidant children revealed no main effects of
child care, and only one of the 25 interactions tested was significant. Thus, in contrast to
the results of earlier research there was no evidence that child-care experience is
associated with avoidance per se.
In conclusion, the results of this study clearly indicate that nonmatemal child care
by itself does not constitute a threat to the security of the infant-mother attachment
relationship. Nor does it foster secure attachment. Instead, there was consistent evidence
that poor quality, unstable, or more than minimal amounts of child care added to the risks
already inherent in maternal insensitivity. In other words, the combined effects of these
child care variables and maternal insensitivity were worse than those of maternal
insensitivity alone. Such results suggest that effects of child care on attachment, as well
as the nature of the attachment relationship itself, depend on the nature of ongoing
interactions between mother and child. In addition, there was also evidence that the
influence of amount of care on attachment security varied as a function of the child's sex.
Our continuing, longitudinal investigation of children's development in the
NICHD Study of Early Child Care will determine the ultimate importance of these
findings for developmentalists, policy makers, and parents, as we consider the effects of
early child care on longer-term outcomes and on the broader variety of social-emotional,
cognitive, and health outcomes the study was designed to assess. To the extent that
evidence emerges in future analyses that early child care is associated with problem
behavior or developmental deficits at older ages, these mother-infant attachment findings
will take on greater importance. To the extent, however, that there is no evidence of
developmental disadvantages associated with early child care, then any concerns raised
here about dual risks with respect to attachment security would be mitigated. In sum, the
full meaning of the findings reported here will not become clear until more is known
about the development of the children participating in the NICHD Study of Early Child
Care.
�Infant Child Care and Attachment Security: Results of the
NICHD Study of Early Child Care
The NICHD Early Child Care Research Network
Mark Appelbaum
Dee Ann Batten
Jay Belsky
Cathryn Booth
Robert Bradley
Celia Brownell
Bettye Caldwell
Susan Campbell
Alison Clarke-Stewart
Jeffrey Cohn
Martha Cox
Kaye Fendt
Sarah Friedman
Kathryn Hirsh-Pasek
Aletha Huston
Bonnie Knoke
Nancy Marshall
Kathleen McCartney
Marion O'Brien
Margaret Owen
Deborah Phillips
Henry Ricciuti
Susan Spieker
Deborah Vandell
Marsha Weinraub
�Time N +1
TimeN
Time N
�SUMMARY OF RESEARCH QUESTIONS
1. Is the Strange Situation valid for infants
with extensive nonmatemal care?
2. Is attachment security related to child-care
experiences?
3. Under what combination of conditions
(mother/child and child care) does the
rate of security increase or decrease?
4. Is insecure-avoidant attachment related to
child-care experiences?
�TABLE 1
NICHD STUDY OF EARLY CHILD CARE
RECRUITMENT SITES--31 HOSPITALS IN OR NEAR:
Little Rock, AK
Orange County, CA
Lawrence and Topeka, KS
Boston, MA
Philadelphia, PA
Pittsburgh, PA
Charlottesville, VA
Morgantown and Hickory, NC
Seattle, WA
Madison, WI
�TABLE 2
NICHD STUDY OF EARLY CHILD CARE
CHARACTERISTICS OF THE SAMPLE IN THESE
ANALYSES
Child Ethnicity
White, non-Hispanic
Black, non-Hispanic
Hispanic
Other
81.5%
11.9%
5.7%
.9%
Child Sex
Girls
Boys
49.4%
50.6%
Maternal Education
< 12 years
High School or GED
Some college
BA
Post-graduate
8.4%
20.2%
34.2%
21.9%
15.3%
Husband/partner in the home
86.9%
Child Care Plans at Birth:
Full time
Part Time
None
53%
23%
24%
�TABLE 3
OVERVIEW OF DATA COLLECTION IN THIS
REPORT
Months
HOME VISITS
1 3 5 6 9 12 14 15
X
X
X
Household composition and
family income
NEO Personality Inventory (select
scales) (Costa & McCrae, 1985)
X
Attitude Toward Maternal
Employment (Greenberger et al.,
1988)
X
Infant Temperament Questionnaire X
(Carey, & McDevitt, 1978)
X
Center for Epidemiologic Studies
Depression Scale (Radloff, 1977)
X
X
Semi-Structured Play Interaction
X
X
CHILP CARE
Observational Record of the
Caregiving Environmnent (ORCE
X
X
Phone Calls
LABORATORY VTSTT
Strange Situation
X
X X
X X X
X
�TABLE 4
MOTHER AND CHILD VARIABLES
Maternal Psych.Adjustment
Alpha=.80
Neuroticism (reflected)
Aggreeableness
Extroversion
CES-D 1,6,15 month average (reflected)
Maternal Sensitivity-Play
(average of 6 and 15 months)
Alphas=.70, .75
Sensitivity to Nondistress
Positive Regard
Intrusiveness (reflected)
Maternal Sensmvity-HOME
(average of 6 and 15 months)
Alphas=.60, .64
Positive factor score
Lack of negativity factor score
Infant Difficult Temperament:
55 ITQ items
Alpha=.81
Child Sex
�TABLE 5
CHILD CARE VARIABLES
ORCE Positive Care Frequency
average of 6 and 15 months
Alphas=.88, .78
ORCE Positive Care Ratings
average of 6 and 15 months
Alphas=.89, .88
Amount of Care
mean hours/week each month, 4-15 months
0 = no non-maternal care
Age of Entry
1 = 0-3 months
2 = 4-6 months
3 = 7-15 months
4 = 15+ months, including those not in care
Frequency of Care Starts
Type of Care (5 and 14 months)
Mother
Father
Relative
In-Home
Child-Care Home
Child-Care Center
�TABLE 6
CHILD CARE CHARACTERISTICS OF THE SAMPLE
IN THESE ANALYSES
Amount of Care (average 4-15 months)
< 10 hours
34.1%
10-30 hours
25.1%
> 30 hours
40.8%
Age of Entry mto care
1 = 0-3 months
2 = 4-6 months
3 = 7-15 months
4 = 15+ months
Frequency of Care Starts
0
1
>1
Type of Care
Mother
Father
Relative
In-Home
Child-Care Home
Child-Care Center
58.1%
, 14.7%
12.1%
15.9%
15.0%
20.1%
64.9%
5 mos
36.9%
11.7%
15.8%
7.9%
18.6%
9.0%
14 mos
29.6%
14.7%
14.0%
8.9%
20.7%
12.1%
�TABLE 7
ATTACHMENT VARIABLES
Final Classifications (n=1153)
A
B
C
D
Coder agreement:
(83%; Kappa=.69)
14.1%
61.8%
8.8%
15.4%
Secure/Insecure
Confidence Ratings
Separation Distress
Coder agreement:
(86%; Kappa=.70)
�TABLE 8
INTERNAL VALIDITY OF THE STRANGE SITUATION
Intensity of Care from 3-15 Months
Low:
< 10 hrs/wk
(n = 263)
High:
> 30 hrs/wk
(n = 257)
Distress
A
B
C
D
U
Total
a
6.0
10.5
13.4
9.3
9.4
9.7
6.5
10.4
13.9
11.8
8.8
10.3
Ii = NS
Coder Confidence
A
B
C
D
U
Total
b
NS: Nonsignificant
Intensity X ABCDU
Distress X ABCDU
a
b
3.0
3.9
3.3
2.8
2.6
3.1
p < .05
j> < .05
3.2
3.9
2.9
3.3
3.9
3.4 p
=
NS
�TABLE 9
EXTERNAL VALIDITY OF THE STRANGE SITUATION
RATE OF SECURITY AS A FUNCTION OF SCORING IN
TOP AND BOTTOM QUARTILES ON PREDICTOR
Predictors
Top
Quart
Bottom
Quart
p
Sensitivity-Play
63.3
57.3
.145
Sensitivity-HOME
68.4
55.0
.001
Psych. Adjust.
66.9
56.7
.012
�TABLE 10
CONTROL AND PREDICTOR VARIABLES
1) CONTROL VARIABLES:
Income-to-Needs Ratio
Benefits of Work
2) MOTHER/CHILD VARIABLES:
Psychological Adjustment
Sensitivity—Play
Sensitivity-HOME
Temperament
Sex
3) CHILD-CARE VARIABLES:
Positive Care. Frequency
Positive Care. Ratings
Amount of Care
Age of Entry
Frequency of Care Starts
4) INTERACTION TERMS
�TABLE 11
SECURE/INSECURE ANALYSES
MOTHER/CHILD EFFECTS
*
Psych. Adjust.
Secure > Insecure
Sensitivity—Play
Sensitivity-HOME* *
Temperament
Sex
*p<.05; **ii<.01
Secure > Insecure
�TABLE 12
SECURE/INSECURE ANALYSES
CHILD-CARE EFFECTS
Pos. Care. Freq.
Pos. Care. Ratings
Amt. of Care (hrs)
Age of Entry (mos)
Care Starts
�TABLE 13
SECURE/INSECURE ANALYSES
SIGNIFICANT MOTHER/CHILD X CHILD-CARE
INTERACTIONS
Pos. Care Pos. Care.
Freq
Ratings
Amt.
Care
Age
Entry
Care
Starts
>
Psych Adjust
Sens. - Play
Sens. - Home
*
*
*
*
Temperament
Sex
*p< .05
*
�TABLE 14
SECURE/INSECURE ANALYSES
SENSITIVITY-PLAY X POSITIVE CARE.
FREQUENCY-ADJUSTED PROPORTION SECURE
Positive Caregiving Frequency
Low
Sensitivity—
Mod.
High
Low
.51
.56
.58
Mod.
.73
.62
.58
High
.69
.61
.53
Play
�TABLE 15
SECURE/INSECURE ANALYSES
SENSITIVITY-PLAY X POSITIVE CARE. RATINGS
ADJUSTED PROPORTION SECURE
Positive Caregiving Ratings
LOW
Sensitiyity-Elay
Mod.
High
Low
.44
.62
.53
Mod.
.65
.65
.59
High
.73
.54
.61
�TABLE 16
SECURE/INSECURE ANALYSES
SENSITIVITY-HOME X POSITIVE CARE. RATINGSADJUSTED PROPORTION SECURE
Positive Caregiving Ratings
t
Low
SensitivityHOME
MM.
High
Low
.45
.57
.63
Mod.
.64
.60
.55
High
.72
.70
.62
�TABLE 17
SECURE/INSECURE ANALYSES
SENSITIVITY- HOME X AMOUNT OF CAREADJUSTED PROPORTION SECURE
Amount of Care (hrs)
>M
SensitivityHOME
10-30
<m
Low
.54
.52
.62
Mod.
.63
.64
.59
High
.66
.73
.66
�TABLE 18
SECURE/INSECURE ANALYSES
SENSITIVITY-PLAY X CARE STARTS-ADJUSTED
PROPORTION SECURE
Care Starts
>1
SensitivityElay
1
0
Low
.56
.60
.60
Mod.
.66
.59
.64
High
.64
.54
.62
�TABLE 19
SECURE/INSECURE ANALYSES
SEX X AMOUNT OF CARE-- ADJUSTED PROPORTION
SECURE
Amount of Care (hrs)
>M
Sex
10-30
<m
Boys
.58
.60
.65
Girls
.66
.65
.58
�TABLE 20
SECURE/INSECURE ANALYSES
SENSITIVITY-PLAY X POSITIVE CARE. FREQUENCY
COMPENSATORY EFFECT?
Positive Caregiving Frequency
Urn
Mod.
High
^ F T : .56
SensitivityElay
Low
.51
.56
.58
PT: .65
Mod.
.73
.62
.58
High
.69
.61
.53
�TABLE 21
SECURE/INSECURE ANALYSES
SENSITIVITY-PLAY X POSITIVE CARE. RATINGS
COMPENSATORY EFFECT?
Positive Caregiving Ratings
Low
Sensitivity-
Jjm
.44
Mod.
.62
High
.53
Eta
^-FT: .55
-PT: .49
Mod.
.65
.65
.59
High
.73
.54
.61
�TABLE 22
SECURE/INSECURE ANALYSES
SENSITIVITY- HOME X POSITIVE CARE. RATINGS
COMPENSATORY EFFECT?
Positive Caregiving Ratings
Um
MM.
High
FT: .59
SensitivityHOME
Low
.45
.57
.63
-PT: .67
Mfld.
.64
.60
.55
High
.72
.70
.62
�TABLE 23
SECURE/INSECURE ANALYSES
SENSITIVITY-HOME X AMOUNT OF CAREADJUSTED PROPORTION SECURE
Amount of Care (hrs)
>M
SensitivityHOME
10-30
<li>
Low
.54
.52
.62
Mod.
.63
.64
.59
High
.66
.73
.66
�TABLE 24
SECURE/INSECURE ANALYSES-SUMMARY
MOTHER/CHILD MATN EFFECTS:
Psych. Adjustment
Sensitivity-HOME
CHTLD-CARE MATN EFFECTS:
None
INTERACTIONS:
Sensitivity—Play X Pos. Care. Freq.
Sensitivity-Play X Pos. Care. Ratings
Sensitivity-HOME X Pos. Care. Ratings
Sensitivity-HOME X Amount of Care
Sensitivity-Play X Care Starts
Sex X Amount of Care
�TABLE 25
SECURE/AVOIDANT ANALYSES
MOTHER/CHILD EFFECTS
Psych. Adjust.
Sensitivity—Play
Secure > Avoidant
Sensitivity-HOME**
Secure > Avoidant
Temperament
Sex
p<.01
�TABLE 26
SECURE/AVOIDANT ANALYSES
CHILD-CARE EFFECTS
Pos. Care. Freq.
Pos. Care. Ratings
Amt. of Care (hrs)
Age of Entry (mos)
Care Starts
�TABLE 27
SECURE/AVOIDANT ANALYSES
SIGNIFICANT MOTHER/CHILD X CHILD-CARE
INTERACTIONS
Pos. Care Pos. Care.
Freq
Ratings
Amt.
Care
>
Psych Adjust
Sens. - Play
Sens. - Home
Temperament
Sex
.05
Age
Entry
Care
Starts
�TABLE 28
SECURE/AVOIDANT ANALYSES
SENSITIVITY-PLAY X CARE STARTS-ADJUSTED
PROPORTION SECURE
Care Starts
>1
SensitivityHOME
Low
.76
.76
.80
Mml.
.84
.79
.80
High
.90
.70
.86
�TABLE 29
SECURE/AVOIDANT
ANALYSES-SUMMARY
MOTHER/CHILD MAIN EFFECTS:
Sensitivity—Play
Sensitivity-HOME
CHILD-CARE MATN EFFECTS:
None
INTERACTIONS:
Sensitivity-Play X Care Starts
�TABLE 30
SECURE/INSECURE ANALYSES
TYPE OF CARE AT 5 AND 14 MOS-PROPORTION SECURE
5 mos
14 mos
Mother
.62
.61
Father
.59
.62
Relative
.59
.56
In-home Non-rel.
.62
.59
Child-Care Home
.65
.63
Child-Care Center
.66
.70
�TABLE 31
SUMMARY OF RESULTS
The Strange Situation was not less valid for children with
a lot of child care than for children with little child care.
Secure, compared with insecure infants had mothers who
were more sensitive and better adjusted psychologically.
Child-care features, in and of themselves, were unrelated
to attachment security or to insecure avoidance
specifically.
Low-quality child care, unstable care, and more than
minimal hours in care were each related to increased rates
of insecurity when mothers were relatively insensitive.
Extensive care for boys and limited care for girls were
associated with somewhat elevated rates of insecurity.
�NIH NEWS ALERT
NATIONAL INSTITUTES OF HEALTH
Embargoed until April 3,1997
6 p.m. E.S.T.
National Institute of Child Health
and Human Development
Contact:
Robin Peth-Pierce
(301) 496-5136
Results of NICHD Study of Early Child Care
Reported at Society for Research in Child Development Meeting
New research being released this week indicates that the quality of child care for
very young children does matter for their cognitive development and their use of
language. In addition, quality child care in the early years, meaning care with a high
degree of positive interaction between caregivers and children, can also lead to better
mother-child interaction, the study finds.
The findings come from a longitudinal study on the effects of early child care
supported by the National Institute of Child Health and Human Development (NICHD).
They will be presented at the biennial meeting of the Society for Research in Child
Development on April 4, 1997, at 4:30 p.m. at the Sheraton Washington Hotel in
Washington, D.C.
"The most striking aspect of these results from the early child care study is that
children are not being placed at a disadvantage in terms of cognitive development if they
have high quality day care in their first three years," said NICHD's Director, Duane
Alexander, M.D. "It's very important to study these issues as they are of such importance
to American families."
1
�A major way in which the NICHD Study of Early Child Care contributes to
understanding the effects of child care is by moving beyond the global questions about
whether child care is good or bad for children. Instead, it focuses on how the different
aspects of child care, such as quantity and quality of care, are associated with children's
cognitive and language development and mother-child interaction patterns over the first
three years of life.
Just as important, the NICHD Study of Early Child Care examines effects of child
care after taking into consideration other factors that shape children's development and
their relationships with their mothers. These factors include family economic status,
mother's psychological well being and intelligence, child sex and infant temperament.
This study design makes it more likely that the effects discerned are truly due to child
care, and not a function of other factors.
The study is clarifying the association between child care and children's cognitive
development, as well as the association between child care and the mother-child
relationship, two issues that are of deep concern to the over 50 million working mothers
and their families in this country. Child care is becoming an ever increasing fact of life
as more women stay in the work force after pregnancy and many more women are single
parents. In 1980, according to U.S. census data, 38% of mothers, ages 18-44, with
infants under one year of age, worked outside the home. By 1990, this percentage
climbed to 50, a rate close to where it stands now. Most of these women return to work
in their child's first three to five months.
Evidence is emerging from the study that across a wide range of child care
settings, quality child care, as defined by positive caregiving and language stimulation
given in the child care environment, are positively related to early cognitive and language
development. While the quality of child care had a small but statistically significant
relation to children's cognitive and linguistic outcomes, the combination of family
income, maternal vocabulary, home environment, and maternal cognitive stimulation
were stronger predictors of children's cognitive development.
"In this study, we found that the amount of language that is directed at the child in
child care is an important component of quality provider-child interaction," said Dr.
Sarah Friedman, NICHD coordinator of the study and one of its investigators. "This
language input is predictive of children's acquisition of cognitive and language skills,
which are the bedrock of school readiness."
Language stimulation was assessed by measuring how often caregivers spoke to
children, asked them questions, and responded to their vocalizations. To assess children's
cognitive development, researchers used standardized tests, including the Bayley Scales
of Infant Development, the Bracken-Scale-of-Basic-Concepts school-readiness subtest,
the MacArthur Communicative Development Inventory, and the Reynell Developmental
Language Scale.
The small but consistent findings indicate that the higher the quality of child care
in the first three years of life the greater the child's language abilities at 15,24, and 36
months, the better the child's performance on the Bayley Scales of Infant Development at
age two, and the more school readiness the child showed at age three.
�Among children in care for more than 10 hours per week, those in center care, and
to a lesser extent, those in child care homes, performed better on cognitive and language
measures when the quality of the caregiver-child interaction was taken into account.
In addition to the cognitive findings, researchers also found that quality and
amount of child care had a small but statistically significant association with the quality
of the mother-child interaction. Again, a combination of other variables, including family
environment, maternal education, and family income, were more influential in
determining the quality of the mother-child interaction.
Researchers found that the amount of nonmatemal child care was weakly
associated with less sensitive and engaged mother-child interactions. The more time
infants and toddlers spent in non-maternal child-care arrangements, the less sensitive and
positively involved were mothers with their infants at 6 months of age, the more negative
they were with them at 15 months of age, the less positively affectionate the child was
toward the mother at 24 and 36 months of age, and the less sensitive mothers were to
their toddlers at the 36 month point.
Where effects of quality on mother-child interaction were found, higher quality
of provider-child interaction in the child care setting predicted greater maternal
involvement-sensitivity (at 15 and 36 months) and greater child positive engagement at
36 months.
Mother-child interaction was evaluated by videotaping mother and child together
during play and observing mother's behavior toward the child to see how attentive,
responsive, positively affectionate or restrictive the mother was when faced with multiple
competing tasks (i.e., monitoring child, talking with interviewer).
In sum, what is happening at home and in families appears to be a powerful
predictor of both cognitive outcomes and mother-child interaction. Still, with the family,
maternal, and child care characteristics considered, the child care variables studied
provided additional, significant prediction of children's cognitive and language outcomes
and mother-child interaction.
In 1991, the NICHD Study of Early Child Care enrolled more than 1,300 families
and their children from 10 locales throughout the country. The children, who were one
month old or less at enrollment, their families, and their child-care arrangements are
being followed through the child's seventh year of life. The families are diverse in terms
of race, maternal education, family income, family structure (single-parent families are
included), maternal employment status, type and quality of child care, and the number of
hours that children spend in non-matemal care arrangements. Arrangements included
father care, grandparent care, care by a non-relative in the child's home, child care homes,
and center-based care.
The child care variables used in the analysis included information about the type
of care, the amount of care, and the quality of care. Higher quality care was defined in
terms of the interactions of child care providers with the study children. Interactions
expected to promote positive affect, better social adjustment and greater cognitive and
language skill were considered of higher quality.
Initiated and conducted by NICHD and investigators at 14 universities
�nationwide, the study was spurred by many questions from parents, developmental
psychologists, and policy makers about the effects of early child care on children's
development. Among the investigators' core interests have been how these child-care
experiences affect children's cognitive and language development and the way in which
parents relate to children who are in child care. These are important study foci because
early cognitive and language development predicts future school achievement and
performance on intelligence tests and because patterns of mother-child interaction predict
future social, emotional, and cognitive development.
Last April, study investigators released data which evaluated the infants up to the
15 month point. They found that child care, in and of itself, neither adversely affects,
nor promotes, the security of children's attachment to their mothers at the 15 month age
point, provided the children were already receiving relatively sensitive care from their
mothers.
For more information about the study, contact NICHD's Public Information and
Communications Branch at (301) 496-5133. The NICHD is part of the National Institutes
of Health, the biomedical research arm of the Federal government. Since its inception in
1962, the Institute has become a world leader in promoting research on development
before and after birth; maternal, child, and family health; reproductive biology and
population issues; and medical rehabilitation.
###
Investigators participating in the NICHD Early Child Care Study:
Mark Appelbaum
University of California at San Diego
(619) 534-7959
(619)534-7190 fax
Robert Bradley
University of Arkansas at Little Rock
(501) 569-3423
(501) 569-8503 fax
Dee Ann Batten
Vanderbilt University
(615)343-1476
(615) 343 -1100 fax
Celia Brownell
University of Pittsburgh
(412)624-4510
(412) 624-4428 fax
Jay Belsky
Pennsylvania State University
(814) 865-1447
(814) 863-6207 fax
Peg Burchnal
Research Triangle Institute
(919) 966-5059
(919) 962-5771
Kimberly Boiler*
Mathematica Policy Institute
(609)275-2341
Bettye Caldwell
Arkansas Children's Hospital,
Department of Pediatrics
(501)320-3333
(501) 320-1552 fax
Cathryn Booth
University of Washington at Seattle
(206) 543-8074
(206) 685-3349 fax
Susan Campbell
University of Pittsburgh
�(412) 624-8792
(412) 624-5407 fax
(913) 864-4801
(913) 864-5202 fax
Alison Clarke-Stewart
University of California at Irvine
(714) 824-7191
(714) 824-3002 fax
Margaret Tresch Owen
University of Texas at Dallas
(972) 883-6876
(214) 883-2491 fax
Martha Cox
University of North Carolina at Chapel Hill
(919)966-2622
(919) 966-7 532 fax
Chris Payne
Western Carolina Center
(704)438-6532
(704)438-6531 fax
Sarah L. Friedman
National Institute of Child Health and Human
Development
(301)496-9849
(301)480-7773 fax
Deborah Phillips
National Academy of Sciences
(202)334-1935
(202) 334-3768 fax
Kathryn Hirsh-Pasek
Temple University
(215)204-5243
(215)204-5539 fax
Aletha Huston
University of Texas at Austin
(512)471-0753
(512) 471-5 844 fax
Elizabeth Jaeger
Temple University
(215)204-7894
(215)204-5539 fax
Bonnie Knoke
Research Triangle Institute
(919) 541-7075
(919) 541-5966 fax
Nancy Marshall
Wellesley College
(617) 283-2551
(617)283-2504 fax6
Kathleen McCartney
University of New Hampshire
(603) 862-3168
(603) 862-4986 fax
Marion O'Brien
University of Kansas
Robert Pianta
University of Virginia at Charlottesville
(804) 243-5483
(804)243-5480 fax
Henry Ricciuti*
Cornell University
(607) 255-0844
(607) 255-9856
Susan Spieker
University of Washington at Seattle
(206) 543-8453
(206) 324-7261 fax
Deborah Lowe Vandell
University of Wisconsin at Madison
(608) 263-1902
(608) 263-6448 fax
Kathleen Wallner-Allen*
Research Triangle Institute
(301)496-9849
(301)480-7773
Marsha Weinraub
Temple University
(215) 204-7183
(215 )204-5539 fax
* Affiliated with the NICHD during the
course of the Early Child Care Study.
�C O Y E R
H
To:
Fax#:
Subject:
Date:
Pages:
Nicole Rabner
202-456-6266
NICHD Early Child Care Study
April 7,1997
, includrng this cover sheet.
COMMENTS:
Nicole,
The attached is a copy of the poster symposium of the study results, presented by Sarah Friedman
on Friday, April 4, 1997 at the Society for Research in Child Development. There is not yet a
formal paper that has been wntten and submitted- I enjoyed the the speech on Thursday night at
the Society's meeting.
v
Please call with any questions.
^
Robin
From the desK of...
FU bin Petb-Pierce
Writer/Editor
NICHD
31 Center Drive, MSG 2425. Building 31, Room
2A32
Betl esda, MD 20892
301-496-5136
Fix: 301-496-7101
I 0 I £ 3 6 6 - 1 0E = Q I
aao aHoiN = woad[ i t = si iB-^o-adv
�ERRATA
Mother-Child Interaction and Cognitive Outcomes Associated with Early
Child Care: Results of the NICHD Study
In The NICHD Study: Sample Characteristics, Sampling Plan and Subject Recruitme it, diamond
number two, please change "24 hospitals" to read "31 hospitals."
In Nonmatemal Child Care and Qualities qfMother-Child Interaction: Findings, St mmary of
Regression Analyses of Cumulative Effects of Care, section two, delete "lower mater aal
sensitivity and child positive engagement with mother at 36 months."
�Mother-Child Interaction and Cog
Outcomes Associated with Early ~
Results of the NICHD Study
n
The NICHD Early Child Care Research Network
Poster symposium presented at the Biennial Meeting of the Society For Researd in Child
Development, Washington, D.C, April, 1997
OVERALL SUMMARY
Does early child care hinder or enhance infants' and toddlers' social and cognitive
development? This question lies at the core of the child care debate. In these posters, we present
results from the NICHD Study of Early Child Care relating child care to mother-chil l interaction
and to cognitive and linguistic development across the first three years of life. This longitudinal
investigation was designed as an ecological study of children from birth through firs" grade to
examine the nature of early caregiving experiences and the effects of those experienc es upon
development. With 1,364 socially and racially diverse children from 10 sites, the sti dy allows
investigation of child social and cognitive outcomes that emerge in multiple context., with
multiple measures, at multiple points in development.
Across two different domains, mother-child interaction and children's cognitive and
language development, three questions were addressed: 1) Is child care related to qualities of
mother child interaction and the child's cognitive and language development in the first three
years of life after considering variables related to both child care use and the outcomes (selection
variables) and other family and child characteristics? 2) Does the child care envirorment
interact with the home environment in prediction of these outcomes? and 3) What s pecific
characteristics of child care arerelatedto outcomes in these two domains?
Cluldren were assessed at 6,15,24, and 36 months of age. Assessments included
observations of the child's child care environment, of the mother and child during a s tructured
interaction, of the child's home environment, and standardized measures of the child s cognitive
and language development. The analysis model involved: selection variables (family
characteristics related to both child care and outcome), child variables (gender and/o:
temperament), additional family variables related to the outcome, and child care variables
(including both structural and process measures). Hierarchicalregressionswere used to examine
the association between the selected child care variables and the outcomes in the tw( • domains
after selection, child, and family variables were controlled.
Results indicated thai the selection, child, and family variables, entered befoi e child care
variables in our predictive equations, were consistently significant predictors of bott
mother-child interaction and cognitive and language outcomes. Child care variables consistently
33tf d
lOliBBfrlOE =ai
ddO
aH3IN=WOad l l = S l
AB-iB-Hdy
�made an additional significant, though usually smaller, contribution to explaining ind .vidua!
differences in these outcomes. Child care variables, especially positive caregiving and language
stimulation, contributed between 1.3% and 3.6% of the variance to early cognitive an i language
development in the first three years of life. However, all the predictors in the analysi;. accounted
for between 5% and 41% of the variance. Similarly, in prediction of qualities of mother-child
interaction, when significant, child care variables accounted for approximately .5% tc 1% of the
variance. However, all the predictors in analyses accounted for between 5% and 259<. of the
variance. Nonetheless, for both mother-child interaction and cognitive and language outcomes,
there were consistent effects of child care variables, especially quality and quantity, a 'ter
controlling for selection, family and child characteristics.
Major findings with regard to child care variables included:
Quality of provider-child interaction was related to better cognitive and language scores
and to more positive mother-child interactions across the first three years. These effe :ts were
generally small, but statistically significant.
Specifically, more positive caregiving and, especially, language stimulation in the
child care setting were related to children's better performance on cognitive ard language
tests when they were 15,24, and 36 months of age. More positive caregiving in the child
care setting was related to more sensitivity and involvement of mothers obser 'ed with
their children at 15 and 36 months.
Amount of child care was associated with less sensitive and engaged mothers hild
interactions across the first three years. Again, these effects were small, but significa iL Amount
of care was unrelated to the cognitive and language outcomes.
Specifically, more hours of nonmatemal care were related to less sensitive play of
the mother with the child at 6 and 36 months, more maternal negativity at 15 months, and
less child affection toward the mother at 24 and 36 months. These findings seemed to
hold particularly for the subgroup of mothers who were not at risk due to poverty or
depression.
In summary, although family and child predictors generally contributed a larger
proportion of total variance in predicting mother-child interaction and cognitive and 1 mguage
outcomes, child care predictors consistently explained an additional small, significant amount of
variance. In other words, what is happening at home and in families appears to influence
children's lives, both for those in child care and for those who are noL Still, child cam variables
provided additional, significant prediction of mother-child interaction and cognitive and language
outcomes.
�Mark Appelbaum
UriveraityoJCafitoniiaatSan
(619)534-7959
(619) 534-7190 fax
Celia Brownell
Urtiw sity Of Pittstjurjh
(412)624-4510
(412) 624-4428 fax
De« Ann Batten
Vafid«rt3fltUnivere«y
(615) 3*3-1*76
(615) 3*3-1100 fax
batomiaOewax.vanrjeitili-edu
Margaret Burehinal
University of North Carolina at
Chapel Km
(919) 966-5059
(919) 962-5771 tax
6ufctuna.fp5Cmns.une.edu
Jay Belsky
Pennsy1v?nia Stale Univertiry
(814) 865-14*7
(814) 863-6207 lax
i3(t)e«mail-psu.edii
ArKansas Children's Hospital
Department of Pediatrics
(501)320-3333
(501) 320-1552 fax
bettyemcOcare.ach.uams.edu
KJmberly Boiler*
Matnemtfiea Policy Research
Institute
(609)275-2341
(609) 799-0005 f t t
kcoller« mamemaoca-mpr. com
Susan Campbell
University Of Pittbursh
(412)624-8792
(412) 624-5407 fax
pr*schievms.cis.piiiedu
Cathryn Booth
Urevtfsily Of Washington at Seaffl?
(2t»)S4*e074
(206) 665-3349 fax
Alison Clarke-Stewart
University of Caiitornia at Irvine
(714) 824-7191
(714) 824-3002 !ax
Bettye Caldwell
acstewarCuaeou
Robert Bradley
University of Artcansas at Lime
Fto*
(501)589-3423
1501) 5694503 lax
mbiaaieyCualr.edu
HO'tfd
Martha Cox
University of Nonh Carolina at
Chapel Hill
(919) 966-3509
(919) 966-7532 fax
ccK-fpg C mhs.uncedu
Kaye Fendt
nafonai Institute of C W Health
W
ana Human Development
(301)594-5414
Nancy Marshall
weiiesiay College
(617)283-2551 .
(617) 283-2054
nmarshaHOwenasieyedu
^ n r y N. Ricciuti*
C omen University
(107) 255-0844
(107) 255-9856 fax
h-iri©comeii.eou
Sarah l _ Friedman
National institute of ChiW Health
and Human Development
(301) 486-9849
(301) 480-7773 fax
friedmasChoOi .nietid.nih.gov
Kathleen McCartney
University of New Hampshire
(603)862-0168 .
(603) 862-»986 lax
kathleenjnceartney* unh.edu
£ usan Spieker
I diversity of Washington at Seattle
(."06) 543-6453
(.•06) 685-3349 fax
i 0 iefcer © u-washington-eOu
Kathryn Hirsh-Pasek
Temple University
(610) 642-5275
(2)5) 204-5539 to*
v5280eevm-tempie.edu eir*i
Marion O'Brien
University of Kansas
(913)864^640
(913) 863-5202 fax
mobtienOfaicon-CC.uSans.Mlu
Deborah Lowe Vandell
l Iniversity of Wisconsin at Madison
(508) 263-1902
(308) 263-&448 fax
1 .v3ndellCjrviec.wisc.etlu
Aletha Huston
University o Texas at Austin
<
(512) 471-07S3
(512) 471-5S« tax
•achustonOmaiLutexsis.edu
Margaret Tresch Owen
University of Tfews at Dallas
(972) 883*876
(214)883-2491 fax
mowen©utd3ilas.edu
Kathleen Wallner-Allen*
: lesearch Triangle institute
•
,301)496-9849
301) 480-7773 fax
Y3iineri(erxtoi.niehd.niti.sov
Elizabeth Jaeger
Temple University
(215)204-7894
(2i 5) 204-5539 tax
v1547gCvm.temple.edu
Robert Pianta
Uni>«rsity of Virginia at
ChaitottesviHe
(804) 243-5483
(804) 243-5480 fast
rCp4pCvirgina.edu
Bonnie Knoke
Research Triangle Insfitute
(919)541-7075
(,
(919) 541-5966 fax
KnokeCrtLorg
I 0 I <L3Gb I 0 E = Q I
Deborah Phillips
National Academy of Sdenees
(202) 334-1935
(202) 334-3829 fax
philips Snas.edu
.larsha Weinraub
reirol© University
215) 232-6572
215) 2C4-5539 fax
/S242e ©vm.temple.edu
• Affiaated with the NICHD during
the course of the Early Child
Care Study.
�\
C
D
U
U
Mother-Child Interaction and Cognitive
Outcomes Associated with Early Child Care:
Results of the NICHD Study
t^
ID
m
Q
n
a
a
o
Q
I
u
O
m
NICHD Early Child Care Research Network
Mark Appelbaum, University of California at San Diego • Dee Ann Batten, Vanderbilt University • Jay Belsky, Pennsylvania
State University • Kimberly Bolter, National Institute of Child Health and Human Development • Cathryn Booth, University of
Washington at Seattle • Robert Bradley, University of Arkansas at Little Rock • Celia Brownell, University of Pittsburgh •
Margaret Burchinal, Frank Porter Graham Child Development Center • Bettye Caldwell, Arkansas Children's Hospital • Susan
Campbell, University of Pittsburgh • Alison Clarke-Stewart, University of Catifornia at Irvine • Martha Cox, University of North
Carolina at Chapel Hill • Kaye Fendt, National Institute of Child Health and Human Development • Sarah L. Friedman,
National Institute of Child Health and Human Development • Kathryn Hirsh-Pasek, Temple University • Aletha Huston,
University of Texas at Austin • Elizabeth Jaeger, Temple University • Bonnie Knoke, Research Triangle Institute • Nancy
Marshall, Wellesley College • Kathleen McCartney, University of New Hampshire • Marion O'Brien, University of Kansas *
Margaret Tresch Owen, University of Texas at Dallas • Deborah Phillips, National Academy of Sciences • Robert Pianta,
University of Virginia at Charlottesville • Henry N. Ricciuti, National Institute of Child Health and Human Development • Susan
Spieker, University of Washington at Seattle • Deborah Lowe Vandell, University of Wisconsin at Madison • Kathleen WallnerAllen, Research Triangle Institute • Marsha Weinraub, Temple University
�\
The
Study:
Background
Does early child care hinder or enhance infants' and toddlers' social
and cognitive development? This question lies at the core of the child
care debate.
In thes9 posters, we present results from the NICHD Study of Early
Child Care relating child care to mother-child interaction and to
cognitive and language development across the first 3 years of life.
This longitudinal Investigation was designed as an ecological study of
children from birth through first grade, which Investigates the nature
of early caregiving experiences and the effects of those experiences
upon development.
Across two different domains — mother-child interaction and
children's cognitive and language development —three questions
are addressed:
1. Is child care related to mother-child interaction and to cognitive
development above and beyond the contribution of selection
effects and family environment?
2. Does the child care environment interact with the home
environment to affect the outcomes?
3. What characteristics of child care are responsible for the effects
in these two domains?
�n
\
G ,
O
Backgrpuncl for tti^
w
1
< Dramatic change has taken place In the early experiences of the
c
^ youngest children in the United States:
• Changes in child care patterns are related to increased
employment among mothers of young children,
• More than half of the infants under 12 months of age receive
care by someone other than their mothers.
5 Fundamental scientific and social policy questions have been raised
£ about the effects of early child care experiences on children's
g development:
• Some argue that early child care poses risks for infants.
n
• Others assert that children thrive in child care when quality is
high.
• Still others argue that early experiences do not alter
developmental trajectories unless they are characterized by
extreme deprivation.
Figure 1: Rolaiionships ol Interest at Any Given Age
and Over Time
Time N
Questions
Two over-arching questions motivate the NICHD Study of Early Child
Care:
1. Under what circumstances do children thrive in child care?
Under what circumstances Is children's development
compromised?
2. Through what processes does child care affect children's
development?
Ecological Mode*
Effects of child care depend on:
• Individual characteristics of child
• Characteristics of family and home environment
• Child care environment.
T!meN + 1
�\
01
i
Analysis Plan
id '•
Idenllfy selection faclore (characterfstics ol family related
lo bolh child care and dependent variables) to control In
analyses.
Idenllfy child characterislics lo control.
Identify addillonal family characleri sties related
lo dependent variables.
Test effects of chifd care with seleclion,
child, and family factors controlled.
Assess possible moderaling influences
of family variables,
Time ol Measurement (monlhs)
Construcl
SocEo-Emotlonal
Quality of Relationships
Adjustment
Self Concept and Identity
6
15
24
36
54
r-G
0
6
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Cognitive
Global Inlellecltial Functioning
Knowledge and Achievement
Cognitive Processes
Language Development
»
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Alternate Care Context
Structural Regulatabtes
Quanlity
Slabilily
Quality
Caregiver Characlerislics
©
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Home/Family Context
Slructural Context
Quality of Hometife
Parent Characlerislics
School Context
Slructural Context
School Curriculum
Child's Perceptions
e
•
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«
•
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0
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6
Sampling Plan and Subject Recmitmeiit
The
Study:
Sample
Characteristics
u
o
Q
I
U
•
Sites selected by competitive review of proposals (scientific
merit), not on basis of demography.
•
Ten sites and the associated 24 hospitals define the sampling
domain of the study.
•
All births in study hospitals during the recruitment period define
a catchment which is the "reference population of the study."
•
Sampling designed to produce unbiased estimates of effects for
the catchment while assuring adequate representation of major
socio-demographic niches.
Location of Data Collection Sites
�\
Sampling Procedure
w
u
«t •
Random assignment of hospitals to sampling days
•
Mother <18 at delivery
•
On assigned dates, all births In 24 hours recorded
•
Multiple birth
•
Each mother contacted In hospital to determine
•
Not fluent in English
— Demographics
•
Family planning to move within 3 years
— Exclusionary characteristics
•
Medical problems of baby or mother
— Permission to be contacted in 2 weeks
•
Adoption/foster placement of baby
Birth lists from all sites sent to Data Coordinating Center
•
Mother refused 2-week call
Excluded families culled
•
Family lives too far from data-collection site
Randomized calling lists created to ensure inclusion of at least
10% of families with low income, low education, and single
parents
•
Family in other study
•
Neighborhood not safe
•
Baby in hospital 7+days
a.
to
•
m •
Q
n
•
•
Calling lists returned to sites
•
Mothers called in order from calling lists at 2 weeks post-birth
for recruitment into study
•
Four families recruited per week at each site
•
Signed consent and official recruitment at 1 -month home visit
�Demographic Characteristics
of Catchment Area and Recruited Sample
o
S
Catchment (%)
Sample (%)
11.3
26,7
20,3
23.8
Postgraduate work
10.3
12.5
While
80.5
13.6
0.5
0.3
Asian
2.7
2.3
Hispanic
2.2
2.3-
Mixed
0.5
0.5
v\
13.0
Native American
-t
81.5
Black
J\ c
1 * ° i §
2B.5
BA level
§ $ t £$
11.1
Some college
8
^ gg
JL h* ci
z
Z
K
C
M
Education
<12th grade
High sci-iooviatu
11
T
<6 to
•*
s ?£*£
£ g s
o
Mother's Ethnicity
I
I
is
1
C5
(9
E
Partner at Home
3
1 o. ? 8!
3
£
O
Mo
13.2
14.2
Yes
86.8
I
1
0
1
s =
?
.1 2
+
1
i i
r 5
? 8 8
65.8
1
Work/School Plans
<10 hours/week
26.7
22.8
10-30 hours/week
24.7
23,0
30 or more hours/week
48.6
o
5
8
S
O
< D
^
w
S?
5? 5*:
6?
S f5 0> <£) £
* £
Is
I 3o
>
54.1
J? I cJ ol S
2 2 V: ^
u
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2
^ ££
£ 2£
£ 2
oi <ri u>
V
«J d
S 5}
5
2
N
i5
(o to
T-
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�At
IS Months
At
1 Month
At
1 Month
At
At
15 Months
36 Months
N=1364
At
36 Months ;
N=1240
N=1161
N=1364
N=1240
N=1161
;
N=1274
N=1231
N=1151
j
Male
51-7%
5^ -3%
51.4%
24.3%
16.7%
16.9%
]
Female
48.3%
41.7%
43.6%
52%
Number of Families
Income-to-Needs
0-1 (poverty)
>1-1.8 (near poverty)
^1.8 (norpoor)
Child Gender
15-4%
13.0%
67.9%
70.1%
Two-Parent Family
N=1364
N=1239
N=1159
76-5%
23.5%
7)!-5%
2;.s%
77.6%
N::1240
N=1161
3-3.3%
31-4%
60.4%
Yes
No
22.4%
N=1363
N=1240
N=1161
No HS Degree
10.2%
8.8%
8.9%
HS Degree or GED
21.1%
20.7%
20.6%
Some College
33.4%
33.6%
32.8%
College Degree
20.8%
21.7%
22.0%
1
10-19
i-5%
9.2%
Post-Graduate Education
14.5%
15.2%
15.7%
I
20-29
112%
10.7%
30 +
43.0%
48.7%
N =1240
N=1161
Maternal Education
Hours/Week in Care
0-9
N=1364
N=1240
N=1161
White. Non-Hispanic
76.4%
77.4%
78.6%
Type Of Care
Black, Non-Hispanic
12.7%
11.7%
11.2%
Child Care* Center
11.3%
29.6%
Hispanic
6.1%
6.0%
5.9%
Child Care Home
2 2.5%
20.2%
Other
4.8%
4.9%
4.4%
Ftelatrve/ln-Home Care
JS.3%
28.5%
Mother
2 9.9%
21.7% .
Child Ethnicity
•
Major assessments were done at 1, 6,15,24,36, and 54 months and will be done in first grade.
•
Intervening phone contacts were made every 3 to 6 months.
•
Questionnaires were completed in kindergarten.
The schedule of assessments is displayed in the table below.
Grade
Child Age (in months)
Assessment
Setting
1
6
15
24
36
54
• Home
O
•
#
•
#
•
•
•
•
•
*
•
o
• Child Care
•
• Laboratory
• Phone
•
•4
•
• Mailed
Questionnaire
K
1
©
•
—
•
•
• School
I 0 I < ! . 9 6 f r l BE = Q I
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\
The
•
•
8
Study:
n
Information provided by mothers in telephone calls
Averages for weekly hours of care determined
•
Amount calculated as mean of weekly hours of care during a
given epoch (e.g., 0 - 6 , 0-15, 0-24, 0-36 months)
Children who experienced no nonmatemal care across epochs
received scores of 0.
Measurements
of Child Care
a
Oi
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Q
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u
mmmmtmiM
Number of arrangements started across epochs (e.g., 0 - 6 ,
0 - 1 5 , 0 - 2 4 , 0 - 3 6 months)
Determined from mother's report of changes in chi!d-care
arrangements
Type of child-care arrangement was assessed at 5,14,23, and 35
months. Type of care was designated for the care arrangement in
which the child was observed as follows:
•
Relative/In-Home Care
- Father
- HeJative
- In-home/nonrelative care
•
Child Care Home
•
Child Care Center
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w
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a.
Child Care
ORCE Behavior Scales * ""^ •
,;
l
" ~-A / ' t
Frequencies:
Observational Record of the Caregiving Environment (ORCE)
•
Behavioral scales: Frequency counts of specific caregiving acts
with the child
•
Qualitative ratings: Ratings of the quality of the caregiver's
behavior in relation to the child
r-
n The scales are substantially similar at all assessment ages, but minor
* modifications were made to accommodate the increasing
S developmental complexity of the caregiver-child interactions.
ORCE General Procedure
•
Four 44-minute cycles of observations
•
Trained, reliable observers
•
Observations took place over 2 days, within 2 weeks
ORCE Ratings of Positiy&Qar^
Ratings completed at the end of each 44-minute cycle.
•
Sensitivity/responsiveness to nondistressed communication
•
Stimulation
•
Positive regard
•
Detachment/disengagement
•
Flat affect
•
Intrusiveness (at 36 months)
•
Fosters exploration (at 36 months}
Composites were formed from ratings to create assessment of
overall quality of care.
•
Shared positive affect
•
-Quality of Care
Positive physical contact
^
Responds to vocalization/child's talk
•
Speaks positively to child
•
Asks questions of child
•
Other talk to child
•
Stimulates cognitive development/teaches academic skill
•
Facilitates behavior
•
Mutual exchange
•
Negative/restricting actions (reversed)
^
Speaks negatively to child (reversed)
•
Child watching/unoccupied/transition (reversed)
�rn
\
ID
Aims
The
Study:
Nonmatemal
Child Care
and
Qualities of
TIT
9 *
The next two posters examine issues pertaining to the association
between the use of nonmatemal child care and global qualities of
mother-child interaction.
• Cumulative and lagged effects of amount, stability, and quality of
nonmatemal child care on mother-child interaction at 6, 15, 24,
and 36 months.
• Qualities of mother-child interaction in various child-rearing
niches, defined by family risk and child-care quantity and quality.
1. Do hours in nonmatemal care predict mother-child interaction in
the.first 3 years of life?
2. Among families using child care, do hours in care, stability of
care, and quality of nonmatemal child care predict mother-child
interaction in the first 3 years?
3. What are the effects of full-time child care on mother-child
interaction for families who differ by poverty status and maternal
depression?
• Does full-time child care — particularly high-quality care —
buffer risk conditions for mother-child Interaction?
• Does full-time child care — particularly low-quality care —
add risk for mother-child dyads at risk?
• Does full-time child care introduce risk for mother-child dyads
not at risk?
�n
\
Background
Ul
U
mm.
1
,
•
Planned Comparisons within Childrearing Niches:
Full-time Care (high- and tow-quality) vs. No Care
u nder C ond iti ons of Risk
Specific predictions tested full-lime nonmatemal care and its quality
versus no regular nonmatemal care under high- and low-risk
conditions.
The study of associations between child care and mother-child
Interaction addresses how the ecology of child rearing, child
care, and family interact.
•
Analysis
Some investigators hypothesize risks to the establishment of
sensitive mother-infant interactions associated with early
extensive child care.
a
•
^
C
D
0)
n
Others hypothesfze benefits of child care for family processes,
especially under conditions of adversity in which child care can
serve as a source of support.
• Parameters of child care (e.g., amount, quality) may have
positive effects on family processes in some families and
negative effects in others.
• In addition to examining main effects of care, analytic models
must test how care and family processes combine to affect
mother-child relationships.
Analysis Plan
Oi
Oi
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Regression Analyses
• Examined effects of child-care experience, cumulated over
epochs of 0-6,0-15, 0-24, and 0-36 months —
"cumulative effects"
- Prediction of mother-child interaction from child-care variables
when selection, child, and family variables controlled
- Hours of nonmatemal care examined for whole sample,
including those with 0 hours
•
-! [cure, ctability, end quality cf nenrrtaterria! cere examined fo
subsample observed in child care
Examined effects of child-care experience in earlier epochs on
later mother-child interaction — "lagged effects"
- Prediction from earlier care experiences (e.g., 0 - 6 months)
to later measured outcomes (e.g., 36-month mother-child
Interaction), after selection, child and family variables
controlled
r
No care = average hours of care across epoch <10
Full-time care = average hours of care across epoch £30
1. Under higher-risk conditions:
• Does full-time care buffer risk? or add risk?
Full-time xno care?
• Does full-time, higher-quality care buffer risk?
Full-time higher-quality > no care ?
• Does full-time, lower-quality care add risk?
Full-time lower-quality < no care?
2. Under lower-risk conditions:
• Does full-time care diminish resources and introduce risk?
Full-time < no care?
• Does full-time, tower-quality care add risk?
Full-time lower-quality < no care?
TWo Risk Conditions Examined
Maternal depression (high risk = upper quartile CES-D)
Poverty
(high risk = <1.8 average income/needs)
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Predictor Variables^
WWW'; • - - ' ^
1. Covariates
Selection Variables — variables correlated with both child-care
and mother-chifd interaction
Outcome V
Qualities of Mother-Child Interaction at 6 and 15 months
•
Maternal Sensitivity
Composited ratings of 15-min videotaped play
•
Incorne-to-needs ratio
- Sensitivity to nondistress signals
•
Maternal education
- Positive regard of infant
Child Varlabfes
•
Child gender
•
- Intrusive play (reflected)
Difficult temperament
Family Variables related to dependent variables
•
Two-parent family status
•
Maternal separation anxiety
•
Maternal depression
alphas = .75, 70
reliabilities = .87, .83
•
Positive Involvement
HOME (Caldwell & Bradley) subscale (factor-analytically derived)
rated from home interview and observation
- Spontaneously vocalizes
Child Care
- Responds verbally to child
•
Hours: Weekly hours averaged for epoch
- Initiates verbal interaction
•
Stability: Number of starts
- Voice§ positive feelings for child
•
Quality: Positive caregiving rating
- Hugs/kisses child
- Watches child (praises child)
alphas = .52, .56
Lack of Negativity (at 15 months only)
HOME subscale (factor-analytically derived)
- Does not shout at child
- Is not hostile
- Does not slap/spank
- Does not criticize
- Does not interfere
- Punishes physically <2/week
alpha = .54
�Outcome Variables . j , \ „ ';>%^.y^M
a Qualities of Mother-Child Interaction at 24 and 36 months
u
a Composited ratings of 15-min videotaped play
• Maternal Sensitivity
at 24 months
- Sensitivity to nondistress signals
- Intrusiveness (reversed)
2
- Positive regard of child
£
alpha = .74
3
relfabilfty = .84
S
at 36 months
2
- Supportive presence
- Respect for autonomy
- Hostility (reversed)
alpha = .78
reliability = .84
• Child Positive Engagement
at 24 months
u
- Child engagement with mother
- Child positive mood
0
•
5
=
=
alpha = .66
reliability = .76
s
°
u,
1
^
?
at 36 months
- Chiia attection for moiner
- Child negativity (reversed)
alpha = .61
reliability = .77
�at 3€liMlti«Ns
Child
Maternal
Sensitivity
36 Months
(n=1023)
Child
Engagement
36 Months
(n=1023)
Covariates 0 - 6
.211"*
.067'"
Child Care 0 - 6
.009""
.005*
-.10*
-.OB'
.008*
ns
ns
ns
-.05
-.01
Family 16 - 24
.009"
ns
Child Care 1 6 - 2 4
Red.
ns
-.03
-.03
Family 2 5 - 3 6
.001
.005*
Child Care 2 5 - 3 6
Red.
ns
.02
-.07
.235
.077
Hours
Family 7 - 1 5
•
and
Qualities of
Findings
Interaction:
Mother-Child
Child Care 7 - 1 5
Hours
Hours
Hours
Adjusted H* Total
* p<.05
" p<.01
" • p<.001
2
NOTE: Bold lype denotes adjusted R at pclnl of entry.
Red. denotes reducHon In R at point of entry.
Plain type denotes beta In final model,
ns = nonslgniflcanl.
Effects lor e-monlh hours on maternal sensitivity rematn stgnlflcanl when 6-month sensdhity
added to covariates Hock.
Family = maternal depression, separation anxiety, and 2 parent status In given epoch.
Covariates 0 - 6 a selection, cnro, ana lamuy covaiiaiw. 0-6.
2
�15 Months
e Months
Observed
(n=578)
Whole
(n=1273}
Observed
(0=581)
Whole
(n=1216)
Observed
(n=742)
Whole
(n=1214)
Observed
(n=739)
Whole
(1-1214)
Observed
(n-739)
Covariates .193***
.15B***
0.87—
.066**
^14*~
•IBS-
.091**
0.78—
121—
.119***
Child Care .004-
Red.
Red.
.017*
.001
Red.
.001
-007*
.006"
Red.
-.07*
-.05
.00
~.ir
-.03
-.0$
.04
.07*
-.08*
-.02
Stability
—
.00
.03
.02
1.03
.03
Quality
—
-.02
.06
-00
-09"
.05
.197
.155
Whole
Hours
Adjusted
R^Total
.086
.082
.187
.214
.086
.032
.127
.119
* p<-05
" p<.01
" * p<.001
2
NOTE" Red. denotes reduction in R .
Bold type denotes R .
Plain type denotes bets.
— denotes not applicaMe for the whole sample
2
Regmssibif.Mfedb for Cumulative Mddlls for E f f ^ s ? ^
24 Months
:
36 Month:?
Whole
(n=1150)
Observed
(n=803)
Whole
(n=l150)
Observed
(n=803)
Whole
(n=1139)
Observed
(n=870)
V/hole
(n =1139)
Observed
(n=870)
Covariates
JSO0**
.191***
.072***
.052—
.242***
^10—
XOT***
.072**
Child Care
ns
Red.
.002*
ns
006**
.010**
.005*
.006*
HOURS
.01
-.02
-.06-
-.06
-.09*
-.06
.08-
-.06
StatxTrty
-.01
.04
.01
.02
Quality
.03
-.03
.10*
.07*
Adjusted
R Total
3
.200
.189
XI74
* p<.05
** p<.01
*** P<-001
2
WOTE Red. denotes reduction in R .
BoW type denotes R .
Plain type denotes beta.
— denotes not applicable for the whole sample
2
loi^asbioE-ai
.052
^48
093
.078
�Compariscns
Care Groups
ns
nsitivfty 6
9.44
9.05
9.10
9.00
*
S.42
5.S6
539
553
•
rs
ns
sitivc Involvement 6
9.53
9.41
9.39
9.43
ns
ns
rs
ns
nsitivity 15
5.58
5.64
5.69
5.56
ns
.ns
IS
ns
sitive Involvement 15
cKof Negativity IS
5.23
S.05
5.10
4.99
«
ns
9^0
9.52
9.45
9.59
ns
ns
l.S
ns
nsitivity 24
5.79
5.67
5.52
5.74
ns
ns
US
ns
.iidEnsagemeni24
nsitivity 3$
17.69
17.22
17.3S
17.21
*
ns
iild Engagement 36
11.57
11.01
10.91
11.10
•p<.05
" p<01
ns = nonsignificant
NC = No Care (<10 hr weekly average)
FT = Full-time Care (>30 hr weekly average)
T7HQ = Higher-Quality Full-time Ciire
T/LQ = Lov^er-Quality Full-time Care
•
ns
ns
ns
*
HOTS Means are adjustedforincome-to-needs, maiarna! education, child gender. 2.parent status, and separation anxiety.
Idjusted MRansaml Planned
or Low-RisK^Monpoyerty
Oomfmm^mjef^^g^
Families'^UM^'tf^:"
Comparisons
Care Groups
fjff
*
ns
ns
ns
ns
ns
ns
ns
ns
5.63
ns
ns
ns
ns
5.09
4.98
ns
ns
*
ns
9^0
9.42
9.S9
ns
ns
ns
ns
5.80
5.63
5.56
5.70
ns
ns
ns
ns
18.05
17.15
17.15
17.15
*
*
«
ns
11.06
•
.•nsitivity 6
9.54
9.14
9.12
9.17
jsitive involvement 6
SA&
5.57
557
5.57
ns
nsitivity 15
9.69
9.47
9.41
9.53
jsrtive jnvotvement 15
5^9
5.67
5.70
ick of Negativity 15
5^0
5.04
^nsitivity 24
9.43
lild Engagement 24
>nsitivity 36
illd Engagement 36
11.63
11.03
11.01
*p<.05
" jx.01
ns = nonsignificant
N C = No Care (<10 hr weekly average)
FT = Full-time Care {>30 hr weekly average)
T/HQ = Higher-Quality Full-time Care
TA.Q = Lower-Quality Full-time Care
•
ns
VOTE: Means are adjustedformaternal education, child gender, 2-parent status, maternal depression, and separation anxiety.
LZ/ZZ
HDWd
MMO
aHOIN=WOMH
XS=SI
iG-iO-MdV
�Comparisons
Care Groups
sitivitye
9.02
9.01
9.07
8.95
ns
ns
re
ns
itive Involvement 6
5.24
5.36
5.59
5.14
ns
•
n;
*
sitivity IS
8.98
9.06
9.23
8.92
ns
ns
n:
ns
itive Involvement 15
5.39
S.46
5.57
5.38
ns ,
.- ns
n:
ns
<of Negativity 15
5.08
4.94
5.02
4.88
ns
ns
n;
ns
sitivity 24
9.19
9.0fi
9.43
8.79
ns
ns
n;
ns
d Engagement 24
5.54
5.25
5.45
5.08
ns
ns
-
ns
sitivity 35
16.67
16.71
17.30
16.31
ns
ns
n;
ns
i Engagement 35
10-97
10.93
10.85
11.06
ns
ns
n:
ns
• fx.OS
ns = nonsignificant
NC = No Care (<10 hr weekly average)
FT = Full-time Care (>30 hr weekly average)
-1Q = Higher-Quality Full-time Care
\.Q = Lower-Quality Full-time Care
(
0T£: Means are adjusted for maternal edugation, child gender, 2'parenl status, maternal depression, and separation anxiety.
Care Groups
Compariscns
snivity 6
9.08
9.19
8.95
9.47
ns
ns
n>
ns
Itive Involvement 6
5-28
5^4
5.43
5.23
ns
ns
n;
ns
sftivity 15
9_20
9-13
9.04
9.22
ns
ns
n;
ns
itive Involvement 15
5.36
554
5.51
5.56
ns
ns
n;
ns
k of Negativity 15
4.96
4.89
4.88
4,89
ns
ns
Sitivity 24
9.05
9.00
9.13
8.87
ns
ns
id Engagement 24
5.43
5.17
5.38
4.99
ns
ns
Sitivity 36
16.67
16.32
10.30
16.25
ns
ns
n:
ns
id Engagement 36
11.00
11.00
11.10
10.90
ns
ns
n..
ns
ns
n:
ns
ns
• p<.05
no = nonsignificant
NC = No Care (<10 hr weekly average)
FT = Full-time Care (>30 hr weekly average)
HQ = Higher-Quality Fulltime Care
OO = Lower-Quality Fulltime Care
Means are adjusted for income-to-needs, maternal education, child gender, 2-paren: status, and separation anxiety.
I0ILSBbl0E = aI
MMO
aH3IN=WOMd Z Z - Z l
iB-^O-MdW
�t^
n
\
Summary of Regression Art
of C u m u l a t i v S i ^ i i l M B "
Summary of Regression lAnalyses
2"of Lagged Effects o f C a i ^ V * ^'*\r*?*:9^*
Q. In the whole sample, do hours of nonmatemal care predict qualities the whole sample, do hours of nonmatemal care from earlier time
In
of mother-chiid Interaction?
periods predict subsequent qualities of mother-child interaction?
• More hours of care predict
• More hours of care in the 0- to 6-month period predict
5
£
- lower maternal sensitivity at 6 and 36 months
- more maternal negativity at 15 months
- lower chifd positive engagement with mother at 24 and 36
months
- lower maternal sensitivity at 36 months
- lower child positive engagement at 36 months
•
Effects remain significant for 0 - 6 hours of care when 6-month
maternal sensitivity is controlled.
C
O
5 For children fn care, do hours, stability, and quality of care predict
g qualities of mother-child interaction?
n
Q • More hours of care predict
- lower maternal positive involvement at 6 months
- lower maternal sensitivity and child positive engagement with
mother at 36 months
but
- more positive maternal involvement at 15 months
• Higher quality of care predicts
- more positive maternal involvement at 15 months
g
- more maternal sensitivity and child positive engagement with
mother at 36 months
Q
u
Summary of Plan
NigK-Rislc Mothers^
No Car©
Full-timo High Quality
Full-time Low Quality
Does use of full-time child care—particularly high-quality care —
buffer effects of risk conditions for mother-child interaction?
• Low-income mothers using full-time higher-quality care had
higher positive involvement at 6 months than low-income
mothers not using care or those using lower-quality full-time
care.
• No buffering effects of care found for mothers with high
depressive symptoms.
Does use of full-time care add risk when mothers are at risk?
• Engagement was lower at 24 months for children of high-risk
mothers in fulf-time lower-quality care than for children of
mothers not using care.
�Summary" of Planm
Low-Risk Mothers
1. Family and child characteristics were consistent predictors of
mother-child interaction. Compared with their influences, child
No Care
care was a much smaller contributor to qualities of mother-child
Full-time High Quality
interaction In the first 3 years.
Full-time Low Quality
• When significant, child care predicted approximately .5% to
1 % of the total variance. Of the variance accounted for, on
When mothers are not at risk, does use of full-time care introduce
average only 6.5% was attributable to care.
risk to mother-child interaction?
2. Nonetheless, where child-care effects were found, findings were
2 • Low-risk mothers (nondepressed and nonpoverfy) were more
consistent
£
sensitive at 6 and 36 months when not using care than when
5
using fult-time care, regardless of its quality.
• Amount of child care was negatively related to mother-child
interaction
5 • When not in care, children of low-risk mothers showed more
Q
positive engagement with mother at 36 months than when in
- For the whole sample (and, for the most part, for the
full-time care, regardless of its quality.
sample of families using nonmatemal care), more hours of
nonmatemal child care were related to less sensitive play
• Low-risk mothers were more negative at 15 months when using
of the mother with her child at 6 and 36 months and more
lower quality full-time care than when not using care.
negative interactions with her child at 15 months.
But
- In addition, children were less positively engaged with their
Similar to high-risk (low-income) mothers, nondepressed
mothers during play at 24 and 36 months when they spent
mothers using full-lime higher-quality care were more positively
more hours in nonmatemal care.
Involved at 6 months than nondepressed mothers not using
- Negative effects of hours in the first 6 months showed a
care.
persistent effect at 36 months on mother-child interaction.
- Mirroring findings for the whole sample, among nonpoverty
and nondepressed mothers, higher qualities of motherchild interaction were observed at 36 months when
mothers used no regular child care than when they used
full-time care across the first 3 years.
1
�\
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u
<
1
• Quality of care was reiated to mother-child interaction
- When higher-quality chifd care was used, mothers were
more positively involved at 15 months than when care was
lower in quality. In addition, mothers were more sensitive
and their children were more positively engaged at 36
months when child care was higher in quality
- For low-income mothers, use of higher-quality fulf-time
care was related to greater maternaf positive involvement
at 6 months, relative to no care.
- Lower-quality full-time care constituted an additional risk for
2
the child's positive engagement with mother at 24 months,
£
relative to no care, for children of htgh-risk mothers.
« n summary, these findings suggest that beyond the more consistent
Q md pervasive effects of family, maternal, and chifd characteristics on
P qualities of mother-child interaction, child care hours and quality
" nake additional, though smali, contributions.
a
a
o
Q
I
u
�r-- —
n
The next two posters examine the extent to which child care Is
related to cognitive and language outcomes during the first 3 years of
life after adjusting for selection, child, and family characteristics.
Background
Intervention Studies
I
i
o
Q
I
u
Linguistic
Outcoi
Background
•
These studies focus on high-quality programs offered to children
from impoverished families.
• The findings consistently demonstrate positive effects of child
care on a range of cognitive and language outcomes and longlasting effects on academic outcomes.
Naturalistic Studies
•
These studies have typically focused on the effects of preschool
care on cognitive performance in white middle-class children.
• Empirical results are mixed showing no effects of care on
cognition and language, positive effects on both cognition and
language, or sometimes negative effects of care on these
outcomes.
�Key Questions
u
^
1. Does quality of care predict cognitive and language outcome
measures In the first 3 years of life?
• • Quality measured by positive caregiving ratings
• Quality measured by frequency of language stimulation
2. Do hours In care and type of care predict cognitive and
language outcomes in the first 3 years of life?
3. Does child care affect boys and girls differently?
r-t
2 4. Do child-care experiences predict differently for children who
£
vary by:
m
Z
• family income?
o
7
2
Cumulative Analyses for Subsample of Children
Observed in Their Care Environment
• home environment?
• ethnicity?
Idenlily selection factors to be used as covariates.
mm
Identily child characlerislics lo be used as
covariates,
Identify addillonal family environmenlal
characteristics to examine Ihe exlent to which
they are related lo the cognitive and language
outcomes.
Regress Ihe cognitive and language
outcome variables on predictor variables
entered in Ihe following order: site,
seteclion, child, lamily envirorment, childcare variables, and Interaction blocks using
hierarchical regressions,
Test interactions:
» language stlmulallon X gender
* language stimulation X Income-toneeds
» language stimulation X lamily
environment (HOME)
�n
\
m
U
U
D
L
Predictor
1. Covariates
Selection Variables
• Maternal vocabulary (Peabody Picture Vocabulary Test)
• Income-to-needs; Family income (exclusive of welfare
payment) divided by the poverty threshold for a family of a
given size
Child Gender
Family Variables
• HOME Total Score: Observed stimulation and support
available to child in home environment
• Maternal stimulation: Rated on a 4-point scale from
videotapes with 15 min of mother-child interaction during play
2. Child Care
• Hours: Mean number of hours of care per week from birth
through the age at which the outcome measure was collected
• At 15 Months
- Bayley Scales of Infant Development:
Standardized developmental assessment yielding
Mental Developmental Index (MDI)
- MacArthur Communicative Development Inventory (GDI):
Standardized questionnaire completed by mother yielding
• produced vocabulary
• comprehended vocabulary
•
• Type:
Child-Care Center: Number of times child observed In center
care prior to and including the assessment period (e.g., at 6
and 15 months, for 15-month outcomes)
Chi Id-Care Home: Number of times child observed in childcare home prior to and including the assessment period
• Quality of provider-child Interaction
- Positive caregiving:
A composite variable from ORCE Rating Scales:
• Sensitivity to nondistress
• Stimulation of cognitive development
• Positive regard
• Detachment (reflect)
• Flatness of affect (reflected)
- Frequency of language stimulation:
A composite variable from ORCE Behavior Scales
• Asks questions of child
• Responds to child vocalization
• Other talk to child
At 24 Months
- Bayley Scales of Infant Development (Revised):
Standardized developmental assessment yielding
Mental Developmental Index (MDI)
- MacArthur Communicative Development Inventory (GDI):
Standardized questionnaire completed by mother yielding
• produced vocabulary
• sentence complexity
•
At 36 Months
- Bracken Scale of Basic Concepts:
School Readiness Composite:
Standardized developmental assessment yielding
School Readiness Composite
- Reynell Developmental Language Scale (RDLS):
Standardized developmental assessment yielding
• comprehended vocabulary
• expressive language
�tandardizcd Regression CooWttenU and AdjU$te
from Analyses Predicting Cognitive and tanguag
rm
Entered before child care predictors: Slle, Seleclion (Maternal Vocabulary,
Income/Needs), Gender, Home (Total HOME, Observed Maternal Cognllive Slfmulatlon)
i
an
Linguistic
Outcomes!
Results and
Discussion
Child Care Predictors:
Model 1: Hours, type, observed posilive caregiving rating
Model 2: Model 1 + observed frequency ol language slimulallon
Vocabulary
Produced
Bayley MDI
Model 1 Model 2 Model 1 Model 2
Adjusted R2 for
covariates
Vocabulary
Comprehended
Model 1 Model 2
.129*
.osr
.013*
.013"
.032*
.036*
2
Adjusted Ft for all
child-care variables
Average hours/week
In child care 0-15 mo
ns
ns
ns
ns
ns
ns
It times in center
6,15 mo
ns
ns
ns
.109*
ns
ns
H times in child care
home 6,15 mo
ns
ns
ns
ns
ns
ns
Observed rating of
posittve caregiving
6,15 mo
ns
ns
.124*
ns
.147'
ns
Observed frequency
of language slimulation
6,15 mo
—
.172*
.245'
—
.176*
2
Tolal adjusted R for
selection, gender,
home, child care
ns= nonsignificant.
*=p<.05
— not In modal
.142*
•
.068*
.049*
�r- -n
\
i
n
u
Performance at Ago 24}Hanthfi^
Standardized Regression
Coefficient-fndi
from Analyses Predicting Cognitive mti
ikamm§
inlered before childcare predfctors: Site, Seleclion (Maternal Vocabulary,
icome/Needs), Gender, Home (Tolal HOME, Observed Malernal Cognitive Stimulation)
Entered before child care predictors: Site, Selection (Maternal Vocabulary,
Income/Needs), Gender, Home (Total HOME, Observed Malernal Cognilive Stlmulalion)
:hlld Care Pred/ctors:
Chifd Care Predictors:
Model 1 : HourSi lype, observed positive caregiving rating
Model 1: Hours, lype, observed posilive caregiving rating
Model 2: Model 1 + observed frequency of language stimulation
Model 2: Model 1 + observed frequency of language slimulalion
r^
to
tn
Vocabulary
Produced
Model 1 Model 2 Model 1 Model 2
Q)
n)
djusted R2 for
ovarlales
.269'
Model 1 Model 2
.110'
.053*
2
•djusted R for all
hild-care variables
verage hours/week
i child care 0-24 mo
times In center
,15,24 mo
limes fn child care
ome 6,15,24 mo
Observed rating of
•osillve caregiving
i s , 24 mo
)bserved frequency
'f language stimulation
.15,24 mo
.032'
ns
.172*
.077*
.160*
ns
.197*
.100*
ns
C
M
ns = nonslgnlflcant.
^ - not In model
ns
ns
ns
ns
.103*
ns
ns
.016*
ns
ns
ns
.118*
ns
.101*
ns
ns
.141'
.234*
.162*
Reynell
Vocabulary
Comprehended
Model 1 Model 2
2
Adjusted R for
covarlales
.316*
.164'
.368*
Adjusted R2 for all
child-cars variables
.014*
.014*
.021*
Average hours/week
in child care 0-36 mo
# times in center
6,15, 24, 36 mo
# times In child care
home 6,15,24,36 mo
Observed rating of
positive caregiving
6,15,24 36tTW
)
z
otal adjusted R for
election, gender,
ome, child care
.023*
ns
Reynell
Bracken
Expressive
School
Language
Readiness
Model 1 Mode! 2 Model 1 Model 2
Sentence
Bayley MDI
r-t
Observed frequency of
language slimulalion
6,15,24, 36 mo
ns
ns
ns
ns
ns
ns
.118*
.137'
.095'
.124*
.142*
.155*
ns
ns
ns
ns
.063*
.093*
.116*
ns
.096*
ns
.148'
,117*
ns
.123*
ns
.330
.178*
.409*
2
.801"
Tolal adjusted R for
selection, genuer,
home, child care
ns = nonsignificant.
* = p<.05
— not In model
�n
Key Question 2
\ |
Key Question 1
Does quality of care predict cognitive and language outcomes in the
first 3 years of life?
•
Do hours in care and type of care predict cognitive and language
outcomes in the first 3 years of life?
Number of Hours?
•
Yes
- Higher child-care quality was consistently related to better
outcomes. The unique contribution of the child-care quality
variables ranged from 1.3% and 3.6% of the individual
differences in cognitive and language performance.
More positive caregiving rating fs related to:
There is no relation between number of hours of care and any
of the outcome variables.
Type?
•
Center care predicts better performance on the Bayley at 24
months, on the Bracken School Readiness at 36 months, and
on measures of language skill at all three ages.
2. Higher language scores —
at all ages
Child-care homes predict better performance on the Bayley at
24 months and on one of two measures of language skill at
36 months.
This finding is primarily accounted for by the Frequency of Language
Stimulation.
•
Yes
After controlling for quality of care
1. Higher cognitive scores—
Bayley at 24 months; Bracken at 36 months
!
No
Higher language stimulation fs associated with:
1. Higher cognitive scores —
Bayley at 15 and 24 months; Bracken at 36 months
Key Question 3
2. Higher language outcomes —
at all ages
Is the relation between child care and cognitive or language
outcomes different for boys and girls?
•
No
- No consistent pattern of interactions between the language
stimulation variable and child gender emerged in analyses.
One significant interaction was obtained in analysis of the
receptive vocabulary at 15 months.
�" Key Question 4
n
" Do chflcf-care experiences predict differently for children who vary by:
g Family Income?
*
•
No
- No signilicant interactions between language stimulation and
income-to-needs were found.
Home Environment?
•
No
- No significant interactions between language stimulation and
the HOME were found.
2 Ethnicity?
•
No
- No significant fnteractions between language stimulation and
ethnicity (African Americans, Caucasian) were found.
Coiickision
1. Quality of provider-child interaction at child care Is related to
better cognitive and language outcome during the tirst 3 years:
Across a wide range of child-care settings, positive caregiving
and language stimulation contribute between 1.3% and 3.6% of
Ihe variance io early cognitive and language development in the
first 3 years of life. Despite the significance of these results, it is
important to note that ail the predictors combined (income-toneeds, mother's vocabulary, mother interaction with the child,
family environment, child gender, and child care) accounted for
between 5% and 41% of the variance.
Because our measures of child-care quality are interactional, the
association between quality of care and children's outcomes
may be due, at least In part, to behaviors elicited by the children
and responded to by the child-care providers.
2. The relation between child-care predictors and outcomes is
similar for children:
- in different types of care
- with different family incomes
- from different home environments
- from different ethnic groups
- of both genders
3. After controlling for quality of care:
Children attending center care have higher cognitive and
language outcomes than children in other types of care.
4. With quality controlled:
the Bayley at 24 months and on Reynell Expressive Language
at 36 months.
�PositiveCaregiv
Higher Cdgrii tiif e
Performance M
For the cognitive and language development of young children,
frequency of language stimulation in the child-care setting is the most
predictive component of provider-chiid interaction. Language
stimulation accounted for a relatively small proportion of the variance
in cognitive and language development, compared with other
environmental characteristics (family income, maternal vocabulary,
quality of the home environment, and mother-child Interaction).
�Overall Summary
Conclusions
Across the
Two Domains
-
Two different domains — mother-child Interaction and children's
cognitive and language development — were examined for their
relations to early child-care experience across the first 3 years of life.
• With selection, child, and family variables controlled, child care
made consistent additional contributions to explaining both
mother-child interaction and cognitive and language outcomes.
- For cognitive and language development:
• Child care experience, especially positive caregiving and
language stimulation in the care setting, accounted for
1.3% to 3.6% of the variance in cognitive and language
development.
- For mother-child interaction:
• Child care, especially amount of care and positive
caregiving in the care setting, accounted for .5% to 1% of
the variance in mother-child interaction.
• Major findings — Child Care Quality:
- More positive caregiving and, especially, language
stimulation in child care were related to children's better
performance on cognitive and language tests when they
were 15, 24, and 36 months of age.
-
More positive caregiving in child care was related to more
positive Involvement of mothers at 15 months and more
sensitivity of mothers at 36 months with their children.
• Major findings — Amount of Child Care:
- More hours of child care was related to less sensitive and
engaged mother-child interactions across the first 3 years.
These findings seemed to hold particularly for mothers who
were not at risk due to poverty or depression.
- Amount of child care was unrelated to children's cognitive
and language development,
In summary, although family, maternal, and child characteristics
generally explained a larger proportion of the total variance, child care
made additional, though small, contributions to qualities of motherchild interaction and to children's cognitive and language development,
�n
\
m
n
Publications Available from the
NICHD Study of Eariy Child Care
Future Papers from the NICHD Study of Early Child Care
mmmmm
u
D,
L
(1993) . Child-care debate: Transformed or distorted? American Psychologist, 48.692-693.
(1994) . Child care and child development: The NICHD Study of Early Chifd Care. In S.L.
Friedman and H,C, Haywood (Eds.) Developmental Follow-up: Concepts, Domains, and
Methods, (pp. 377-395). New York; Academic Press.
(1996). Characlerislics of Infant child care: Factors contributing to posilive caregiving.
Early Childhood Research Quarterly, 11,269-306.
(Spring, 1996) Child care and the family: An opportunity lo study developmenl In context.
Newsletter of the Society for Research in Child Development,
(in press). Poverly and pallerns of child care. In J. Brooks-Qunn & G. Duncan (Eds.)
Consequences of growing up poor. New York: Russell-Sage.
Infant child care and mother-child Interaction al 6 and 15 months.
Early child care and self-conlrol, compliance, and problem behavior al 24 and 36 monlhs.
The effeels of child care on cognitive OUICOIT.DS at 15,24, and 36 monlhs.
The effects of child cars on heallh and growth,
The ef feels of child care on peer relations at 24 and 36 monlhs.
Predictors of posilive caregiving at 15, 24, and 36 months.
Child care and mother-child interaction at 24 and 36 monlhs.
Child care and atlachment to mother at 24 and 36 monlhs,
Patterns of child care across the first three years of life.
(in press). The effects of infant child care on Infant-mother attachment security; Resulls of
Ihe NICHD Study of Early Childcare. Child Development.
Early life and child care experiences of Head Start eligible chitdren.
(in press). Family factors associated with characlerislics of nonmatemal care for Infants.
Journal of Marriage and the Family.
Studying Ihe effects of early child care experiences on the development of ethnic minority
children in the US: Towards a more Inclusive agenda,
(in press). Child care experiences during the first year of life. Merrid-Patmar Quarterly.
Fathers and child care.
These papers can be obtained by wriling to the:
Effects of child care for children from families with psychosocial risk.
Public Informalion and Communications Branch
National Inslilute of Chifd Health and Human Development
Building 31, Room 2A32
Belhesda, MD 20692-7510
Do developmenlal processes operate differently across child care niches?
Effects of regulable aspects of child care on child oulcomes.
Chronldly of maternal depressive symptoms, molher-chiW Interaclion, and child outcome.
�APR-07-37
1 2 = 2 8 FROM=NICHD
ORR
ID:3014967101
PAGE
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hild Care Research Network
< Appelbaum
UnjvefSity Of CaWomia at San
(619)S34-7959
(619)534-TJ90tSK
mappelsa ©psy.ucsd-sciu
Dee A n n Batten
Vbrxteittlt uniueidty
(61^)343-1476
(G15) 343-1100 to
baBendaQctrvax.vanaertjaiedu
Jay Belsky
Penrsytvania State University
^14) 865-1447
(614) 863-6207 tax
ixbOefnaii.pstiGdij
Kimberly Boiler*
Mahamasea Policy Research
tnsttute
(609) 275-2341
(609) 7990005 to
Msotler® matriematica-mpr.com
2etia Brownell
Jnkersity of Pittsburgh
•412) 624-4510
•412) 62^4428 to
7rqwnellOvnB.cis.pitLedu
Margaret Burchinal
University of North Carolina at
Chapel Hill
(919)9e&S059
(919) 962-5771 to
biiKitina.1pg9niiis.une.edu
Bettye Calctwell
Af kansas ChiWren's HospW
Department of Pediatrics
(501) 3203333
(501) 320-1552 to
Oettyemc« care.ach.uams.edu
S u s a n Campbell
University Of Pittsburgh
(412)624^792
(412) 624-5407 to
preschlQvms-cis-pitLGdu
i&CbOu.wsshington.edu
A l i s o n Clarke-Stewart
University of Cafifomia at Irvine
(714) 824-7191
(714) 624-3002 to
acstewardtjci.edu
Robert Bradley
University of Arfcansas at Little
Rock
(501) 569-3423
(501) 569-6503 to
rttaadleyauair.sdu
Martha Cox
Untveisity of North Carolina at
Chapel Ha
(919) 966-3509
(919) 966-7533 to
eo>(.fpg©rTihs.une.edo
Cathryn Booth
Urtverslty of Washington at Seatte
(206)543^074
(206) 685-3349 to
Kaye Fendt
National institute of ChiW Health
and Human Development
(301)594-5414
Sarah t_ Friedman
National tnsfitute of Child Health
end Human Development
(301)496-9849
(301) 480-7773 to
friedmas'&hdOl jilchd-nih.gov
Nancy Marshall
Wellesley College
(617) 283-2551
(617) 283-2054 fax
nmarshall ©wellesleyedu
Henry N. Ricciuti*
Cornea University
(607)255-0344
(607) 255-9856 fax
hnrl OcomeHedu
Kathleen McCartney
University of New Hampshire
S u s a n Spieker
Univeisity of Washington at Seattle
(200)543^453
(206) 685-3349 to
spieker@uwashirtgton.edu
(603) 862-3168
(603) 862-4986 to
tathleen_rTiccartney9urih.edu
Kathryn Hirsh-Pasek
Temple University
(610) 642-5275
(215) 2043539 to
v$230eOvm.temple.edu email
Marion O'Brien
University of Kansas
(913)864-4840
(913) 8636202 to
rnobrienQtonrLoc.ukan&edu
Deborah Lowe Vandell
University of Wisconsin at Madison
(601)) 263-1902
(6011) 263*448 to
dvaivlellOmacc.wisc.edu
Aletha Huston
University of Texas at Austin
(512) 471-0753
(512) 471-5844 to
achustonOmaiLutexas.edu
Margaret Tresch Owen
Kathleen Wallner-Allen*
Reteareh Triangle Institute
(301)496-9849
(301) 480-7773 to
walinertcQ hdol .nichd.riih.gov
Elizabeth Jaeger
Temple Unlvereity
(215)204-7894
(215) 20^5539 to
vi547gOvm.teniple.edu
Robert Pianta
University of Virgin ia at
Charlottesville
(804) 243-5483
(804)24*5480 to
rcp4pOvirgina.edu
Bonnie Knoke
Research Triangle Institute
(919)541-7075
(919) 541-5966 to
knokB@rti.org
Unrversity of Texas at Dallas
(972)8834876
(214) 863-2491 to
mowen«utdaiias.edu
Deborah Phillips
National Academy of Sciences
(202) 334-1935
(202) 334-3829 to
phillips©nas.edu
Marsha Weinraub
Temple University
(21.5)232-6572
(215) 204-5539 tax
v5?42«Ovm.temple.edu
' Atliliated with the NICHD during
the course of the Early Child
Care Study.
�
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Health Care Reform
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2006-0810-F
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<p>This collection consists of records related to Hillary Rodham Clinton's Health Care Reform Files, 1993-1996. First Lady Hillary Rodham Clinton served as the Chair of the President's Task Force on National Health Care Reform. The files contain reports, memoranda, correspondence, schedules, and news clippings. These materials discuss topics such as the proposed health care plan, the need for health care reform, benefits packages, Medicare, Medicaid, events in support of the Administration's plan, and other health care reform proposals. Furthermore, this material includes draft reports from the White House Health Care Interdepartmental Working Group, formed to advise the Health Care Task Force on the reform plan.</p>
<p>This collection is divided into two seperate segments. Click here for records from:<br /><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0810-F+Segment+1"><strong>Segment One</strong></a> <br /><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0810-F+Segment+2"><strong>Segment Two</strong></a></p>
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Clinton Presidential Records
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William J. Clinton Presidential Library & Museum
Text
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Original Format
The type of object, such as painting, sculpture, paper, photo, and additional data
Paper
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Child Care Study - NICHD [National Institute of Child Health and Human Development]
Creator
An entity primarily responsible for making the resource
First Lady's Office
Nicole Rabner
Source
A related resource from which the described resource is derived
7763278
42-t-7763278-20060810F-Seg2-020-005-2015
Identifier
An unambiguous reference to the resource within a given context
2006-0810-F Segment 2
Is Part Of
A related resource in which the described resource is physically or logically included.
Box 20
<a href="http://clinton.presidentiallibraries.us/items/show/36145" target="_blank">Collection Finding Aid</a>
<a href="https://catalog.archives.gov/id/7763278" target="_blank">National Archives Catalog Description</a>
Provenance
A statement of any changes in ownership and custody of the resource since its creation that are significant for its authenticity, integrity, and interpretation. The statement may include a description of any changes successive custodians made to the resource.
Clinton Presidential Records: White House Staff and Office Files
Publisher
An entity responsible for making the resource available
William J. Clinton Presidential Library & Museum
Format
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Adobe Acrobat Document
Medium
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Preservation-Reproduction-Reference
Date Created
Date of creation of the resource.
5/27/2015