D A Y C A R E L E S S

Studies increasingly confirm the common-sense intuition that day care poses dangers to small children. So why is the Clinton Administration pushing it?

WARNING: MAY BE HARMFUL TO CHILDREN

UNTIL recently, parents typically had a far more negative view of day care than experts did. Not long ago, I stumbled across the following datum in a 1992 issue of The Journal of the American Medical Association that may help explain why: In the course of one year of full-time day care, a middle-class white male toddler was "likely to be bitten'' nine times.

A social scientist might point out that there is no firm evidence that being mauled by one's peers has any negative effect on one's psychosocial development. But I have never run across the parent who, faced with this bit of news, does not shudder. That is the difference between a social scientist and a parent.

But over the last decade, the gap between expert and folk wisdom appears to be closing. A growing number of child-development experts have joined the ranks of parents who worry that extensive day care is not good for young children.

An emerging body of research suggests that children in full-time day care are less likely to be firmly attached to their parents and are on average more disobedient toward adults and more aggressive toward their peers than children cared for primarily by their parents. In certain circumstances, day care also puts children's cognitive development at risk.

Of course, not all children in day care are damaged by the experience. But the new data should give parents -- and policymakers -- pause, especially as the Clinton Administration is ready to unveil a major new child-care initiative. For in this case, the Administration is promoting as "child-friendly'' policy something actively harmful to some children.

A review of the day-care literature was published in 1996 by Michael E. Lamb of the National Institute of Child Health and Human Development (NICHHD). While noting that non-parental care "need not'' have harmful effects, Lamb concluded that it often does, depending "on the quality of care and the child's age, temperament, and individual background.'' Under ideal circumstances -- when the child develops a strong, stable attachment to an alternative caregiver -- day care may not be harmful. But, he concludes, "in other circumstances, [non-parental care] leads to behavior problems (including aggression & noncompliance).''

The trouble is that most day-care kids are, indeed, in "other circumstances.'' Quality child care, as experts now understand it, does not refer to variables such as group size or caregiver training that can be regulated by government (day-care boosters tend to be obsessed with licensing and training). Instead, quality care is dependent on the same underlying emotional processes that make for strong mother - child relationships. For young children, high-quality care means a caregiver who stays with the child for long periods -- "years, not months,'' says one expert. A high-quality caregiver babbles, chatters, coos, hugs, strokes a baby or toddler, and consistently makes the effort to respond warmly to his verbal and non-verbal attempts at communication.

Few employees can meet such demanding standards. A 1995 national study by the University of Colorado found that only 8 per cent of day-care centers serving infants and toddlers offer high-quality care; in 40 per cent of centers, the care is so bad that it endangers young children's psychological and cognitive development. Indeed, for cognitive development, the research suggests that the children of educated mothers may be at special risk -- because of the contrast between the care they get at home and at the typical day-care center.

Just how harmful is the day care most children receive? The evidence falls into two categories. The first comes from medical researchers. Day care, it turns out, is definitely not good for babies' health. This is not surprising: group care exposes babies and toddlers to large numbers of biological strangers, many of whom are not toilet trained and who drool, making day care a breeding ground for infectious disease.

A 1992 review published in The Journal of the American Medical Association concludes: "[C]hildren less than age 2 years who attend day-care centers are more likely to acquire respiratory infections at an earlier age than those cared for at home.'' Children in day care are about one and one half times as likely to get "acute respiratory illness'' as children at home and have up to three and one half times more outbreaks of acute diarrhea.

Most of these day-care illnesses are not life-threatening. But sometimes even minor illnesses can have long-lasting consequences. A study published in March 1997 in Pediatrics concludes that between 1981 and 1988 the proportion of preschoolers with chronic ear infections leapt from 18.7 per cent to 26 per cent, largely because more children are in group care.

Not only is a chronic earache unpleasant; it can also lead to "hearing loss, lowered IQ, poor school performance, learning disabilities, and even school dropout,'' reports child-care expert Ron Haskins. A 1996 study by Penn State researcher Lynne Vernon-Feagans and colleagues found that "day-care-attending children with chronic [ear infections] in the first 3 years of life play alone more often and have fewer positive and fewer negative verbal interactions with peers than nonchronic children in day care.'' Overall, according to a 1989 estimate by Dr. Haskins in the Bulletin of the New York Academy of Medicine, the excess illness attributable to day care costs American families and society $1.8 billion and the lives of at least one hundred children each year.

THE medical consequences of group care should be disturbing enough. But nearly as chilling is the large number of studies that link early, extensive day care with psychological, social, and behavioral problems.

A 1994 international meta-analysis by Claudio Violato and Clare Russell of the University of Calgary, involving over 22,000 children, concludes: "Full-time care for infants and young children [puts] a substantial proportion of the population at risk for psychological maladaptation.'' Almost 50 per cent of day-care children, for example, had an insecure attachment to their mothers, compared to about 30 per cent in the population as a whole.

Violato and Russell's finding exactly mirrors the results of two longitudinal studies reviewed by Jay Belsky and Michael Rovine in Child Development in 1988: About half of infants placed in twenty or more hours of nonparental care per week, they found, had insecure attachments to their mothers.

Sons of mothers who worked more than 35 hours a week were also less likely to be securely attached to their fathers. As a result, almost 30 per cent of day-care kids were insecurely attached to both parents, compared to just 7 per cent of children in families that used less than twenty hours a week of nonparental care.

Many (though not all) studies also find that children in extensive day care are more aggressive with peers and less compliant with the requests of adults. In a Texas study of 236 children by Deborah Lowe Vandell and Mary Anne Corasaniti, for example, 8-year-olds who had a history of extensive day care received lower ratings by teachers and parents for compliance, work habits, peer relationships, and emotional health. Day-care kids also received lower academic and conduct grades and were rated more difficult to discipline. In this study, child-care history was a better predictor of problems than family characteristics such as socioeconomic status.

And in 1991 Jay Belsky and David Eggebeen studied a large national sample in the National Longitudinal Survey on Youth. They found that 4-to-6-year-old children were much more likely to be rated "less compliant'' if, during their first 2 years of life, their mothers had worked more than thirty hours a week. Again, early and extensive day care had more influence on a child's behavior than family characteristics such as socioeconomic status or the mother's education.

Michael Lamb, in his review of day-care literature for the NICHHD, found these tendencies turning up over and over again, "particularly when the care is of poorer quality.''

DAY-CARE defenders faced with such dark data show an almost comic insistence on looking at the bright side of life. "Children who have been in day care,'' suggests Alison Clarke Stewart, in a 1989 article for The American Psychologist, "think for themselves'' and "want their own way.'' Striking a blow for infant independence everywhere, "They are not willing to comply with adults' arbitrary rules . . .''

When redefining childhood virtue does not suffice, day-care defenders are apt to resort to the "per se'' defense. There is no evidence that day care "per se'' is harmful to children; after all, many children in day care do just fine. What harms children, they argue, is low-quality care.

The NICHHD's ongoing highly publicized seven-year day-care study is perhaps the biggest, most sophisticated attempt to disentangle the effects of quality of day care from the effects of quantity of day care. This study is using a diverse but not a nationally representative sample, with the parents being predominantly white, married, and middle class. The results have been widely trumpeted as offering a clean bill of health for day care. The reality is more complex. The first report, released last year, analyzed infants' attachment to their mothers at 15 months. The study found a pattern of dual risks for infants in day care: in the case of mothers who were relatively less sensitive to their children's needs, placement in as little as ten hours of day care each week regardless of quality, or in low-quality care, or with more than one caregiver in the first year, made it more likely that those children would be insecurely attached to their mothers.

Jay Belsky, a professor at Penn State University and one of many researchers involved in the design and analysis of the NICHHD study, points out that this study may understate the dangers of day care for the average family. "The most stressed, least sensitive mothers,'' he says, "are the group that looks most vulnerable, and they are also least represented in the NICHHD sample -- we may have underestimated the effects of day care.''

The second batch of analyses, reported last spring, also contained some disturbing results from direct observations of mother - child relations. "What we found was an intriguing, consistent, and disconcerting pattern people run away from,'' Belsky notes: more time in day care led to a small, but measurable, deterioration in mother - child relationships.

The deterioration was evident both in terms of mothers' attitudes toward their children and in terms of children's attitudes toward their mothers. More time in day care was related to less sensitive mothering when the child was 6 months, more negative maternal interactions when the child was 15 months, and an increase in insensitive mothering at 36 months. Meanwhile, day-care children were less positively oriented toward and engaged with their mothers, and expressed less affection for them at age three.

Although the magnitude of these changes is not large, Prof. Belsky points out, the direction of the changes is clear and consistent: children who spend more time in day care develop weaker and more problematic relationships with their mothers.

Put the NICHHD findings together, and the pattern becomes even more disturbing. Day care has the worst immediate effects on children with less sensitive mothers. And, over time, women who put their children into day care become somewhat less sensitive.

Most remarkable for Belsky was the reaction of many of his fellow researchers to the data. "They said, in effect, 'These findings don't matter because we didn't find any attachment differences when we looked at 15 months,''' he reports incredulously. "It is imbecilic to say that findings at 24 and 36 months don't matter because of something you found at 15 months.''

Though the effects uncovered by the NICHHD were not dramatic, the question lingers in Belsky's mind: are the relatively small negative effects uncovered by the NICHHD study "small because they are small in nature, or because our assessment capacities are limited?'' He points out, "We examined mother - child interaction for fifteen or twenty minutes, and observed child care for two days.''

IN the NICHHD sample, the amount of time a child spent in day care had in itself no effect on cognitive development, but quality of care did. Again, quality of care, in this context, refers not to externals but to how much caregivers talk to their charges. Given the research on the quality of existing infant care, the NICHHD study thus strongly suggests that most children now placed in early day care are at intellectual risk. This is particularly true when educated mothers leave their babies in the care of less educated caregivers.

One longitudinal study of 33 private nurseries in Great Britain, for example, found that 6-year-olds who had been placed in extensive day care as infants had retarded language skills compared to home-reared children. This finding, reports Patricia Morgan, a senior research fellow at the Institute for Educational Affairs and author of Who Needs Parents?, was the more remarkable given that the parents of day-care toddlers were of higher socioeconomic status on average than the parents of home-reared toddlers.

Even older children may suffer when mothers work long hours and leave them with others. Several recent studies suggest, in the words of sociologists Paul Amato and Alan Booth, that "mothers who work part-time have more academically competent children, on average, than do mothers who work long hours or who are not in the labor force.'' Mothers who work part-time, for example, are more likely than those employed full-time to discuss school with children, check their homework, and restrict their television viewing.

Amato and Booth's own 1997 book-length study, A Generation at Risk, analyzing data on some two thousand married couples followed over a 15-year period, found that sons of women who work overtime (more than 45 hours a week) will attain on average a full year less of education, and earn nearly $9,000 a year less (after controlling for their education) than sons of women who work less or not at all. When the mothers are highly educated, their sons suffer even more from the loss of time and attention. "Overall,'' conclude Amato and Booth, "sons have the highest level of attainment when their mothers are employed part-time and the lowest level of attainment when their mothers are employed overtime.''

As troubling as the immediate effects of day care on children are questions about the long-term effects of day care on families. Will people who, as children, spent most of their waking hours cared for by employees still feel obliged to help care for ailing parents in their old age? Will they place as high a value on family life? Is it likely that the two-career day-care model is contributing to the decline of marriage and family life? Research to date provides no definitive answers, but some disturbing clues.

Several researchers, for example, have found that very young children whose mothers work full-time tend to have poorer relations not only with their mothers but also with their fathers. In a study by Wendy Goldberg and M. Ann Easterbrooks, for example, men with employed wives found their toddlers' behavior more aggravating and viewed their kindergartners' behavior more negatively.

Weakened attachment of fathers to children may, in turn, help explain the fact that marriages in which both partners work full-time are far more prone to divorce. Even when two-career couples stay together, their children may not. According to research by Amato and Booth, women whose mothers worked full-time are 166 per cent more likely to end up divorced, even after taking into account the parents' marital status and the daughters' own education and career achievements.

The data confirm common sense: attitudes matter. Family-centered parents tend to raise family-centered children, who value stable marriage in no small part because it permits children to be cared for by their own kin.

ONE of the long-standing findings of day-care research is that children suffer both when mothers who want to work stay at home, and when mothers who would prefer to stay at home must work. But, in the real world, mothers who want to put their babies into day care are a rare breed. Researchers in one small study who tried to distinguish between the effects of maternal satisfaction and those of day care found that the data did not permit them to do so: because, to their surprise, "the dissatisfied mothers were predominantly the employed mothers and the satisfied mothers the nonemployed (and largely the part-time employed as well),'' note Margaret Owen and Martha J. Cox.

Data from the NICHHD study tend to confirm the importance of respecting mothers' preferences. "For kids in full-time child care, the mother's belief that work is good for children seems to be positively related to functioning at 3 years of age,'' Belsky reports. "For kids not in nonmaternal child care, the mother's belief that work isn't good for children is positively related to their function at 3 years.''

Thus, it stands to reason, the more that outside pressures -- including government subsidies -- help push grudging parents into using day care, the worse the negative effects of day care are likely to become.

THE kinds of problems associated with day care don't necessarily show up in all day-care studies. The research is typically conducted on fairly small groups of children who are not representative of the population at large. Even the NICHHD study involves a group of parents who, having agreed to intrusive observation of the family at home and of the children in day care may be inherently unrepresentative.

Whether the current research raises big warning flags or small ones depends in part on how unusual the modern form of commercial day care is as a child-rearing method. Day-care advocates like to portray exclusive parental care of children as an historical anomaly. "They say mothers have always shared caregiving,'' Belsky remarks. "That passes off as intellectual sophistication these days. What they don't go on to say is that in aboriginal societies where mothers share caregiving they do so with networks of blood relatives -- with people who will know both the parents and the child their whole lives.'' By contrast, the current reality of day care -- children cared for by a series of biological strangers who have no long-term commitment to the child or the parents -- is an experiment unprecedented in human history.

Parents, of course, instinctively know this. One of the best-kept secrets in the child-care debate is that most parents, including a majority of working mothers, try hard to keep child care in the family. In a national survey conducted by Princeton Survey Research Associates last February among parents with children under age 4, 72 per cent of parents said their child was cared for primarily by the mother or father. An additional 10 per cent reported that some other relative cared for the child while the parents worked; just 9 per cent of parents used a day-care facility.

The fact that more than 8 out of 10 small children are cared for by family members may help explain why in one recent survey, when asked, Is finding good day care a problem for your family? only 13 per cent of parents reported that it was "a major problem''; 69 per cent indicated it was "not a problem at all.''

American families' strong, demonstrated preference for care by kin is consistent with the practices of every other human society that has ever existed and with the growing data on the effect of day care on children. In a January 1997 NBC/Wall Street Journal poll, Americans were asked to name the two or three most important issues facing the nation "that you personally would like to see the Federal Government in Washington do something about.'' Just 1 per cent said child care.

The day-care debate is often portrayed as pitting old-fashioned stay-at-home moms against the needs of modern working women. But the reality is that almost half of mothers of young children who work are not in the market for child care at all. A tax credit available only for commercial care -- which is what President Clinton is set to propose -- will bypass not only women who are homemakers, but all women who choose to keep their kids' care in the family -- in other words, the vast majority of all American mothers of young children.

So who benefits from subsidized day care? There is one obvious answer: the day-care industry, a multi-billion-dollar concern which, like so many businesses, looks to use the power of government to increase its profits. To promote government subsidies only for those who use commercial child care is to push a service that is actively harmful for some children and one that most parents emphatically do not want. In other words, it is the kind of social policy only Washington could love.