Day Care in America: What Is Needed?

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Day

Care

in America:

What

Is Needed?

Edward Zigler, PhD, and Elizabeth Gilman, MA, JD

In the past 20 years, major demographic changes

have irrevocably altered the character of American

family life. More mothers than ever are in the

out-of-home labor force: the number of school-age

chil-dren whose mothers work outside the home rose to

65% in 1990; for mothers of preschool children, the

number is around 50%.I Most startling of all, nearly

54% of mothers of children younger than age I are

now in the out-of-home labor force.2 By 1995, it is

projected that 75% of all mothers will be working

outside the home.3 Another critical change is an

in-creased number of single parents, who are

predom-inantly women. Today in the United States, 25% of all

children are being raised in single-parent homes; 90%

of these single parents are women.1 These parents

must work to support themselves and their children;

they can do so only if they have child care.

In fact, at the last White House Conference on

Children in 1970, child care was voted to be the No.

I problem facing American children and families.

Subsequently, the 1971 Child Development Act was

passed, only to be vetoed by President Richard

Nix-on. This legislation would have established a

na-tional network of child care centers. For the next 20

years, very little action was taken at the national

level. Finally in 1990, a child care bill authorizing $750 million in appropriations was passed, a funding

level lower than that proposed in 1971. The

dra-matic demographic changes noted above were

re-sponsible for this change in political climate,

illus-trating Alfred Kahn’s dictum that demographics

drive social policy.5

In addition, because of the different size of various

age cohorts, we are approaching a massive shortage

of workers. According to the US Department of

La-bor, in the near future two out of three of all new

employees will be women who are not already in the

out-of-home work force. Women work outside the

home primarily for economic reasons; today, two

in-comes are usually needed for a decent standard of

family living. Given the coming worker shortage,

employers will need women as badly as women will

need jobs. Consequently both employers and women

will be demanding more child care.

Against this background of increasing use of

out-of-home child care, the central concern is its impact

on the developing child. Based on 35 years of

expe-rience in the field, we are convinced that we have the

knowledge necessary to provide healthy,

growth-en-From the Department of Psychology, Yale University, New Haven, CT.

Received for publication Jul 7, 1992; accepted Aug 5, 1992.

Acad-emy of Pediatrics.

hancing care to children of every age, from infancy

through the school years. No further research is

needed to demonstrate that high-quality care is good for children and that poor-quality care is destructive. Until society is willing to support high-quality care for all children, there will continue to be vast

differ-ences in the sort of care children receive, based on

their economic status. Surprisingly, it is the

working-and middle-class children who are most likely to

experience inadequate care: the wealthy can pay for

excellent care and the poor can take advantage of

subsidized programs.6

Unfortunately, the overall state of child care in

America is abysmal. This fact has been shown

through a number of national studies, first by a

re-port entitled Windows on Day Care7 and more recently by the National Child Care Staffing Study.6 Evidence suggests that this society is getting precisely the level of day-care services it is paying for: the average wage for day-care-center workers is $5.40 an hour, and the 6-month staff turnover rate is 20%; the annual rate is

41 %6 Moreover, 40% of children in out-of-home care

are in family day care, in which five or six children

are cared for in a private home. Some 75% to 90% of

these homes are unregulated, and the majority of

these providers make less than the minimum wage.8

The Child Care Staffing Study, a study of 227

day-care centers, concluded that two thirds of the sites

were “barely adequate” in quality.6 Michael Lamb

and his colleagues,9 in a review of the nation’s child

care settings, concurred with this finding. Such low

quality of child care may seriously jeopardize

child-ren’s growth and development. At a time when

America is particularly concerned with the problem

of school readiness, it is ironic that we as a nation

have failed to consider the plight of a child who is

expected to enter school ready to learn after some 5

years of poor or even destructive child care.

The quality of care may be higher in states that

have better child care standards, but these standards are not uniform and give little cause for optimism.

Whitebook et al6 discovered that 70% of children in

the centers they studied received care of less than

good quality. Many states permit an untrained

worker to care for six or even eight infants. Never-theless, the National Governor’s Association

contin-ues to oppose federal standards, and, in the name of

“parental choice,” the new regulations in the Child

Care and Development Block Grant undermine such

standards as do exist, by prohibiting states from

us-ing funding requirements to force adherence to such

standards as compulsory immunization for children

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176 WHAT IS NEEDED?

Although the 1990 child care bill may have seemed a victory for families, in fact it will have very little impact, in that 75% of the funds are directed toward poor and near-poor families.11 For example, Califor-nia was able to subsidize child care for 25% of eligi-ble poor families before the bill; now, it can subsidize

30%.12 Child care for mainstream American families

will remain much the same. Thus there is real danger of backlash as working families see their tax dollars directed toward child care for another segment of the population, child care that they themselves desper-ately need. In addition, the bill is likely to engender

the false belief among members of Congress that the

child care problem has been “solved.”

What our society must do is to conceptualize child

care in a different way. Just as every child is now

believed to be entitled to a good education, we must

also commit ourselves to the proposition that each

child who needs it is entitled to good-quality child care. Today, day care in America is an incoherent,

heterogeneous collection of hundreds of thousands

of settings and services. This nonsystem is

incompre-hensible to families who are forced to use it.

Al-though some have unrealistically asserted that such a

hodgepodge of for-profit and not-for-profit centers,

industry-based facilities, family-day-care homes,

group homes, and so forth can be made to work, this

is not so, and no amount of tinkering can make it

work. It is time to simplify and to organize a real

child care system in America. One means of

accom-pushing this is to use as the core of a new system an

already established institution, the American school.

We as a nation have a $1 to $2 trillion investment in

school buildings, an investment that should be more

fully utilized.

By restructuring the American school, we can meet

not only the child care needs but also other needs

now experienced by American families. This new

school, which I call the School of the 21st Century,

would house two separate but allied systems.13 The

first would be the traditional formal school with

which we are familiar, typically operating from 8 AM

to 3 PM, 9 months a year. The second would be a child

care and family-support system operating from

about 7 AM to 6 PM, 12 months a year, to coordinate

with the working day. The second system would be

open to children from age 3 onward, for parents who

need out-of-home care for their preschool children. The system is intended to be highly flexible; mothers

who do not work or who work part-time could use

the facility for half-day nursery care, as needed. It is

planned to function as do the child care systems in

place in France and Italy today, where children

at-tend preschool at age 3 and receive early education and child care services at the same time. In France,

90% of the children enter such programs at age 3.

(For French children younger than age 3, contractual

government assistance for day nurseries has become

a national priority and has spurred a major increase

in the number of these facilities.14)

The fact that the 21st-Century School offers child

care services for parents who need them does not

mean that formal schooling will begin at age 3; what will be made available is developmentally

appropri-ate, high-quality care for preschool children, the kind of play-oriented program that fosters optimal

devel-opment. The second child-care component would

serve school-age children, many of whom lack adult

supervision before and after school. These “latchkey” children (aged 6 to 12) would be able to participate in

supervised recreational programs before and after

school and during school vacations.

In addition to this child care plan, I am proposing three outreach programs, the first of which is a par-ent-education and support plan. Once a child is born

within the cachement area of the school, someone

from the child care and family-support system

would make a home visit to the child’s parents. The

visitor would become a link to the school and its

supportive services, such as health screening, parent education, and inoculations for the child. Such a

pro-gram is entirely workable, and the model for this

component is the “Parents as Teachers” program,

now operating successfully in every school

through-out Missouri and in certain locations in 35 other

states)5’16

The second outreach program would be directed to

family day care. Although the School of the 21st

Cen-tury would place child care for children aged 3 to 12

within the school building, care for children aged 0 to

3 would still be needed. We know that a large

num-ber of children aged 0 to 3 are already placed in

family day care, in which five or six children are

placed in a private home and in which the greatest

variability in quality is found. The 21st-Century

School child care and family-support system would

organize all these homes into a network, using the

school as its hub. This hub would have the task of

training, monitoring, and supporting

family-day-care workers, thus creating a higher quality, more

uniform system.

The third and final outreach program would

pro-vide an information and referral service for families.

There are currently some two or three hundred

pro-grams offering services such as eye-testing, food

stamps, night care for children, and the like. An

in-formation and referral component, located within the

school building, would help families make use of the

baffling array of available services.

The underlying principles of this child care and

family-support system are that parents are the

pri-mary raisers of their children and that parents and

schools should work together to ensure that each

child is given the best possible chance in life. The

21st-Century School emphasizes constant

communi-cation between family and school and a high degree

of parental involvement. The child care and

family-support system planned for children aged 0 to 3 also

includes home visitation, to allow for parental sup-port and early recognition of potential problem areas for the child and to promote good relations between

parents and the school staff, who would be well

trained in early childhood education and child

de-velopment. As to organizing and funding these

ser-vices, some school systems could simply utilize their own available resources, while others might contract for services with other local agencies.

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Given the serious economic straits of many of our

states and communities, the primary operational cost

of the School’s family-support services would have

to be borne by parents, at least initially. However, parents are already paying for catch-as-catch-can

child care and would likely be delighted to pay a

trusted facility like the school for reliable,

consis-tently high-quality services. In some districts,

fund-ing for such schools has come through local

initia-tives, with corporate and community foundation

assistance in the start-up phase. We have found that,

once these programs have been initiated, they can be

operationally sustained through parent-paid fees

structured on a sliding economic scale. Where

ser-vices must be extended to low-income parents, a

combination of funds from the new Child Care Block

Grant and from Title XX can be used.

Only 4 years ago, the 21st-Century School was

only an idea; today, examples of these schools are to

be found all over America. The first 21st-Century

Schools were established in Independence, Missouri.

Subsequently 21st-Century Schools have been

estab-lished in Colorado, Connecticut, Wyoming, Texas,

Kansas, Iowa, and Arkansas. As of last year, Schools

of the 21st Century were to be set up in 131 school

districts in Kentucky. After many years of effort, I

have become convinced that the child care problem

will not be resolved through the actions of the federal government. Seemingly, child care as a social policy

initiative will soon resemble education: we will be

able to expect federal government (as with

educa-tion) to fund 6% or 7% of the cost, with these monies

focused on poor and/or handicapped children; most

of the funds needed for child care will be provided at

the state or local level.

One advantage of the 21st-Century model is that it

is flexible: school districts can adopt those pieces of

the model that fit their local needs; the program may

be varied according to existing resources and

ser-vices. Thus, in the state of Hawaii and in the city of

Los Angeles, children now receive before- and

after-school care. In North Carolina, a network of

school-based child care centers has been proposed, to serve

only 3-, 4- and 5-year-olds. Although there would be

local variation, all Schools of the 21st Century would

have to adhere to certain guiding principles and to

the provision of high-quality, developmentally

ap-propriate care to families and children.

Implementa-tion guidelines and staff and administrative training

requirements would have to be established to ensure

program quality.

Despite the apparent success of the 21st-Century

School model in providing child care for children

between 3 and 12 years, we still are left with the

difficulty parents have in finding affordable child

care for children in the first 3 years of life. We had

hoped that a child-care leave bill would help

allevi-ate the stress parents feel after the birth of a child,

when there is loss of income and no available infant

care. Unfortunately, it is unlikely that President Bush

will sign a bill granting even a 12-week unpaid leave,

despite the fact that a number of experts have

rec-ommended a 6-month to 12-month infant-care leave,

with at least partial pay for 3 months.15’172#{176}

To address this discrepancy between

developmen-tally optimal guidelines and political reality, I

pro-pose that the nation establish a child care allowance.

An unpaid leave does not assist families who need

two incomes for economic survival. Under this

pro-posal, a family would receive, at the birth of a child, a $5000 allowance, to be used either to permit a par-ent to remain home with the child during the child’s first year, or to defray the cost of purchased child care.

There are a number of means of funding such an

allowance. The money could come from an

individ-ual’s Social Security retirement account, to be

with-drawn at an earlier point in that person’s working

career, perhaps with the option of repayment as

fam-ily income increases. This is but one possible means

of securing funding, but it seems economically

fea-sible. The allowance might be structured in such a

way that the mother takes one half from her Social

Security account and the father, the other half. One of

the benefits of this sort of plan is the element of

choice for working families: it permits a single parent

or either partner to cease working for a time to care

for the new baby or to remain working and pay for

infant care.

Infant care, which requires a high staff-child ratio,

is prohibitively expensive, typically costing more

than $200 a week in many areas of the country.21 For

lower income working families, the cost of infant

care thus represents a high proportion of family

in-come. The Profile of Child Care Settings, conducted

in 1991, found that families with annual incomes

below $15 000 who do pay for infant care pay as

much as 23% of their income for such care.22

More-over, care for infants is not always readily available. Day-care centers do not necessarily accept infants,

and there are signs of a growing national shortage of

child care. The National Child Care Survey,

con-ducted in 1990, found that 88% of the spaces

avail-able in early-education and day-care settings, as well

as those in regulated family-day-care homes, had

been filled.8

The nation as a whole lacks a comprehensive,

af-fordable, and high-quality child care network, and it

has also failed to produce national guidelines for the

regulation of child care facilities. There are many

individuals of the political right who would like to

see mothers remain at home to care for their children,

but this is not an economically possible option for

many families. Clearly, pervasive labor-force trends

in America have not been reflected in national

poli-cies for workers and parents that support them as

nurturers of the next generation.5’23

Many other nations have seen fit to enact such

measures as parental leave and child care services.

America now stands alone among industrialized

na-tions in its failure to enact a paid infant-care leave

and other forms of family assistance. Clearly, some

means must be found to help families with their child

care needs, particularly in the area of infant care. We

must find such a means that does not require vast

federal and state expense.

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178 WHAT IS NEEDED?

to assist parents who must spend $100 to more than

$200 per week for care. As noted earlier, the recent

Child Care and Development Block Grant assists

pri-marily the poor or near-poor. Implementation of the

School-of-the-21 st-Century model, with its child care

and family-support components, coupled with a

$5000 national child allowance for the first year of

life, offers a comprehensive, economically feasible

solution to our child care crisis. Most importantly,

these proposals offer some assurance that our next

generation will receive child care that will encourage,

rather than threaten, optimal growth and

develop-ment.

REFERENCES

1. Children’s Defense Fund. Children 1990: A Report Card, Briefing Book, and Action Primer. Washington, DC: Children’s Defense Fund; 1990 2. US Bureau of Labor Statistics. Marital and family characteristics of the

labor force from the March 1990 Current Population Survey.

Unpub-lished raw data

3. Hofferth 5, Phillips D. Child care in the United States 1970-1995.

IMarriage Fain. 1987;49:559-563

4. Child Care and Development Block Grant of 1990. 42 US Code 9801.

1990

5. Kahn AJ, Kamerman SB. The Responsive Workplace: Employers and a

Changing Labor Force. New York, NY: Columbia University Press; 1987

6. Whitebook M, Howes C, Phillips D. Who Cares? Child Care Teachers and

the Quality of Care in America. Final Report, National Child Care Staffing

Study. Oakland, CA: Child Care Employee Project; 1989

7. Keyserling MD. Windows on Day Care. New York, NY: National Council

of Jewish Women; 1972

8. Hofferth SL, Brayfield A, Deich 5, Holcomb P. The National Child Care

Survey 1990. Washington, DC: The Urban Institute; 1991

9. Lamb M, Sternberg KJ, Ketterlinus RD. Child care in the United States:

the modern era. In: Lamb ME, Sternberg KJ, Hwang CP, Broberg A, eds.

Nonparental Child Care: Cultural and Historical Perspectives. Hillsdale, NJ: Erlbaum Associates; in press

10. Child Care and Development Block Grant. 42 US Code 9801 .Public Law

101-508. §5082. 1990

11. Child Care and Development Block Grant. 42 US Code A. §9858c (c) (3).

1990

12. DeBare I. Tough to know whom to trust: rules lax in big industry.

Sacramento Bee. August 25, 1991:A1

13. Zigler E. Addressing the nation’s child care crisis: the school of the 21st century. Orthopsychiatry. 1989;59:484-491

14. David MG, Starzec C. France: a diversity of policy options. In: Kamer-man SB, Kahn AJ, eds. Child Cart’, Parental Leave, and the Under 3s: Policy Innovation in Europe. New York, NY: Auburn House; 1991:81-113 15. Winter M. Parents as first teachers. Principal. May 1985

16. Missouri Dept of Elementary and Secondary Education. Parents as Teach-ers Program Planning and Implementation Guide. Jefferson City, MO:

Mis-souri Dept of Elementary and Secondary Education; 1986

17. Hopper P. Zigler E. The medical and social science basis for a national infant care leave policy. Orthopsychziatry. 1988;58:324-338

18. Zigler E, Frank M, eds. The Parental Li’ave Crisis: Toward a National Policy.

New Haven, CT: Yale University Press; 1988

19. Advisory Committee on Infant Care Leave. Statement and

Recommen-dations, November 26, 1985. New Haven, CT: Yale Bush Center in Child

Development and Social Policy; 1985

20. Brozan N. Infant care leaves: panel urges policy. New York Times.

No-vember 28, 1985

21. Zigler E, Lang M. Child Care Choices: Balancing the Needs of Children, Families, and Society. New York, NY: Free Press; 1991

22. Wilier B, Hofferth SL, Kisker EE, Divine-Hawkins P, Farquhar E, Glantz F. The Demand and Supply of Child Care in 1990: Joint Findings From the National Child Care Survey 1990 and A Profile of Child Care Settings. Wash-ington, DC: National Association for the Education of Young Children; 1991

23. Scarr 5, Phillips D, McCartney K. Facts, fantasies, and the future of child care in the United States. Psychol Sci. 1990;1 :26-35

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1993;91;175

Pediatrics

Edward Zigler and Elizabeth Gilman