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I
Intro cluction
.
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1
Child Care in a Changing Society
The United States, along with most other industrialized countries, has
experienced a social revolution during the past quarter century. Since the
mid-l96Os, more and more women, including those with children, have
entered and remained in the paid work force. Their employment has been
accompanied by falling birth rates, rising divorce rates, and older ages at
marriage. Idgether these trends have had dramatic erects on the roles of
men and women and on the form and function of families. Scholars, com-
mentators, and public leaders alike have expressed amazement about the
scope of social change in U.S. society and concern about its consequences
for parents, for children, for employers, and for the nature of work and
family life. Since the late 1980s, a major focus of this concern has been on
the care and rearing of American children. There is growing recognition
that if parents are to manage productive roles in the labor force and at the
same time fulfill their roles within the family, a substantial social response
is required. An issue that a generation ago was strictly regarded as a private
family matter is today the subject of public discussion and public policy.
In 1988 more than 10.5 million children under age 6, including nearly
6.6 million infants and toddlers under age 3, had mothers in the labor force.
Another 18 million children between the ages of 6 and 13 had working
mothers, and the numbers are expected to rise into the l990s (Bureau of
Labor Statistics, 1988~. Using U.S. Department of Labor data, Johnston
and Packer (1987) project that by 1995 roughly two-thirds of all new labor
force entrants will be women, and 80 percent of those in their childbearing
years are expected to have children during their work life (Scarr et al.,
1988~. Many children of working mothers are and will continue to be cared
for by their parents, siblings, or other relatives, but a growing proportion
receive care from unrelated adults in their own homes, in their caregivers'
3
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4
WHO CARES FOR AMERICA'S CHILDREN?
homes, in schools, and in organized child care facilities (Bureau of the
Census, 1987~. As a result, concern about the quality, availability, and
affordability of nonparental child care has become a widespread national
priority. What was traditionally viewed by most Americans as a problem of
the poor has in the 198Os become a fact of everyday life for the majority
of U.S. children and their families. Child care is now an essential aspect of
domestic life and of the economic structure of the country.
Although there is broad consensus that society should promote the
healthy development of the next generation and minimize potentially harm-
ful conditions, there is less agreement about what kinds of care are best for
children of different ages and for those who are living in different social,
economic, and cultural circumstances. There is, similarly, little agreement
about who should provide care and who should pay for it. Debate over
the appropriate role of government, employers, and parents themselves has
intensified in recent years and has led to numerous proposals from leaders
of both political parties and a broad array of special interest groups to
address the increasing need for child care support and services.
Although they differ greatly in their specifics, these proposals share
the fundamental recognition that child care is costly, whether it is provided
by parents, other family members, or unrelated caregivers and whether it
is privately or publicly financed. For parents, usually mothers, who stay
at home to care for their own children, there are "opportunity costs":
the forgone income and work experience that employment outside the
home would have yielded. For working parents, the purchase of child
care services entails significant cash outlays. Quality care-care that is
developmentally enriching and protective of physical health and safety
is generally more costly than minimally adequate or poor-quality care.
And quality care has been shown to compensate for disadvantaged family
environments and to promote better intellectual and social development
for some children than they would have experienced only in their homes
(McCartney et al., 1985; Ramey et al., 1985~. For children who do not
receive adequate care, the short-term costs are often manifested in a variety
of poor social, emotional, and cognitive outcomes; behavioral difficulties;
and health problems, especially for those from poor and disorganized
home environments. The long-term costs, to the extent that they have
been documented, are measurable in poor skills development, dropping
out of school, reduced earnings, antisocial behavior, and even economic
dependency.
For society, a commitment to quality child care will inevitably entail
substantial resources, which in the current context implies monetary costs
that must be borne by parents, employers, taxpayers, or some combination
of them. Until recently, however, the high costs of child care were largely
invisible in an economic sense. The labor of a mother caring for her own
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CHILD CARE IN A CHANGING SOCIETY
child is not counted as productive economic activity in calculations of the
gross national product; in contrast, one parent caring for the children of
others is counted if it involves monetary expenditures. It is this transfer of
money that has become more commonplace and has focused attention on
the costs of child care in recent years.
Another powerful aspect of the debate over child care policy is the
growing recognition that children are a valuable national resource. Declin-
ing fertility and a growing demand for skilled labor in the United States
have drawn increasing attention to children. Pragmatic observers call at-
tention to the fact that a smaller proportion of young workers will have to
support a larger proportion of nonworking old people over the next several
decades. They argue, therefore, that it is in society's self-interest to sup-
port the development and optimize the productivity of each child. There
is evidence of growing public concern about whether children are receiving
appropriate social and cognitive stimulation and about whether they are
physically safe and emotionally nurtured. Despite the strong conviction of
most Americans that government should not intervene in the family except
in the most extreme circumstances, they also believe in high standards for
childrearing. Although these de facto standards will not dictate child care
policy, they may provide a basis for national action.
What public policy ought to be, of course, rests in part on assessments
of the costs and benefits of quality child care and the costs of inadequate
care. It also depends on consideration of who reaps the benefits and who
should pay the costs. What level of quality is 'Good enough"? Who should
make that judgment? Should childless individuals and families subsidize
the costs of child care and childrearing? Should employers help bear
these costs for their employees? 1b what extent and in what ways should
government play a role in the care of children whose parents work outside
the home and those whose parents remain at home?
CONTEXT OF THE DEBATE
The United States, unlike most Western industrialized countries, lacks
a clear public child care policy. Issues concerning the care and rearing
of children are complex, controversial, and they touch on closely held
values. Virtually everyone holds definite views about how children should
be nurtured. For this reason, any debate over child care policy inevitably
raises a number of fundamental political, ideological, and developmental
concerns.
For some people, the overriding concern is mothers' labor force partic-
ipation regardless of the availability and affordability of child care. Despite
broader social and economic trends over the past two decades, some regard
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WHO CARES FOR AMERICA'S CHILDREN?
mothers' working outside the home as a menacing threat to traditional fam-
ily values. They argue that a mother's care for her children is preferable,
that daily care by adults other than a child's own mother significantly risks
the social and emotional well-being of the child and weakens mother-child
attachment. Fears that "institutionalized" child care will lead to abnormal
withdrawal and maladjustment have caused some people to completely
oppose employment of mothers of young children and out-of-home care
arrangements.
Others, however, believe that changing patterns of maternal employ-
ment are the inevitable consequence of broader social trends, including U.S.
economic conditions, gender equity in the workplace, feminism, changing
family forms and patterns of marriage, changing education and work pat-
terns, and the declining standard of living in single-income families even if
both parents are present. Public policy and programs, they suggest, should
be neutral about whether or not mothers enter or remain in the paid labor
force, but they should be aimed at optimizing the health and development
of children whose mothers do work by ensuring accessibility to quality child
care services. The costs of providing appropriate care for young children,
they contend, are far less than the costs of ameliorating the predictable
long-term negative consequences for children who are not well cared for.
Still others argue that public policies should be aimed at enhancing
women's labor force participation and career opportunities. For mothers
of young children, child care is an essential condition of employment. Par-
ticularly for low-income mothers, many of whom are the single heads of
their households, the availability and affordability of child care may be a
significant determinant of whether they seek job training and employ ment
or receive support from Aid to Families with Dependent Children. As
increasing numbers of middle-class mothers have entered the labor force
over the past 15 years, concern about the employability and economic self-
sufficiency of poor mothers has become more salient. There is growing
recognition on the part of many who urge ~`workfare'' (working as a condi-
tion of receiving welfare) that such change cannot occur without adequate
child care support. Indeed, the intention that low-income women, including
those with children, should acquire job skills and enter the work force was
a powerful force in the passage of the 1988 Family Support Act.
In addition, there are many who argue that comprehensive early child
development programs including education, social services, medical and
dental care, and nutrition are needed to give children from low-income
and otherwise disadvantaged backgrounds the kinds of social skills and pre-
academic experiences that will adequately prepare them for early schooling.
Programs such as Head Start, they contend, have been instrumental in
fostering the early academic success of many poor and minority children,
regardless of the labor force status of their mothers. Such initiatives
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CHILD CARE IN A CHANGING SOCIETY
7
represent fundamental investments in human capital that have far-reaching
social and economic benefits to the individuals, their families, and society.
In the context of the current policy debate, there are questions about
whether Head Start-type programs can and should be adapted to meet the
child care needs of low-income working parents and their children.
Widespread disagreement about the nature of the child care problem
has created confusion and conflict over what to do about it. Political
leaders, program planners, early childhood professionals, as well as parents
themselves appear divided over what the primary goals should be: to
provide safe and developmentally appropriate care for all children whose
parents work outside the home; to enhance the employability and career
opportunities of women, including women who are the mothers of young
children; to provide incentives for mothers on welfare to seek education
and job training and accept positions in the work force that will help them
achieve economic self-sufficiency and reduce welfare dependency; or to
provide comprehensive early childhood services for disadvantaged children
to ameliorate the negative consequences of deprivation and to enhance
their readiness for entry into regular elementary education programs.
Historically, the care and rearing of children was regarded as a private
family affair, not as a public responsibility. Americans held as a fundamen-
tal tenet the right of parents to raise their children according to their own
values and beliefs. Government involvement in the family domain consis-
tently provoked controversy except when parents were clearly unable or
unwilling to provide the necessary care, nurturing, and supervision. Child
protection, not child care, was regarded as an appropriate public role. This
view provided a meager basis for legitimizing child care and child devel-
opment as an item on the public agenda, and it discouraged far-reaching
designs, such as the defeated Comprehensive Child Development Act of
1972 (see Hayes, 1982~. In 1971, despite congressional support, President
Nixon rejected efforts to launch an ambitious federal child care program.
In his veto message, he charged that the proposed program threatened
the sanctity of the American family and promoted communal approaches
to childrearing. Decisions concerning child care policy, especially at the
federal level, were played out in highly value-laden debates about state in-
trusion in family life (Hayes, 1982; Phillips, 1988; Steiner, 1981~. Child care
has once again become a significant public concern in the late 1980s, and
debate about the appropriate balance of public- and private-sector respon-
sibility continues. Indeed, it now goes beyond the availability, affordability,
and quality of care for children in out-of-home care and includes consider-
ation of the appropriate public role in enhancing the economic feasibility
of mothers staying at home to care for their own children.
The diversity of child care arrangements adds to the complexity of the
issue and has worked against the development of a national policy. Child
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WHO CARES FOR AMERICA'S CHILDREN?
care is not a monolithic service system. It includes an array of professional
providers and program types, such as child care centers, family day care
and group homes, public and private nursery schools, prekindergartens
and kindergartens, Head Start programs, and before and after school
programs, as well as informal arrangements such as relative care, in-home
babysitting, and nanny care. 1b some extent, this diversity reflects both the
varied preferences and the limited options of parents in different social,
economic, and cultural circumstances. Concern that a federal child care
law would limit parents' flexibility and choice in making the arrangements
they believe best meet their own needs and their children's has often been
cited as an argument against support for categorical service programs.
Disagreement and division within the professional service-provider
community has also hampered efforts to develop a coherent child care
policy. Historically, child care traces its roots in two separate traditions,
social welfare and early childhood education. Child care as a component
of the social welfare system has been regarded as a custodial and protective
service for children whose parents worked, attended school, or needed
out-of-home care themselves. Beginning with the charitable day nurseries
that were established during the last quarter of the nineteenth century for
poor immigrant children, such programs have served poor and dependent
children. In contrast, early childhood education programs have provided
comprehensive services for young children with an emphasis on cognitive
growth and the development of social competence. Nursery schools and
kindergartens were often initiated at the urging of middle-class parents con-
cerned about providing academic and social enrichment to their children.
These child-centered institutions were predicated on a belief that early
learning will result in later cognitive gains and better school performance.
Other child-oriented programs drawing on and expanding this model, most
notably Head Start, were initiated by the federal government in the late
1960s to provide similar preschool experiences for low-income children.
The early childhood field has developed in this mixed tradition, and unfor-
tunately little has changed to unite the divergent public images of care and
education. Many knowledgeable observers argue that it has resulted in a
dichotomy that, at best, hampers effective program planning, coordination,
and advocacy, and at worst, creates a two-tiered system that segregates
poor children from their middle- and upper middle-income peers (Cahan,
1988; Kagan, 1988; Phillips and Zigler, 1987~.
The lack of a clear public child care policy in the United States also
stems in part from the fact that child care is intimately related to a number
of other social policy issues about which there has been disagreement:
women's participation in the labor force, welfare and workfare, compen-
satory early childhood education, and the special protection of children
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CHILI) CARE IN A CHANGING SOCIETY
9
at risk of developmental delay or damage. Unlike some other emotion-
ally charged issues that have strongly united constituencies (such as gun
control), the child care issue has had a crowded field of political players
with divergent and often contradictory interests. These key individuals and
organizations have rarely spoken with a unified voice. As a result, the
child care issue has generally been characterized by vagueness. As Woolsey
noted (1977:128~: All specify objectives clearly what form of care, for
which children, financed through which institutional structures, employing
what sort of staff, would undermine team spirit and is thus avoided."
Moreover, despite the magnitude of the child care issue, there is a
lack of detailed information about the costs, benefits, and feasibility of
alternative policies and programs. Understanding of trends in mothers'
labor force participation, the social and economic structure of families, and
the developmental effects of supplemental care has advanced significantly
in recent years, but knowledge of the effects and effectiveness of formal
and informal, public- and private-sector responses to the child care needs
of working families has not kept pace. In part, this is because the system of
services is so diverse. Many kinds of child care arrangements are difficult
to study, and systematic data at the national level are lacking. In part,
inadequate empirical knowledge also reflects the fact that child care has
not, until very recently, been an issue of national or even state-level priority.
During much of the 1980s, federal research dollars were not allocated to
national studies of child care. In addition, however, deeply conflicting
concepts of the role of child care and its effects on children, parents,
and society have made it difficult for researchers to frame questions and
interpret data in ways that provide checks and balances over their own
values and biases on these issues.
For many American families in the l980s and for the foreseeable future,
mothers' employment and their earnings are not a luxury. They are essential
to maintain an adequate standard of living or simply to escape poverty. For
many employers, women with children comprise a significant and growing
component of their work force. Recruitment, retention, and productivity in
many firms increasingly depend on the availability of supports and services
to assist employees in managing their family responsibilities. In light of this
reality, many observers conclude that, as a society, the United States may
be ready to make the necessary adjustments to bring the separate worlds
of work and family life closer together.
CROSS-NATIONAL CONTEXT
The United States was not alone in experiencing dramatic social
changes during the past two decades. By the mid-197Os, labor force
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WHO CARES FOR AMERICA'S CHILDREN?
participation was the modal pattern for adult women in most Western
industrialized countries. As in the United States, women's increasing role
in the paid work force made the tensions between work and family life
more visible and universal. Although the policy responses have varied
among countries, cross-national researchers and advocates often point out
that the United States "lags" behind the rest of the developed world in
its efforts to address the child care needs of working parents and their
children (Kamerman and Kahn, 1981; Scarr et al., 1988~. Some countries
have based their policies and programs on facilitating women's employment;
others stress the child development focus of their initiatives. Regardless
of their primary objectives, however, child care has come to be viewed as
a public responsibility In many European countries, Canada, and Israel.
These nations have invested heavily in child care, and they seem prepared
to continue to do so. Despite a decade of fiscal constraints, none has
curtailed its child care subsidies, and several are now moving to expand
their commitments (Kamerman, 1988~.
Almost all industrialized countries other than the United States have
established maternity/parenting policies that permit working parents to re-
main at home for a period of time after childbirth to recover physically
and to care for their infants. These policies allow parents (natural and
adoptive) to take leave without forfeiting either their employment or their
income. The primary differences among countries that have adopted ma-
ternity/parenting leave policies is the length of the leave (from 6 months to
3 years), the level of wage replacement (from 25 to 75 percent), and the
inclusion of fathers as well as mothers (see Kamerman, 1988; Moss, 1988~.
Almost all the European countries, as well as Canada and Israel, have
acknowledged the importance and value of early childhood education for
3- to 5-year-olds and have taken steps to make these programs available
to all children regardless of their mothers' work status. Primarily aimed
at enhancing children's socialization and school readiness, these programs
also provide child care services for the children of working mothers. In-
creasingly, these programs are universal, free, and publicly funded, and they
are often publicly operated as well. Even though they are not mandatory,
they are used by all children whose parents can secure a place. Even in
those countries that have established child care systems separate from the
educational system, early childhood programs stress age and developmen-
tally appropriate programming for all children regardless of whether their
mothers are in the paid labor force or not (Kamerman, 1988; Moss, 1988~.
Among most industrialized nations, there is also growing recognition
of the need to expand the supply of child care services for children under
age 3. As in the United States, concern about the availability of infant care
has been accompanied by concern about the quality and cost of such care.
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11
The demand for child care arrangements for very young children appears
to exceed the current supply in many countries, but only Sweden and
Finland have announced any significant commitment to expand services.
Indeed, there is a growing trend in Europe to extend parenting leaves in
some form to encourage one parent to remain at home until a child is
18 months, 2 years, or even 3 years of age (Kahn and Kamerman, 1987~.
This type of policy, which began first in Hungary, has emerged in several
Western European countries as well, including France, Finland, Germany,
and Austria. The extraordinarily high costs of purchasing satisfactory out-
of-home infant care, a deep-seated conviction that very young children
are best cared for by their mothers, and an effort to encourage low-skilled
women to stay out of the labor force in periods of high unemployment have
all been cited as rationales for extending parental leaves as an alternative
to expanding organized out-of-home infant care (Kamerman, 1988~.
It is important to note that several countries have adopted these types
of parental leave and child care initiatives as a complement to broader
family policies that provide child or family cash allowances and in-kind
benefits or both. These benefits are designed to supplement the income
of low-income families with very young children so that married women
with employed husbands can elect not to enter the labor force without
suffering economic hardship. At the same time, however, the benefit is
available to families in which both parents work or a single parent (usually
the mother) is employed. In France and other countries that provide
child and family allowances, there may be an implicit pronatalist objective,
although, to date, parental leave has not been associated with noticeable
increases in birth rates. Overall, family allowances have been successful
in redistributing money from individuals and families with no children to
those with children, and have benefited low-income families in a way that
does not require mothers' employment (Kamerman and Kahn, 1981~.
What are the implications of the experiences of other industrialized
countries for the development of an appropriate social response to the
growing need for child care supports and services in the United States?
The United States is clearly different than many other countries because of
its size and the social, economic, and cultural diversity that characterizes
its population. The political process and social welfare traditions are also
significantly different. The challenge for U.S. policy makers is to fashion
policies and programs that fit the social and economic climate that values
children and supports family life. Accordingly, regardless of whether there
are direct lessons to be learned from the experiences of other countries,
there are relevant points of comparison that can inform the continuing
policy debate.
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WHO CARES FOR AMERICA'S CHILDREN?
THE PANEL'S STUDY
This study by an interdisciplinary panel, established under the auspices
of the National Research Council's Committee on Child Development
Research and Public Policy, was supported by the U.S. Department of
Health and Human Services, the Foundation on Child Development, and
the Ford Foundation. Over a 2-year period, the panel, through a set of
working groups, has sought to gather, integrate, and critically assess data
concerning the implications of child care services for child development;
regulations, standards, and enforcement; the child care market; and the
child care delivery system as a basis for recommending future directions
for policy and program development. Each working group commissioned
background papers, conducted analyses of available data, and convened
a workshop involving an array of researchers, policy makers, employers,
providers, consumers, and child care advocates to gather information,
identify significant issues, and highlight differing political, ideological, and
intellectual perspectives. In addition, the panel gathered data to develop
state profiles of the child care system.
Child care policies and programs, and the issues that underlie them,
touch upon deeply felt values. No review of existing research will ultimately
resolve disputes arising from different political and ideological orientations.
Scientific data and analysis are only some of the relevant inputs in the
policy-making process. Nevertheless, a broad interdisciplinary synthesis
of what is known about the developmental implications of supplementary
care and a dispassionate assessment of what is known about the supply
of and demand for different types of services and the factors affecting
their costs, quality, and delivery will serve several important purposes.
First, it will help clarify the issues, sharpen awareness of crucial decision
points, and focus attention on the tradeoffs and complementarities among
different positions. Second, it will bring together, in one source, the many
types of information that policy makers, service providers, and researchers
regularly need. Third, it will identify gaps in existing knowledge. Finally,
and perhaps most importantly, such a review of available evidence will
provide a useful contribution to the continuing debate and it will suggest
promising directions for future policy and program initiatives.
Objectives of Child Care:
A Framework for the Study
Any analysis of the child care issue in this country must recognize the
different yet interrelated purposes of relevant policies and programs. At
the most abstract and simplistic level, these objectives are threefold: to
promote the health and well-being of children, to enhance the employability
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CHILD CARE IN A CHANGING SOCIETY
13
of their parents, and to improve the economic health and productivity of
the nation at large.
Although these objectives overlap, they are not always congruent.
Promoting the health and development of children requires that the care
they receive protects their physical health and safety and stimulates their
social and cognitive growth. The quality of the physical environment,
the child care provider, and the interactions between children and their
adult caregivers significantly influence children's health and developmental
outcomes. Enhancing the employability of parents requires that child care
services be available in convenient locations and during the hours when
parents work or participate in education and job training programs. It
also requires that these services be affordable so that parents who want
or need to work outside their homes can bear the economic burden of
doing so. Finally, improving the economic health and productivity of
the nation requires a strong, reliable work force now and in the future,
which means that public investments should enhance the productivity and
economic self-sufficiency of U.S. citizens. It is in the interest of society as
a whole for today's workers who are parents to have the ability to manage
their employment and family responsibilities and for the children who are
tomorrow's workers to be well-prepared for the roles they will be expected
to fill.
In the absence of fiscal constraints, achieving quality in child care,
improving access, and enhancing affordability, especially for low-income
families, are not inconsistent or incompatible goals. However, in light
of current economic realities in the United States, formulating child care
policies will inevitably involve tradeoffs. Improving the quality of out-of-
home child care services will raise the costs of care. Higher costs will have to
be passed on to consumers in the form of higher fees or partially or wholly
offset by employers or government. Without such subsidies, raising the price
of care will likely make it unaffordable to many families, especially those
with low incomes. Faced with a shrinking consumer market, many providers
will be forced to decrease their services or to close their doors, thereby
reducing the supply of child care services and making them inaccessible to
families who are unable to pay. Accordingly, public policies to improve
child care will have to balance concerns for the quality, accessibility, and
affordability of programs and arrangements.
These three fundamental goals of child care policy provide a frame-
work for examining the needs and interests of children, parents, and society
as a whole; for relating knowledge concerning the health and developmen-
tal consequences of out-of-home child care to knowledge concerning the
functioning of the current child care system; and for assessing the costs,
effects, and feasibility of alternative proposals to improve it.
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WHO CARES FOR AMERICA'S CHILDREN?
Structure of the Report
In the remaining nine chapters of this report, we review what is known
about the costs and effects of child care quality, the nature of existing
programs and arrangements, and their accessibility to children and families
in different social and economic circumstances, as well as the affordability
of different types and quality of care to families with different levels of
income. These chapters are grouped in four sections. The second chapter
of this introductory section summarizes trends in work, family structure and
income, and child care and their implications for the supply and demand
for alternative child care programs and arrangements.
Section II presents what is known about the relationship between child
care and child development, which has implications for the way in which
policies are structured and services are provided. Chapter 3 traces the
development of child care research. Chapter 4 reviews what is known
about the quality of care and children's developmental needs at different
ages and stages of development. Chapter 5 highlights knowledge concerning
the best practices for safeguarding children's health and safety and for the
design and implementation of child care services.
Section III presents what is known about the current child care sys-
tem in the United States and assesses current and proposed policies and
programs in terms of their effects on quality, availability, and affordability.
Chapter 6 examines the delivery system for child care and early childhood
education programs. Chapter 7 focuses on public policies and programs
at the federal and state levels, as well as employer policies and benefit
programs. Chapter 8 addresses Issues concerning the tradeoff between
quality, availability, and affordability and what Is known about the extent
to which each would be affected by proposed policies.
Finally, Section IV presents the panel's recommendations. Chapter
9 outlines directions for future data collection and research. Chapter 10
presents the panel's priorities for future policy and program development.
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Cahan, E.D.
1988 Poverty and the Care and Education of the Preschool Child in the United States,
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CHILD CARE IN A CHANGING SOCIETY
15
Hayes, CD., ed.
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Kagan, L"
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Kametman, S.B., and AJ. Kahn
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McCartney, K., S. Scarr, D. Phillips, and S. Grajek
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Representative terms from entire chapter:
labor force
