The stress and child care project

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The stress and child care project

• Professor Margaret Sims
• University of New England
• New South Wales, Australia,
• margaret.sims_at_une.edu.au
• www.une.edu.au/staff/msims7

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Background

• A lot of research has argued that child care is
  bad for children
• Long hours of care or attending from an early age
  are particularly problematic
• Impacts found on social skills, aggression,
  compliance with adults, behaviour, attachments to
  parents

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but

• Research also shows that child care benefits
  children
• Better cognitive and language outcomes
• Australian research better attachment with
  parents
• Centre-based early intervention programmes (eg
  Perry High/Scope) showed long term improvements
  in a wide range of areas including less welfare
  dependency, better physical and mental health,
  better educational achievement, less involvement
  in crime etc

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Quality of care NOT who delivers care

• Many American centres are of low quality
• Multiple and/or unstable care arrangements are
  problematic
• Outcomes are clearly better for children when
  quality of care is high
• High quality better academic and language skills
  irrespective of length of time in care

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Research difficulties

• Impact of care requires longitudinal studies
• Difficulty of isolating impact of alternative
  care from other experiences in the early years
• Limited projects world-wide have been successful
  in getting sufficient money to follow children
  over a number of years, and those that have are
  generally funded to deliver interventions rather
  than investigating the impact of standard
  (available to anyone) services

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Cortisol

• Cortisol is a tool we can use to measure the
  IMMEDIATE impact of the environment on a child
• We see a change in cortisol levels within 20
  minutes of experiencing a stressor
• In a quality environment cortisol levels should
  return quickly to baseline

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Chronic stress

• But
• Where stress is chronic cortisol levels remain
  elevated for a long time
• Ultimately the body adapts to the atypical
  cortisol levels
• Hypocortisolism
• Hypercortisolism

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Outcomes of atypical cortisol levels

• Chronic high levels of cortisol behaviour,
  depression, type II diabetes, malnutrition,
  cardiovascular disease, memory, immune system,
  drug and alcohol addiction
• Chronic low levels of cortisol chronic fatigue
  syndrome, fibromyalgia, immune system (autoimmune
  disorders), rheumatoid arthritis, allergies,
  asthma

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The research model

• Chronic stress leads to atypical levels of
  cortisol
• When this happens over sufficient time there are
  changes to the brain and biochemistry that lead
  to negative long-term outcomes
• We can identify if a child is stressed by the
  environment and then predict the impact of the
  environment on long-term outcomes

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My research

• Collected cortisol levels of children in child
  care centres in Perth, WA
• Took measures of the quality of the child care
  environment
• 15 child care centres
• 156 children, 75 boys and 81 girls
• 38 infants (under 12 months of age), 57 toddlers
  (between 1 and 3 years of age) and 61 kindy aged
  children (between 3 and 6 years of age).

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Child care centre quality

• QIAS principles rated written observations,
  checked 25
• Quality Area 1 Relationships with children - 2
  of 2 principles used in this study
• Quality Area 2 Respect for children - 3 of 4
  principles used in this study
• Quality Area 3 Partnerships with families -1 of
  3 principles used in this study
• Quality Area 4 Staff Interactions - 1 of 1
  principles used in this study
• Quality Area 5 Planning and evaluation - 2 of 4
  principles used in this study
• Quality Area 6 Learning and Development - 1 of 6
  principles used in this study

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• Staff create a happy, engaging atmosphere and
  interact with children in a warm and friendly
  way.
• Staff guide childrens behaviour in a positive
  way
• Staff initiate and maintain communication with
  children, and their communication conveys respect
  and promotes equity.
• Staff respect the diverse abilities and the
  social and cultural backgrounds of all children
  and accommodate the individual needs of each
  child

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• Staff and families use effective spoken and
  written communication to exchange information
  about individual children and about the centre
• Staff communicate effectively with each other and
  function well as a team
• Programs reflect a clear statement of centre
  philosophy and a related set of broad centre
  goals
• Programs cater for the needs, interests and
  abilities of all children in ways that assist
  children to be successful learners

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• Programs encourage children to make choices and
  take on new challenges
• Staff supervise children at all times
• Toileting and nappy changing procedures are
  positive experiences and meet childrens
  individual needs
• staff ensure that children are dressed
  appropriately for indoor and outdoor play and
  that rest/sleep time and dressing procedures
  encourage self help and meet individual needs for
  safety,rest and comfort
• Staffing policies and practices facilitate
  continuity of care for each child

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Cortisol response to overall quality 3-6 years
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Principle 1.1 interact warmly - differentiation
between satisfactory and high quality (3-6 years)
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Similar patterns for kindy aged children in other
relationship measures

• 1.2 Positive guidance
• 2.1 Respect and equity
• 3.1 Family communication
• 5.3 Programme for childrens needs
• 6.1 Programme for choices
• 7.2 Supervise at all times
• 7.3 routines individualised
• 10.2 Continuity of care

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Different pattern for programming / curriculum
measures of quality 2.2 Individual needs (3-6
years)
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Infants (0-1 year) and toddlers (2-3 years)

• More likely to show increases in cortisol in
  satisfactory programmes
• ie more vulnerable to less than high quality

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Principle 2.2 Meeting individual needs - 3-6
years on left, babies on right
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We have known about the importance of
relationships for many years

• Demonstrate better school achievement as they get
  older
• Are more likely to have friends
• Are more likely to be healthy
• Are less likely to have mental health problems
• Have less extreme reactions to stressful
  situations and they return to a non-stressed
  state more quickly

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but

• We have not had evidence that is judged
  appropriately scientific to be credible
• Cortisol research and some of the new epigenetic
  research is now supporting this

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Rhesus monkeys those who are genetically highly
reactive

• Remain with poor mothers disrupted sleeping,
  high cortisol levels, anxiety, depression,
  excessive alcohol consumption, aggression, poor
  mothering so inter-generational transmission of
  neglect/abuse
• Fostered with highly nurturing mothers had good
  outcomes good social skills, robust immune
  responses, lower cortisol levels, females become
  nurturing mothers

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Message for early childhood services

• If children feel unloved, unsafe, unwanted,
  insecure, nervous
• They will be biologically stressed which means
• They will not learn
• Exciting, challenging, developmentally
  appropriate activities will stress them more and
  lead to negative long-term outcomes

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Caregivers responses to quality
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Factors impacting significantly on caregiver
cortisol levels

• Quality level of service
• Older caregivers more stressed
• More stressed when more than one trained
  caregiver in the room
• More stressed when children with disabilities
  included
• Lower stress when children from CALD included

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Caregiver factors significantly impacting on
childrens cortisol

• Children less stressed when
• caregiver more cc experience
• More trained staff in the room
• Caregivers worked less hours per week

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Caregiver factors significantly impacting in QIAS
scores

• Higher QIAS scores when
• Caregivers have been employed at the same centre
  for longer
• Better adultchild ratios
• Increasing numbers of children from CALD

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The importance of early childhood services

• Voluntary, high quality, publicly funded
  universal pre-kindergarten programme for 3-4 year
  olds in America
• Cost 6300 per child for 7 million children
• Annual benefits outstrip costs in 9 years
• By 2050 annual benefits 779 billion - 191
  billion in government budget benefits, 432
  billion in increased compensation of workers,
  156 billion in reduced costs to individuals from
  less crime and child abuse. By 2050 benefits
  exceed costs by 8.2 to 1 (Lynch 2007)

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There is enough money to develop high quality
services

• 5 of the money spent on military technology and
  training in 1999 could have provided basic
  education, health care, nutrition, potable water
  and sanitation to ALL the people of the world
  (Arias, 2000/2001)

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High quality services are those where we focus on
developing and maintaining secure attachments
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Fostering secure attachment

• Children need to develop a sense of trust that
  you will meet their needs
• You can learn how to develop secure attachments

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Responding to cues

• Learn to read the non-verbal language of each
  individual child
• always check out your interpretation
• use language even though child does not
  understand the words
• use voice intonations
• provide opportunities for infants to lead
  interactions

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Inter-actional synchrony

• Interactions involve turn taking
• recognise infants turn is non-verbal
• provide time and space for the infants turn in
  the conversation
• adapt YOUR goals for the interaction to follow
  the infants needs and signals

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Positive language

• Always explain what you want to happen, NOT what
  you do not want to happen
• Thomas is about to empty the bucket of sand over
  Janies head. Say Thomas, bring your bucket of
  sand over here so I can help you build a
  sandcastle
• Dont climb on the fence vs Come and climb
  over here

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Consistency and continuity

• Infants can not learn to trust a caregiver if
  they have a different person each day
• services adjust their routines and staffing to
  the needs of the infants rather than the reverse
• primary caregiver model of service delivery

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Social referencing

• When in a new or ambiguoussituation, infant
  looks to attachment figure for clues on how to
  react
• social referencing experiments on depth
  perception
• if good relationship between parent and caregiver
  infant more likely to feel safe with caregiver

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Handles for attachment

• Stranger and child share happy/fun time together
  - link the good time with the person
• identify activities children enjoy
• set up situations where child given opportunity
  of playing this with you
• share time one-to-one and in small groups making
  sure it is a happy time for the child

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Holding and physical comfort

• Hugs essential to secure attachments
• never leave child to cry even when rejects touch
• distress must be recognised as valid and real
• use voice for comfort (reassurance) and physical
  presence
• carrying common in some cultures
• floor useful for contact with more than one
  child

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Remember

• Someones child today is our future prime
  minister who will determine the level of your
  retirement pensions
• Do you want that childs experiences today to be
  focused more on rationalism than empathy?
• WHAT YOU DO TODAY
• MATTERS