The NICHD Child Care Study Results: What do they mean for parents, child-care professionals, employers and decision makers?

Christine M. Todd
Professor of Child and Family Development
University of Georgia

The April 2001 release of the results from the most current wave of the longitudinal National Institute of Child Health and Human Development (NICHD) Child Care Study has some very positive things to say about the importance of high-quality child care. Unfortunately, most media attention was given to one result of this highly complex study-the findings on child behavior problems. This article contains more detailed information on the major findings and suggests implications of these results for parents, caregivers, employers and decision makers.

The NICHD Child Care Study

As people who care deeply about children, how should parents, caregivers, employers and decision makers react in light of the most recent NICHD results? First, carefully evaluate the quality of the research and consider the results in light of other findings.

The NICHD child-care study is well designed and implemented. It overcomes many of the problems in previous child-care research studies by following more than 1,300 children at 10 different sites across the country from birth into the school-age years. Information on more than 500 variables thought to affect children's development was collected at frequent intervals using well-developed measures. The study looked at the interaction between child characteristics, the home environment and child-care settings to help explain how the children developed over time. The care with which this study was conducted suggests that we should take the results seriously, especially since the results are generally consistent with findings from other studies that have been conducted.

The results once again demonstrate that child-care quality matters. Caregivers with higher levels of education and who worked in settings with fewer children per adult were more sensitive and responsive to children and provided a more stimulating environment.
When care environments were more stimulating and well organized, children had better vocabularies, more advanced attention and memory skills and got along better with peers. In contrast, children who spent more time in front of the TV showed more behavior problems, had smaller vocabularies and did less well on math problems.

The hours spent in various types of care also affected child outcomes. More care by relatives was neither facilitating nor detrimental to child outcomes. More time in home-based, non-relative care (defined as a non-relative caregiver who cared for the child in the study and at least one other child) was associated with better language outcomes during the toddler years but lower language outcomes during the preschool years. There was no evidence that hours in center-based care during infancy had especially negative effects on later development, at least through the early school years. Moreover, by the preschool years, children with more hours in center care were displaying more advanced language and cognitive skills although caregivers also reported somewhat more behavior problems among children who had more hours in center-based care.

The positive effects of center-based care on cognitive development may be related to the finding that center-based caregivers had higher levels of training and education, provided more language stimulation and provided more structured activities than home-based providers. The somewhat higher level of problem behaviors in center settings suggests, however, that it is important for caregivers to provide experiences that promote social and emotional development along with providing a cognitively enriching environment.

The number of hours in care also mattered. A few children (less than one in five) who were in care 30 hours or more per week were reported to have somewhat higher levels of problem behaviors compared to children who experienced less time in care. In many of the media reports these problem behaviors were labeled as “aggressive” behaviors. Some of the reported behaviors, such as fighting, would be viewed as aggression by most adults. Other reported behaviors, however, such as demanding attention or talking back to adults, are probably more likely to be labeled by adults as “challenging” rather than “aggressive” behaviors.

It is important to look at the exact findings related to problem behaviors and the amount of time in care to fully understand the implications of these findings. At age 4-1/2, 16% of the children who were in care 30 hours or more per week showed higher levels of problem behaviors than children in fewer hours of care. This effect was also evident in kindergarten where 17% of the children showed higher levels of these behaviors. It is important to note, however, that 16-17% of ALL children typically exhibit higher levels of these problem behaviors. Therefore the incidence of behavior problems for children in full-time care was no higher than that found in the general population of children.

On the other end of the continuum of care, children in care less than 10 hours per week showed very low levels of problem behaviors. Only 6% of these children demonstrated higher levels of these behaviors at 4-1/2 years, although this increased to 9% in kindergarten. It will be important to follow children with few hours in child care through elementary school to determine if problem behaviors in this group increase as they spend more time in complex, large-group settings.

Previous research has shown that children in child care may experience normal events sooner than children cared for at home because of the nature of the child-care setting. For example, children in child care tend to have more respiratory tract infections (e.g., colds, ear infections, sore throats, flu, etc.) as preschoolers whereas children raised at home tend to have more of these illnesses in later life. All children need to develop immunity to common diseases. They begin building this immunity whenever they are exposed to more germs. For some children this is when they enter group care as infants, toddlers and preschoolers. For other children it is when they enter elementary school. Similarly, it is possible that children will begin to demonstrate more problem behaviors whenever they enter complex, large-group settings. This may happen sooner for children in child care than for children cared for at home.

Finally, the quality of parenting and the home environment was also related to children's behaviors in the NICHD study. Children whose mothers were more sensitive and responsive to their needs displayed better pre-academic and language skills and fewer behavior problems.

This study once again demonstrates that the quality of both the home and child-care environments matter. Taken together, these findings have important implications for parents, caregivers, employers, and decision makers.

Implications for Parents

Parents selecting care should choose high-quality settings. In high-quality environments-whether offered by friends and relatives, family child-care providers or center staff-children spend less time watching TV and more time talking with adults. Children in high-quality settings are exposed to caregiver-initiated activities that stimulate language and cognitive development and activities that promote social development.

Caregivers should talk with and encourage infants to “talk” back by smiling, paying attention when they talk, and repeating the sounds infants make. They should play games with infants, such as peek-a-boo, and sing to them. They should help infants and toddlers learn the words they need to communicate their needs and express their emotions. Toddlers and preschoolers can learn early reading and math skills through everyday events provided by adults, such as making play dough, playing with blocks and different size containers (e.g., boxes, food storage containers) that fit inside one another, telling stories and reading books.

At all ages, caregivers should help children learn more acceptable ways to act when they misbehave. They should teach children how to trade or share toys, resolve conflicts, and use words instead of hitting.

High-quality settings also provide time for less-structured activities that allow children to run outside to build strong and healthy bodies, to develop creativity and learn problem-solving skills as they play, to recognize and express emotions in acceptable ways, and to interact with others in socially appropriate ways.

The indoor and outdoor environments should be uncluttered and well organized. These environments should include a variety of materials that encourage children to develop their large and small muscles, engage in creative activities (e.g., music, art, drama) and provide opportunity to play with cognitively stimulating materials appropriate to the child's age.

As a parent, what can you do if you cannot find this quality of care in your community? Some parents choose to stay home with their children. Other parents, however, are not able to do this. In this case, the first thing to do is relax. The findings of this study, and many other studies, suggest that the quality of the home environment is especially important to children's development. Good parenting and a stimulating home environment consistently is associated with better outcomes for children.

Parents must also work to improve the quality of care. Encourage your caregiver to attend training. Consider paying their training fees and/or the costs to hire qualified substitutes so the caregiver can attend training. When divided among many families, the amount each family would pay is relatively small. Be sure to recognize caregivers when they complete training, obtain certifications or receive higher levels of education. Moreover, parents who have the financial resources to do so should be willing to pay more for higher quality care.

Finally, make your views known to local, state and federal decision makers and to your employer. Breakdowns in child-care arrangements are a major source of stress for working parents, which may reduce the quality of parenting in the home, cause parents to miss work and/or be less productive on the job.

Implications for Caregivers

Caregivers-whether friends or relatives, family child-care professionals or center-based staff-should carefully examine the care setting they provide to children. How do the caregivers interact with the children? What experiences do they provide to children? Do caregivers talk with children often in a sensitive and stimulating manner? Are there structured activities that help children pay attention, learn and remember? Is there also time to learn through play and interact with other children in unstructured activities? Is there a variety of materials for children to play with both indoors and outdoors and is the space well organized and uncluttered?

When children show aggressive or unkind behaviors (as all normal children do), do caregivers teach them better ways to act? Children need help from adults as they learn to use words instead of hitting. Adults can help young children resolve conflicts by teaching them to take turns or to find a way both children can play with a favorite toy. Children also need help learning to express emotions in acceptable ways-to go off and sit by themselves or run outside when they are upset instead of hurting other children with words or by hitting.

Programs that provide part-day experiences for children should talk with parents to find out how their particular program fits with the rest of the child's day. Do meal and snack times coordinate across the various settings? Are there times throughout the whole day for children to experience all the types of activities that they need? Children need time for both active and quiet play. They need time with adults and time to play with friends or by themselves. They need both structured and unstructured indoor and outdoor activities that promote physical, mental, social and emotional development. Although your program may place more stress on one component of development-cognitive, social, emotional or physical development-it is important to work with parents and other professionals in the child's life to ensure that across the entire day children are exposed to settings and activities that promote development in all four areas.

Implications for Employers and Decision Makers

Employers, decision makers, caregivers and parents can work together to ensure that there are many different high-quality care options available to parents in local communities. Quality care by parents and other caregivers will help ensure that children grow up to be good employees and caring, competent, productive and engaged adults.

Employers and decision makers should continue their efforts to improve the quality of care provided to children, both at home and in out-of-home settings. Employers can examine their benefit packages to ensure that parents have access to benefits that allow choice in how they care for their children and that can help them afford higher quality care. They can provide funds to local child-care resource and referral agencies to help parents locate high-quality care that meets their needs. And they can provide access to parent education programs for their employees to help parents better understand how to identify quality care as well as to improve their parenting skills. Decision makers at all levels can ensure that child-care standards promote training for all groups of caregivers and specify appropriate adult-child ratios for the age groups served.

Employers and decision makers also can promote high-quality caregiver education, training and professional development opportunities. These training systems must meet the needs of ALL caregivers who desire training-relatives and friends as well as licensed child-care professionals; caregivers in rural communities and inner cities as well as suburban communities. Caregivers must know about and have easy access to this training. And caregivers should be rewarded financially for obtaining higher levels of training, certification and education, just as employees in other job classifications are. When parents are not able to afford the true cost of quality care, employers and the public sector can help to ensure caregivers receive a fair wage, given their levels of training and education.


High-quality care-both in the home and out of the home-results in better outcomes for children. By working together, parents, caregivers, employers and decision makers can ensure high-quality care for ALL children. Ensuring high-quality care environments for children is everyone's businessand everyone benefits.


Selected Bibliography for Researchers and Professionals

NICHD Early Child Care Research Network. Quantity of child care and problem behavior. Paper presented at the Biennial Meeting of the Society for Research in Child Development, Minneapolis, MN.

Children's Defense Fund (2001, April 23). NICHD releases latest findings from study of early child care. Child Care Advocacy Newsletter. Washington, DC: Author.

Hayes, C. D., Palmer, J. L., & Zaslow, M. J. (Eds.). (1990). Who cares for America's Children: Child care policy for the 1990s. Washington, DC: National Academy Press.

Hill, E. J., Hawkins, A. J., Ferris, M., & Weitzman, M. (2001). Finding an extra day a week: The positive influence of perceived job flexibility on work and family life balance. Family Relations50 (1), 49-58.

NICHD Early Child Care Research Network. (2001, April). Quality of child care and child care outcomes. Paper presented at the Biennial Meeting of the Society for Research in Child Development, Minneapolis, MN.

NICHD (no date). The NICHD study of early child care and youth development. Available:

NICHD (no date). The NICHD study of early child care and youth development: Publications and presentations. Available:

NICHD Early Child Care Research Network. (2001, April). Overview of early child care effects at 4.5 years. Paper presented at the Biennial Meeting of the Society for Research in Child Development, Minneapolis, MN.

Peth-Pierce, R. (1998). The NICHD study of early child care. NICHD Health Information and Media-Publications. [On-line]. Available:

Perry-Jenkins, M., Repetti, R. L., & Crouter, A. C. (2000). Work and family in the 1990s. Journal of Marriage and the Family62 (4), 981-998.

Robinson, A. & Simpson, A. (2001). Responding to reporters and parents on the new
study on child care and behavior
. Washington, DC: National Association for the Education of Young Children.

Society for Research in Child Development. (2001, April 19). New research demonstrates unique effects of quantity, quality, and type of child care experienced from birth through age 4.5. Ann Arbor, MI: Author. Available on-line:

NICHD Early Child Care Research Network. (2001, April). Overview of early child-care effects at 4.5 years. Paper presented at the Biennial Meeting of the Society for Research in Child Development, Minneapolis, MN.

Resources for Parents and Professionals and Links to Relevant Web sites can be found at:

National Network for Child Care Web Site:

Of special interest:

Quality Child Care: Choosing Child Care:

Guidance and Discipline: Behavior Management:

Agencies and Organizations in Child Care Index:


Author Contact Information:

Written by Dr. Christine M. Todd, chair of the national Extension CARESfor America's Children and Youth (ECI) evaluation and research committee and professor of child and family development, University of Georgia, Athens, GA. Phone: (706) 542-2817; FAX: (706) 542-4389;

May, 2001

Developed by the Extension CARESfor America's Children and Youth Initiative (ECI), a national initiative of the Cooperative Extension System. The ECI web site is: For more information on the ECI contact Dr. Nancy Valentine, National Program Leader, Cooperative State Research, Education and Extension Service, USDA, (202) 720-2908 or Dr. Eddie Locklear, Department Extension Leader, North Carolina State University (919) 515-3242.

This article reflects the views of the author and does not represent the views or policies of the United States Department of Agriculture.


Copyright Information:

Permission is granted to reproduce ECI materials in whole or in part for educational purposes only (not-for-profit beyond cost of reproduction) provided that the author, ECI and NNCC receive acknowledgement and this notice is included:

Reprinted with permission from the Extension CARES Initiative-ECI and National Network for Child Care (Todd, C. M. (2001). The NICHD Child Care Study Results: What do they mean for parents, child-care professionals, employers and decision makers? Washington, DC: USDA/CSREES: Extension CARESfor America's Children and Youth Initiative.

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