Can you put your children into childcare without worry about damaging their emotional, cognitive and social welfare? Research suggests you can, writes Maureen Gaffney
In her column of last Saturday Breda O'Brien takes issue with my "certainty" regarding the effect of childcare on children's emotional attachment: that is, that the quantity, quality, stability of arrangement and age of entry into childcare have no effect on the security of mother-child attachment.
She goes on to cite - in apparent opposition to that conclusion - the National Institute of Child Health and Development (NICHD) study on childcare. But as she herself observes, the devil is in the detail. Not the least of which is that the precise NICHD study she quotes is the one which came to that conclusion.
The major findings of the NICHD study are worth examining because it is the largest, most rigorous, ongoing investigation of the effects of childcare on children available.
Starting in 1991, 1,300 children and their families have been studied at regular intervals from birth onwards. There are now in excess of 100 densely-argued scholarly articles based on these data published in the most prestigious peer-reviewed academic journals. Based on these findings, we can begin to answer these vital questions with growing confidence.
Does being in childcare affect a child's attachment security?
Some previous studies in the 1980s found that, compared to children looked after full-time by their mothers, children in childcare were at increased risk of forming an insecure attachment to their mothers. The NICHD study found otherwise. It reported that at 15 months children who had experienced extensive and early childcare (defined as more than 30 hours a week from birth) were no more likely to be insecurely attached than children with less than 10 hours a week childcare.
In addition, the proportion of securely attached children who were reared full-time by their mothers was identical to that of the children in any type of childcare. These findings held irrespective of the quality or quantity of the childcare.
So, if quantity and quality of childcare did not determine secure attachment what did? The finding here was unambiguous: maternal sensitivity did - defined as the mother's readiness to respond to a child's distress, her positive regard and affection for the child, and her willingness to play co-operatively with, and provide appropriate cognitive stimulation for, the child.
For children with sensitive mothers, the quality and quantity of childcare made no difference to their emotional security. In contrast, for children with insensitive (or depressed) mothers, more hours in childcare, poor-quality childcare and more than one care arrangement put them at higher risk of insecure attachment. In other words, a bad situation (ie, an insensitive and unresponsive mother) was made much worse by poor quality and extensive experience in childcare.
Why? There may be a "dosage effect" - children with less sensitive mothers may need more time with them to develop confidence in their mother's psychological availability and, correspondingly, such mothers may need more time with children to become intimately familiar with, and connected to, them.
But, ironically, insensitive mothers are more likely to put their children in childcare for longer hours, in poorer-quality care and at earlier ages. They are also more likely to hold strong views that children benefit from maternal employment because it makes them more independent.
There was also an interesting difference in the effect of longer hours in childcare on boys and girls. Boys who experienced more than 30 hours of care per week were most at risk of insecure attachment with their mothers. In contrast, girls with less than 10 hours in childcare a week were at highest risk. Why?
The explanation may be that boys are generally more vulnerable than girls to psychosocial stress of any kind and therefore may be more sensitive to mother absence. Girls, in contrast, may be more sensitive to mother presence and involvement; especially if their mothers have psychological difficulties or do not provide cognitive stimulation. In fact, girls lacking in childcare experience in infancy score lower on later intelligence tests.
Overall, then, with regard to the effect of childcare on a child's emotional security - what parents worry about most - the overall conclusion of the NICHD study is rather less apocalyptic than many commentators fear: "The results of this study clearly indicate that childcare by itself constitutes neither a risk nor a benefit for the development of the infant-mother attachment relationship . . . The effects of childcare on attachment depend primarily on the nature of the ongoing interactions between mother and child."
Does childcare affect children's cognitive and educational development?
The NICHD study conclusion is that childcare does, generally, have positive effects on children's cognitive and educational development, but it depends on the quality of the childcare.
High-quality childcare promotes language, pre-reading, reading, analytic and problem-solving skills, as well as better memory and attention.
But, again, as in the case of emotional security, family factors - maternal sensitivity, the quality of the home environment (including father's positive involvement with the child, a subject meriting its own discussion) and family income - were better predictors of all cognitive and educational outcomes than any aspect of early childcare.
The big exception is for children from socio-economically disadvantaged backgrounds, for whom high-quality childcare has significant cognitive and educational benefits, an issue that will be detailed in the forthcoming National Economic and Social Forum report on early childcare and education.
Does childcare make children more aggressive?
Breda O'Brien referred to the NICHD findings that, at age 4½, among children who experienced early and extensive childcare, 17 per cent showed aggressive behaviour (teasing, fighting, hitting) to peers and non-compliant behaviour (being non-co-operative and defiant) to adults, compared to only 6 per cent of children who had less than 10 hours childcare a week.
But, again, the devil is in the detail. As the NICHD researchers have pointed out, if the psychological measure used in this study was administered to any group of four-year-olds, typically 17 per cent of them - exactly the same proportion - will receive such high scores on aggression and non-compliance. In other words, the increased aggression and non-compliance found is a cause of concern, but is still within the normal range.
More importantly, she may also be unaware that the most recent wave of the NICHD research found that when the children were followed up at age 9-10, these adverse effects had disappeared. Why? One explanation may be that in group care, "normal things" happen to kids sooner; for example, they pick up childhood infections earlier. In the same way, young children in complex social settings, where they have to compete and find their place in the group, may also develop more aggressive and demanding behaviours earlier than children reared at home.
But, while children's problem behaviours wax and wane, one thing remains constant in wave after wave of the study. As with emotional security and cognitive capacities, children's behaviour is much more strongly influenced by the quality of mothering and the home environment than by the quantity and quality of childcare.
That is not to say that quality of childcare does not count - it does, very much. High quality is consistently related to better emotional, cognitive and educational outcomes for children. Neither is it to say that quantity does not count. This leads me to the last question
How much childcare is too much childcare?
The answer is that there is no scientifically established threshold. We have to carefully monitor the effects of children from infancy rightthrough their childhood clocking up extensive hours in care and away from parents. Researchers have to remain vigilant about so-called sleeper effects, that is, latent vulnerabilities which may take time to manifest themselves. That is precisely the value of longitudinal research.
Parents constantly struggle to balance the many needs and desires of families: their child's welfare, their economic situation, their interest in their careers, their leisure. If possible, one parent should try to work not more than 20 hours a week in the first and second years, and not more than 30 hours a week years in the third year. The NESF has recommended that, by 2009, maternity and parental leave be extended so that mothers can choose to stay at home full-time in the first year.
But, for some, such a formula is neither possible nor desirable. For such parents, maximise your positive and affectionate high-quality time with your child. Keep vigilant about signs of distress and be prepared to regularly re-examine your priorities. Spend as much time as possible with your child in the early years, not just because it is good for your child but because it is your only chance to see that child growing up.
Dr Maureen Gaffney is chairwoman of the National Economic and Social Forum and a member of the board of the Health Service Executive