Long Hours in Day Care Increase Risk of Behavior Problems

From the WebMD Archives

April 19, 2001 -- Children who spend extended time in day care risk behavior problems when they reach kindergarten. But most of these kids don't have behavior problems -- and the better their day care, the better their memories and learning skills.

These findings are part of a new report from the National Institute of Child Health and Human Development (NICHD) Study of Early Childcare and Youth Development. The report was presented recently at the biennial meeting of the Society for Research in Child Development, held in Minneapolis.

During the study, researchers followed 1,200 children from birth to the age of 4.5 years. They found that 17% of children enrolled in child care for more than 30 hours exhibited aggressive behaviors, while these behaviors were seen in only 8% of children with less than 30 hours of day care per week.

"Children who had more hours in child care were reported by the caregivers and then by their kindergarten teacher to show more behavior problems than children with fewer hours of care, regardless of the quality and type of that care," study presenter Deborah Lowe Vandell, PhD, tells WebMD. "The behavior problems we see are more boisterous, rambunctious children who are more likely to get into fights."

Why some of these children developed these behaviors while most others did not remains a mystery. But Vandell, a professor of educational psychology at the University of Wisconsin, thinks parent-child relationships explain part of the problem.

"I think we do see that more hours in child care also affects mother-child interactions," Vandell says. "When these hours are higher, mother-child interactions are a little less positive. When you [take into account] these interactions you see the effects of child-care hours go down, so it looks like that is part of it."

NICHD researcher Sarah L. Friedman, PhD, is the scientific coordinator and project scientist for the study. She warns that although long hours of child care may increase a child's risk of behavior problems, reducing a child's time in day care can also bring problems -- particularly for working families.

"For parents to work fewer hours seems like a simple solution, but it may not be the best one," Friedman tells WebMD. "If parents reduce the hours they work, it may put them under financial stress, and this is true for a lot of families. It may also have implications for maternal depression. When people have more financial stress they are more likely to be depressed. Because we know the more depressed the mother, the less well the children do, this is another thing to consider. It is possible the link between day care and behavior problems will go away if there are changes in what happens at home."

Child-behavior expert David Fassler, MD, chair of the American Psychiatric Association's council on children, adolescents, and their families, discussed the study with WebMD. He advises parents to find their children the best day care they can, and he notes that day care can be a very positive experience for preschoolers.

"Be an advocate for your child and find the very best day care setting you can," he said. "Look for ratio of staff to children, the turnover rate of the staff, and the overall size of the facility and the number of children being cared for. Children can do very well and develop in a very healthy manner when exposed to good day care settings."

Indeed, Vandell, Friedman, and co-workers found that day care improved children's short-term memories and learning skills at age 4.5. This is the age of entry into kindergarten, and there is strong evidence that the skills and behaviors a child has at that age are important to future school performance. As Fassler suggested, the study showed that the better the child care, the better the child's skills.

"We are finding some good news and some bad news," Vandell says. "Think about an elephant. You wouldn't say the elephant is just the tail. Well, quantity is the tail of the child care elephant and quality is its trunk. To really understand child care you have to be thinking about the whole elephant."