Child Care Today

Getting It Right for Everyone

by Penelope Leach

Knopf, 368 pp., $25.95

Single mothers moving out of public assistance, and low-income families searching for affordable child care, will applaud the $4 billion increase in stimulus funds for programs like Head Start, Early Head Start, and Child Care Development Block Grants, which support state programs for subsidized care. But it's far from certain whether the children who actually receive these services will be better off, and that's Penelope Leach's particular concern.

This British child development expert, the best-selling author of Your Baby and Child: From Birth to Age Five, has earned an international reputation for helping readers consider their offspring's point of view on matters like infant sleep disturbances and potty training. This new volume also offers a child-centered perspective, but Leach has moved out of the nursery and stands ready to make her mark on an entrenched ideological debate that asks whether nonmaternal child care helps or harms young children.

Actually, she thinks that's the wrong question to initiate a discussion on a contentious subject. Readers must first consider, she says, "what kind of care, where, by whom, for which children, from what age, for what hours, paid for by whom, and with what results?"

Designed for concerned parents and interested policymakers, Child Care Today explores every element of the childcare picture--sometimes to a tedious degree. Like any good lobbyist, Leach prods her readers to rethink their complacency; a portion of the book compares our ad hoc, tough love practices with more predictable "top down" policies in enlightened European nations.

Leach bemoans the grim consequences of Americans' conflicted feelings about child care: From the scarcity of paid maternal leave, to the small pool of strong programs for at-risk preschoolers, to the spasms of guilt suffered by working mothers. Leach is clearly impressed with the "supply-driven" policies of some European nations that secure provisions like high-quality universal child care and allowances for at-home mothers. But this practical work isn't a stealth argument for the construction of a social welfare state: Leach realizes that the political and cultural framework that supports Sweden's day care regime doesn't exist here.

Still, she wants readers to come to grips with an unpleasant truth: Much of American day care is just plain "bad." Given the available options, infants in particular are better off at home with their mother, a family member, or a nanny. Working mothers of very young children express greater satisfaction with in-home care, in part because caregiver/infant ratios remain too high in most affordable group programs. That problem can delay the developmental milestones of underprivileged children already at risk because of family instability.

This is especially relevant for American families. About 12 percent of three-month-olds here are placed in day care, and another 24 percent are in family day care, where small groups of children are cared for in private homes. Though British child care practices track most closely with our own, fewer than one percent of three-month-olds attend day care in Great Britain, and just one percent are brought to family day care. Comparisons between American and other Western European practices are even more striking.

American parents with toddlers have more options. Still, Leach cautions readers to assume nothing: Each child's needs should be assessed individually, and the staff and practices of available programs must be scrutinized. Children's needs would also be better served if we addressed the poor academic qualifications and high turnover of the staff at many American centers for older children.

Leach respects the passionate instinct of mothers to guard their young, whatever their child-care decisions. Indeed, maternal possessiveness leads some working mothers to choose sub-par care in order to prevent their child from establishing closer bonds with the hired help. But she sets such mothers straight: Warm, competent caregivers can't dislodge a child's primary attachment to his parents.

The larger point is that mothers are fully in charge of decisions about child care. While Leach devotes a chapter to the increasing role of fathers in the nursery--a trend likely to accelerate as women outpace men in obtaining college degrees--single mothers now account for almost 40 percent of live births in the United States. If anything, these developments increase the urgency of improving affordable child care for the working poor. Leach finds it "shameful" that family finances, rather than maternal preferences, drive child-care choices here, and she opposes welfare-to-work programs that press single mothers with young children to enter the workforce and ignore the scarcity of decent child care.

There are bright spots, of course. Over the years studies of a handful of model programs, such as the Perry Preschool Project, have established a direct correlation between early intervention for at-risk children and their subsequent ability to stay employed and out of trouble as adults. Politicians lobbying for universal preschool often cite the Perry Project results. But Leach says it's a mistake to conflate the outcomes of "state-of-the-art remedial programs" with the limited impact of programs designed for ordinary children: "Applying the data from the highly resourced experience of a small group of at-risk preschoolers to all children is questionable."

Leach is generally supportive of Head Start, and Early Head Start, which targets low-income mothers and infants. But she freely explores their problems, too. In fact, Head Start doesn't come cheap--annual, full-time costs top $22,000 per child--and several studies conducted by the Department of Health and Human Services have concluded that Head Start's initially positive impact appears short-lived. In 2007 the program's advocates convinced Congress to discontinue the National Reporting System, which was designed to review the outcomes of individual centers, making it almost impossible to identify and promote the best practices of solid operations.

Such moves don't inspire confidence. Leach cites Sharon Ramey, director of the Center on Health and Education at Georgetown, who worries about the "culture of silence and defeatism that has crept" into discussions between experts in the field. Ramey contends that child care advocates and researchers are

fearful that criticism of existing standards and the quality of publicly funded programs, such as subsidized child care for welfare-to-work families and Head Start and pre-K public-school programs, will lead to a total withdrawal of any public support for very low-income families or those with two working parents.

Well, federal funding for Head Start, and for child-care subsidies for low-income families, has actually increased; but you could make a case for putting an expansion of state-funded child care on hold until policymakers address the systemic problems of existing programs. It's more likely, however, that bureaucratic ineptitude, entrenched ideological positions, and a deep-seated American resistance to "top-down" solutions--enlightened or not--will leave the status quo essentially unchanged. Penelope Leach will be scandalized, and who can blame her?

Joan Frawley Desmond, who writes on religious and social issues for a variety of publications, lives in Maryland.

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