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To the Editor: We are concerned that Cook's article1 lacks a balanced
review of the literature on childcare, being biased in its portrayal
of the possible negative effects without consideration of the likely
positive ones. This could have detrimental consequences for the many
children in formal childcare in Australia, their parents, and the
staff and others involved in what is now an integral and vital
component of Australian society. Cook's article also draws strongly
on overseas studies, although childcare systems in Australia are
likely to be different from those in other countries.
Positive health outcomes for children attending childcare include
the detection of vision and hearing problems, higher vaccination
rates, appropriate nutrition, the detection of child abuse and
neglect, primary health and dental care, psychosocial benefits, and
opportunities for health promotion.2
The issue of socioemotional development, including attachment
theory, has been debated in the literature. Cook cites Belsky, but
Belsky has been noted as often citing research that did not take into
account the specific characteristics and quality of
care.3 It is probable that social
and cognitive development are related to quality of care, and
Caldwell's study suggests that childcare may provide better quality
of care, at least for cognitive development, than home
care.4 Thus, childcare does not
appear to be consistently detrimental to cognitive and language
development and may have a positive influence.4 The
investigation of the influence of childcare on children's
development is complex and should be considered in interpreting such
research. Harvey,5 in an extensive
longitudinal study, found that parental employment had "minimal
effects on children's later functioning", and that increased early
parental income could positively affect childhood development.
We do agree with Cook that increased flexibility for working parents
should be encouraged. Flexible options, such as parental leave and
part-time work for parents of young children, are often
advantageous. In addition to increasing work options for parents, it
is important that we strive for high quality childcare, subsidised if
necessary, so that all families have the choice of providing such care
for their children.
Linda M Slack-Smith
Senior Lecturer, School of Oral Health Sciences
179 Wellington
Street, Perth, WA 6000
lindasATcyllene.uwa.edu.au
Anne W Read
Senior Research Officer, Division of Psychosocial Research
TVW
Telethon Institute for Child Health Research, Perth
Stephen R Zubrick
Associate
Professor, and Head, Division of Psychosocial Research
TVW
Telethon Institute for Child Health Research, Perth
- Cook P. Rethinking the early childcare agenda. Med J Aust
1999; 170: 29-31.
-
Andersson B. Children's development related to day-care, type of
family and other home factors. Eur Child Adolesc Psychiatry
1996; 5: 73-75.
-
Melhuish E, Moss P. Current and future issues in policy and
research. In: Melhuish E, Moss P, editors. Day care for young
children. London: Tavistock/Routledge, 1991: 225.
-
Caldwell B. Impact of day care on the child. Pediatrics
1993; 91(1 Pt 2): 225-228.
- Harvey E. Short-term and long-term effects of early parental
employment on children of the National Longitudinal Survey of Youth.
Dev Psychol 1999; 35: 445-459.
In reply: A literature review was beyond my purpose, but I
summarised findings of a major meta-analysis, and explained why
psychological outcomes are of most concern. Benefits of childcare
are often publicised, but risks, proven or probable, should not be
concealed from parents and policy-makers.1
Notwithstanding the 1971 New South Wales child psychiatrists'
memorandum,2 it became politically
incorrect to express concerns about childcare. In social sciences,
the now-discredited ideology of cultural determinism prevailed,
denying the relevance of evolutionary biology to human behaviour,
even mothering.
A pro-childcare "spin" has pervaded research reports. Slack-Smith
and colleagues' statement that "childcare does not appear to be
consistently detrimental to cognitive and language development . .
." is a typical childcare-advocacy "straw man". The reply is: nobody
said it was! Ochiltree's review3 seemed to me to have eight
such statements within five paragraphs, and was so "unbalanced" that
I wrote a book,1 to which I refer readers. It
covers the points made by Slack-Smith et al, which cannot be answered
in a few words.
Childcare advocates seldom acknowledge that "high quality
childcare" is not reliably achievable. They quote overseas studies
when favourable, but, when not, they claim Australian childcare is of
higher quality.3 But one carer to five infants
is "nobody's definition of quality".4
I argue that the early childcare agenda is misconceived and needs
rethinking. Qualitatively better outcomes should be achievable
without the associated risks.1,5,6
Peter S Cook
Child Psychiatrist (retired)
PO Box 84, Repton, NSW 2454
- Cook PS. Early child care -- infants and nations at risk. Melbourne:
News Weekly Books, 1997.
-
New South Wales Branch of the Child Psychiatry Section of the
Australian and New Zealand College of Psychiatrists. Memorandum on
some aspects of the welfare of children aged under three years whose
mothers are in full-time employment. Med J Aust 1971; 1:
446-448.
-
Ochiltree G. Effects of child care on young children: forty years of
research. Melbourne: Australian Institute of Family Studies, 1994:
65-66. (Early Childhood Study Paper No. 5.)
-
Hope D. Spare the non-maternal care and nurture the child. The
Australian 1998; June 4.
-
Cook PS. Home truths absent in early childcare debate: we need
parent-friendly options [opinion]. The Australian 1999;
March 24.
- Cook PS. The role of myth in childcare policy [letter]. The
Australian 1999; April 14.
©MJA 1999
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