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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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