Early use of non-parental childcare is not harmful for most children, Norwegian study finds

These are some of the questions that are explored in a new report prepared by the Norwegian Institute of Public Health as part of a collaborative project with the Ministry of Education and Research. The report indicates that there is no evidence that early centre-based childcare is harmful for most children.

Most pre-school children in Norway attend different types of childcare arrangements on a daily or weekly basis, and by far the majority are in centre-based childcare (kindergarten). In contrast to most other countries, children with physical and/or mental disabilities are not separated from the other children, but attend regular groups or classes in public kindergartens and schools.

Childcare is an important arena for language development and learning and for preventing and coping with mental health issues, regardless of the child's functional level. Because most children in Norway participate in childcare we have opportunities to learn about what the best arrangements are for learning, as well as how best to cope with daily challenges for children with different levels of functioning. The significance of different types of childcare for children's development is frequently discussed in many research groups as well as in the preschool education sector.

The aim of this report "Barnepass fram til 18 måneder. Sammenhenger mellom barnepass fram til 18 måneder og språklige ferdigheter og psykisk fungering ved fem år" (English: Childcare up to 18 months. Relations between child care up to 18 months and language skills and mental function at five years) has been to provide more knowledge about the use of different childcare arrangements and how they affect children's functioning as well as the impact of starting in childcare at an early age.

The report provides an overview of the current status and is based on data from the Norwegian Mother and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health. The first part of the report presents information about childcare arrangements based on questionnaire data from more than 60 000 children in MoBa aged 18 months, in the period between 2001 and the end of 2009. Then impact of childcare (up to 18 months of age) was studied in the context of language skills, language-related difficulties and psychological function in 13 000 children who had reached five years by the end of 2010.

What works for whom?

Overall, the report shows that neither the language skills nor the psychological function of most children varies with the type of childcare, their age when starting in childcare outside the home, whether they used a combination of childcare arrangements or just one type, or how many hours per week they were in childcare.

"For most children there is no evidence from our findings to suggest that it is harmful to begin in centre-based childcare at 12 months," said Synnve Schjølberg, researcher and specialist in clinical psychology. "The small effect sizes of the findings indicate that the differences between children attending childcare at an early age and those starting later have no clinical implications for most children" she explains.

"Neither do the findings suggest that most children who are cared for at home up to 18 months of age are better prepared than children cared for by others in the same period," said Schjølberg.

"It is possible that the small differences found could be attributed to some children's particular vulnerability. Low quality childcare could be hypothesised as another explanation," said Schjølberg. "We will investigate these relationships further. The debate around centre-based childcare needs to be more nuanced and now rather focus on what works for whom" she added.

Main findings

The report is only available in Norwegian but here is a summary of the main findings:

1. The majority of children cared for outside the home before they are 18 months were in centre-based childcare. A larger proportion of children were in non-maternal care outside the home in 2009 relative to previous years. Although most children are cared for at home until they are 10-12 months old, with increasing age there is an increase in the number of children who are cared for outside of their home. Across year of data collection, and thus coverage of child-care centres, we found that 40 per cent of 18 month old children attended centre based childcare, while one in four children (26 per cent) are with a nanny/family-based care. In 2008 and 2009 we found that 59 per cent of the children attended centre-based childcare at 18 months, while 15 per cent were with a nanny/family-based care.
2. The number of hours children are in child care outside the home at 18 months increases. In the interval between 2001 and 2009, most of the 18 month old children (63 per cent) were in childcare between 25 to 40 hours per week. The average number of hours children were cared for by others increased from 27 hours for children who were 18 months old between 2001 and 2003 to 31 hours for children who were 18 months old between 2007 and 2009.
3. Approximately half of five year olds attend public childcare centres. 98 per cent of the five year olds participating in MoBa attend centre-based childcare. Approximately half of the children (52 per cent) attend public childcare centres while a slightly smaller proportion (45 per cent) attends privately run childcare centres.
4. Choice of childcare is related to the length of mothers' education. A smaller proportion of 18-month-old children were cared for at home in 2009 relative to 2003. The most substantial change across time was found among mothers without any completed higher education. In 2003, 40 per cent of mothers with low levels of education utilised non-maternal care outside home, whereas this number had increased to 63 per cent in 2009. Relative to mothers with higher education, a larger proportion of mothers with lower education levels care for their children at home until 18 months (50 per cent vs. 14 per cent). Child-minder / family-based childcare were found to be more often used by mothers who did not have higher education.
5. Children of parents with a non-Norwegian mother tongue begin care outside the home later than children of two Norwegian speaking parents. At 18 months of age, 74 per cent of the children with two Norwegian speaking parents were cared for outside the home whereas 65 per cent of children from families where neither parent has Norwegian as their mother tongue were cared for outside the home.
6. Girls who attend child care outside the home from 12 months are not negatively affected in language development or language related problems. The same holds true for girls being cared for in different types of child care. There are no advantages in the girls' language development to being cared for at home in the first 18 months compared to being in childcare at an earlier age.
7. Boys who attend child care outside the home are rated as having slightly higher score on language related difficulties at five years relative to those who were cared for at home until 18 months. The effect size is small. Being cared for in childcare before 18 months only explains about one per mille (‰) of the variation in language-related difficulties at five years. Thus, the difference between the two groups is not of clinical significance for most of the boys.
8. Boys who began in childcare outside the home before 18 months are rated with slightly higher scores on behavioural symptoms at five years relative to those who were cared for at home until 18 months. The effect sizes are small. Childcare experience only explains about one per mille (‰) of the variation in behavioural symptoms and is thus not likely to be of clinical significance.
9. Children who are cared for more than 40 hours a week outside the home are rated with slightly more behavioural symptoms at five years of age. Both girls and boys who were cared for outside the home for 40 hours or more per week at 18 months were found to have slightly more behavioural problems at five years of age relative to children who were cared for less than 40 hours per week outside the home at 18 months. The effect sizes are small. The difference in childcare experience only explains about 1.2 per mille (‰) of the variation in behavioural symptoms and thus for most of the children is not of clinical significance.
10. There is no association between childcare history and emotional problems at five years. Independent of the age when children start with care outside the home, neither girls nor boys who were cared for by others were found to be more anxious or sad than those who are cared for at home.
11. Many children have documented developmental difficulties or increased risk for developing such difficulties already during the first year of life. When the children reached five years of age, it is reported that five per cent had birth defects, syndromes or have had serious medical problems. It is also reported about seven per cent were at risk of developmental difficulties due to birth related factors(1). In addition, the parents of a third of all five year olds reported either having been concerned about the child's development at some point or that the child had been diagnosed with a developmental disability by a healthcare professional.

It is important to stress that all significant differences that were identified were very small. This implies that the reported effects of childcare history are not likely to be of any clinical importance. The small differences between the groups could potentially be due to a small number of children being particularly sensitive to the time at which they start care outside the home or for the amount of time they spend away from home. Qualitative differences across the types of childcare institutions may also potentially influence these outcomes. However, these mechanisms will be explored further in future publications.

(1) Low birth weight, low gestational age, low Apgar score 5 minutes after birth.