The experience and perception of continuity between home and day care from the perspectives of child,mother, and caregiver

To examine the consistency between children's home and day care experiences and the impact of home#shday care differences upon adult‐child interactions, 36 preschoolers [mean age 42 months] were observed at home with mother and in full‐time subsidized family day care. Discontinuities as well as continuities in interactions were observed. Open‐ended interviews with family day care providers and mothers furnished further insights in perceptions of similarities and differences between the settings and speculation about possible impact on the children's development.     

Limited english proficiency, primary language at home, and disparities in children's health care: how language barriers are measured matters

BACKGROUND: Approximately 3.5 million U.S. schoolchildren are limited in English proficiency (LEP). Disparities in children's health and health care are associated with both LEP and speaking a language other than English at home, but prior research has not examined which of these two measures of language barriers is most useful in examining health care disparities. OBJECTIVES: Our objectives were to compare primary language spoken at home vs. parental LEP and their associations with health status, access to care, and use of health services in children. METHODS: We surveyed parents at urban community sites in Boston, asking 74 questions on children's health status, access to health care, and use of health services. RESULTS: Some 98% of the 1,100 participating children and families were of non-white race/ethnicity, 72% of parents were LEP, and 13 different primary languages were spoken at home. "Dose-response" relationships were observed between parental English proficiency and several child and parental sociodemographic features, including children's insurance coverage, parental educational attainment, citizenship and employment, and family income. Similar "dose-response" relationships were noted between the primary language spoken at home and many but not all of the same sociodemographic features. In multivariate analyses, LEP parents were associated with triple the odds of a child having fair/poor health status, double the odds of the child spending at least one day in bed for illness in the past year, and significantly greater odds of children not being brought in for needed medical care for six of nine access barriers to care. None of these findings were observed in analyses of the primary language spoken at home. Individual parental LEP categories were associated with different risks of adverse health status and outcomes. CONCLUSIONS: Parental LEP is superior to the primary language spoken at home as a measure of the impact of language barriers on children's health and health care. Individual parental LEP categories are associated with different risks of adverse outcomes in children's health and health care. Consistent data collection on parental English proficiency and referral of LEP parents to English classes by pediatric providers have the potential to contribute toward reduction and elimination of health care disparities for children of LEP parents.     

Family day care and day care centres: Carer, family and child differences and their implications

The present study investigated child, maternal and caregiver characteristics in two day care settings, the independent contributions of these characteristics to children's adjustment to day care, and the utility of a goodness-of-fit framework as a means of assessing the impact of parent-caregiver differences on children's adjustment. Eight measures were used to assess child behavioural problems, maternal satisfaction with care, child temperament, maternal and caregiver child rearing practices, developmental timetables, day care goals, and demographic background. The study found strong support for the existence of differences between mothers choosing different types of care, between caregivers in these two settings, and between mothers and caregivers; and for the linkage between child, maternal and caregiver characteristics and child adjustment. However, the impact of goodness-of-fit between mothers and caregivers on children's adjustment to day care was not supported.     

Family Home Care Providers' and Parents' Beliefs and Practices Concerning Mathematics with Young Children

Three studies are reported which describe aspects of the early childhood environment surrounding the development of mathematics concepts. Study 1 examined the beliefs and attitudes of family home day care providers concerning mathematics. Although providers rated math skills lower in importance than other skills, they thought that math skills were acquired in the same way as other skills. In Study 2 both parent and family day care providers reported similar frequencies for engaging children in math activities. In Study 3 we addressed the question of whether the beliefs and reported activities of parents and providers predict children's performance on the Test of Early Mathematics Ability-2. The frequency of math activities reported by parents or family day care providers was not significantly correlated with children's mathematics achievement scores in either age group. It appears that some mathematical activities do occur in children's homes and in family day care, but the frequency and scope of these experiences is limited.     

Day care nutrition programs and children's home diets

Information on children's eating practices in both their homes and day care centers is reported and is discussed in relation to the degree of nutritional coordination that exists between home and day care centers. The sample consisted of 15 Pennsylvania day care operators and 94 mothers. Both operators and mothers were asked questions about food served to children, about children's eating patterns, and center-home communications. The study identified communications between the centers and the homes as a weakness of day care nutritional programs. Both operators and mothers were unfamiliar with children's breakfast patterns and use of nutritional supplements. Suggestions are made for informal gathering of information about children's home eating practices.This research was supported by the Department of Public Welfare, Commonwealth of Pennsylvania. Opinions expressed are those of the authors and do not necessarily reflect those of the sponsoring agency.     

Children''s Health Insurance Status, Access to and Utilization of Health Services, and Unmet Health Needs in a Rural Alabama School System

PURPOSE: This study examines the relationship between children's health insurance status and utilization of health services, establishment of a medical home, and unmet health needs over a 3-year period (1996-1998) in a rural Alabama K-12 school system. METHODS: As part of a children's health insurance outreach program, questionnaires were administered to parents of 754 children regarding health and health care access. In addition, noninvasive head-to-toe physical assessments of children were conducted on-site at 4 schools. FINDINGS: A relationship between health care utilization and insurance status was observed. Results found that insured children had 1.183 (P < .0115) times the number of medical visits as uninsured children. Among uninsured children, the time since last dental visit was 1.6 (P < .001) times longer than that of insured children. Also, insured children were 5.21 times more likely than uninsured (P < .0001) to report having a medical home. No significant differences between insured and uninsured children were found regarding unmet health needs as measured by referrals made after the children's physical assessments. CONCLUSIONS: Child health coverage is an important determining factor in the ability of families to access and utilize health care services. These findings have implications for populations in similar rural communities across the nation.     

Perceptions of infant/toddler temperament in three child care settings

The relationships among different types of infant and toddler child care (at home care, family day care home and day care center) and perceived temperament were investigated. Subjects in this study included mothers, fathers and supplementary caregivers (where applicable) of 64 infants and toddlers, aged 5‐22 months from middle to upper middle class homes. Parents and supplementary caregivers (where applicable) completed the Carey Infant Temperament Questionnaire.

ANOVAs were used to assess differences of temperament perceptions between the three child care groups. There were no significant differences between the groups of parents in their perceptions of the nine temperament characteristics or overall temperament. However, caregivers from day care centers perceived the temperament of children in their care as significantly more difficult (p = 0.002) than caregivers of children in family day care homes.     

Family day care in two countries: Parents,caregivers, and children in Canada and Israel

The results of two studies of family day care conducted in two different countries, Israel and Canada, are reported and compared. In both studies, the quality of family day care was found to range from poor to excellent. Children's activities in the day care setting were found to be associated with specific aspects of day care environment. In Israel, the caregiving style was found to contribute to the nature of children's activities and behaviors. In Canada, the quality of the learning and physical environments was correlated with the frequency of developmentally facilitative activities engaged in by the children. Both studies revealed strong linkages among caregiver education and background, the quality of the day care setting, and the children's daily activities while in care.     

Teacher Re-creation of Negative Interactions with Toddlers

Fifty two-year olds and fifty three-year olds from low-income families were observed in 10 urban day care centers serving disadvantaged families. Microanalytic chains of child-teacher interactions were recorded and then recoded to represent positive and negative behaviors. Two-year old male toddlers behaved more negatively than two-year old girls or three-year old children. In turn, male toddlers elicited more negative behaviors from their caregivers. Teachers seemed to be controlled by children's behaviors—responding positively to positive behaviors and negatively to negative behaviors. Providers may unwittingly recreate in group care the negative interactions, predictive of poor socioemotional adjustment, that toddlers are already experiencing at home. These data have important implications for mental health toddler workers involved in training teachers in early childhood settings.     

Providers' evaluations of family day care services

Family day care is an informal and largely unregulated form of child care with providers a key element in creating effective programs. Relatively little is known of how providers perceive the needs of clients [parents and children] and how they evaluate the adequacy of their services in meeting family needs. Thirty-two registered home providers estimated parents' reasons for selecting family day care, and the degree to which their services met parents' and children's needs for care. They also evaluated the importance of program goals and provider qualifications and indicated their experience and training for day care. Knowledge of providers' perceptions of the quality of their services and their ability to meet client needs can help educators create training programs with appropriate content and format.     

Family and Child Characteristics, Child-Rearing Factors, and Cognitive Competence of Young Children

In this paper, the contribution of a number of family, child, and parental child-rearing characteristics to the explanation of differences in the cognitive competencies of young children are considered. A model is formulated with not only clear attention to the ethnic and linguistic characteristics of the family, but also such factors as the child-rearing behavior of the parents, parent-child interactions, and the child-rearing competence of the parents. The model is then evaluated with the aid of data from a recent large-scale Dutch study of six-year-old children ( n = 10,774). The results of the LISREL analyses show the parental level of education to play a central role in the explanation of differences in the cognitive competencies of the children. The ethnic origin of the family, the use of Dutch in the home, and the parental level of mastery of the Dutch language are also found to be of influence. Parental child-rearing factors, however, do not affect the children's cognitive competence.     

Associations among Food Insecurity, Acculturation, Demographic Factors, and Fruit and Vegetable Intake at Home in Hispanic Children

The purpose of this cross-sectional pilot study was to examine associations between food insecurity, acculturation, demographic factors, and children's fruit and vegetable intake among a sample of Hispanic children ages 5 to 12 years. A convenience sample of 184 parents of low socioeconomic status completed one-time, self-administered questionnaires assessing demographic information, acculturation, and food insecurity in the spring of 2006. In addition, children's fruit and vegetable intake at home was measured using a validated seven-item index. Parents were recruited through local elementary schools in San Antonio, TX. Pearson and Spearman correlations were used to examine the associations between the variables. t tests were used to explore the differences in means of children's fruit and vegetable intake at home for acculturation and food insecurity levels. Statistical significance was set at P<0.05. Significant correlations were found between demographic variables, acculturation, food insecurity, and children's fruit and vegetable intake at home. The overall mean fruit and vegetable intake at home was 1.04±0.63 (mean±standard deviation) servings per day. Higher rates of acculturation and higher rates of food insecurity were associated with lower fruit and vegetable intake at home. The findings reported in this study suggest a need for culturally tailored interventions targeting Hispanic children because fruit and vegetable intake at home among Hispanic children was low, regardless of the level of acculturation or food insecurity.     

The influence of social and environmental factors on dust lead, hand lead, and blood lead levels in young children

The roles of environmental and behavioral factors in determining blood levels were studied in a cohort of young children living in an urban environment. The subjects were observed at 3-month intervals from birth to 24 months of age. Repeated measurements were made of the children's blood lead levels, environmental levels of lead in house dust, and in the dust found on the children's hands. A qualitative rating of the residence and of the socioeconomic status of the family was obtained. Interviews and direct observation of parent and child at home were used to evaluate various aspects of caretaker-child interactions. Data analysis consisted of a comparison of results obtained by simple correlational analysis, multiple regression analysis, and structural equations analysis. The results demonstrated that structural equation modeling offers a useful approach to unraveling the complex interactions present in the data set. In this preliminary analysis, the suspected relationship between the levels of lead in house dust and on hands and the blood lead level was clearly demonstrated. Furthermore, the analyses indicated an important interplay between environmental sources and social factors in the determination of hand lead and blood lead levels in very young children.     

Useful Early Childhood Assessment: Play-Based, Interviews and Multiple Intelligences

Some types of early childhood assessment focus on the evaluation of children in their natural, everyday settings such as the home, day care, or preschool center. Information obtained from these assessments can be functional because it identifies skills for intervention that will be immediately useful for young children with special needs and their families. This article describes three types of functional assessment: play-based, family interviews, and the evaluation of multiple intelligences. All three types are useful for planning developmentally appropriate interventions and are positive because the emphasis is more on the children's and their families' strengths rather than on their weaknesses.     

Psychological health status of mothers and the admission of children to hospital for gastroenteritis

The prevalence of psychological distress was measured by the 30-item general health questionnaire in two populations of mothers: those who had children hospitalized for gastroenteritis and those who cared for children with gastroenteritis at home. Significant differences emerged, with mothers of hospitalized children reporting higher levels of psychological distress. There were no differences in severity of the children's illness between the two groups as indicated by blind ratings of symptomatology from six infectious diseases hospital doctors. Thus hospitalization of children for gastroenteritis was not contingent on medical symptomatology. Instead the evidence indicates that the psychological status of mothers may influence doctors' management decisions on childhood gastroenteritis. Significant positive associations between poor psychological status and poor social resources illustrate the social context in which maternal vulnerability may influence child health care generally. The impact of maternal psychological status on decisions about paediatric care is discussed.     

Family structure differences in health care utilization among U.S. children

This study explores the relationship between family structure and children's access to health care using data from the 2001-2003 waves of the child sample files from the U.S. National Health Interview Survey. Specifically, we investigate the extent to which family structure types predict children's utilization of preventive health care, and barriers to care. We then explore whether observed differences across family structures can be attributed to differences in demographic characteristics, socioeconomic status (SES), and child health status. Using logistic regression models, we document substantial variation in health care usage and barriers to health care across a variety of family structures. Of note is the finding that the children of single mothers demonstrate extremely different patterns of health care access than do the children of single fathers, and the importance of SES as a risk factor for diminished levels of access to health care varies by family type. SES plays a major role in mediating the relationship between access to care for children in single mother and cohabiting families (when contrasted against children in two married parent families), but less of a role for children living with stepparents, a single father, or with parents and other relatives.     

A case-control study on factors relating to discontinuation of domiciliary care for the bedridden elderly in a metropolitan area]

A case-control study was conducted to examine factors relating to discontinuation of domiciliary care for the bedridden elderly in Shinagawa-ku, Tokyo. Cases were bedridden residents aged 65 years and over who had abandoned home care and applied for admission to live in a special nursing home for the aged between April and September in 1990 after being recipients of welfare allowances for disabled elderly. Controls were bedridden residents who continued to be given home care and matched to cases by sex, age and beginning month of the receiving of allowances. Among 50 cases and 94 controls interviewed, we obtained responses from 31 cases (62%) and 60 controls (64%). The main results were as follows: 1. During the home-care period, ADL (activities of daily living) of cases, especially walking ability, deteriorated more severely than in controls. Night delirium also appeared more frequently in cases. 2. The primary caregivers of cases were older than those of controls. Remarkable differences between cases and controls were observed in the family structure, the number of family members and the number of sub-caregivers. Cases tended to live alone or live with a spouse only, and with smaller number of family members and caregivers. 3. Case lived more frequently in houses with small numbers of rooms and without rooms of their own. 4. As regards utilization of domiciliary care services, cases used dispatch of home helpers more frequently and used day services less frequently.     

儿童学习成绩与智力、气质、家庭环境因素的相关研究

「目的」探讨智力、气质、家庭环境因素对儿童学习成绩的影响。「方法」采用瑞文测验联合型（ＣＲＴ）和中国学龄儿童气质量表（ＣＳＴＳ）评定儿童智商及气质特征。并采用自拟问卷调查儿童的家庭环境状况。「结果」男童学习成绩较女童低，男女童在一些气质维度上表现也不同。儿童智商与学习成绩相关系数为０．４４。学习成绩较差儿童中困难型（Ｄ）和中间近困难型（Ｉ－Ｄ）气质比例较成绩优良儿童高；学习成绩优良儿童中容易型（Ｅ     

Perceived Access to Pediatric Primary Care by Insurance Status and Race

The Nemours system of children's clinics in Delaware was designed to offer comprehensive primary care (medical homes), to children regardless of families' abilities to pay for services. Racial and insurance status differences in perceptions of access to the provisions of medical home and differences by the Short Medical Home Index are assessed. A probabilities proportionate to size sampling method was used to randomly select families in nine clinics. A total of 323 caregivers of children ages 6 to 48 months were surveyed. Results suggest that there are minimal differences in perceptions of access to provisions of the medical home concept by insurance status and race in the clinics studied. However, when using a composite measure of medical home, differences in perceptions were found. The results suggest that insurance status and racial differences in perceptions of access remain even when the system is specifically designed to provide medical homes without regard to demographic factors. Future studies should focus on improving patient interactions with clinic personnel to ensure that access to provisions of care are understood by all consumers.