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Child Care and Common Communicable Illnesses
Results From the National Institute of Child Health and Human Development Study of Early Child Care
The National Institute of Child Health and Human Development Early Child
Care Research Network
Arch Pediatr Adolesc Med. 2001;155:481-488.
Objectives To examine the relationship between experiences in child care and communicable
illnesses (gastrointestinal tract illness, upper respiratory tract infection,
and ear infections or otitis media) throughout the first 3 years of life and
to investigate whether increased frequency of these illnesses is related to
language development, school readiness, and behavior problems.
Design Health, child care, family, and child developmental data were obtained
from more than 1200 participants in the National Institute of Child Health
and Human Development Study of Early Child Care, a 10-site prospective study
that began at the participants' birth. Longitudinal logistic regression analyses
were performed using each type of communicable illness as the outcome variable,
with family, child, and child care variables as predictors in the model, and
followed by a series of regression analyses with developmental measures as
the outcome variables.
Results Rates of illness were higher in children in child care than for children
reared exclusively at home during the first 2 years of life, but the differences
were nonsignificant by age 3 years. Number of hours in child care per week
during the first year and number of other children in the child care arrangement
were related to the rates of illness. There was no evidence that increased
rates of illness have a negative effect on school readiness or language competence.
However, there was some evidence that increased illness was associated with
behavior problems as reported by mothers, but not by child care providers.
Conclusions Children in child care experience more bouts of illness in the first
2 years of life, but differences are negligible by age 3 years. The increased
rates of illness bear little relation to other aspects of children's development,
except, perhaps, for a small increase in behavior problems.
From the National Institute of Child Health and Human Development Early
Child Care Research Network.
Corresponding author and reprints: Robert H. Bradley, PhD, Center
for Applied Studies in Education, University of Arkansas at Little Rock, 2801
S University Ave, Little Rock, AR 72204 (e-mail: rhbradley{at}ualr.edu).
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