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INSERT CONFERENCE INSERT CONFERENCE INSERT PRESENTER’S NAME INSERT PRESENTER’S NAME INSERT DATE INSERT DATE American Academy of Pediatrics 2007 American Academy of Pediatrics 2007 Choosing Quality Child Care
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American Academy of Pediatrics American Academy of Pediatrics 20072007
Choosing Quality Child Care
OverviewOverview TerminologyTerminology –Key words in the –Key words in the
child care field and how to use child care field and how to use these phrases to find quality child these phrases to find quality child care.care.
Benefits/RisksBenefits/Risks – What are they? – What are they? Quality Child CareQuality Child Care – What is it? – What is it? ResourcesResources – Access AAP resources. – Access AAP resources. QuestionsQuestions – How to get your child – How to get your child
care questions answered.care questions answered.
Types of Child CareTypes of Child Care Parent only careParent only care Relative care Relative care
(kith/kin)(kith/kin) Nannies/Nannies/
babysittersbabysitters Friend/neighbor Friend/neighbor
carecare Family child care Family child care
home home Child care centerChild care center Specialized careSpecialized care
Most familiesMost familiesuse a combinationuse a combinationof care types.of care types.
The “best” care is The “best” care is thethe
arrangement thatarrangement thatworks for your works for your
familyfamilyand meets yourand meets yourchild’s needs.child’s needs.
US Children in Child US Children in Child CareCare
A majority of children are in child care in A majority of children are in child care in the US (60-70% of children less than 6 the US (60-70% of children less than 6 years old; by the age of 6, 84% of all years old; by the age of 6, 84% of all children have been enrolled at some children have been enrolled at some time).time).
Most health issues (caries [cavities], Most health issues (caries [cavities], obesity, mental health issues) have their obesity, mental health issues) have their basis in early childhood, so focusing on basis in early childhood, so focusing on this audience maximizes health this audience maximizes health promotion for many kids at a critical promotion for many kids at a critical age!age!
US Children in Child US Children in Child CareCare
12 million children: more than 9 12 million children: more than 9 million are in licensed child care million are in licensed child care facilities.facilities. 105,444 child care centers.105,444 child care centers. 213,966 family child care homes.213,966 family child care homes. 16,110 other licensed facilities.16,110 other licensed facilities.
About 3 million children are cared for About 3 million children are cared for in unlicensed and unregulated care.in unlicensed and unregulated care.
Helpful Terms and ToolsHelpful Terms and Tools Child Care Resource & Referral Child Care Resource & Referral
Agencies OnlineAgencies Onlinewww.childcareaware.orgwww.childcareaware.org
Accredited/AccreditationAccredited/Accreditation NAEYC NAEYC www.naeyc.orgwww.naeyc.org NAFCC www.nafcc.orgNAFCC www.nafcc.org
Child Care Regulations by State Child Care Regulations by State Online Online http://nrckids.org/STATES/states.htm http://nrckids.org/STATES/states.htm
Helpful Terms and ToolsHelpful Terms and Tools Day Care, Child Care, Early Care Day Care, Child Care, Early Care
and Education, Early Education and and Education, Early Education and Child Care Child Care
Licensed, Regulated, MonitoredLicensed, Regulated, Monitored Early Learning Guidelines/Quality Early Learning Guidelines/Quality
Rating and Improvement SystemsRating and Improvement Systems
Benefits ofBenefits ofHigh Quality Child CareHigh Quality Child Care
Safety first.Safety first. Health is the foundation of quality care.Health is the foundation of quality care. First few years are key due to brain First few years are key due to brain
development.development. Promotes development (physical, Promotes development (physical,
cognitive, social-emotional).cognitive, social-emotional). Improves school performance (better Improves school performance (better
math, language, cognition, social skills, math, language, cognition, social skills, relationships, and self-regulation).relationships, and self-regulation).
Risks Related to Child Risks Related to Child Care:Care:
Children exposed to a poor quality Children exposed to a poor quality environment (whether at home or at environment (whether at home or at school) are less likely to be prepared for school) are less likely to be prepared for school demands and more likely to have school demands and more likely to have their socio-emotional development their socio-emotional development derailed.derailed.
Sudden Infant Death Syndrome (SIDS).Sudden Infant Death Syndrome (SIDS). Infectious diseases and illness.Infectious diseases and illness. Injuries.Injuries.
SIDS in Child CareSIDS in Child Care SIDS is the unexplained death of SIDS is the unexplained death of
seemingly healthy babies 12 months or seemingly healthy babies 12 months or younger.younger.
Experts don’t know what causes SIDS; Experts don’t know what causes SIDS; cannot predict or prevent SIDS (only cannot predict or prevent SIDS (only reduce the risk).reduce the risk).
About 20% of deaths attributed to SIDS About 20% of deaths attributed to SIDS occurred while the infant was in the occurred while the infant was in the care of a non-parental caregiver.care of a non-parental caregiver. 60% in family child care.60% in family child care. 20% in child care centers.20% in child care centers.
SIDS in Child CareSIDS in Child Care About About 11//33 of SIDS deaths in child care of SIDS deaths in child care
occur in the first week, occur in the first week, 11//22 of these on the of these on the first day.first day.
Something intrinsic to child care? No.Something intrinsic to child care? No. Unaccustomed tummy sleeping? Yes.Unaccustomed tummy sleeping? Yes. Caregivers challenged by parents? Yes.Caregivers challenged by parents? Yes. Best practices:Best practices:
Child care policies, training, and regulations.Child care policies, training, and regulations. Back to sleep, tummy to play, no soft bedding. Back to sleep, tummy to play, no soft bedding.
State Child Care State Child Care RegulationsRegulations
Should Should REQUIREREQUIRE:: Written “Safe Sleep” policy, shared with Written “Safe Sleep” policy, shared with
allall Training for a child care professionals Training for a child care professionals
before they start work and regularly before they start work and regularly thereafterthereafter
Caregivers should place all babies up to Caregivers should place all babies up to 12 months to sleep on their backs, in a 12 months to sleep on their backs, in a safety-approved crib, with no soft bedding safety-approved crib, with no soft bedding (bumpers, comforters, quilts, toys etc)(bumpers, comforters, quilts, toys etc)
Baby in a Safe CribBaby in a Safe Crib
Infectious Diseases and Infectious Diseases and IllnessIllness
Increased illness before age 1.Increased illness before age 1. Increased illness first year of child care.Increased illness first year of child care. Children in care with 6 or more have a Children in care with 6 or more have a
higher incidence of:higher incidence of: Infections (ear and respiratory).Infections (ear and respiratory). Antibiotic use.Antibiotic use. Diarrhea (Salmonella, Shigella, Giardia, Diarrhea (Salmonella, Shigella, Giardia,
Hepatitis A).Hepatitis A).
Infectious Diseases and Infectious Diseases and IllnessIllness
Good news:Good news: Most infections are mild, are Most infections are mild, are
present in the general community, present in the general community, and resolve without treatment.and resolve without treatment.
More common colds in preschool More common colds in preschool years, but protected against colds years, but protected against colds (and asthma) between the ages of (and asthma) between the ages of 6-11 (same number of colds at age 6-11 (same number of colds at age 13).13).
Exclusion and Exclusion and PreventionPrevention
State regulations not based on medical State regulations not based on medical evidence.evidence.
Programs are allowed to adopt stricter Programs are allowed to adopt stricter standards.standards.
Evidence shows:Evidence shows: Children may be infectious before symptoms.Children may be infectious before symptoms. Exclude if a) child too ill to participate, b) Exclude if a) child too ill to participate, b)
child needs greater care than caregivers can child needs greater care than caregivers can offer, or c) child has a harmful infectious offer, or c) child has a harmful infectious disease.disease.
Parents, caregivers, pediatricians equally Parents, caregivers, pediatricians equally misinformed about evidence, when to misinformed about evidence, when to exclude.exclude.
Exclusion and PreventionExclusion and Prevention
The Keys to Prevention The Keys to Prevention ImmunizationsImmunizations Hand washingHand washing Sanitation of toys and surfacesSanitation of toys and surfaces
ResourcesResources Article: Article:
Equipment in Child Care Centers Can REquipment in Child Care Centers Can Reduce Illnesseduce Illness
Health and Safety E-News:Health and Safety E-News: Infectious Infectious DiseasesDiseases
Handout: Preventing the FluHandout: Preventing the Flu
InjuriesInjuries Children in:Children in:
Child care centers fewer injuries than those only Child care centers fewer injuries than those only at home. at home.
Child care centers fewer injuries when they are at Child care centers fewer injuries when they are at home than those who receive care only at home.home than those who receive care only at home.
Family child care programs have more injuries Family child care programs have more injuries than either children in centers or those who only than either children in centers or those who only at home.at home.
May be due to increased supervision in May be due to increased supervision in child care or more risk-taking behaviors child care or more risk-taking behaviors among children transitioning from care among children transitioning from care to home.to home.
InjuriesInjuries Most common and severe injuries Most common and severe injuries
happen when children fall from happen when children fall from climbing equipment that don’t climbing equipment that don’t have appropriate cushioning have appropriate cushioning materials under them.materials under them.
13 Indicators of Quality 13 Indicators of Quality CareCare
Appropriate supervision/discipline.Appropriate supervision/discipline. Nurturing care.Nurturing care. Staff to child ratio and group size.Staff to child ratio and group size. Immunization requirements.Immunization requirements. Hand washing and diapering Hand washing and diapering
sanitation.sanitation. Staff director qualifications.Staff director qualifications. Staff teacher qualifications.Staff teacher qualifications.
13 Indicators of Quality 13 Indicators of Quality CareCare
Staff training.Staff training. Medication administration.Medication administration. Emergency plan/contact.Emergency plan/contact. Fire drills.Fire drills. Appropriate outdoor playground.Appropriate outdoor playground. Safe storing of toxic substances.Safe storing of toxic substances.
Developed by AAP.
Includes rationale for why standards are important; based on evidence where possible.
Available online at http://nrc.uchsc.edu Print copies from:AAP, APHA, NAEYC.
Managing Infectious Managing Infectious DiseasesDiseases
Written for parents, caregivers, teachers and health professionals. Signs/Symptoms chart. Quick Reference Sheets for more than 50 common infections.
Healthy Child Care Web Healthy Child Care Web sitesite
www.healthychildcare.orgwww.healthychildcare.org
Existing Web site – originally Existing Web site – originally designed to support the national designed to support the national Healthy Child Care America Healthy Child Care America CampaignCampaign
HEALTHY KIDS, HEALTHY CARE:
Parents as Partners in PromotingHealthy and Safe Child Care
www.healthykids.us
Available in Spanish – www.healthykids.us/spanish
Questions?Questions?
Your Your name/contact name/contact
information hereinformation here
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