Purpose
While there is considerable research on the associations between childcare factors and both child behavioural outcomes and infectious illness, the majority of this information has come from international studies. Studies on behavioural outcomes and infectious illnesses associated with ECE factors in New Zealand are notably lacking. Given the considerable government investment in ECE, the target participation rates and the increasing trends in average weekly hours of attendance in NZ, it is important to consider how ECE participation is related to child behavioural development and health within a NZ context.
This report explores the relationship between ECE factors such as:
- Type of service;
- Hours of attendance;
- Group size;
- Adult to child ratio;
- Multiple childcare use;
- Presence of a primary caregiver at ECE service;
- with two primary measures of child wellbeing in under 5-year-olds:
- Behavioural outcomes (emotional symptoms, conduct problems,
hyperactivity/inattention, peer relationship problems, prosocial behaviour); - Mother-reported and hospitalisations for infectious illnesses (ear, chest, gastro, skin).
Methodology
Using data from the Growing Up in New Zealand longitudinal study, in this report researchers examine two primary measures of child wellbeing:
- child behaviour (emotional symptoms, conduct, hyperactivity/inattention, peer relationships, and prosocial behaviour) and the association with ECE use, in terms of childcare type, and hours of weekly attendance.
- prevalence of common infectious illnesses and associated hospitalisations. They investigated associations for four common childhood illnesses (ear, chest, gastro and skin infections) at two time points (9 months and 2 years of age) with childcare attendance at the same age by type of service.
Firstly, we investigated child behaviour (emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behaviour) and the association with ECE use, both in terms of childcare type, and hours of weekly attendance. Secondly, we examined the prevalence of common infectious illnesses and associated hospitalizations. We investigated associations for four common childhood illnesses (ear, chest, gastro and skin infections) at two time points (9 months and 2 years of age) with childcare attendance at the same age by type of service. We also report associations between service type and hospitalization for ear, chest or gastro infections across the preschool period. We further explore the link between childcare characteristics at 2 years of age (group size, multiple childcare use, hours of attendance per week, and teacher-to-child ratio) and risk of infectious illness, including hospitalization.
Key Results
ECE and behavioural outcomes
- Participation in centre-based care was inversely associated with the development of peer problems. Children who participated in ECE at 24 months showed significantly lower odds of peer problems at 54 months when compared with children who did not use ECE at 24 months (odd ratio = 0.77), after adjustment for sociodemographic covariates.
- 20-30 hours in ECE per week was inversely associated with the development of emotional difficulties and peer problems when compared to no time in ECE at all.
ECE and infectious illness
- Centre-based care at both 9 months and two years of age was independently associated with 1.5-2.5 times greater risk of ear infections, chest infections, and gastro illnesses, when compared to children in parental care.
- There were no significant associations between ECE usage and skin infections.
- Two year olds attending childcare for more than 30 hours per week had an independently increased risk of ear infections (odd ratio = 1.5) compared to children attending childcare less than 10 hours a week.
- Centre-based care in infancy and more than 30 hours a week in care at 2 years of age was associated with increased risk of hospitalisation due to ear, chest or gastro infection.
The findings suggest that ECE may contribute positively to the task of supporting the young child’s healthy relationships with self and peers, however the researchers note that centre-based ECE services should be aware of the increased risk of infectious illness for children in their care and be encouraged to follow public health advice on how to reduce the risk of infections spreading.