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Journal of Developmental & Behavioral Pediatrics:
Book Reviews

Infants and Toddlers in Out-of-Home Care

Twomey, Jean E. Ph.D.

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Author Information

Infant Development Center; E. P. Bradley Hospital; Brown Medical School; Providence, Rhode Island

Infants and Toddlers in Out-of-Home Care, edited by Debby Cryer and Thelma Harms, Baltimore, MD, Paul H. Brookes Publishing Co., 2000, 376 pp, $34.00.

This comprehensive and timely text examines the myriad issues related to out-of-home child care for infants and toddlers, providing a wealth of information that should be of interest to a range of professionals, providers, and public policy makers. The first section of the book examines cognitive, linguistic, and social development, giving attention to relational, experiential, and cultural factors that influence child development in all of these domains.

The second section presents in-depth discussions of various aspects of child care programs, including ways in which quality of care can be more systematically and thoroughly assessed. Guralnick's chapter in this section makes a convincing case for optimizing the developmental outcomes of young children with significant environmental and biological risks by integrating child care services with early intervention programs that are specifically geared to meet the needs of these high-risk children. The common health problems of respiratory infections and diarrhea that beset infants and toddlers in day care are discussed, and ideas are offered for how to mitigate the spread of these infectious diseases.

The final section focuses on "ecological perspectives," leading with a strong chapter on the need for cultural considerations to inform and guide care to a heterogeneous group of infants and toddlers who are the reflection of our increasingly diverse society. Policy issues related to infants and toddlers in the arenas of health care, child care and early education, and parenting services are addressed. Current inadequacies in public policy and policy recommendations to address these concerns are provided, with the authors expressing cautious optimism that with the increased attention being paid to infants and toddlers, more and better integrated policy initiatives will be taken. Examining the role of the workplace, Galinsky and Bond report on how individuals' ability to fulfill their parental responsibilities may be facilitated or impeded by their employment benefits and policies.

A strength of this book is the applied use of research and theory to relevant issues affecting child care for infants and toddlers. A good example is Howes's discussion of high staff turnover in child care centers after she has cogently provided a sophisticated theoretical overview of attachment.

Another reason that this book succeeds so well in examining the complexities of out-of-home care for infants and toddlers is that the authors keep early childhood developmental needs as a central, unifying thread in their writing, while at the same time placing the child within the larger contexts that influence and define the world in which the child will grow and develop. In a thoughtful and considered manner, societal forces such as racism, economics, and public policy are discussed in terms of the multiple meanings they have in the life of the child and the child's family, with a particular focus on ways in which the availability and quality of child care programs are affected. Indeed, it is because of major societal changes in the past two decades that out-of-home care for infants and toddlers has begun to warrant close attention. Mothers have become a standard part of the work force, while extended families and other traditional community support systems have become less available to assume the task of caring for young children.

An appreciation of the centrality of relationships for fostering all aspects of infant and toddler development is conveyed throughout the book. It is interesting, however, that there is limited discussion of the child's relationship with the mother. Perhaps a statement by Howes captures the rationale for this: "In order to understand children's social development, it is important to consider a network of relationships, rather than focus only on the mother-child relationship" (p. 90). This is a change from the early writings on child care for infants and toddlers, in which the primary question was the effect that separation from the mother would have on the child, with the implicit and explicit answers being that such separations would be deleterious. Although in this text the specific role of the mother is not emphasized, the importance of the child's family is stressed in terms of appreciating the primacy of the family in the child's life, the significance of the family's cultural heritage and beliefs, and the importance of recognizing and addressing the family's needs to best facilitate the child's healthy development.

The opportunities and challenges facing child care that are presented in Infants and Toddlers in Out-of-Home Care are solidly based on the depth and brcadth of this multidisciplinary group of authors' extensive knowledge and experience. They have produced a book that serves as a finely detailed blueprint for what is needed to provide infants and toddlers with enriching, growth-promoting experiences in the settings where they will be spending significant amounts of time. Perhaps the greatest drawback for readers will be the frustration of realizing that, although we know how to provide optimal out-of-home care to infants and toddlers, making such programs an expectable part of a child's earliest years still eludes us as a nation.

Jean E. Twomey, Ph.D.

Infant Development Center; E. P. Bradley Hospital; Brown Medical School; Providence, Rhode Island

© 2001 Lippincott Williams & Wilkins, Inc.

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