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  1. 1. INSERT CONFERENCEINSERT CONFERENCE INSERT PRESENTER’S NAMEINSERT PRESENTER’S NAME INSERT DATEINSERT DATE American Academy of Pediatrics 2007American Academy of Pediatrics 2007 Choosing Quality Child Care
  2. 2. OverviewOverview  TerminologyTerminology –Key words in the child care–Key words in the child care field and how to use these phrases to findfield and how to use these phrases to find quality child care.quality child 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 care– How to get your child care questions answered.questions answered.
  3. 3. Types of Child CareTypes of Child Care  Parent only careParent only care  Relative careRelative care (kith/kin)(kith/kin)  Nannies/babysittersNannies/babysitters  Friend/neighbor careFriend/neighbor care  Family child careFamily child care homehome  Child care centerChild care center  Specialized careSpecialized care Most familiesMost families use a combinationuse a combination of care types.of care types. The “best” care is theThe “best” care is the arrangement thatarrangement that works for your familyworks for your family and meets yourand meets your child’s needs.child’s needs.
  4. 4. US Children in Child CareUS Children in Child Care  A majority of children are in child care in the USA majority of children are in child care in the US (60-70% of children less than 6 years old; by the(60-70% of children less than 6 years old; by the age of 6, 84% of all children have been enrolledage of 6, 84% of all children have been enrolled at some time).at some time).  Most health issues (caries [cavities], obesity,Most health issues (caries [cavities], obesity, mental health issues) have their basis in earlymental health issues) have their basis in early childhood, so focusing on this audiencechildhood, so focusing on this audience maximizes health promotion for many kids at amaximizes health promotion for many kids at a critical age!critical age!
  5. 5. US Children in Child CareUS Children in Child Care  12 million children: more than 9 million are in12 million children: more than 9 million are in licensed child care facilities.licensed child care 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 inAbout 3 million children are cared for in unlicensed and unregulated care.unlicensed and unregulated care.
  6. 6. Helpful Terms and ToolsHelpful Terms and Tools  Child Care Resource & Referral Agencies OnlineChild Care Resource & Referral Agencies Online www.childcareaware.orgwww.childcareaware.org  Accredited/AccreditationAccredited/Accreditation  NAEYCNAEYC www.naeyc.orgwww.naeyc.org  NAFCC www.nafcc.orgNAFCC www.nafcc.org  Child Care Regulations by State OnlineChild Care Regulations by State Online http://nrckids.org/STATES/states.htmhttp://nrckids.org/STATES/states.htm
  7. 7. Helpful Terms and ToolsHelpful Terms and Tools  Day Care, Child Care, Early Care and Education,Day Care, Child Care, Early Care and Education, Early Education and Child CareEarly Education and Child Care  Licensed, Regulated, MonitoredLicensed, Regulated, Monitored  Early Learning Guidelines/Quality Rating andEarly Learning Guidelines/Quality Rating and Improvement SystemsImprovement Systems
  8. 8. Benefits ofBenefits of High 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 development.First few years are key due to brain development.  Promotes development (physical, cognitive,Promotes development (physical, cognitive, social-emotional).social-emotional).  Improves school performance (better math,Improves school performance (better math, language, cognition, social skills, relationships, andlanguage, cognition, social skills, relationships, and self-regulation).self-regulation).
  9. 9. Risks Related to Child Care:Risks Related to Child Care:  Children exposed to a poor quality environmentChildren exposed to a poor quality environment (whether at home or at school) are less likely to be(whether at home or at school) are less likely to be prepared for school demands and more likely toprepared for school demands and more likely to have their socio-emotional development derailed.have their socio-emotional development derailed.  Sudden Infant Death Syndrome (SIDS).Sudden Infant Death Syndrome (SIDS).  Infectious diseases and illness.Infectious diseases and illness.  Injuries.Injuries.
  10. 10. SIDS in Child CareSIDS in Child Care  SIDS is the unexplained death of seeminglySIDS is the unexplained death of seemingly healthy babies 12 months or younger.healthy babies 12 months or younger.  Experts don’t know what causes SIDS; cannotExperts don’t know what causes SIDS; cannot predict or prevent SIDS (only reduce the risk).predict or prevent SIDS (only reduce the risk).  About 20% of deaths attributed to SIDSAbout 20% of deaths attributed to SIDS occurred while the infant was in the care of aoccurred while the infant was in the care of a non-parental caregiver.non-parental caregiver.  60% in family child care.60% in family child care.  20% in child care centers.20% in child care centers.
  11. 11. SIDS in Child CareSIDS in Child Care  AboutAbout 11 //33 of SIDS deaths in child care occurof SIDS deaths in child care occur in the first week,in the first week, 11 //22 of these on the first day.of these on the 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.
  12. 12. State Child Care RegulationsState Child Care Regulations ShouldShould REQUIREREQUIRE::  Written “Safe Sleep” policy, shared with allWritten “Safe Sleep” policy, shared with all  Training for a child care professionals beforeTraining for a child care professionals before they start work and regularly thereafterthey start work and regularly thereafter  Caregivers should place all babies up to 12Caregivers should place all babies up to 12 months to sleep on their backs, in a safety-months to sleep on their backs, in a safety- approved crib, with no soft beddingapproved crib, with no soft bedding (bumpers, comforters, quilts, toys etc)(bumpers, comforters, quilts, toys etc)
  13. 13. Baby in a Safe CribBaby in a Safe Crib
  14. 14. Infectious Diseases and IllnessInfectious Diseases and Illness  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 higherChildren in care with 6 or more have a higher incidence of:incidence of:  Infections (ear and respiratory).Infections (ear and respiratory).  Antibiotic use.Antibiotic use.  Diarrhea (Salmonella, Shigella, Giardia, Hepatitis A).Diarrhea (Salmonella, Shigella, Giardia, Hepatitis A).
  15. 15. Infectious Diseases and IllnessInfectious Diseases and Illness  Good news:Good news:  Most infections are mild, are present in theMost infections are mild, are present in the general community, and resolve withoutgeneral community, and resolve without treatment.treatment.  More common colds in preschool years,More common colds in preschool years, but protected against colds (and asthma)but protected against colds (and asthma) between the ages of 6-11 (same number ofbetween the ages of 6-11 (same number of colds at age 13).colds at age 13).
  16. 16. Exclusion and PreventionExclusion and Prevention  State regulations not based on medicalState regulations not based on medical evidence.evidence.  Programs are allowed to adopt stricterPrograms 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) childExclude if a) child too ill to participate, b) child needs greater care than caregivers can offer, or c)needs greater care than caregivers can offer, or c) child has a harmful infectious disease.child has a harmful infectious disease.  Parents, caregivers, pediatricians equallyParents, caregivers, pediatricians equally misinformed about evidence, when to exclude.misinformed about evidence, when to exclude.
  17. 17. Exclusion and PreventionExclusion and Prevention  The Keys to PreventionThe 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 Reduce IllnessEquipment in Child Care Centers Can Reduce Illness  Health and Safety E-News:Health and Safety E-News: Infectious DiseasesInfectious Diseases  Handout: Preventing the FluHandout: Preventing the Flu
  18. 18. InjuriesInjuries  Children in:Children in:  Child care centers fewer injuries than those only at home.Child care centers fewer injuries than those only at home.  Child care centers fewer injuries when they are at homeChild care centers fewer injuries when they are at home than those who receive care only at home.than those who receive care only at home.  Family child care programs have more injuries than eitherFamily child care programs have more injuries than either children in centers or those who only at home.children in centers or those who only at home.  May be due to increased supervision in childMay be due to increased supervision in child care or more risk-taking behaviors amongcare or more risk-taking behaviors among children transitioning from care to home.children transitioning from care to home.
  19. 19. InjuriesInjuries  Most common and severe injuries happenMost common and severe injuries happen when children fall from climbing equipmentwhen children fall from climbing equipment that don’t have appropriate cushioningthat don’t have appropriate cushioning materials under them.materials under them.
  20. 20. 13 Indicators of Quality Care13 Indicators of Quality Care  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 sanitation.Hand washing and diapering sanitation.  Staff director qualifications.Staff director qualifications.  Staff teacher qualifications.Staff teacher qualifications.
  21. 21. 13 Indicators of Quality Care13 Indicators of Quality Care  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.
  22. 22.  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.
  23. 23. Managing Infectious DiseasesManaging Infectious Diseases  Written for parents, caregivers, teachers and health professionals.  Signs/Symptoms chart.  Quick Reference Sheets for more than 50 common infections.
  24. 24. Healthy Child Care Web siteHealthy Child Care Web site www.healthychildcare.orgwww.healthychildcare.org Existing Web site – originally designed toExisting Web site – originally designed to support the national Healthy Child Caresupport the national Healthy Child Care America CampaignAmerica Campaign
  25. 25. HEALTHY KIDS, HEALTHY CARE: Parents as Partners in Promoting Healthy and Safe Child Care www.healthykids.us Available in Spanish – www.healthykids.us/spanish
  26. 26. Questions?Questions?
  27. 27. Your name/contactYour name/contact information hereinformation here

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