Most child and adolescent psychiatrists recognize that the ideal environment for raising a small child is in the home with parents and family. Intimate daily direct parental care of infants for the first several months of life is particularly important. Since the ideal environment often is not available, the role of day care, especially in the first few years of the child's life, needs to be considered. Some experts recommend a minimum of six or more months leave for parents. All agree that when day care is used, the quantity and quality of the day care are significant in the child's development.

Before choosing a day care environment, parents should be familiar with the state licensure regulations for child care. They should also check references and observe the caregivers with the child.

Parents sometimes take their young child to the home of a person who is caring for one or more other children. Infants and children under two-and-one-half need:

More adults per child than older children require
A lot of individual attention
The same caregiver(s) over a long period of time
A caregiver who will play and talk with them, smile with them, praise them for their achievements, and enjoy them

Parents should seek a caregiver who is warm, caring, self-confident, attentive, and responsive to the children. The caregiver should be able to encourage social skills and positive behavior, and set limits on negative ones. Parents should be sensitive to the caregiver's capacity to relate to children of different ages. Some individuals can work well only with children at a specific stage of development.

It is wise for parents to find out how long the individual plans to work in this day care job. High turnover of individuals, several turnovers, or any turnover at critical points of development, can distress the child. If parents think or feel the day care they have chosen is unsatisfactory, they should change caregivers. All parents have the right to drop in during the day and make an unannounced visit.

Many children, particularly after the age of three, benefit from good, group day care, where they can have fun and learn how to interact with others. Child and adolescent psychiatrists suggest that parents seek day care services with:

trained, experienced teachers who enjoy, understand and can lead children
enough teachers and assistants, ideally, at least one for every five children, small rather than large groups if possible. (Studies have shown that five children with one caregiver is better than 20 children with four caregivers)
staff that has been there for a long period of time
opportunities for creative work, imaginative play, and physical activity
space to move indoors and out
lots of drawing and coloring materials and toys, as well as equipment such as swings, wagons, jungle gyms, etc.

If the child seems afraid to go to day care, parents should introduce the new environment gradually: at first, the mother or father can go along, staying nearby while the child plays. The parent and child can stay for a longer period each day until the child wants to become part of the group.

Though parents may worry about how the child will do, they should show pleasure in helping their child succeed. If the child shows unusual or persistent terror about leaving home, parents should discuss it with their pediatrician.

© Copyright © 1997 by the American Academy of Child and Adolescent Psychiatry.The American Academy of Child and Adolescent Psychiatry (AACAP)