Abstract
A longitudinal investigation of childcare for children with developmental disabilities (N = 89) was conducted, with in-person assessments at 12, 15, 30, and 45 months of age, and phone interviews with mothers at 14, 29, 37, and 44 months. When compared with typically developing children from another sample, and with census data, the participants entered childcare at an older age and for fewer hours; they were more likely to be in "informal" (father, relative, in-home nonrelative) care; and they were less likely to transition into more formal care (childcare center, childcare home) with increasing age. Finding good-quality care, the cost of care, distance/transportation issues, and integration with other services/special needs received the highest ratings for childcare issues. Children who were not in childcare had lower adaptive behavior scores if their mothers cited their child's special needs as an issue in keeping them out of care, compared with children whose mothers did not indicate that special needs were an issue. These 2 groups did not differ in their diagnoses, mental, or motor development scores. Results are discussed in the context of family leave policies and welfare work exemptions, and the need for high-quality caregiving options.
RELIANCE on nonmaternal childcare has become a normative aspect of childrearing in the United States. In the most recent childcare data report from the US Census Bureau, Smith (2002) found that 63% of children under 5 years of age were spending time in some form of regular childcare arrangement for an average of about 37 hours per week. Whether out of economic necessity or choice, dramatic increases in maternal employment in the past few decades have led to a concomitant increase in the need for childcare arrangements for infants and young children.
Although there are no national statistics on childcare usage among families with children with disabilities, Landis (1992) found that the mothers of these children entered the labor force at the same rate as the general population. In an earlier report on the present sample of children with disabilities, as well as children with biomedical risk factors, we found that more than 58% were in some form of nonmaternal childcare by 15 months of age (Booth & Kelly, 1998). Thus, it would appear that the need for childcare is no less evident among families of children with special needs than it is for families of typically developing children. In fact, childcare issues have been among the most important problems reported by parents of children with disabilities in survey research (Axtell, Garwick, Patterson, Bennett, & Blum, 1995; Bailey, Blasco, & Simeonsson, 1992; Freedman, Litchfield, & Warfield, 1995; Herman & Thompson, 1995; Horner, Rawlins, & Giles, 1987; Palfrey, Walker, Butler, & Singer, 1989).
Like many other families with young children, families of children with disabilities are faced with a variety of childcare issues, such as finding good-quality, affordable care that is within a reasonable distance from home or work. Additionally, they are faced with logistical problems such as transportation between early intervention (or special education) and childcare programs, and with limited availability of childcare options due to their children's special care needs. Despite federal mandates that all early childhood programs must be accessible to all children (Americans with Disabilities Act, P.L. 101-336), many programs are not equipped to meet the needs of these children (Bredekamp, 1993), and many caregivers lack the appropriate training (Crowley, 1990; Dinnebeil, McInerney, Fox, & Juchartz-Pendry, 1998; Fewell, 1993; Warfield & Hauser-Cram, 1996). Additionally, the severity of the child's disability or illness compounds these problems (Breslau, Salkever, & Staruch, 1982; Stoiber, Gettinger, & Goetz, 1998; Warfield & Hauser-Cram, 1996). Although model training and consultation programs have yielded encouraging results (eg, Giovinazzo & Cook, 1995; Jones & Meisels, 1987; Klein & Sheehan, 1987; Richey, Richey, & Webb, 1996; Ross, 1992), the majority of caregivers have not received such training.