Child Care Health and Development · 2006 · 69 citations · 44 references
MedicineChild HealthPediatricsChild DevelopmentHealth Services ResearchPediatric EndocrinologyHuman HealthWell-child CareChild Care Quality EvaluationChild Health QualityChild Outcomes MonitoringCortisol DynamicsRepeated Measures AnalysisRepeated Measures AnovaSalivary CortisolSplit-plot Anova
BACKGROUND: Cortisol levels are increasingly being used as an indicator of stress levels. Research suggests that children who attend child care demonstrate higher cortisol levels than children in their homes, suggesting that child care acts as a risk factor for poor child outcomes. However, it is also suggested that quality influences outcomes. METHODS: Cortisol levels were measured through samples of saliva taken from children (3-5 years of age) attending long-day care centres in Perth, Western Australia. Quality of the programme was measured using industry national quality assurance indicators designed for child care centres. The analysis employed a 2 (time of collection: average am cortisol, average pm cortisol) by 3 (centre quality: high, satisfactory, unsatisfactory) split plot ANOVA with repeated measures on the time factor. RESULTS: Cortisol levels of children attending high-quality programmes demonstrated a decline across the child care day. Levels in children attending unsatisfactory programmes demonstrated an increase across the day. CONCLUSIONS: Although we do not yet know how high, and for how long, cortisol levels need to be elevated for risk of undesirable outcomes to increase, this research signals the importance of emphasizing the need for high-quality care for young children.
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Child Care Quality Matters: How Conclusions May Vary With Context
John M. Love, Linda Harrison, Abraham Sagi‐Schwartz et al. · Child Development · 2003 · 366 citations