NIH study finds no significant link between time spent in childcare and young children's mental health, even amid early adversity
Sending children to childcare outside the home may not significantly affect children’s mental health, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health. This finding holds true even for children who face challenges, such as a parent’s mental illness or financial struggles at home.
Many children in the U.S. under the age of 5 years spend some time in childcare outside the home. Researchers wanted to learn whether attending childcare influenced the mental health of children, particularly those who had experienced early adversity.
“Despite the extensive use of childcare in the U.S. and documented benefits, there are still some concerns that childcare attendance (vs. staying at home with a parent) increases the risk for poor child outcomes,” said Michelle Bosquet Enlow, PhD, of Boston Children’s Hospital and Harvard Medical School. “This can lead to considerable feelings of guilt and worry for parents who use childcare.”
The study looked at various forms of childcare, including center-based care, home-based non-relative care, and care by a relative. However, previous findings on the role of childcare in child mental health have produced mixed results. While many studies highlight positive associations with attending childcare, some raise concerns that childcare may increase the risk for poor child developmental outcomes. “Understanding how childcare can influence children's development, especially for those facing extra challenges, can help shape public policies that promote healthy outcomes for kids,” said Dr. Bosquet Enlow.
Key Findings
- Children facing early life adversity were more likely to have higher levels of anxiety, depression, aggression, or hyperactivity symptoms.
- Childcare attendance did not seem to be associated with increased or decreased levels of mental health symptoms, including among children facing adversity.
- The study did not find any evidence that the number of hours in childcare corresponded to worse mental health outcomes for children, even those at elevated psychosocial and socioeconomic risk.
The findings suggest that while children facing higher levels of stress, mental illness in the family, and economic hardship were more likely to have higher levels of internalizing symptoms (such as anxiety and depression) and externalizing symptoms (such as aggression and hyperactivity), number of hours in childcare did not appear to play a significant role in altering these outcomes.
About the study
The study followed 2,024 parent-child pairs from three diverse U.S. research groups within the ECHO Cohort. Participants were recruited from hospitals in North Carolina, Pennsylvania, and Tennessee, as well as from adoption agencies across the United States.
Researchers measured children’s childcare experiences from birth to age 3 years and examined parental factors like childhood adversity, depression, and education level. Between ages 3 and 5.5 years, the children’s mental health was assessed for symptoms like anxiety, depression, and aggression.
This collaborative research was published in Development and Psychopathology.
Bosquet Enlow, M., et al. (2024) The Influence of Early Childhood Education and Care on the Relation between Early Life Social Adversity and Children’s Mental Health in the Environmental influences for Child Health Outcomes Program. Development and Psychopathology. DOI: 10.1017/S0954579424001822
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About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.
About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.
Journal
Development and Psychopathology
Method of Research
Observational study
Subject of Research
People
Article Title
The Influence of Early Childhood Education and Care on the Relation between Early Life Social Adversity and Children’s Mental Health in the Environmental influences for Child Health Outcomes Program
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