What Johnny Needs Most

Book cover
The Four-Thirds Solutionby By Stanley I. Greenspan M.D.Perseus Publishing. 260p $26

Finding quality child care in America is almost every parent’s quest or nightmare. Presently, 13 million American children (out of a population of 21 million) are in child care. Half of those in child care spend 35 hours or more a week in some facility away from the home. One-third of the children in child care are in arrangements that involve two or more different caregivers.

This proportion of infants and toddlers in child care in this country is unprecedented. Stanley Greenspan, a child psychiatrist at George Washington University Medical School in Washington, D.C., and the prolific author of over 30 books on childhood development, asks: are we engaged in a monumental social experiment in raising children whose impact may come back to haunt us? Are we paying enough attention to the crucial developmental needs of children in their first three years?


The bad news is that most child care in America is not of high quality. The ratio of caregivers to children is too high to provide young children (especially children in the first three years) the amount of one-on-one attention, play time, touching, vocal and nonverbal interaction (e.g., through smiles and nods) they need for healthy development. Children also need stability and consistency in child care. Yet the turnover of child care providers in most facilities is quite rapid. This is partially due to the inhumane salaries paid to them. At a national average of $6.61 per hour, it is less than what we pay to janitors or parking lot attendants. Many child care centers have rules that rotate caregivers every year, breaking continuity of presence in the first three years.

Greenspan amasses data about current child care arrangements in the United States. A study of day care in four states (California, Colorado, Connecticut and North Carolina) by the National Academy of Science concluded that 86 percent of the facilities were less than good. Another study by the National Institute of Child Health and Human Development estimated that only 12 percent of child care arrangements were of high quality. Only one-third of the states set any minimum standards for facilities.

What do we know about children in day care arrangements? Greenspan shows that in-home caregiving (even if not by parents) is best. To be sure, research shows little difference in cognitive and language development between children who are in child care arrangements and those who are not. But other factors do make a significant difference. Having relatives care for the child seems to work better than group settings. Large group social settings have a negative impact. So do the long hours each day (more than 30 hours a week). Long hours are associated with increased problem behaviors in children, high corisol levels (a bodily secretion induced by anxiety) and greater aggression and externalization of problems. Quality counts, but quality also costs: small ratios between caregivers and children; safe, secure and calm yet interesting environments; warm, nurturing interactions with long-term caregivers. As Greenspan notes, properly caring for children is neither easy nor cheap.

Greenspan is neither a traditionalist nor a patriarch. He is aware of the economic forces that drive parents to seek two incomes and work longer hours. He accepts the legitimacy of working mothers and wives. Child care is a political hot potato. Parents want to thinkeven, at times, if it requires denialthat the care their children are getting is good, but they are often rushed into choices that are less than good. Nor do welfare reformers want to face up to the facts. They have forced welfare mothers into work but have not provided adequate help for child care. The United States lags significantly behind every other industrial nation in providing standards and subsidies for child care and allowing paid and unpaid parental leave, without risk of job loss.

The four-thirds solution in the title is to find ways in which parents can spend significant time with their children during waking hours. It seeks to limit the use of child care outside the home to less than 30 or so hours a week. What would this entail? It might mean that one parent (not necessarily the mother) works only part time for the first years of infancy and early childhood. It might mean dual-shift working (one parent works at night and the other during the day) to maximize in-home care during the crucial first three years. This solution, as I know from experience in my own family, while good for the children, can put heavy strains on young marriages. Greenspan paints for us a portrait of six different families trying to cope with financial need, raising children and finding optimum child care.

Greenspan suggests a range of solutions to the current crisis in child care. Ratios should be improved so that no caregiver has more than three babies to care for at a time, no more than four early toddlers and no more than five children in the age range 2 to 3. Government should adopt policies to encourage an increase in wages for child caregivers and provide training programs for them. Tax or other incentives might be devised to encourage companies to provide on-site child care facilities, so parents can interact with their children during the day. We need better parental leave policies. Schools should extend their hours to provide after-school care options. (Schools are often rather insensitive to the new working patterns of today’s parents.) Welfare mothers with young children, aged 1 to 3 years, might be allowed to fulfill their work requirements by working half time. In a word, welfare reform policies must put children first.

The cliché runs: it takes a village to raise a child. Every stakeholder in the child care issue is called upon to do some new things. Parents can consider alternative working arrangements (including at-home work) for the first three years. They should play a proactive role with caregivers and inform them about the special needs of their children. Occasionally, they need to visit their children at the caregiving site. Couples might simplify their material needs for a few years until the children reach school.

Government’s role includes adjust ing policies so they are more family friendly. The United States lags behind almost every developed nation when it comes to national family policies. Corporations should consider better ways to allow leaves, flexible hours and part-time working options for parents. Surely, nothing is so important for parents (or for those of us who are not parents but fellow citizens) than the healthy development of a future generation of citizens.

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