key assessment

Developed by Ron Lally and Cathy Tsao. © 2004, WestEd, The Program for Infant/Toddler Care. This document may be reproduced for educational purposes.

Definition The concept of continuity of care refers to the policy of assigning a primary caregiver to an infant at the time of enrollment in a child care program and continuing this relationship until the child is at least three years old. With continuity, the infant is not moved to a new group; either the entire group moves with the caregiver to another space more appropriate for older infants, or the caregiver modifies the environment to meet the children’s changing needs. The most important relationship to continue is the one between the child and the primary caregiver, but promoting long-term relationships with other caregivers and with other children in the group is also important. Foundation: Theory and Research In attachment theory, stability and consistency of caregivers are seen as important factors in the development and maintenance of secure attachment relationships (Bowlby, 1973). Children take a significant amount of time to form attachments to caregivers, so they are less likely to form attachments if frequent caregiver changes occur. More frequent changes in primary caregiver have been associated with negative child outcomes, including withdrawing behaviors and higher levels of aggression as preschoolers (Howes & Hamilton, 1993). On the other hand, time with a high-ability teacher has been positively associated with security of attachment in infant day care (Raikes, 1993). When infants are able to develop a relationship with a teacher over time, the infant-teacher relationship becomes more defined and predictable, creating a secure base for the infant. Raikes (1993) found that attachment security increased as children spent more time with their primary caregivers, and that 91% of infants who had been with their teacher for over one year were categorized as securely attached. These results are consistent with attachment theory, which suggests that time in a relationship is required in order for secure attachments to develop. However, the theory does not imply that time with an insensitive or non-responsive teacher would also promote security in infant-teacher attachment; in fact, such an arrangement may lead to the infant’s developing an insecure relationship with the teacher. The quality with which the teacher interacts with the child is key. Context There is a clear link between child care quality and child outcomes, where child care quality is defined by either structural variables, which can be regulated, such as group size and continuity of care; or process variables, which require judgment and interpretation, and are difficult or impossible to regulate, such as sensitive and responsive caregiving (Howes, Phillips, & Whitebook, 1992). Structural variables are thought to influence process variables, and researchers (Raikes, 1993) have conceptualized the infant-teacher relationship as a mediator between child care quality and child outcomes.

Continuity of Care

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Research and theory have established the necessity of intimate caregiving relationships for laying a foundation of trust, providing predictability, regulating attention, and creating interest for infants. Raikes (1993) hypothesizes that “time with teacher”—the length of time a high-ability teacher cares for an infant—is an indicator of quality for the infant-teacher relationship. Structural Variables In the context of the PITC philosophy’s six essential policies1, continuity supports the secure, warm relationships infants and toddlers need in order to thrive. Continuity begins with assignment of a primary caregiver who develops a close relationship with the child and the family and is primarily responsible for the child’s care. These relationships—and all relationships in the setting—are supported by the organization of caregivers and children into small groups. These three program policies—primary care, small groups, and continuity— promote feelings of security and predictability for infants and toddlers in group care. These policies work best together, but any one of them will improve the quality of care. Process Variables The ideal match is between program policies that support relationships and highly sensitive teachers who implement those policies. In addition to the three policies described above, other components of the PITC philosophy—responsive caregiving, culturally sensitive care and family support, and attention to temperamental differences—contribute to the quality of interactions. With a working knowledge of these components teachers become increasingly able to provide appropriate infant care and family support. Barriers Among continuity, primary caregiving, and small groups, the concept of continuity is the most likely to encounter resistance, in part because it is the newest idea. In a study of child care centers across the United States, the practice of continuity of care was found to be rare (Cryer, Hurwitz, & Wolery, 2000). While the infant’s need for close relationships is incontrovertible, the idea that we can and should promote long-term relationships in infant/toddler programs challenges us to new heights at a time when many programs are consumed with basic survival. Teachers and administrators need support and information to help them in the process of implementation of continuity of care and to ensure the entire staff believes in its role in the development of relationships and healthy attachment. Without disregarding the real-life concerns that programs face, we can strive to set the bar—rather than aim for the lowest common denominator—by encouraging programs to take one step at a time and to move steadily to the provision of continuity. Structuring infant/toddler programs to promote long-term relationships often means reorganizing the environment, staffing, training, admission policies—the very systems by which we staff, enroll and care for children. It raises logistical questions that cannot be answered in the abstract, e.g., safety regulations, subsidy requirements, age-related fee and reimbursement schedules. Every program needs to find its own solutions to the arrangement of space and equipment, the scheduling of children and caregivers, staffing ratios and group size, etc. Ultimately, continuity of child care relationships—along with small groups and primary caregiving assignments—benefit everyone in a program, promoting staff and family cooperation

1 PITC’s six essential policies are continuity, primary caregiving, small groups, individualized care, cultural sensitivity, and inclusion of children with special needs.

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and loyalty; creating a calmer, less stressful environment; and providing better opportunities for the growth and development of adults as well as children. References

Barnas, M.V., & Cummings, E.M. (1994). Caregiver stability and toddlers’ attachment-related

behavior towards caregivers in day care. Infant Behavior and Development, 17, 141 – 147.

Bowlby, J. (1973). Attachment and loss, Vol. 2: Separation. London: Basic Books. Cryer, D., Hurwitz, S., & Wolery, M. (2000). Continuity of caregiver for infants and

toddlers in center-based child care: Report on a survey of center practices. Early Childhood Research Quarterly, 15(4), 497 - 514.

Howes, C., & Hamilton, C.E. (1993). The changing experience of child care: Changes in

teachers and in teacher-child relationships and children’s social competence with peers. Early Childhood Research Quarterly, 8, 15 – 32.

Howes, C., Phillips, D.A., & Whitebook, M. (1992). Thresholds of quality: Implications for the

social development of children in center-based child care. Child Development, 63, 449 – 460.

Raikes, H. (1993). Relationship duration infant care: Time with a high-ability teacher and infant-

teacher attachment. Early Childhood Research Quarterly, 8, 309 – 325.

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/HRV (Za stvaranje Adobe PDF dokumenata najpogodnijih za visokokvalitetni ispis prije tiskanja koristite ove postavke. 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