Elsevier

Current Opinion in Psychology

Volume 15, June 2017, Pages 201-206
Current Opinion in Psychology

Children’s physiological responses to childcare

https://doi.org/10.1016/j.copsyc.2017.03.006Get rights and content

Highlights

  • Children display higher cortisol levels at childcare than at home.

  • Childcare quality is associated with children’s elevated cortisol levels.

  • Cortisol rises are more prominent for toddlers and preschoolers than for infants.

  • Group size and type of care do not seem to explain children’s elevated cortisol.

This review focuses on children’s physiological responses to out-of-home childcare. The finding that children’s cortisol levels are higher at childcare than at home has been well-replicated. Here we summarize recent evidence examining possible correlates of elevated cortisol levels. Reviewed studies suggest that childcare quality matters, whereas group sizes and type of care do not. As for child characteristics, elevated cortisol at childcare is more pronounced in toddlers than in infants, and in inhibited and aggressive children. We discuss recent advances focusing on hair cortisol analysis and immunomarkers of stress, and suggest that there is a need for experimental and longitudinal studies to examine causal relations and possible negative long-term consequences for children’s health and development.

Introduction

Out-of-home childcare is a substantial part of life for many children. However, childcare may elicit not only positive challenges (e.g., development of cognitive skills) [1] but may also create persistent strains and stresses. This review covers childcare quality from children’s perspective, focusing on their physiological responses to childcare. These are important, because young children must cope with the novel situation, parental separation, the need to reorganize security seeking behavior around multiple adults, and the peer group that involves frequent emotional arousal. These issues have been labeled as important stressors [2••]. Physiological measures to assess children’s stress responses in childcare have been a particular focus, because observed behaviors do not always reflect children’s stress levels reliably. We focus on recent evidence examining links between childcare and physiological stress, and summarize what is known about possible triggers of elevated cortisol in childcare. We end with suggestions for future research, including hair cortisol that seems a promising method for childcare.

Section snippets

Diurnal cortisol at childcare

Cortisol is the primary hormonal product of the hypothalamic–pituitary–adrenocortical (HPA) axis, which is involved in complex biological processes implicated in stress regulation. Cortisol production follows a circadian rhythm with high levels early in the morning and low levels in the evening [3]. Therefore, atypical cortisol patterns (flat or rising) across the day are usually considered as biological markers of stress. It should be noted however that the mature pattern (decrease over the

Childcare quality

An intriguing question is whether children’s physiological responses are influenced by childcare quality. The often-made distinction between global quality and process quality [16] has also been applied in cortisol studies. Process quality refers to children’s actual experiences in childcare, including caregiver–child interactions. Both animal studies and studies with humans [17] have shown that caregiving plays an important role in stress regulation. Sensitive caregiving – prompt and adequate

Childcare context

Because of country-dependent regulations there exists large variety across countries in childcare quality [32] and attendance. Nevertheless, elevated cortisol at childcare has been reported not only in the US but also in Canada [33], France [34], Germany [25], and the Netherlands [10]. The question arises what specific contexts elict children’s elevated cortisol. Previously [14] we suggested that a large peer group and environmental chaos (for an overview, see Ref. [35]), especially noise [36,

Child characteristics

Earlier [6] we hypothesized a curvilinear relation between age and cortisol with a peak around 2–3 years. Recent studies point in the same direction [9, 33]. Bernard et al. [9] studied changes in cortisol patterning during the first 10 weeks in a new childcare setting. Differences between cortisol changes at home versus childcare were moderated by children’s age; 35% of the school-age children, 45% of the infants, and 62% of preschoolers showed a cortisol rise across the childcare days. In

Conclusions and suggested future directions

Childcare quality matters in the explanation of children’s physiological responses to childcare. To understand which component of childcare quality is important in regulating children’s cortisol responses to childcare, future studies should incorporate simultaneous assessments of caregiver behavior and children’s physiological measures. In addition, researchers should control for possible influences on children’s HPA system such as nap time, nutrition, and movement.

Group size and type of care

Conflict of interest statement

The authors confirm that there are no conflicts of interest.

References and recommended reading

Papers of particular interest, published within the period of review, have been highlighted as:

  • • of special interest

  • •• of outstanding interest

References (54)

  • M.T. Brady

    Infectious disease in pediatric out-of-home child care

    Am. J. Infect. Control

    (2005)
  • S.M. Côté et al.

    Short- and long-term risk of infections as a function of group child care attendance

    Arch. Pediatr. Adolesc. Med.

    (2010)
  • I. Ouellet-Morin et al.

    Diurnal cortisol secretion at home and in child care: a prospective study of 2-year-old toddlers

    J. Child Psychol. Psychiatry

    (2010)
  • M.R. Gunnar et al.

    Temperament, social competence, and adrenocortical activity in preschoolers

    Dev. Psychobiol.

    (1997)
  • C. De Weerth et al.

    A longitudinal study of basal cortisol in infants: intra-individual variability, circadian rhythm and developmental trends

    Infant Behav. Dev.

    (2002)
  • D.A. Phillips et al.

    Same place, different experiences: bringing individual differences to research in child care

    Child Dev. Perspect.

    (2011)
  • M.G. Groeneveld et al.

    Children’s hair cortisol as a biomarker of stress at school entry

    Stress

    (2013)
  • J. Belsky et al.

    Are there long-term effects of early child care?

    Child Dev.

    (2007)
  • M.R. Gunnar et al.

    Social regulation of the cortisol levels in early human development

    Psychoneuroendocrinology

    (2002)
  • K. Tout et al.

    Social behavior correlates of cortisol activity in child care: gender differences and time-of-day effects

    Child Dev.

    (1998)
  • H.J. Vermeer et al.

    Children’s elevated cortisol levels at daycare: a review and meta-analysis

    Early Child. Res. Q.

    (2006)
  • E.M. Albers et al.

    Cortisol levels of infants in center care across the first year of life: links with quality of care and infant temperament

    Stress: Int. J. Biol. Stress

    (2015)
  • K. Bernard et al.

    Examining change in cortisol patterns during the 10-week transition to a new child-care setting

    Child Dev.

    (2015)
  • M.G. Groeneveld et al.

    Children’s wellbeing and cortisol levels in home-based and centre-based childcare

    Early Child. Res. Q.

    (2010)
  • M.R. Gunnar et al.

    The rise in cortisol in family day care: associations with aspects of care quality, child behavior, and child sex

    Child Dev.

    (2010)
  • D.S. Lumian et al.

    The impact of program structure on cortisol patterning in children attending out-of-home child care

    Early Child. Res. Q.

    (2016)
  • H.J. Vermeer et al.

    Child care quality and children’s cortisol in Basque Country and the Netherlands

    J. Appl. Dev. Psychol.

    (2010)
  • Cited by (0)

    View full text