Children’s physiological responses to childcare
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)
- et al.
Stressor paradigms in developmental studies: what does and does not work to produce mean increases in salivary cortisol
Psychoneuroendocrinology
(2009) - et al.
Developmental changes in baseline cortisol activity in early childhood: relations with napping and effortful control
Dev. Psychobiol.
(2004) - et al.
Daycare attendance, stress, and mental health
Can. J. Psychiatry
(2006) - et al.
Young children’s full-day patterns of cortisol production on child care days
Arch. Pediatr. Adolesc. Med.
(2010) - et al.
Cortisol patterns at home and child care: afternoon differences and evening recovery in children attending very high quality full-day center-based child care
J. Appl. Dev. Psychol.
(2009) - et al.
Parental buffering of fear and stress neurobiology: reviewing parallels across rodent, monkey, and human models
Soc. Neurosci.
(2015) - et al.
Infant–mother attachment and social development: socialisation as a product of reciprocal responsiveness to signals
- et al.
Classroom emotional support predicts differences in preschool children’s cortisol and alpha-amylase levels
Early Child. Res. Q.
(2013) - et al.
Transition to child care: associations with infant–mother attachment, infant negative emotion, and cortisol elevations
Child Dev.
(2004) - et al.
Child care setting affects salivary cortisol and antibody secretion in young children
Psychoneuroendocrinology
(2010)