THE DAY CARE DILEMMANoted pediatrician calls “90 percent of day care inadequate

Whether it’s because of economic necessity, or a desire to get youngsters into a group setting for learning and socialization as early as possible — day care is worrisome, contends noted child development expert Dr. Stanley Greenspan. Dr. Greenspan, author with Dr. T. Berry Brazelton of The Irreducible Needs of Children: What Every Child Must Have to Grow, Learn, and Flourish, puts forth a possible solution in his brand-new book, The Four-Thirds Solution: Solving the Childcare Crisis in America Today. His plan calls for the following: In a two-career family, each parent works two-thirds of the time for a total of four-thirds. Together, both parents can then engage in childcare two-thirds of the time, leaving only a third of the care to others. There can be many variations on the four-thirds solution, from one parent working half-time and another 80 percent, to one completely taking off from a career for a couple of years and providing childcare full-time, followed by the other parent doing the same. Single parents obviously cannot follow the four-thirds plan, but hopefully they can reach out to a family member such as a grandparent for childcare. If custody is shared, work schedules can sometimes be juggled to accommodate the child more. The “Four-Thirds Solution” is a plan that enables parents to reclaim the care of their children and to put children first, claims Dr. Greenspan, clinical professor of psychiatry and pediatrics at George Washington University Medical School, and author of several leading books on child-rearing.

His prescription is bound to be controversial. And he hastens to add that he is cognizant of economic stresses. “Today’s economic forces are stretching our emotional bonds almost to the breaking point. Many parents see no choice but to have both parents in the workforce. Millions of families — including single-parent families and those earning low hourly wages — must work ever longer hours in order to put bread on the table,” Dr. Greenspan allows. But in his book he outlines the results of his research into childcare in America today: —Ninety percent of day care is not considered to be of high quality.

—The "quality of care" (i.e. the ability to read and respond to a baby's emotional, social, and cognitive cues) is a critical factor in children's language, intellectual, and emotional growth.

—The amount of time in day care (i.e., over 30 hours per week) is associated with increased problems, especially those involving aggressive behavior.

—All-day care is associated with increased stress hormones in young children in the latter part of the day. Increases in these hormones are often associated with poorly regulated behavior.

—Day caregivers have a hard time providing nurturing care in group settings (day care centers) and experienced caregivers are getting harder and harder to retain in these settings.

—Babies and young children whose parents have entered the workforce as part of welfare reform are more likely to be in very poor quality childcare, characterized by toddlers aimlessly wandering around without appropriate relationships or guidance.

—The need for intimacy with one or a few ongoing caregivers is often compromised because most babies and toddlers in full-time day care experience changing caregivers due to staff turnover or routine shifts from the infant to the toddler room.

Given these findings, and with over half the nation's preschool children in some form of out-of-home care, Dr. Greenspan believes our society has embarked on a “massive social experiment” that may change who we are as individuals and ultimately the nature of our society. He contends that we are asking the day care system to be a surrogate well-functioning family though it cannot provide our children with the kind of interaction they need for healthy emotional development. Instead, he says, parents should plan their careers and lifestyles more consciously, making sacrifices if necessary, so that children get the attention they need.

While Ellen Galinsky, co-founder and president of the New York-based Families and Work Institute, does not dispute Dr. Greenspan’s research, she worries that parents who can’t do it all will feel as if they are failing. “Life is more complicated than saying childcare is bad and parenting is good. Parenting and childcare are not competitive,” she asserts. “Childcare can be like an extended family and provide support to a child and his parents. A good program can be good for children, while a bad program is bad for them.” Manhattan mom, Lisa Tiersten, a history professor at Barnard College, has had her a 3-and-a-half-year-old son in Tompkins Hall Daycare since he was 14 months old, and agrees with Galinsky. However, she and her husband had to tour 25 day care facilities on the Upper West Side before finding one that met their high standards, so she feels lucky. Nevertheless, she admits, “I felt awful at first because I never saw my son. It was a long day for him and for me. But I began to feel less and less guilty when I saw that he was thriving.” Today her son is adaptable, imaginative and socially mature. Now that she’s on maternity leave, Lisa asked if she could pick him up earlier so they could spend more time together. “Maybe only a half-hour earlier,” her son replied. “I don’t want to miss anything!” Many mothers, however, share the feelings of Catherine, a business manager in Tuckahoe, with two daughters ages 4 and 6. While her older daughter attends first grade, her younger daughter goes to pre-school in the morning and family day care in the afternoon. Catherine has tried various arrangements in her work/family life — from commuting into the city for a full-time job with her husband picking up the children, to working part-time and leaving early to meet the children, to staying home for a year-and-a-half. “It’s really hard,” Catherine admits, “I am constantly re-evaluating the situation, trying to get closer to my ideal without losing the benefits of work, the income for our long-term plans, and my market value as a woman. But there’s always the feeling of guilt that I’m missing out on what my children do each day.” In her book, Ask the Children, Galinsky asked children what one wish they had regarding their working parents. Most wished their parents could be less stressed and tired when they came home. “Instead of beating yourself up because you work, give more thought to how you come home from work and be more intentional about the transition from work,” Galinsky advises. Dr. Greenspan agrees that parents without other options should try to make good use of the evening hours and spend quality time with their children. “Make sure that evening time is properly made use of,” he tells Queens Parent. “This time while sometimes limited, should be quality time spent between parents and children.” Galinsky agrees with Greenspan on what kids need: “We know they need warm responsive relationships.” But arranging one’s life to meet these needs is not always simple. She suggests parents “put all the things in life that matter, starting with your kids, into the hopper and figure out what’s most important. Single parents have to feed their kids, and adults must think about their own needs, too. Some adults absolutely need to work.” “As a child gets older, he/she may not need as much emotional support from parents and can function independently of their parents,” Dr. Greenspan explains. “If there is a nanny accompanying the child to activities, hopefully he/she is still being cared for by an individual they are comfortable with and is receiving the proper attention a child needs to flourish.”

The clearest finding of Dr. Greenspan’s research on childcare indicates that regardless of whether a child is cared for by a stay-at-home parent or by a day care provider: “Quality counts, no matter what the setting.” Dr. Greenspan identifies the six criteria for quality childcare:

1. Safe physical surroundings and a calm yet interesting environment that will awaken children's interest in sight, sound, and other sensations.

2. Caregivers who can engage warmly with children and treat them with loving care. Interactions that involve joyous feelings as well as sights, sounds, touches and other sensations to foster learning, language, and attention.

3. Communicative caregivers who can engage in playful emotional interactions. Playful emotional interactions with long sequences of smiles and other facial expressions, sounds, and gestures.

4. Caregivers who can engage a child in long sequences of interactions or long dialogues in which problems are solved. Discussions without words — negotiations with gestures to solve problems.

5. Caregivers who help a child learn to use ideas. Creative elaboration of ideas through pretend play.

6. A caregiver who can be rational and logical, and who enjoys hearing children's opinions and debating them. Debates and discussions that elicit a child's opinions and foster logical thought.

“Urgent changes are needed — in family roles, in day care, in laws and governmental regulations, in corporate policies — before we can truly say we’ve done our best for future generations,” Dr. Greenspan says. Day care facilities need better trained people, smaller teacher/child ratios, and higher salaries for teachers, he writes. We need reasonable childcare leave policies for mothers and fathers; more opportunities for part-time and flexible work schedules; adequate health and mental health insurance; on-site quality day care at large businesses; and tax breaks and other incentives to encourage these policies. And parents have to take the initiative. “These children are our future generations and we as a nation need to take this seriously. We need to shift our priorities — both as a culture and individually — so that the demanding but infinitely valuable task of raising children gets the highest priority…”