has responded to the
need of working mothers, many of whom work long hours or
during the nighttime hours, by establishing governmentally
authorized night care facilities. This formalization of center-
based night care is rare in nations outside Japan. Even in Japan,
few studies have assessed the influence of center-based night
care on child development (Anme, 1998). This study sought to
identify correlations between 1) extended-hour center-based,
including nighttime care and school children’s health; and 2)
the childrearing environment provided by parents and chil-
dren’s health at when they are at school age.
Methods
Setting and Sample
All authorized child-night-care centers and attached child-
day-care facilities across Japan participated in the study at
when the children were toddler-aged. Centers unauthorized by
the government were excluded as they often do not cooperate
with external investigators. The subjects were all parents and
service providers in the authorized facilities. Parents were sur-
veyed regarding the home environment, and service providers
evaluated the development of each child in the facility. The
baseline return rate was 74.6% (1957 between the ages of 0 - 6
years) both for parents and service providers. Of these, 271
children from 22 authorized child care, participated in the sur-
vey at school age. Several families had moved their children
from the 22 facilities that did participate; this is not unusual as
parents often move residences for a variety of reasons. Parents
and caregivers of children with disabilities were excluded from
this second analysis as the needs and outcome measures of
children with disabilities differed substantially from those of
children without disabilities. The final usable set of follow-up
responses was 271; children were between the ages of three to
six years old at the time of the first study and were currently
between the ages of seven and eleven. The usable responses
were substantially lower than would have been preferred, yet
sufficiently large to provide some meaningful findings.
Table 1 provides the gender and grade enrollment of the
subject population. The distribution of boys, 123 (45.4%), and
girls, 148 (54.6%), was fairly even. The largest number of chil-
dren was in first grade (35.0%), followed by those second
(28.4%) and third (17.0%) grades.
Table 1.
Demographic background.
Items N %
Gender
Male 123 45.4
Female 148 54.6
Grade in school
First 95 35.0
Second 77 28.4
Third 46 17.0
Forth 29 10.7
Fifth 24 8.9
Family type
Nuclear family
Parents 184 67.9
Mother only 43 15.9
Father only 2 0.7
Extended family
Parents, gra ndparents 25 9.2
Mother, grandparent 9 3.3
Father, gra ndparent 0 0.0
Other 8 3.0
Siblings
Yes 176 64.9
No 95 35.1
Quantity of child care
11 hours or more 146 53.9
Less than 11 hours 125 46.1
Respondent
Mother 254 93.7
Father 13 4.8
N.A. 4 1.5
Total 271 100.0
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T. ANME ET AL.
Overview of Measures
Indicators of child-care quantity (length of time in care ), sta-
bility (regularity of attendance), a nd type (normal vs long hours)
along with measures of family background [socioeconomic
status (determined by the requirement to pay income tax), fa-
mily composition], the child’s demographic characteristics, and
child adaptation to center-based care (willingness to go to cen-
ter-based care) were obtained from questionnaires completed
by the parents responsible for the children in the first six years
of their lives. Parents completed Japanese versions of ques-
tionnaires on the child-rearing environment (HOME, Caldwell
& Bradley, 1984, J-HOME, Anme, 1991, 1996) and on self-
efficacy and support for childcare (Anme, 1995). Self-efficacy
was evaluated by parental response on the item “I am con-
vinced my capability to provide quality childcare”. Support for
childcare was determined by whether the parent reported assis-
tance from a spouse or others.
Childcare professionals evaluated children’s social compe-
tence, communication, and development in vocabulary/motor/
intelligence for each child from 2000 to 2005 using develop-
mental scales (Anme, 2006). This scale was standardized in
Japan and revealed that 10% of children in the Japanese popu-
lation were below the normal range of age-appropriate cogni-
tive development.
The social competence subscale includes items such as,
“drinks from cup without assistance” at 11 months and, “able to
change clothes” at 56 months. The communication subscale
includes items such as, “smiles in response to caregiver’s
voice” at 4 months, “takes a particular role in playing ‘house’”
at 36 month, etc. The vocabulary subscale includes “is able to
say at least one word” at 12 months, and “follows story telling”
at 60 months, etc. The motor subscale includes “is able to walk
without assistance” at 14 months, “is able to draw an ‘X’” at 45
month, etc. The intelligence subscale includes “understands
‘eyes’, ‘mouth’, ‘nose’ etc.” at 21 month and can “count to
three” at 42 months.
All childcare professionals, already qualified in child deve-
lopment, were provided with a minimum of eight hours of
training to translate children’s development into the measures
indicated on the child development scale. These variables, se-
lected to be consistent with earlier studies by the NICHD
(1999a), were then used to explore the relationship between
length of care and child development.
The two categories of childcare were identified by the time at
which children left the center-based care: “normal care” (use of
center-based care for under 11 hours), and “extended care” (use
of center-based care for 11 hours or more). Of the subjects, 125
(46.1%) were enrolled in “normal care”, and 146 (53.9%) in
“extended care”.
Family and child variables included the child’s gender and
age, child development along the Anme (2006) scale, the child
rearing environment at home, the caregiver’s efficacy for care,
and the existence of childcare support. Professional caregivers
measured child development along six variables (gross and fine
motor, social competence, communication, vocabulary, and
intelligence development) that were categorized into 2-point
items [(normal, delayed) Anme, 2006]. These service providers
in the center-based childcare facilities also evaluated the health
and disabilities of the children based on descriptions by physi-
cians.
The child rearing environment was assessed based on re-
sponses (yes/no) to activities in the home environment (see
Table 2). For analysis, the 25th percentile point was used as a
cut-off for non-nominal items. Caregivers’ self reports on the
five-point scale, (where 1 = always, 2 = often, 3 = sometimes, 4
= rarely, 5 = never) measured parental efficacy for care (Anme,
1998). The items used to assess the child’s health at school age
are believed to be reliable and valid and are consistent with
those on the annual National School Health Survey by Japanese
Ministry of Education.
Results
The difference between the two categories of care (“normal”
and “extended”) was examined by using items of child devel-
opment, positive qualities of parents’ behavior, parent efficacy
for care, and existence of care support. The Statistical Analysis
System (SAS) statistical package was used for analy sis. Multiple
Table 2.
Number and percentage in risk group.
items No. %
1) Child development
Gross motor 10 3.7
Fine motor 7 2.6
Social competence 6 2.2
Communication 3 1.1
Vocabulary 7 2.6
Intellectual 4 1.5
2) Parent be havior
a) Human stimulation
Play with child 8 3.0
Reading bo oks 43 15.9
Singing songs togeth er 18 6.6
At least one meal with parents 3 1.1
b) Avoidance of restriction
Appropriate respons e to mistakes 11 4.1
Punishment 95 35.1
c) Social stimulation
Going to groc ery store with p arent 7 2.6
Going to park with pare nt 63 23.3
Going to friends’ houses 121 44.7
d) Support
Support for child care 67 24.7
Having con s ultation 16 5.9
Support from spouse 33 12.2
Talking with spouse a bo ut child 30 11.1
3) View of child care
Confidenc e about chil d caring abil it ies 17 6.3
4) Adaptation for center based care
Adaptation for center based care 5 1.9
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T. ANME ET AL.
regression analysis was used to predict child health symptoms
at school age (yes or no) with independent variables such as
types of care (“extended care” or else), positive qualities of
parents’ behavior (13 items), parent efficacy for care, and exis-
tence of care support, child development (delayed or normal)
and child adaptation to center-based care (adapted or not) at
toddler age. An odds ratio was calculated to clarify the magni-
tude of effects. The odds ratio was calculated applying a multi-
ple logistic analysis to estimate the strength of relations. All
results were assessed significant at the p < .01 or p < .05 level,
however, the variable “types of care” was not always selected
as a related varia bl e in all analyses .
Table 2 reports the number of risks in parent behavior.
Table 3 shows correlations with the child’s health at school
age. The maximum percentage is 17.0% for “easy to fatigue”,
while the minimum percentage is 7.8% for poor physical
strength.
Table 4 reports the results of the Chi-square test between
factors at the toddler age and the child’s health at school age.
The delay of fine motor at the toddler age was significantly
related to anxiety at school age. Interestingly, being the only
child was related being easily fatigued at school age.
Table 4 also presents the relationship between the care-
giver’s factors expressed when the child was a toddler and the
child’s health at school age. Not singing songs together in the
early years was significa ntly related to poor physical strength at
school age. Not going to the park with parents was related to
headaches at school age.
As indicated in Table 5, a multiple regression analysis, that
input all factors and excluded the effects of gender and grade in
school, was employed to explain children’s health at school age.
Poor physical strength at school age was significantly related
not playing with the child at the toddler age (odds ratio 3.23).
Feelings of loneliness at school age was significantly related to
not being adapted to center-based care at the toddler age (9.40).
Discussion
This is the first nation-wide study of center-based care that
Table 3.
Child’s health at school age.
Item Yes (%) No (%)
Feeling ove r whelmed 8.1 91.9
Anxious 11.4 88.6
Get irritated 15.1 84.9
Poor physical strength 7.8 92.2
Easy to fatig ue 17.0 83.0
Lonely 11.4 88.6
Displeasure and easy to get angry 14.0 86.0
Poor endura nce 13.7 86.3
Headache 10.7 89.3
Feel depressed 8.5 91.5
Want to attack someone 15.5 84.5
Lose interest in study 14.4 85.6
(n = 131)
focuses on the effects of extended-hour care, including night
care, and that assesses child health at school age based on the
complex relations among factors, including the quality of par-
ent behavior. Center-based extended-hour care through mid-
night is unique in Japan, reflecting the increase in the number
of parents who work late into the night. This investigation ex-
plored the influence of extended-hour center-based care (over
11 hours of care per day, including night care), in comparison
to normal care (11 hours or less). All night care centers in this
study had passed governmental standards and attempted to
ensure that the natural circadian rhythms for children, such as
sleeping, eating, and playing, were well maintained.
Several relatively recent large-scale, center-based childcare
studies conducted outside Japan have documented relations
between early and/or extensive childcare experience, noncom-
pliance, and problem-behavior, even after controlling for selec-
tion effects (Bates et al., 1994; Baydar & Brooks-Gunn, 1991;
Belsky & Eggebeen, 1991; Borge & Melhuish, 1995; Park &
Honig, 1991; Vandell & Corasaniti, 1990). Divergent results
emerged from the current investigation, which found little evi-
dence that the amount of time children spent in non-parental
care in the first 2 or 3 years of life is, in and of itself, system-
atically related to children’s self-control, compliance, or prob-
lem behavior by the time they reach the school-age years.
In light of prior studies and contemporary theory about the
complex ecology of child development, the general absence of
strong or consistent effects of the variable “type of care”, by
itself, may not be surprising. The compensatory-process, and
lost-resource perspectives outlined in the introduction led to the
anticipation of findings that highlight interactions between
quality and quantity of care and child development more than
main effects of the length of center-based care. Although qua-
lity was the most consistent predictor of child development, the
amount of explained variance was modest, and standardized
regression coefficients never exceeded .26 in the cumulative-
experience analysis and/or .16 in the lagged-and-concurrent
analysis.
On the basis of analyses employed to identify selection-effect
variables, several of the caregivers’ and family characteristics
that distinguished between families that participated in this
study, and those who did not, may be systematically related to
childcare quality. Nevertheless, the high rate of return and the
highly homogeneous nature of Japanese society may minimize
these effects. That the home environment was more strongly
related to child development and adaptation than was length of
center-based care is consistent with results of prior examina-
tions of the effects of childcare on infant-mother attachment
(NICHD, 1998b) and child development (Langlois & Liben,
2003). The principal conclusion of this large-scale, multisite
research project is that child rearing behavior by the caregiver
may be more important in explaining children’s health at school
age than whether parents routinely use the services of high
quality center-based care facilities or the length of time children
spend in these facilities. Items strongly related to child health at
school age, such as “playing with child” in infancy, may serve
as a proxy items for a number of factors at home, because they
indicate the opportunity to engage in activities inside and out-
side home, with other children, and in proximity of their care-
givers.
Literature does suggest, however, that center-based care ex-
erts some influence upon children. Studies report that the qua-
lity of care is the most consistnt child-care predictor, with e
Copyright © 2012 SciRe s .
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T. ANME ET AL.
Copyright © 2012 SciRe s . 267
Table 4.
Factors related to child’s health at sch ool age.
Category Anxious %
Easy to fatigue
% Poor physical
strength % Headache %
Child’s factors at toddler age
Delay 42.9* .0 14.3 14.3
Fine motor Normal 10.6 17.4 13.6 10.6
No 14.7 26.3** 14.7 13.7
Siblings Yes 9.7 11.9 13.1 9.1
Caregiver’s factors at toddler age
No 16.7 16.7 33.3* 16.7
Singing songs together Yes 11.1 17.0 12.3 10.3
No 9.5 15.9 15.9 17.5*
Going to park with parents Yes 12.0 17.3 13.0 8.7
Note: **p < .01; *p < .05.
Table 5.
Odds ratio for child’s health at scho ol age.
Poor physical strength Lonely
Item Odds Range Odds Range
Gender 2.79** 1.29 - 6.01 3.03* 1.29 - 7.11
Grade in scho ol 1.09 .82 - 1.45 .99 .72 - 1.37
Play with child 3.23* 1.02 - 10.22
Adaptation for center-based care 9.40* 1.09 - 81.23
Intercept –2.6523 –2.6979
H-L test .6836 .8609
Note: **p < .01; *p < .05.
higher quality of care relating to greater social competence and
cooperation and less problem behavior at both two and three
years of age (NICHD, 1998a). More time in low-quality care
and more numerous care arrangements (i.e., less stable care) are
predictors of negative outcomes for children at 2 years of age
(NICHD, 1999b). Furthermore, greater experience in groups
with other children predicted more cooperation and fewer
problems at both 2 and 3 years of age.
While further follow-up research with the current sample will
investigate less obvious effects of child-care that may emerge
later in development, the findings of this study are believed to
be useful in parent education programs. Outcomes of this study
were integrated into practice as early childhood parent educa-
tion programs highlighted the importance not only of the
physical care of children but of increasing the quality of social
interaction between parent and child.
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