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Purpose – This study examines parents’ financial stress associated with obtaining care for young children while employed in unstable low-wage jobs. The child care subsidy program aims to both improve child care quality and support employment, and we expect that a substantial infusion of resources into this program would reduce parents’ financial stress.

Methodology/approach – We use a mixed-methods research design to study parents’ financial costs of child care, how predictable the cost of child care is to a parent, and what strategies parents employ to manage child care costs.

Findings – We find that parents perceive the subsidy program essential to their ability to manage the needs of their children and working. Yet, receiving subsidies does not appear to alleviate parents’ financial stress because child care costs continue to consume a large share of the family's income and subsidy policies make it difficult for parents to predict their portion of the costs. Parents manage the large and unpredictable expense of child care by decreasing other expenditures and increasing debt.

Practical implications – Changing subsidy policies so they better fit the reality of these families’ lives could result in a more substantive stress reduction. States can reduce unpredictability by reducing and stabilizing participants’ child care cost burden and revising eligibility policy.

Originality/value of paper – This research project fills an important gap in our knowledge about financial stress of low-income working families, provides insights into the role subsidy program participation plays in these parents’ lives, and informs discussion of subsidy policy.

This chapter is a qualitative study on how an Early Childhood Educator Professional Development grant impacted early childhood educators and their literacy practices. This chapter also discusses how the grant impacted the researcher who was also an instructional specialist working with the educators as part of the professional development.

The professional development changed practitioners’ literacy practices by encouraging them to improve children's access to books, to increase read alouds, to change literacy activities and to improve access to writing materials. These changes were also reflected in the experiences of the instructional specialist who also altered her own life.

This paper looks at the changes in the time allocation of welfare recipients in the United States following the 1996 welfare reform and other changes in their economic environment. Time use is a major determinant of well-being, and for policymakers to understand the broad influences that their policies can have on a population they ought to consider changes in all activities, not simply paid work. While an increase in market work of the welfare population has been well documented, little is known on the evolution of the balance of their time. Using the Current Population Survey to model the propensity to receive welfare, together with a multiple imputation procedure, I replicate previous difference-in-differences estimates that found an increase in child care and a decline in nonmarket work. However when additional data sources are used, I find that time spent providing child care does not increase. This is especially relevant as welfare recipients are overwhelmingly poor single mothers and the welfare reform increased time at work with ambiguous effects on time spent with children. I also find that time at work follows business cycles, with dramatic increases in work time throughout the strong economy of the late 1990s, accompanied by less time in leisure activities.

Over the past three decades, the U.S. economy experienced a sharp increase in the labor-force participation of women, causing a similar increase in the demand for non-parental child care. Concurrent with these developments has been a dramatic rise in the prevalence of childhood obesity, prompting the question as to what extent the increase in child-care utilization is responsible for the growth in obesity. This chapter examines the impact of various child-care arrangements on school-age children's weight outcomes using panel data from the Early Childhood Longitudinal Study, Kindergarten Cohort (ECLS-K). An advantage of the ECLS-K for our purposes is that it tracks children's child-care arrangements between Kindergarten and the 5th grade. Our fixed-effects' results suggest that non-parental child-care arrangements are not strongly associated with children's weight outcomes. Our findings are robust to numerous sensitivity and subgroup analyses.

Using Andersen’s (1968) behavioral model of health services use as a guiding conceptual framework, this study examined how receipt of family-centered care relates to the perceived family challenges for families of children with autism spectrum disorder (ASD).

Data from the 2009–2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) were analyzed for 812 parents of children with ASD.

Multiple regression analyses provided substantive statistical evidence that a child’s race, the adequacy of a family’s insurance, and the stability of child’s health care needs significantly contributed to predicting his or her receipt of family-centered care. Further results suggested a relationship between receipt of family-centered care and the perception of challenge for these families; families receiving family-centered care perceive fewer challenges and feel less unmet need for child health services.

Family-centered professionals provide critical voices in the development of policies and programs geared toward improving the health outcomes of children with ASD and their families.

Among U.S. children, research indicates that early childhood experiences, including the child care environment, affect later educational outcomes. Yet, research on educational stratification in low-income countries rarely features the preschool years. We investigate the organization of child care among preschoolers in China. In-depth interviews reveal that grandmother care and formal care are highly desirable. Formal care, in particular, is perceived to provide educational advantage. Using China Health and Nutrition Survey (CHNS) data, and mixed random effects logit models, we explore the determinants of grandmother care and formal care. Results suggest poverty is associated with gender bias; in low-income households, boys without siblings are especially likely to receive formal care. These results call for greater attention to early childhood in research on educational stratification in China and other low-income settings.

Evaluating primary care for children has not before been undertaken on a national level, and only infrequently on an international level, an adult-focused perspective is the norm. The Models of Child Health Appraised (MOCHA) project explored the evaluation of quality of primary care for children in a nationally comparable way, which recognises the influence of all components of child well-being and well-becoming. Using adult-focused metrics fails to account for children’s physical and psycho-social development at different ages, differences in health and non-health determinants, patterns of disease and risk factors and the stages of the life course. To do this, we attempted to identify comparable measures of child health in the European Union and European Economic Area countries, we aimed to perform a structural equation modelling technique to identify causal effects of certain policies or procedures in children’s primary care and we aimed to identify and interrogate large datasets for key tracer conditions. We found that the creation of comparative data for children and child health services remains a low priority in Europe, and the largely unmet need for indicators covering all the healthcare dimensions hampers development of evidence-based policy. In terms of the MOCHA project objective of appraising models of child primary health care, the results of this specific work show that the means of appraisal of system and service quality are not yet agreed or mature, as well as having inadequate data to fuel them.

Since the reforms started in the Romanian child protection, and in spite of adopting children’s rights, and investing in the professionalization of the child protection staff, research has indicated that children continue to suffer violence in care settings.

This chapter contributes to the literature that documents children’s rights violations in Romanian residential care, before and after the political shift in 1989, including the period after the accession to the EU, by presenting and discussing interview data of 48 adults who spent parts of their childhoods in child protection settings.

The conceptual framework of this analysis is based on the human rights perspective and the transitional justice. The main body of the article presents the testimonials of adults who grew up in institutional care in Romania, as collected in the framework of the SASCA project, funded by the European Union. ¹

This chapter considers the interwoven history of child care advocacy and feminism in Canada. It begins by examining the efforts of second-wave feminists to make child care part of national political discussions. It then moves into the 1980s and 1990s, when, as part of broader neoliberal reforms, feminist demands were no longer foregrounded in child care advocacy. Instead, ‘social investment’ and childhood development rationales took centre stage. This chapter considers the implications of the ‘disappearing woman’ from child care advocacy, and concludes by making a case for the ongoing relevance of intersectional feminism to the child care landscape, to ensure that all women are offered meaningful choice, opportunities and rights when it comes to their roles as caregivers and workers.

Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.