Socio-Emotional Outcomes of Child Care Participation: Results of a Four-Year Longitudinal Cohort Study.

BACKGROUND/OBJECTIVES: Despite a wealth of research on potential socio-emotional outcomes of child care participation, results have been mixed, likely reflecting between-study differences in confounding variables assessed. Moreover, there is a need for updated studies using Canadian population data. The purpose of this study was to assess associations between child care participation between the ages of 1 and 5 years and socio-emotional outcomes four years later, accounting for a wide range of potential confounding variables. METHODS: This study uses data from 8929 children ages 1-5 who participated in the 2019 Canadian Health Survey on Children and Youth, for whom follow-up data were available from the 2023 collection cycle. Parents reported on their use of child care for the target child in 2019; children's socio-emotional functioning was assessed via a parent report in 2023. Associations between child care participation and outcomes were assessed using logistic and linear regression, adjusting for confounding factors including child age and gender, low family income, parental education, parental marital status, positive parenting, and education disruptions due to the COVID-19 pandemic. RESULTS: Child care participation among 1-5 year olds was associated with higher scores for symptoms of attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and internalizing problems but a lower likelihood of having functional difficulty making friends four years later. Differences in these associations were noted based on the type of child care attended and family income, with centre-based care showing the most robust associations with ODD and internalizing symptoms, particularly among those living above the low-income threshold. CONCLUSIONS: These results highlight important contextual differences in associations between child care participation in early childhood and socio-emotional outcomes four years later. Associations with socio-emotional outcomes persisted after adjusting for important contextual factors, including positive parenting and COVID-related school disruptions.