Child care research: a clinical perspective.

Two new studies on day care suggest that young children demonstrate increased aggressive behavior in relationship to time spent in day care and increases in cortisol levels in relationship to full-time, group-oriented, out-of-home care. These observations can be more fully understood in a clinical context that looks at individual differences in children, families, and child care environments. Factors likely to increase risk include sensory processing and modulation challenges; family stress; and lack of sensitive, nurturing interactions associated with less high-quality child care. Because 85% to 90% of current day care is not considered to be of high quality, individual families that can provide high-quality care need to explore carefully their options to see if it is possible to provide direct nurturing care for their infants and young children for at least half of the day.