Orit Bergman
Photo by Orit Bergman
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Most parents are familiar with heart-rending leave-takings from bitterly weeping tots at the day-care facility, the nursery school or the kindergarten. Sometimes in the car, as they rush off to work, and sometimes later in the day, the parents are overcome with anxiety: Did my little boy or girl indeed calm down after a few minutes, as the caregiver or kindergarten teacher usually tells me, or was my child, heaven forbid, left to his or her own devices until the crying subsided? And later, another disturbing thought comes to mind: Is anyone smiling and giving personal attention to my child, calling him or her by name? But these anxieties are often dispelled as soon as they surface. After all, one has to go on working.

About 40 percent of the children in Israel between the ages of three months and three years are registered in public or private preschools or other educational facilities. According an Industry, Trade and Labor Ministry estimate, this year there are about 87,000 children of these ages in public day-care facilities. These institutions were established with the aim of encouraging women to go out to work. For this reason, historically, they have been run under the auspices of the Industry, Trade and Labor Ministry - not the Education Ministry. And, of course, they are expected to provide more than just babysitting services.

The fact that an infant or toddler is enrolled in such a facility should provide a sense of assurance and security to parents. Only if they feel this are they able to be productive and see the benefit from their work. Unfortunately, however, parents do not always have the right knowledge or tools to judge whether their children are truly in good hands.

A new study by the Baker Center for the Study of Development Disorders in Infants and Young Children at Bar-Ilan University offers just these sorts of tools, and the preliminary findings of the study are being published here for the first time.

Specifically, the researchers examined the quality of the care at the public preschools in the country, evaluating the small details of caregiving, the attitude toward the children and the caregiver's communicativeness, along providing an evaluation of the quality of the physical facility itself and the use of various aids and toys there. The picture arising from the findings is quite bleak.

The study was conducted in classes for children aged 2 to 3, in 42 day-care centers in the center of the country that are operated by the WIZO, Na'amat and Emunah women's organizations. The researchers - Dr. Cilly Shohet, head of the pedagogical training unit in the education department at Bar-Ilan, and Dr. Esther Adi-Japha, head of the child development unit there - both examined the facilities and analyzed scores of observations and interviews accumulated by the Baker Center during the course of a decade, in the context of research projects and training programs for master's degree students.

The importance of this study is that for the first time in the country, researchers have succeeded in defining the elusive essence of the quality of child care offered in out-of-the-home settings, and to determine the level of care in the frameworks in question.

'Crowded spaces'

The aspects of care that were examined included first and foremost the "physical" environment - i.e. the space and furnishings in the center, and the ratio between caregivers and children. While such factors are easy to discern, and parents know they should check them out when choosing a preschool, the study also looked at how these factors affect child care. Also examined were more fundamental aspects of the daily routine, including separation from and greeting of the parents, feeding, nap time, diapering, hygiene and safety, as well as the quality of the interaction between the caregivers and the children, and among the children themselves.

Among other things, in order to obtain a detailed picture of what happens in such facilities, the researchers used an international means of measurement: the Infant Toddler Environment Rating scale, known for short as the ITERS. This measure is used to rate certain variables, and possible scores range from 1 to 7 (a score of 1 is unsatisfactory, 3 is minimum, 5 is good and 7 is excellent ).

When compared to the other areas examined, the centers received the highest score when rated with respect to their physical environment: 4.4, on average. More fundamental factors related to the actual care and contact with the child chalked up far lower scores on the ITERS scale, however. When it came to the day-care routine, the score was 2.98 - short of the bare minimum. With respect to communication with and activities involving the children, as well as the attitude toward them as reflected in how they were addressed during those activities - the score was 3.4, or only slightly better than the minimum.

Intentionally, th Bar-Ilan researchers has refrained from entering into the polemic of comparing parent care to caregiver care.

In general, Shohet says she "did not want to pour out the baby with the bathwater. We don't ask whether it is good to send a child to a child-care facility," she explains. "In the reality in which parents need a solution for their child, we ask what the framework is and what the quality is of the care given there."

The fact that in 12 percent of the centers examined the care was found overall to be good is a positive finding, in Shohet's opinion, even if in one-quarter of the facilities the level is lower than what is considered to be the minimum.

"This shows that even within the same budgetary framework and in the same conditions, it is possible to achieve a very high level of care," she says, adding that later in the study, there will be a closer analysis of the factors that cause variability among the facilities, in order to find ways to improve the quality of care.

"We found many facilities that were unable to take in all the children and have sufficient space," Shohet explains. "In crowded spaces they could not have two groups active simultaneously. Moreover, there was no space for taking out certain educational aids and as a result the room becomes boring and the aids are in storage all the time. The environment constitutes a sort of textbook about the world for infants and toddlers. It is thus necessary to ensure that the children will have ample space for walking about in the room without stepping on each other; alternatively, there should be large areas in which they can wander about."

As one student observed at a preschool: "In the classroom there is a 'kitchen corner' that is not equipped at all. The children use it for climbing around or sitting. The round table that is usually part of the kitchen is on a different side of the space. This creates a difficulty in the flow of the play."

Waiting for meals

In evaluating the care routine, explains Shohet, "We examined, for example, how the caregiver treats a child who has just arrived, whether she speaks in a pleasant voice and relates to him, and whether the atmosphere is calm and friendly."

The researchers also checked hygienic standards in the facilities. According to Shohet, the prevailing attitude is apparently that "it's all okay, you don't need to go overboard" about cleanliness.

The toys are not washed sufficiently and the caregivers do not always wash their hands after changing diapers. Moreover, at nap time the usual, required distance between mattresses is not maintained, and sometimes they are pushed together into a kind of carpet because otherwise there would not be enough space for all the children.

Furthermore, in some preschools, the children jump on the mattresses and they are not clean.

Another serious finding of the researchers was that for lack of space, children sometimes had to wait too long for meals, particularly in places where they eat in two or three shifts. Also from a student's observation: "After they come back from the gymboree, it is 10:55. All the children are sitting on the carpet, two of them are crying because they are tired and hungry ... The caregiver does not offer them games because 'We'll be eating in a little while.'"

In the area of communication, the study examined whether the caregivers talked to the children when they were caring for them individually, for example, when diapering them; what kind of atmosphere prevailed at nap time; whether a child who does not want to sleep is offered an alternative activity; and in what tone of voice the caregivers speak to the children.

"The caregiver's way of speaking is an important lesson in interpersonal communication," notes Shohet. Some of the shortcomings stemmed from the ratio between caregivers and children. "There is a chronic shortage of manpower at the day-care centers," she explains. "One director once told me in despair that she has considered going out to recruit caregivers at bus stops. This is an occupation that is not rewarding in any respect and it leads to burnout. When there is one caregiver for 10 tots, for example, problems arise."

The researchers looked not only at how caregivers spoke to the children but also whether they encouraged their charges to be attentive to language. And what kind of speech did they use - personal or collective speech? An example of the latter is, "Who wants to do this?" Or talking to the group together, by saying "My darlings." And so on, without mentioning the individual by name.

"The caregiver should be paying attention to the children's initiatives," says Shohet. "For example, a toddler who is trying to initiate a relationship with another child. He is holding a toy and wants to give it to another child, but the other child gets frightened and begins to cry. The caregiver stands there with her back to them, turns around when she hears this, and says, 'What have you done to him?'

"The child's initiative should be pure gold for the educator. For example, at a mealtime a child relates, 'I went to the zoo with Daddy and Mommy.' If you just say, 'That's nice,' the circle of communication is closed. But it is possible to develop it like a game of ping-pong. You can say: 'Wow, what animals did you see?' And when the child answers you can go on to ask: 'Did you see the baby elephant?' Then other children will join in and the conversation will continue."

When there is no verbal dimension or support, conflicts and situations of aggressiveness develop among the children.

It is important for Shohet to make it clear that she is wagging an accusing finger at the state, "which is not taking responsibility for early childhood" - not at the workers, the facilities or the organizations that run them, which are operating in difficult budgetary conditions. According to her, the solution is not necessarily inspection or supervision, but rather proper instruction and training for caregivers.

"In public day-care center infrastructures today it is difficult for the caregivers to give the best possible care or to educate," Shohet argues. "There are too many children in the groups, the employment conditions are very problematic, the salaries are low and there is a permanent manpower shortage. There are not really any organized breaks during the course of the day and there isn't a cleaning staff at the facilities. In fact, the same woman is often the educator, the caregiver and the cleaner. Caregivers feel exploited.

"Work with babies is hard. Every mother feels the difficulty with just one, never mind when there are six or seven. Professional input is necessary. What will help the caregiver is regular input of this sort, as part of her work routine. Without this, and without improvement in her conditions, how can the woman who is working with the little ones be expected to give her best?"

Nevertheless, stresses Shohet, there were quite a number of excellent caregivers in the preschools she and the other researchers studied.

Stuck in the Knesset

The grave findings of the Bar-Ilan study may flash warning lights in front of legislators in the Knesset, who could decide to advance the Day-care Center Law that is supposed to improve the situation. In 2010 the law passed its first reading but since then nothing has happened.

Just one year beforehand the Ministry of Industry, Trade and Labor was persuaded that the standards at the preschools should be improved and it published a splendid report, which was supposed to become the "day-care center Bible" (it contains recommendations concerning the ratio between caregivers and children, the desired physical environment at facilities, and more ).

However, at the ministry now they are blaming the women's organizations operating the day-care centers for their opposition to the law, which has put a spanner in the works. According to the ministry, "The tools in the hands of the ministry for supervision and inspection of the day-care centers run by WIZO, Na'amat and Emunah are not at all sufficient. In order to raise the standards, there is a necessity for compulsory legislation. The objections to such laws are based on the budgetary implications for the entire preschool system, and the supervisory organizations are against regularizing and strengthening the supervision and enforcement ability of the Ministry of Industry, Trade and Labor. The ministry is working toward obtaining budgeting that will prevent the transfer of the cost of the 'revolution' to the parents."

WIZO and Na'amat have responded: "The public day-care facilities are among the best and most highly invested educational systems for early childhood that exist today. The organizations operate a high-quality and professional system of child care, and educational and welfare services. To this end the organizations maintain standards higher than those required by the government supervisory bodies. We welcome any research that will support the organizations' claim that more must be invested, and the claim that the state must take responsibility for the early childhood education system and budget funds for it as appropriate.

"The organizations have raised this demand before all the government institutions and have also presented the prime minister and the Trajtenberg committee with solutions that cam be implemented - among them ... increasing the manpower allotments. To our regret, the committee has not formulated suitable solutions for overall reorganization or for improvement of the early childhood education system."

The response from Emunah: "A research study - however comprehensive and thorough it may be - should be viewed in the proper proportions, in part because it does not necessarily express an absolute truth, certainly when it is a matter only of preliminary findings dealing with 'the quality, on average.' Emunah is conducting a no-less comprehensive and no-less thorough study - day by day - and its results are manifested, most often, in the children's glee when they arrive at preschool, the joy of their encounter with the caregiving staff, their daily enjoyment of the story, the song and the game as well as in the satisfaction of tens of thousands of parents.

"The directors of the Emunah day-care centers are women who hold a relevant academic degree, and the caregivers are professionally qualified. To our regret, the basket of funding set by the Ministry of Industry, Trade and Labor does not allow for hiring of manpower that would be optimal and more desirable, according to the researchers."