A Review of the Literature on Access to High-Quality Care for Infants and Toddlers

Children develop most rapidly during the first three years of life. While we know that high-quality early learning experiences that begin early in life can promote young children’s development and help reduce achievement gaps, much of the literature has focused on child outcomes related to attendance in early care and education programs for preschool-age children; less is known about how quality child care contributes to the development of infants and toddlers.

In addition, less is known about families’ ability to access high-quality child care for infants and toddlers. Recent federal policy and program initiatives have provided states with opportunities to expand high-quality care for infants and toddlers. As federal and state initiatives begin to address the needs for access to high-quality infant and toddler care, it is important to understand what the research suggests will facilitate families’ access to care and what practices strengthen the quality of care for infants and toddlers.

The literature review summarized below aims to better understand the research on supporting access to high-quality child care for infants and toddlers. The review was supported by funding from the W.K. Kellogg Foundation.

Purpose

The literature review examines research between 2008 and 2018 on supporting access to high-quality infant and toddler care and the effectiveness of approaches to improving access to and quality of infant and toddler early care and education (ECE). The literature review addresses the following questions:

1. What facilitates or hinders families’ access to high-quality care for infants and toddlers?
2. What do we know about the factors that contribute to strengthening quality in ECE for infants and toddlers and that are associated with positive outcomes for children under age three?

We assume that access to and quality of infant and toddler care are inherently related. It is difficult to conceptualize how to support access to high-quality care without also examining supports for strengthening the quality of care. The more the field understands how to improve the quality of infant and toddler care and implements effective approaches for improving quality, the more accessible that care will be for the families that need it.

Approach

The literature review involved identifying and then carefully summarizing and integrating research published between 2008 and 2018 related to access to and quality of ECE for infants and toddlers in the United States.

First, we identified candidate articles and reports using a set of search terms based on two guiding frameworks, which focused on (1) access to high-quality care for infants and toddlers and (2) quality care for infants and toddlers. Initial searches yielded a total of 455,466 hits for the access search and 40,537 hits for the quality search.

Titles and abstracts were then reviewed to ensure that they met inclusion criteria (i.e., that they were published between 2008 and 2018 within the United States and focused on child care that included infants and toddlers). Articles and reports that met the initial review criteria were then accessed in full to confirm that they fit the focus of the review. At this step, 41 articles and reports related to access and 43 articles and reports related to the quality of infant and toddler care were summarized in detail in table format (see Appendix of literature review for a list of included literature). Key findings from these articles and reports, their implications for programs and policy, and the highest priority next steps for research, are summarized in the literature review.

Throughout this executive summary we summarize key findings from the review, highlighting a limited selection of studies. For the full set of relevant references, please access the literature review.