Attendance at a nursery/crèche staffed by professionals may be linked to better psychological development than being looked after by family/friends or a childminder in early childhood, suggests new research published online in the Journal of Epidemiology & Community Health.

It may be associated with lower odds of poor social skills, difficult relationships with peers, and behavioral issues, particularly if attendance lasts a year or more, the findings indicate.

Previous evidence suggests that early childcare may boost a child's language and thinking skills, and possibly academic prowess. But the jury is still out on its potential impact on behavior.

To explore this further, the researchers drew on data for 1428 children taking part in a French study(EDEN) looking at the factors involved in child health and development.

In France, formal childcare provision is widespread, of good quality, and open to all. Most children (97%) start school by the age of 3, making it a good setting to look at the potential impact of different types of early childcare on development, say the researchers.

They tracked children's emotional development from birth up to the age of 8, using responses to a validated questionnaire (Strengths and Difficulties Questionnaire), completed by parents when the children were 3, 5.5, and 8 years old.

Behavioral and emotional problems

The questionnaire includes 25 items, focusing on behavioral and emotional problems, including difficulties in making friends, hyperactivity/inattention, conduct, and social skills.

When their children were 4, 8, and 12 months old, and again when they were 2 and 3 years old, parents were also asked what type of childcare had been provided up to the age of 3: formal (nursery, day care centre, crèche staffed by professionals); informal (provided by family/friends); or childminder.

Some 636 (44.5%) children had been in the care of a childminder; nearly one in four (just under 26%, 367) had attended formal care; while nearly a third (just under 30%, 425) had been cared for by family/friends.

Overall, 15.5% of the children had persistently high levels of conduct problems; just over 15% were hyperactive/had low attention spans; 16% had emotional issues; just under 7% found it difficult to make friends with their peers, and just over 13% had poor social skills.

Analysis of the data showed that compared with children who had been looked after by family/friends, those who received formal care were less likely to have emotional and behavioural problems, and more likely to have better social skills.

Compared with boys in receipt of informal care, boys in receipt of formal care had fewer emotional problems, but those looked after by a childminder had more behavioural problems.

Observational study

This is an observational study, and as such, can't establish cause, added to which the families studied were better educated and more affluent than the average for France. Nor were the researchers able to assess the quality of, or time spent in, a particular type of childcare.

Nevertheless, they suggest that, overall, the low levels of emotional symptoms, relationship issues, hyperactivity/inattention observed among children who had attended nurseries/crèches/day care centres might reflect a combination of the mental stimulus derived from play, praise, and reading, along with rules to follow, and quality child-caregiver interactions.

And they conclude: "Access to high quality childcare in the first years of life may improve children's emotional and cognitive development, prevent later emotional difficulties and promote prosocial behaviours." But future research will be needed to find out whether these benefits translate into a lower risk of psychiatric disorders in later life, they caution.