Purpose: In previous research, middle- and upper-income mothers of disabled children report reducing their employment due to inadequate or unsatisfactory child care, and an inability to balance their caregiving responsibilities and their employment. However, little is known about the experiences of low-income single mothers, who are the target of welfare reform efforts. Low-income single mothers are no longer exempted from work requirements under TANF, yet no population-based research has been conducted to understand whether child care is available for low-income children with disabilities. The present study examined childcare in a nationally-representative sample of disabled and non-disabled children living with low-income single mothers. Child care is a prerequisite of maternal employment that ultimately benefits the mothers, their families, communities and society.

Methods: Data were analyzed from the 1999 wave of the National Survey of America's Families (NSAF). The NSAF is a nationally representative household survey that oversampled low-income families. Multivariate logistic regression and analysis of covariance models were estimated for 139 disabled and1,797 nondisabled preschoolers who lived with their single mothers, with total income below 200% of the federal poverty level. The sample represented 0.22 and 3.17 million U.S. children. Analyses controlled for child's age, maternal education, and total number of minor children in the household, factors that have been shown to impact maternal employment in previous research.

Results: Disabled and nondisabled children did not differ in their likelihood of being in center-based, kin care, or care in their own homes; the size of the child care center attended, or their weekly number of care arrangements. However, disabled children spent significantly more hours per week in care than their nondisabled counterparts (41 v. 33) and had hourly costs of care that were 60% below the cost of care for the nondisabled children. Disabled children were also much less likely to be cared for by an adult when receiving care in their own homes.

Implications: While child care quality could not be directly measured with this dataset, established research has found higher costs are strongly predictive of better quality care. However, our finding regarding the hourly costs of care for disabled children raises serious questions about the quality of care they received. Additionally, disabled children were in care for longer periods each week, and were more likely than nondisabled children to be cared for by a minor in their own homes. These findings suggest potentially serious implications for the quality of care received by disabled children, a situation complicated by their impairments. The latter finding that disabled children in their own homes were cared for by other minors is particularly troubling given the fact that their impairments typically require more skilled care than what is needed by nondisabled children – care that children are less likely to be able to provide.

Social workers could play a valuable role in advocating for expanded child care subsidies targeted for low-income single mothers of disabled children, and for policies to ensure care received by low-income disabled children meets minimum standards.