Child Care Arrangements for Young Children with Disabilities: A Nationally Representative Description

Background/Purpose:  Child care is a crucial support for working parents and, in some cases, may confer developmental benefits.  Yet, many families struggle to find affordable care, and for families raising a young child with a disability it may be especially hard. Families who have a disabled child are also more likely to be economically disadvantaged (Parish et al., 2008), and experience a variety of challenges as they seek to balance work and caregiving. Adding to this burden is often a struggle to find appropriate child care for their child with special needs (e.g., Booth-LaForce & Kelly, 2004).  Despite the potential for child care to promote social inclusion, very little is known about care arrangements for children with disabilities. Understanding child care experiences will also provide insight into whether current policy and programmatic supports are adequately serving these vulnerable families.

Methods: We pool data from four waves (1995, 2001, 2005, 2012) of the Early Childhood Program Participation survey from the National Household Education Surveys program (N=29,464). These data are nationally-representative of households with children six-years-old or younger. The ECPP contains in-depth information about child care arrangements and a child’s disability status; it also contains an appropriately large sample of children with disabilities (N=2,688).  Our key outcome is a parent-report of the type of regular child care arrangement the child experiences, including: (1) no regular non-parental care (50% of sample); (2) regular informal non-parental care (10 or more hours/week) provided by a relative or non-relative (27% of sample); and (3) formal, center-based care (10 or more hours/week; 23% of sample).  The key independent variable is whether the child has an identified disability, based on parent report.  We include the following covariates: income, race, family structure, subsidy receipt, and parental employment.  We use multinomial logistic regression to compare the likelihoods of being enrolled in different care arrangements by disability status.

Results:  Overall, compared with children without disabilities, young children with disabilities are more likely to be in non-parental care. Specifically, children with disabilities are more likely to be enrolled in formal care (OR: 1.4, p<.01, roughly 36%) and informal care (OR: 1.3, p<.05, roughly 23%), holding other factors constant. Looking only at preschoolers (ages 3-5), children with disabilities are more likely to be in formal care (roughly 48%) than other types of care (OR: 1.3, p<.01 compared to no non-parental care, roughly 34%; OR:1.4, p<.01 compared to informal care, roughly 18%). Dissimilarly, infants and toddlers with disabilities (ages 0-2) are equally likely to be enrolled in informal and formal care.

Conclusions/Implications: This study highlights the unique needs of families raising young children with disabilities, and social work’s role—both research and practice—in supporting these families’ right to equitable access to appropriate, quality care. The findings suggest that policies encouraging inclusion and equal opportunities for young children with disabilities in early learning and child care environments may be effective. The comparatively high rates of participation in child care underscore the need to ensure that caregivers are sufficiently trained in these children’s developmental needs.