| Sumario: | Question: What are the effects of out of home daycare on educational, health, and welfare outcomes for preschool children and their families? Data sources: Studies were identified by searching Medline, Embase, Cochrane Controlled Trials Register, Social Science Citation Index, PsycLIT, ERIC, and BIRD databases; hand searching journals (1977-96); scanning bibliographies of relevant papers, books, reports, and conference proceedings; and contacting authors. Study selection: Studies were selected if they included children < 5 years of age who received non-parental day care and if they used randomised or quasi-randomised methods to allocate participants to groups. Data extraction: Data were extracted on changes in children's developmental and intelligence quotients (IQ), school performance, behaviour, and health and on maternal employment, fertility, and interaction with children. Main results: 8 studies of disadvantaged populations in the US met the inclusion criteria. Compared with no daycare, daycare led to increased IQ at age 3 years (weighted mean difference [WMD] 14.4,95% CI 12.3 to 16.4,4 studies) and at age 5 years (WMD 8.0, CI 5.8 to 10.2, 2 studies). Daycare also led to fewer children remaining in the same grade for 2 years and having special education classes (table). At 27 years old, those who were in daycare before 5 years of age were less likely to be arrested, receive welfare assistance, or give birth outside of marriage and were more likely to graduate from high school, be married, earn higher wages, and own a home than those who were not in daycare before the age of 5 years (1 study). The average number of reported health conditions was higher for children in daycare at age 3 years, but not at 5 years; rates of admission to hospital were similar (1 study). Mothers of children in daycare were more likely to be employed than mothers of children in control groups (3 of 4 studies). Teenage mothers of children in daycare were less likely to have more children than teenage mothers of children who were not in daycare (1 study). Children in daycare and their mothers communicated more than children who were not in daycare and their mothers (3 of 4 studies). Conclusions: Studies on disadvantaged populations in the US show that out of home daycare before the age of 5 years benefits children's intelligence quotients, school performance, and behaviour. Long term benefits include higher socioeconomic status, fewer births outside marriage, and decreased criminal behaviour. Benefits for mothers include positive effects on employment, fertility, and interaction with children. [Original article accession number: 1999023132 (research, systematic review, tables/charts)]
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