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tachment in a low-risk sample. Child Dev., 58:945-954 .Belsky,J. (1986), Infant day care: a cause for concern? Zero to Three,

VI(5):1-9.-- (1987), Risks remain . Zero to Three, VII(5):22-24.-- (1988), The "effects" of infant day care reconsidered, Early

Childhood Research Quarterly. 3:235-272.National Center for Clinical Infant Programs (Jun e 1987), Infants

Can 't Wait: The Numbers. Unpublished report, Washington, D.C.Phillips, D., McCartney, K., Scar, S. & Howes, C. (1987), Selective

review of infant day care research . Zero to Three, VII(5):18-21.

NEGATIVE: JACK C. WESTMAN, M.D.

For the first time in history, our society is concerned aboutchildren, not only because they are uneducated, abused, orneglected,but because they have special developmental needs.This concern has surfaced dramatically in the controversyover institutional day care of infants and young children whiletheir parents are employed away from home.

Influenced by our technologically oriented society, manyparents and public planners are turning to experts for answersto questions about the developmental needs of young chil­dren. The parents are stirred by feelingsof guilt and frustrationassociated with placing young children, and now infants, inday care for 8 to 12 hours a day 5 days a week (Blum, 1983).

Parents are bewildered by assurances that day care of goodquality is not harmful and even is beneficial for infants andtoddlers and that their frustrations simply result from theunavailability of that kind of care. They hear that full-timeemployment away from home is here to stay and that theyshould seek subsidized day care as a right of citizenship andemployment. Yet many would prefer to care for their youngchildren themselves. They sense that they are being exploitedby the financial interests of their employers and even day­care providers. They see that adjustments can be made in theworkplace rather than simply conforming their family livesto traditional working patterns. In essence, they suspect thatassurances that they need not worry about placing theirchildren in day care of good quality is not based on theinterests of their children or themselves. Most know that theyplace their children in full-time day care because they areemployed away from home, not because they seek it as abenefit for their children.

Child psychiatrists can help parents and society understandthe importance of supporting the care of infants and toddlersby their own parents. As responses to questions concerningthe effects of day care on young children are formulated , wemight separate the questions into two kinds. The first kindasks how much of a child's care can be delegated to otherswithout harming the child or the child-parent relationship;this concern reflects a dominant social attitude in which thelimits of health hazards are tested until experts call attentionto potential or actual damage. In contrast, the second kind ofquestion asks about optimal child-rearing patterns for meetingthe needs of both children and parents.

In response to the first kind of questions about the adverseeffects of early day care, most child psychiatrists draw upon aseries of relevant assumptions. For example, we do not regardyoung children as freestanding but as parts of child-parentunits. We are aware of both child and parent development.

We know that determining whether or not infant day careharms or helps children is not a simple matter (Gamble andZigler, 1986). We know that short-range empirical researchtechniques cannot answer this question and that observer biasis inherent in even the most rigorous research in thephysical sciences. Consequently, we realize that research onday care for children is confronted with almost insurmount­able obstacles because of definitional, population, continuity,site, personnel, control group, and duration factors; age ofentry variables; and, in addition , confounding workplace,social, ecological, individual difference, and ethical factors.

We do believe that the failure to develop, and substant ialdisruptions of, attachment bonds during infancy have psycho­pathological consequences (Bowlby, 1988). We suspect that ,when attachment bonds are interrupted repeatedly, a short­range effect is an insecure parent-child relationship. Thiscould be one reason for the widespread prescription of medi­cations for insecure children and frustrated parents. We sus­pect that a long-range effect is an impaired ability to formcommitted relationships with other people, a factor in thealienation that underlies teenage alcoholism, drug abuse, andsuicide. We believe that, when children are better off in daycare than at home, therapeutic attention to the parent-childrelationships and the children's life circumstances are indi­cated rather than daily removal of the children from theirparents.

In response to questions about optimal child-rearing pat­terns in early life, we can help parents and public plannersthink clearly about the multiple socioeconomic, cultural, andpsychological factors that influence child rearing. We canraise at least three important points.

The first consideration is helping parents and society rec­ognize that infancy and early childhood are brief, never-to­be-recovered periods in the lives of a child and parent andthat the needs of children and parents vary with their ages. Inthis context, parental decisions about employment away fromhome can be made with awarenessof the importance of timingin the consequences for them and their children. At the sametime society can be helped to recognize that the majority ofthe labor force is composed of men and women who areparents, necessitating the routine consideration of their fam­ilies.

The second consideration is encouraging thinking aboutchild-rearing objectives. In the United States the objective ofchild development probably is producing competent, produc­tive citizens capable of committed attachments to others.Because children no longer are financial assets, contemporaryparents are motivated by love for their children and the hopeof lifelong relationships with them and their grandchildren.For both society and parents the critical issue is less thephysical care and education of young children and more thequality of their developing capacities for human relationships.Much of the frustration parents experience with delegatedchild care results from their inability to purchase the kind ofaffection and concern they desire for their children.

The third consideration is how parents and public plannerscan most clearly think about meeting these child-rearingobjectives. On the one hand are the parents' intuitive percep­tions and urges based upon the biological foundations ofchild-parent relationships and cultural wisdom. Most of the

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children on earth are raised on this basis. On the other hand,in the United States many parents turn to experts for adviceand to the marketplace for resources. They either find advicethat encourages accommodation of their lives to their childrenor accommodation of their children 's lives to the workplace.The latter often is influenced by the profit motives of theburgeoning multibillion dollar day-care industry and thevested interests of associated child care professionals andbureaucracies.

In this light, we can help public planners to move beyondsimply addressing crises in child care to the long-range needsof children, parents , and society. They can be encouraged tolearn from the experience of other societies that have tried tofacilitate the full-time employment of parents and to developsocially responsive children by institutionalizing the care ofinfants and young children (Blasi, 1986; Langmeier and Ma­tejcek, 1975). Nations with a strong commitment to the groupcare of children, such as Israel, the Soviet Union, Czechoslo­vakia, and the People's Republic of China, have backed awayfrom institutional infant care and have adjusted workplacesso that parents can raise their own babies during extendedparenting leaves and return to their workplaces with supple­mentary child care.

The challenge for parents in the United States is to balancethe priorities of their families and employment away fromhome. The priority they give to their children early in lifeinfluences the priority their children will give to them in laterlife.

The challenge for society is to recognize the social value ofparenthood and to support, rather than undermine, family

life. Social policies should not be based upon the assumptionthat full-time parental employment will continue withoutadjustments of the workplace to parenting. Already the futur­ists' prediction that we willbecome a society with home-basedworkers is being realized in flexiblework locations and sched­ules that benefit many parents.

The challenge for child psychiatrists is to help parents andsociety think clearly about the importance of children in theirlives and how to raise the competent, compassionate, andcommitted offspring that parents desire and that a democraticsociety requires.

ReferencesBlasi, J. (1986), The Communal Experience of the Kibbutz. New

Brunswick , NJ: Transaction Books.Blum, M. (1983), The Day Care Dilemma. Lexington, MA: Lexington

Books.Bowlby, J. (1988), Developmental psychiatry comes of age. Am. J.

Psychiatry, 145:1-10.Gamble, T. J. & Zigler, E. (1986), Effects of infant day care. Am. J.

Orthopsychiatry, 56:26-42.Langmeier, J . & Matejcek , Z. (1975), Psychological Deprivation in

Childhood. New York:-Wiley.

The debaters in this section were asked to respond to theresolution from the respective viewpoints; the opinions theyexpress may not necessarily reflect their true positions. Be­cause four separate positions resulted from the responses, thedebaters will not rebut one another. They will, however, replyto 'questions posed by readers through the Journal's Letters tothe Editor column. Readers are encouraged to write.