April 2017Vol. 18, No. 2Developing Infant-Toddler Relationship-Based Care

According to a recent research brief from the Office of Planning, Research and Evaluation (OPRE) within the Administration for Children and Families within the U.S. Department of Health and Human Services, early childhood practitioners and policymakers should encourage the establishment of relationship-based care for infants and toddlers to promote more responsive caregiving. The OPRE brief notes that infants and toddlers learn best in the context of relationships with caregivers who know them well, and responsive caregiving provides the foundation infants and toddlers need to be engaged learners in preschool and beyond. The OPRE brief explains the relationship-based care approach, related practice considerations, and the implications of existing State standards for incorporating relationship-based care into early care programs.

It also points out that approximately half of all children under age 3 in the United States have some sort of regular child care arrangement and that developmental research supports relationship-based early care and education to optimize learning in infants and toddlers and improve long-term outcomes.

According to the brief, "policies, procedures, and practices (or specific components) that support families, teachers, and children as they build relationships with and among each other" are at the heart of relationship-based care. This interaction forms a partnership that allows families, teachers, and children to better understand each other's needs and promotes trust, security, and comfort.

The brief recommends two relationship-based care supports: primary caregiving and continuity of care. Primary caregiving involves assigning infants or toddlers to one teacher who has the primary responsibility of caring for a small group of children within a larger group setting. The primary caregiver takes the lead in building relationships with the children and families in their care "by providing intentional and individual care for the child's routine needs such as feeding, sleeping, and diapering times." This person also keeps track of a child's developmental progress and communicates regularly with the parents. Continuity of care refers to the practice of keeping infants and young children and their caregivers together for an extended period of time—preferably until the child turns 3—rather than switching to a new caregiver or new group based on age or developmental milestones.

OPRE points to several options that existing child care centers can explore for promoting relationship-based care, including organizational, staff, and space/facility adjustments to enhance the teacher-child relationship. The brief also notes that States can incentivize this approach by rewarding child care centers that use primary caregiving and continuity of care with additional supports or higher subsidy payments.

The May 2016 OPRE Research-to-Practice Brief, Including Relationship-Based Care Practices in Infant-Toddler Care: Implications for Practice and Policy (OPRE Report #2016-46) is available at https://www.acf.hhs.gov/sites/default/files/opre/nitr_inquire_may_2016_070616_b508compliant.pdf (1,320 KB).