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Infant & Toddler Group Care

Continuity of Care

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Learning ObjectivesParticipants will be able to:

• Discuss how continuity of care assignments support the development of close, caring relationships between teacher/child, child/peers, teacher/parents.

• Identify the benefits over the first 3 years of keeping the same care teacher assignments to children, parents and care teachers.

• Explore how continuity of care might be implemented in your early care and education program.

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Definition of Continuity of CareThe concept of continuity of care refers

to the policy of assigning a primary caregiver to an infant at enrollment in the child care program and continuing the relationship until the child is at least 3 years of age. With continuity of care, the same children stay together over the time of enrollment in the program.

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Continuity of Care

• Provides a secure base during the rapid changes in the first 3 years of life.

• Is often built into the family child care model.

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Activity: Exploring the Importance of ContinuityHow important is continuity in your own life?

Reflect on situations (a) and (b) and answer the following questions:

1. What feelings were you experiencing as you read the situations?

2. What would your response be to these situations if they really happened?

3. How does this experience relate to continuity of care in infant/toddler care.

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Activity: Exploring the Importance of Continuity (cont’d)

Step 1: Discuss how you might relate

these feelings and thoughts to the experience of an infant or toddler in care who must move to a space and a new teacher.

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Activity: Exploring the Importance of Continuity (cont’d)

Step 2:

a. Identify benefits of providing continuity of care on the worksheet provided;

b. Identify challenges and list them on the worksheet;

c. Brainstorm and write down possible solutions to the challenges you identified on the worksheet.

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With continuity …The infant is not moved to a new group; either the entire group moves with the care teacher to another, more appropriate space, or the caregiver modifies the environment to meet the children’s changing needs.

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Together in Care: Continuity of Care

Together in Care: Meeting the Intimacy Needs of Infants and Toddlers in Groups, 1992

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With continuity…The most important relationship to continue is the one between the child and the primary care teacher, but promoting long-term relationships with other caregivers and with other children in the group is also important.

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Intimate caregiving relationships …Lay the foundation of trust, providing

predictability, regulating attention, and creating interest for infants. Raikes (1993) hypothesizes that “time with teacher”— the length of time a high-ability teacher cares for an infant — is an indicator of quality for the infant-teacher relationship.

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Attachment Theory and Research

• Children take a significant amount of time to form attachments to caregivers, so they are less likely to form attachments if frequent caregiver changes occur.

• More frequent changes in primary caregivers have been associated with negative child outcomes, including withdrawing behaviors and higher levels of aggression as preschoolers (Howes & Hamilton, 1993).

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Implementing Continuity:• Structuring infant/toddler programs to promote long-term relationships often means reorganizing the environment, staffing, admissions policies, and training.• Implementing continuity raises logistical questions that require each program to find its own solutions.

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One teacher’s experience

“Continuity of care is the best new idea to come into this profession in my entire 25-year career. After the children and families get comfortable with the care, the teacher’s job is much easier. Personally, I do not have to spend a

half a semester at the beginning of each and every year gaining the trust of the children and their parents. The

children I get are happy to be with me, they are not “mourning” the loss of last year's teacher. The parents

get to know and trust my judgment so when I have difficult things to discuss with them it is much easier and the child gets the needed help much quicker. It is much

better for the child, and after all, isn’t that why we are all here?”

—Dawn Celyan, Toddler Teacher

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Three Ways to Implement Continuity1. Primary care teacher stays with the similar age group of

children by moving “up” to the next classroom with them.

2. Primary care teacher stays with similar age group of children by staying in the classroom and changing furnishing and equipment to meet the new developmental needs of the children.

3. Primary care teacher stays with a mixed-age group (similar to family child care). When a child leaves the program, a young infant would be placed in the group and stay in the group until he/she ages out or leaves the program.

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Activity: Problem-Solving Barriers to Implementing Continuity

• In small groups, review together the handout “Implementation of Continuity of Care in Infant/Toddler Programs.

• Discuss which barrier your program may encounter and the suggested solutions for your program.

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Developing an Action Plan..• Determine which solutions are most viable for your program.

• Identify the major steps that will need to be taken to implement the selected model.

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Review of Learning ObjectivesParticipants will be able to:

• Discuss how continuity of care assignments support the development of close, caring relationships between teacher/child, child/peers, teacher/parents.

• Identify the benefits over the first 3 years of keeping the same care teacher assignments to children, parents and care teachers.

• Explore how continuity of care might be implemented in your early care and education program.