Designing Quality Rating Systems Inclusive of Infants and Toddlers

Quality Rating Systems (QRS) are being implemented in States to establish a means to both define and promote quality in child care settings. These rating systems include five common elements: 1) standards, 2) accountability measures, 3) program and practitioner outreach and support, 4) financial incentives, and 5) parent/consumer education. A comprehensive focus on QRS can be found in Issue 32 of the Child Care Bulletin (Winter/Spring, 2007),¹ including a description of these key elements.

Many of the elements included in QRS are program-wide in scope, and apply to the care of all children. Given the developmental needs of babies and toddlers, however, specific aspects of care can be defined that speak to quality for the very youngest children in child care. At this time, six of the 14 existing State QRS efforts include criteria and standards specific to infants and toddlers. These are described in the NCCIC document Quality Rating System Standards Specific to the Care of Infants and/or Toddlers. In the six states specifically addressing infants and toddlers, the primary consideration is in the definition of caregiver/ child ratio and group size.

High quality child care for infants and toddlers, however, includes characteristics of care beyond those of group size and ratio. This document offers suggestions for the intentional inclusion of quality indicators for infants and toddlers in State QRS.

1. Standards

The standards defined in a State’s QRS are the criteria that a program must meet to achieve the rating. Baseline standards are typically set at the State’s licensing criteria, and are tiered to more stringent standards as programs increase in quality to achieve a higher rating in the QRS. General considerations related to defining standards of quality for infants and toddlers:

• Include standards that specifically address aspects of quality related to infants and toddlers.
• Assure that standards are inclusive of all legally operating care systems, including family, friend and neighbor care.
• Assure that standards are tied to evidence-based research on infant/toddler care.

Standards for rating quality specific to infant and toddler care might include the following:

Key Standard of a QRS	Infant/Toddler-Specific Considerations
Professional Development/ Professional Qualifications/ Training	Requirement of Infant/Toddler specific training or education, such as: an Infant/Toddler Credential Infant/Toddler specific coursework Infant/Toddler specific training (such as the Program for Infant/Toddler Care - PITC) Specific Health and Safety training, such as Awareness of Abuse and Neglect, Safe Sleep Practies and Sudden Infant Death Syndrome. Core Knowledge and Competencies for Infant/Toddler Caregivers are identified and tied to the QRS.
Learning Environment/ Curriculum	Standards defining quality in infant/toddler environments (such as NAEYC Accreditation criteria or Head Start Performance Standards for Early Head Start) are required at appropriate levels of the QRS. Approved curricula or learning approaches are specific to infants and toddlers such as Creative Curriculum for Infants and Toddlers, Innovations for Infants and Toddlers, or the approach defined in the PITC. The curriculum is individualized to the routines and rhythms of infants and toddlers receiving care. The curriculum utilizes Early Learning Guidelines and program standards for infants and toddlers. Caregiving routines reflect the culture, family life-style, and language of infants and toddlers.
Ratios/Group Size	Standards meet recommendations for high quality care for infants and toddlers. Infants are served in smaller group sizes than toddlers, Low caregiver/child ratios are in place for children ages birth through two years of age
Parent/Family Involvement	Written, daily communication with parents is documented, especially as relates to caregiving routines such as feeding, sleeping, toileting/diapering.Learning Environment/ Curriculum Written, daily communication with parents is documented, especially as relates to caregiving routines such as feeding, sleeping, toileting/diapering.Learning Environment/ Curriculum
Administrative Policies/ Program Design	Principles related to quality for infants and toddlers are supported in program design and policy, such as:Learning Environment/ Curriculum Assignment of a primary caregiver Continuity of caregiver over time Program policies specifically address infant/toddler issues, such as: Safe sleep policies Policies supporting the individualized needs of infants and toddlers Health, Safety and Nutrition policies specific to Infant/Toddler routine care
Program Evaluation	Infant/Toddler-specific criteria are used, such as the ITERS-R.Administrative Policies/ Program Design Program evaluation includes a close look at caregiver/child interactions, utilizing such tools as the Caregiver (Adult) Interaction Scale (Arnett)
Children with Special Needs	Programs partner with State Part-C system. Support services are in place for the inclusion of infants and toddlers with special needs. Staff receive training related to infants and toddlers with special needs.

2. Accountability Measures

The second element of a QRS includes the accountability measures that will be used to determine how well programs are meeting QRS standards. General considerations for maintaining an infant/toddler focus in the determination of accountability measures include: Assuring that monitoring, program evaluation, or program assessment tools include aspects of quality related to infants and toddlers, as described in the key standards above.

3. Program and practitioner outreach and support

The third element of a QRS is designed to promote professional development and technical assistance methods that will support quality improvement, and to encourage participation in the system. General considerations for maintaining an infant/toddler focus in the determination of program and practitioner outreach and support include:

• Inclusion of research related to the importance of quality indicators in infant toddler care as a part of efforts aimed at promoting participation.
• Training specific to infant/toddler care.
• Mentoring and coaching through such systems as Infant/Toddler Specialist Networks.
• Inclusion of an Infant/Toddler Credential in the QRS.

4. Financial incentives

The fourth element, incentives such as tiered reimbursement for participating programs, offers a reward to those programs increasing quality through the QRS, and encourages participation. General considerations for maintaining an infant/toddler focus in the determination of financial incentives include:

• Scholarships or wage bonus for providers achieving an Infant/Toddler Credential.
• Wage supplements specific to infant/toddler staff for professional development efforts that result in increasing rating of infant/toddler care.
• Establishing tiered reimbursement systems that acknowledge and support the higher cost maintaining quality in infant/toddler care.
• Use of CCDF Infant/Toddler Targeted Funds to support the high cost of quality in infant/toddler care.
• Contracts for quality enhancement grants that require specific infant/toddler qualifications.

5. Parent/consumer education efforts

The final element of QRS targets parents, helping educate and inform child care consumers about the importance and effects of high quality programming. A primary consideration in these efforts is the inclusion of information about the critical importance of quality in infant/toddler care. Educating parents on key indicators of quality for infants and toddlers will help them make informed decisions as they seek and choose child care settings for their children.

Footnote:
¹http://www.nccic.acf.hhs.gov/ccb/issue32.pdf