In their article, “Child Care Attendance and Educational and Economic Outcomes in Adulthood,” Domond et al1  confirm extant literature revealing the lifelong impact of high-quality early care and education participation. Specifically, 2 seminal early intervention studies conducted in the United States, the HighScope Perry Preschool Program2  and the Carolina Abecedarian study,3  have revealed the academic, social, economic, and health benefits of early childhood education, especially for children placed at risk primarily because of poverty.4  These studies, which were based on a small sample of primarily African American children in specific communities, make it challenging to generalize the findings, and the lack of rigorous examination of the core components makes it difficult to replicate. The current study extends and expands our current knowledge about the impact of regulated early care and education, specifically child care, on children’s education attainment and economic stability.

Of particular note is the overwhelming benefit of regulated child care to boys, especially those who enter care in infancy. Authors of other studies have noted the biological and social vulnerability of boys in the early years. The distinct neurobiology of boys in utero and for the first 2 years of life may make them susceptible to later problems, especially under conditions of environmental stress.5  Furthermore, there is evidence that boys and girls start life with different capabilities and emotional skill sets because of sex-specific genetic and environmental factors.6  For example, infant boys and girls display different responses to postpartum maternal depression, negatively impacting boys’ later outcomes.7  Similarly, boys also show different sensitivity to quality of parenting and attachment, with boys likely to exhibit problem behaviors in preschool and beyond when experiencing insensitive and disorganized attachment with their primary caregiver.7  Regulated child care may provide a nurturing and protective environment for boys that sets them on the right track for school and life success, as indicated by lower likelihood of not being poor as adults compared with those who did not participate in regulated child care. This is important especially in light of the concern about male school disengagement, graduation rates, contact with the criminal justice system, and economic stability, especially for African American male individuals in the United States.

Most importantly, the finding that participation in regulated child care is associated with lower likelihood of not being poor as an adult provides us with at least one antipoverty strategy. Poverty is associated with a multitude of poor functioning and outcomes from birth through adulthood8 ; thus, there is a greater need for policies that combat poverty at the population level starting in childhood. Unfortunately, this study is unable to inform us as to whether regulated child care is particularly effective for children placed at risk primarily because of poverty or whether it closes the school and economic gap between children from low-income compared with higher-income households. There is evidence that high-quality early education may be more beneficial for children from low-wealth households compared with those from more advantaged households.9  Although the authors of this study provide evidence that child care participation is linked to a lower likelihood of not being poor, there is a need to examine the extent to which child care is associated with economic stability and wealth generation, which would have multi- and intergenerational effects.

Although child care is the focus of this study, one should not disregard the importance and value of family economic stability and functioning. Ensuring that families are emotionally, socially, and economically stable would ensure that children are on track for school and life success. Although the authors sought to control the impact of various family and child demographics, that control may not completely mute the effects of familial factors, especially when the children in child care were likely to come from families in which mothers were employed and more educated. Understanding the mechanisms linking child care to later school and life outcomes are critical to ensure that children are supported and on track across the life course.

Opinions expressed in these commentaries are those of the author and not necessarily those of the American Academy of Pediatrics or its Committees.

FUNDING: No external funding.

COMPANION PAPER: A companion to this article can be found online at www.pediatrics.org/cgi/doi/10.1542/peds.2019-3880.

1
Domond
P
,
Orri
M
,
Algan
Y
, et al
.
Child care attendance and educational and economic outcomes in adulthood
.
Pediatrics
.
2020
;
146
(
1
):
e20193880
2
Schweinhart
LJ
,
Montie
J
,
Xiang
Z
,
Barnett
WS
,
Belfield
CR
,
Nores
M
.
Lifetime Effects: The High/Scope Perry Preschool Study Through Age 40
.
Ypsilanti, MI
:
High/Scope Press
;
2005
3
Campbell
FA
,
Ramey
CT
,
Pungello
E
,
Sparling
J
,
Miller-Johnson
S
.
Early childhood education: young adult outcomes from the Abecedarian Project
.
Appl Dev Sci
.
2002
;
6
(
1
):
42
57
4
Heckman
J
,
Pinto
R
,
Savelyev
P
.
Understanding the mechanisms through which an influential early childhood program boosted adult outcomes
.
Am Econ Rev
.
2013
;
103
(
6
):
2052
2086
5
Schore
AN
. Bowlby’s “environment of evolutionary adaptedness:” recent studies on the interpersonal neurobiology of attachment and emotional development. In:
Narvaez
D
,
Panksepp
J
,
Schore
AN
,
Gleason
TR
, eds.
Evolution, Early Experience and Human Development: From Research to Practice and Policy
.
New York
:
Oxford University Press
;
2012
:
31
73
6
Golding
P
,
Fitzgerald
HE
.
Psychology of boys at risk: indicators from 0–5
.
Infant Ment Health J
.
2017
;
38
(
1
):
5
14
7
Schore
AN
.
All our sons: the developmental neurobiology and neuroendocrinology of boys at risk
.
Infant Ment Health J
.
2017
;
38
(
1
):
15
52
8
Wells
NM
,
Evans
GW
,
Beavis
A
,
Ong
AD
.
Early childhood poverty, cumulative risk exposure, and body mass index trajectories through young adulthood
.
Am J Public Health
.
2010
;
100
(
12
):
2507
2512
9
Yoshikawa
H
,
Weiland
C
,
Brooks-Gunn
J
, et al
.
Investing in Our Future: The Evidence Base on Preschool Education
.
Washington, DC
:
Society for Research in Child Development
;
2013

Competing Interests

POTENTIAL CONFLICT OF INTEREST: The author has indicated he has no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The author has indicated he has no financial relationships relevant to this article to disclose.