Specialized training is required. Finally, we have learned just how much infants' and toddlers' development is affected by the degree to which their families are under stress or are part of a network of social support. Child care and related services, functioning as a team, can be part of this support. It stands to reason that individualized care, such as that described above, requires low ratios of adults to children, small group sizes and continuity of care by well-trained teachers and caregivers. Recent studies confirm just how important these factors are to developmental outcome.
Quality is significantly lower than that for preschool care.
Yet many states have regulations that do not begin to meet the needs for quality for this youngest age group. Since millions of infants and toddlers are in child care in the United States today, many for more hours than they are with their immediate families, millions of infants and toddlers are at developmental risk. In fact, the United States is far behind most industrialized countries in developing a coherent vision and policy about the care and education of its youngest children. Policy is slowly moving in other areas affecting infants and toddlers. Prenatal care for all poor and near-poor pregnant women is now covered by Medicaid.