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As a Pediatrician, I Know the Value of Quality Child Care

By: Dr. Judy Romano

There are few investments more important to a child’s early development and long-term health, behavioral, and educational outcomes than quality early education and child care. As a pediatrician, I have seen extraordinary advances in developmental science, neuroscience, genetics, epigenetics, and medical practice. What the research tells us is that the health, safety, and education of infants and toddlers not only shapes their ability to thrive throughout their lives, but also affects our collective ability to thrive as a country.

The first 1,000 days of a child’s life determines future health and productivity. Ignoring this obvious truth is like ignoring the necessity of air to breathe. During those first 1,000 days, infants and toddlers require safe, stable, and nurturing relationships to be healthy in the truest sense of the word. At the same time, parents and families need support to be a strong base for their children.

The reality is that young children spend large amounts of their time in settings that are outside of the home. More than two-thirds of Ohio children under the age of 6 have all parents in the workforce. As working parents have long recognized – and as the COVID pandemic has illuminated – access to quality child care is a necessity for our society. Without child care, people cannot work.

Quality makes a difference in all out-of-home care settings. While this is true for all young children, it is especially true for children who are disproportionately disadvantaged due to their race, geographic location, or family income. Given that we know environmentally-induced changes occur in brain and body development when children are in sub-optimal settings, we should be doing everything that we can to make sure that these settings are safe, healthy, and support young children’s development.

Quality early childhood education not only keeps young children safe and healthy, but it also keeps kids on their developmental trajectory to be ready for kindergarten. Only 41% of Ohio children demonstrate kindergarten readiness, meaning the child enters kindergarten with the social and emotional skills, language and literacy, motor development, and other abilities to succeed in the kindergarten classroom. Why is it important for children to be ready for kindergarten? Because kindergarten readiness sets the tone for a lifetime – not just a child’s performance in school, but also their future career success, mental and physical health, and health behaviors.

It’s abundantly clear that quality child care matters. This is why I have worked closely with the Ohio Chapter of the American Academy of Pediatrics as well as the Early Childhood Advisory Council in Ohio to promote quality child care and early learning. I have now worked with three governors and their administrations and have seen great strides in Ohio being a state where our youngest and most disadvantaged children are valued – not just in words, but in deeds. This value is made evident by the resources provided for children’s care and safety.

However, while great strides have been made in supporting the healthy development of Ohio’s youngest children, we must work until all children are given the support they need to reach their full potential. Every young child – no matter their race, where they live, or their family’s income – deserves access to quality early childhood education.


Judy Romano, MD, FAAP is the past president of the Ohio Chapter of the American Academy of Pediatrics.


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