Is stability always a good thing? Low-income mothers' experiences with child care transitions

Children and Youth Services Review 53 (2015) 147–156

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Children and Youth Services Review journal homepage: www.elsevier.com/locate/childyouth

Is stability always a good thing? Low-income mothers' experiences with child care transitions Katherine E. Speirs a,⁎, Colleen K. Vesely b, Kevin Roy c a b c

University of Illinois at Urbana–Champaign, 904 West Nevada Street, MC-081, Urbana, IL 61801, USA George Mason University, Thompson Hall 1102, 4400 University Drive, MS 4C2, Fairfax, VA 22030, USA University of Maryland, 255 Valley Drive, Room 1142, School of Public Health Building, College Park, MD 20742, USA

a r t i c l e

i n f o

Article history: Received 16 December 2014 Received in revised form 23 March 2015 Accepted 26 March 2015 Available online 3 April 2015 Keywords: Child care Instability Preschool-aged children Low-income families

a b s t r a c t Recent research has drawn attention to the deleterious effects of instability on child development. In particular, child care instability may make it hard for children to form secure attachments to their care providers which may have a negative impact on their development and school readiness. These effects seem to be heightened for lowincome children and families. However, there remains a lack of clarity regarding how and why low-income mothers make changes to their child care arrangements. Using ethnographic data from Welfare, Children, and Families: A Three City Study, this study explored 36 low-income mothers' experiences of child care instability and stability and the factors that promoted each. We identified four kinds of child care transitions: planned, averted, failed, and forced. Financial resources, transportation and the availability of care during the hours that mothers work were important for helping mothers find and maintain preferred care arrangements. Our findings have implications for research on child care instability as well as the development of policy and programs to help low-income families secure high quality child care and maintain stable employment. © 2015 Elsevier Ltd. All rights reserved.

1. Introduction Children thrive in family and community contexts that are stable and secure. A growing body of literature suggests that there are various types of instability (e.g., economic, employment, residential, familial, school, and child care) that can be harmful to young children's development (Sandstrom & Huerta, 2013). From an ecological perspective, instability in multiple areas can compound and directly and indirectly shape children's lives by contributing to both proximal and distal developmental outcomes. In particular, instability in multiple areas can expose children to toxic stress, or the constant activation of the body's stress management systems due to chronic exposure to environmental stressors, which coupled with inconsistent support from caring others can be damaging to young children's developing brains (National Scientific Council on the Developing Child, 2014). Low-income families are particularly vulnerable to this potential pile up of stress due to instability. However, family stress theory suggests that families' access to resources as well as how families frame or make meaning of stressful situations can buffer the harmful effects of stress (McCubbin & Patterson, 1983). Given the connections among instability, stress, and child development, further refining our understanding of child care instability for low-income families is important ⁎ Corresponding author. Tel.: 1 217 300 4487; fax: 1 217 333 9061. E-mail addresses: [email protected] (K.E. Speirs), [email protected] (C.K. Vesely), [email protected] (K. Roy).

http://dx.doi.org/10.1016/j.childyouth.2015.03.026 0190-7409/© 2015 Elsevier Ltd. All rights reserved.

to ensure that policy and practice support children's healthy development. To this end, we examine child care instability among lowincome families with a focus on describing different kinds of child care instability and the factors that promote instability as well as challenging the assumption that child care instability is always negative and stability always positive. 1.1. Literature review Child care is an important resource for many families. In 2011, more than half of the children under five years old had a mother who worked outside of the home. Of these young children, approximately 88% spent time in a regular child care arrangement. For low-income children under age five whose mothers were employed, 86% were in some form of child care (Laughlin, 2013). Given the widespread use of child care, access to reliable high-quality care is important as it helps mothers maintain stable employment (Bromer & Henly, 2009; Hofferth & Collins, 2000); promotes positive child development and school readiness, particularly in terms of language development and cognition (Bradley & Vandell, 2007; Burger, 2010; Votruba-Drzal, Coley, Chase-Lansdale, 2004); and provides access to parenting resources (Cahan & Bromer, 2003; Vesely, Ewaida, & Kearney, 2013). The benefits of high quality child care may be even more important for low-income families who are more likely than their higher income counterparts to experience chronic instability in many areas (Sandstrom & Huerta, 2013). For low-income children and families, stable high quality

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child care may buffer the effects of instability in other areas (Shonkoff & Phillips, 2000). However, when child care arrangements are unstable, the benefits of high quality care may be undermined. Given this, the Office of Child Care (OCC) within the U.S. Department of Health and Human Services has demonstrated a commitment to ensuring that low-income families have access to high-quality child care. Part of OCC's strategy for accomplishing this is developing principles within the Child Care and Development Block Grant that help ameliorate negative instability and promote continuity of child care (Office of Child Care, 2012). 1.1.1. Defining child care instability Child care instability has been inconsistently defined across the literature with most authors using one of three definitions (see Adams & Rohacek, 2010 for a detailed review). First, and most commonly, child care instability is defined as a change from one primary or secondary child care arrangement to another (e.g., Gordon & Högnäs, 2006). Second, instability has been defined as a change within an arrangement such as a change in the child care provider, child groupings, or daily routines (e.g., Ritchie & Howes, 2003). A third conceptualization, sometimes called arrangement multiplicity, considers the number of different child care settings a child spends time in during each day or over the course of a week (e.g., Morrissey, 2009). In this paper we use the first definition and consider any changes to a mother's primary or secondary child care arrangements. 1.1.2. Prevalence of child care instability Multiple studies suggest that children from all income levels move from one care arrangement to another relatively frequently. Using data from the nationally representative National Institute of Child Health and Human Development (NICHD) Study of Early Child Care, Tran and Weinraub (2006) found that 39% of infants experienced a change in their primary caregiver between 6 and 15 months of age. There is also evidence that low-income children experience frequent changes to their child care arrangements. Ha, Magnuson, and Ybarra (2012) used a sample of 11,027 low-income children who were cared for in subsidized child care in Wisconsin and found that, on average, the children in the sample changed care providers 2.7 times during their first five years. This number is likely an underestimation as children were not followed when they were not receiving a child care subsidy and only 44% of the children were followed from birth to age five; the remaining 56% of the sample was followed from age 1 or 2 to age 5. Using a sample of 1105 families from the Fragile Families and Child Well-Being Study, Pilarz and Hill (2014) found that, on average, children moved from one care arrangement to another 1.9 times between birth and age three and 24% of the children in their sample experienced two or more changes to their care arrangement during the first three years. Based on these studies, it seems as though young children, and low-income young children in particular, experience significant instability in their care arrangements within the first five years of life. 1.1.3. Impact on children The empirical literature exploring the effect of child care instability on child developmental outcomes is limited but suggests complex relationships. The relationship between instability and attachment has received the most attention. Early studies suggest that an increased number of transitions negatively impact a child's ability to develop a secure attachment relationship with a care provider, especially for infants (Adams & Rohacek, 2010; Barnas & Cummings, 1994). However, later work (Tran and Weinraub, 2006) found that the number of transitions experienced between different kinds of care during the first 15 months was not related to infant–mother attachment in a sample of 416 infants from the NICHD Study of Early Child Care. Additional research suggests differences by race/ethnicity (Tran & Winsler, 2011). Other authors have begun to explore associations between instability and cognitive and language development and school-readiness,

again with mixed findings. Instability has been associated with more externalizing behavior problems (Pilarz & Hill, 2014), higher teacherreported language skills (Tran & Winsler, 2011), and lower ratings of social competence (Bratsch-Hines, Vernon-Feagans, & Family Life Project Key Investigators, 2013) in national or large regional samples. Additionally, two studies suggest the importance of considering the kind of care that children transition out of and into. Ansari and Winsler (2013) examined transitions between and stability within family-based care, center-based care, and public pre-kindergarten using a sample of 2682 low-income children between ages 3 and 4. There were differences in fine motor, cognitive, language, social skills, and behavioral development based on the kind of care children entered or left. For example, children who transitioned from center-based to family-based care or from family-based care to center-based care demonstrated declines in fine motor-skills when compared to national averages, however, children who transitioned from center-based care to public pre-kindergarten demonstrated gains in fine motor skills. Tran and Weinraub (2006) found no effect on cognitive performance or language development when examining the number of transitions experienced during the first 15 months. However, their results suggest that transitions from familial care to nonfamilial care or from in-home care to out-of-home care may be more likely to be associated with poorer language comprehension than other kinds of transitions.

1.1.4. Impact on parents Most research that considers how child care instability impacts parents explores the effect on maternal employment. There is evidence that when mothers lose their child care, they are unable to continue working (Chaudry, 2004; Hofferth & Collins, 2000) and that employment decisions are influenced by challenges related to the availability, cost or quality of child care (Mason & Kuhlthau, 1992). However, two studies suggest that child care instability may not always disrupt mothers' employment. In their qualitative study of 44 mothers who were receiving child care subsidy in Oregon, Scott and Abelson (2013) found that for most of the mothers in their sample their employment was not disrupted when they had to make a change to their child care arrangement. Rather, they were able to anticipate the child care disruption and make plans to smoothly transition to a new arrangement. Using a sample of more than 3500 low-income women, Miller (2006) found that losing child care (i.e., moving from non-parental care to parental care) was associated with leaving employment, but switching from one kind of child care to another (i.e., moving from center-based care to family day care) was not associated with leaving employment. In sum, this research seems to indicate that losing child care is more detrimental to mothers' employment than a change in the care arrangement, especially when mothers are able to plan for the change.

1.1.5. Types of instability One of the reasons for inconsistent findings concerning the impact of child care instability on child development and maternal employment may be that most of the literature fails to distinguish what Lowe, Weisner, and Geis (2003) term “changes” from “instability.” They argue that changes, or planned transitions from one care arrangement to another, are qualitatively different from instability, or sudden unanticipated changes to a care arrangement. Planned changes are more likely to result in the child being moved into higher quality care that better helps the parent maintain stable employment than instability which may disrupt parental employment and/or force the parent to quickly find a new care arrangement that may be of lower quality or a temporary arrangement. Qualitative studies suggest that parents experience both child care changes and instability (Lowe & Weisner, 2004; Scott, London, & Hurst, 2005). However, there remains a dearth of research that systematically explores these different kinds of transitions, their causes, and/or consequences.

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1.2. Study aim Despite the increased attention on instability in general and child care instability in particular, there remains a lack of clarity regarding how and why low-income mothers make changes to their child care arrangements. Much of the literature ignores the distinction between child care transitions that are planned and those that are unanticipated. There is also limited discussion about mothers' motivation for transitioning child care, as well as stability within lower quality arrangements. This study fills these gaps by using ethnographic data from 36 low-income mothers in Boston, Chicago, and San Antonio to explore low-income mothers' experiences of child care stability and instability and the factors that promote them. 2. Methods Our interest in understanding mothers' experiences transitioning between care arrangements and their motivations for making these transitions within the context of instability in other areas (e.g., housing and employment) guided our decision to take a qualitative approach. Qualitative analysis is uniquely suited for understanding process, meaning and context (Daly, 2007). In particular, the ethnographic data that we draw on provide insights into how child care transitions unfold in mothers' lives, important aspects of the larger context that shape these mothers' experiences with stability and instability, and how mothers understand these experiences. 2.1. Data collection Our sample consists of low-income mothers from three states who participated in the ethnographic component of the Welfare, Children, and Families: A Three-City Study (hereafter the Three-City Study). The Three-City Study was designed to evaluate the consequences of welfare reform for the well-being of children and families. This multi-site study integrated survey, developmental, and ethnographic components. A detailed description of the Three-City Study is available at www.jhu. edu/~welfare. The Three-City Study purposively sampled from one state with liberal welfare policies (Massachusetts); one state with restrictive welfare policies (Texas); and one state which provided measured (or average) welfare policies (Illinois). Relevant to child care instability is how differential state implementation of the Child Care and Development Fund (CCDF) resources led to a range of impacts on families living in different states (Meyers et al., 2006). Meyers and colleagues considered the dynamics of child care subsidy use in five states, paying particular attention to the stability, continuity, and duration of subsidy receipt, all of which are potentially important to the stability of care among families using child care subsidies. In Massachusetts subsidy spells were longer than for families in Illinois and Texas (Meyers et al., 2006). Health and safety requirements for the receipt of subsidies also varied across states with Illinois and Massachusetts being a bit more restrictive than Texas (National Child Care Information Center, 2002). The 256 families who participated in the ethnographic component of the Three-City Study were recruited between June 1999 and December 2000. Recruitment sites included formal childcare settings (e.g., Head Start); the Special Supplemental Nutrition Program for Women, Infants, and Children offices; neighborhood community and youth centers; churches; local welfare offices; and other social service agencies. Multiple neighborhoods in each city were targeted for recruitment, based on compatibility with probability sampling areas used to recruit participants for the Three-City Study survey component. All families who participated in the ethnography had household incomes at or below 200% of the Federal Poverty Line when they were enrolled in the study. Ethnographers collected data from each family for 12–18 months using a method of “structured discovery”. In-depth interviews and participant observations were developed to explore specific topics, but

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ethnographers were also allowed the flexibility to capture unexpected findings and explore relationships among topics (Roy & Burton, 2007). The interviews addressed child care; work experiences and future plans; child development; parenting; intimate relationships; health and health care access; experiences with child care subsidies, TANF, and other public assistance programs; education; family economics; support networks; family routines; and home and neighborhood environments. Ethnographers also engaged in participant observation, accompanying mothers and their children to locations such as child care and Head Start centers, welfare offices, doctor's offices, or workplaces, and noting both context and interactions. Ethnographers met with each family once or twice each month, on average, for 12 to 18 months, with follow-up interviews at six months and one year after the 12–18-month intensive period. Mothers were compensated with grocery or department store vouchers for each interview and participant observation visit. Pseudonyms, not actual names, are used in this paper. 2.2. Participants and data For the analyses described in this paper we created a subsample of 36 families from the 256 who participated in the ethnographic component of the Three-City Study. To create our subsample, we started by excluding 44 families who were recruited because they included a child under eight years of age with a moderate to severe disability. We did not include these families in our analysis due to the unique strategies involved in securing appropriate child care for children with a disability. From the remaining 212 families, all of whom included a child aged two to four years old, we excluded 63 families who did not have detailed information about child care and employment. We determined which families had detailed child care and employment information using timelines that were created for each family. Each family's timeline included information about the type and timing of employment, sources of income, child care, health insurance and health conditions, and housing. By presenting a visual display of each family's transitions in several areas, these timelines allowed us to better understand how instability in one area interacted with or led to instability in another area. Next, we read through detailed profiles for each of the 149 remaining families. These profiles are 20–80 page summaries of all of the ethnographic documents (e.g., interview transcripts and field notes) for a given family. The profiles are organized by topic (e.g., child care, employment, and housing) and provide a summary of each area. For this paper we relied most heavily on the summaries of the family's child care and employment histories. We identified 12 families from each city (four African American families, four Latino families, and four non-Latino White families) that had detailed information about at least one child care transition. In using families from each of the three cities as well as from the three racial/ethnic groups represented in the larger sample, we were able to preserve the diversity found in the larger sample while working with a more manageable subsample necessary for examining the depth and richness of each families' data; a common practice among researchers working with this large ethnography (Roy, Zvonkovic, Goldberg, Sharp, & LaRossa, 2015). Our sample included 36 mothers: 12 mothers from each of the three cities (Boston, Massachusetts; Chicago, Illinois; and San Antonio, Texas) and racial/ethnic groups (African American, Latino, and non-Latino White) represented in the larger study (see Table 1 for complete sample demographics). Half of the mothers in our sample were single when they enrolled in the study. The average age at enrollment was 28 years (SD = 8.76) for the mothers and 2.90 years (SD = 1.23) for the focal children. On average, the mothers were responsible for two children (SD = 1.34) and 19 of the focal children were girls. Twentythree of the mothers received child care subsidy at some point while enrolled in the study. Seventeen of the mothers were receiving TANF money at the beginning of the study and nine were receiving it when they left the study.

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Table 1 Demographic characteristics at the beginning of the ethnography for the study sample (n = 36).

City Boston Chicago San Antonio Maternal characteristics Ethnicity Latino African American Non-Latino White Age in years (M, SD) Marital status Single Divorced, separated, widowed Married Education Less than a HS degree or GED HS degree or GED More than a HS degree or GED Employment status Working Not working Number of children mother is responsible for (M, SD) Number of people in the household (M, SD) Receiving TANF Receiving food stamps Received child care subsidya Child characteristics Age in years (M, SD) Gender Female Male

N

%

12 12 12

33 33 33

12 12 12 28

33 33 33 8.76

18 10 8

50 28 22

17 8 11

47 22 31

16 20 2 4 17 21 23

44 56 1.34 1.80 47 58 64

2.90 19 17

1.23 53 47

Notes. TANF = Temporary Assistance for Needy Families. a Ever received a child care subsidy while enrolled in the Three-City Study.

The families in our sample reported, on average, 3.7 child care transitions (either planned or forced transitions). This number is higher than estimates from other samples, however it is difficult to make comparisons across studies. To calculate the number of transitions for our sample, we included every change to a primary care arrangement reported by each mother during the 12–18 months that she participated in the study. Most mothers also provided information about child care transitions that took place before they began participating in the study. As mothers were recruited when their children were between two and four years old, mothers who were enrolled when their children were two years old may have provided information for two fewer years than mothers who were enrolled when their children were four. Ha et al. (2012) found an average of 2.7 transitions between birth and five years old for their sample of 11,027 low-income children in Wisconsin. However, they were only able to count child care transitions that occurred while the family was receiving child care subsidy. Additionally, Pilarz and Hill (2014) found an average of 1.9 transitions for their sample of 1105 families from the Fragile Families and Child Well-Being Study, but they only followed the children from birth to age three.

2.3. Analysis Analysis began by reading through each family's timeline and profile to get an overview of their child care history and how child care stability and instability fit into the larger context of the family's life. We then coded the interview transcripts and field notes related to child care using grounded theory coding. This coding occurred in two phases. During the first phase the first two authors examined mothers' experiences of child care stability and instability and identified four types of child care transitions: planned, averted, forced, and failed transitions. During the second phase we identified reasons for or causes of each of the four kinds of transitions.

During both of these phases of coding we moved through the three stages of grounded theory coding: open, axial and selective coding (LaRossa, 2005). During open coding we read through the interview transcripts and field notes and assigned codes to sections of text. During the first phase of coding we began by identifying sections of text that described child care instability or transitions from one care arrangement to another. After reading through several interviews and field notes we realized that stability was also an important part of the process of arranging child care for young children and began coding sections of text that described child care stability. Open coding during the second phase of analysis involved identifying sections of text that described reasons for the instability and stability we identified during the first phase. Axial coding involved grouping the open codes into categories. During the first phase of data analysis, we placed the examples of stability and instability into groups which resulted in the four kinds of transitions that are described in the Findings section (see Fig. 1). For the second phase of data analysis, axial coding involved grouping the reasons for stability and instability into categories. During axial coding we moved back and forth between our codes and the data to test and revise the codes and deepen our understanding of the data. Finally, selective coding involved bringing together the categories that were created through axial coding to tell a coherent story (Daly, 2007). During the first phase of analysis this involved defining two axes, stability and well-being. Our interest in stability and instability in child care arrangements guided the decision to use stability to define one axis. In further exploring the different types of stability and instability we determined that some were supportive of a family's overall wellbeing while others challenged overall well-being. The decision to frame the types of transitions in terms of well-being was also, in part, guided by the literature and Lowe et al.'s (2003) suggestion that some child care transitions could be productive and supportive of positive child outcomes. We made determinations about what was supportive and unsupportive of a family's well-being based on mothers' perceptions, experiences and observations. For example, when a mother indicated that she was transitioning her child from home-based care to what she considered to be higher quality center-based care, we coded this as supportive. In addition, if a mother indicated that because her relative child care provider found another job and could no longer provide care, she was transitioning her child to another family member, who the mother worried was not reliable, we coded this as unsupportive. During the second phase of analysis, selective coding involved looking at what influenced or shaped stability and instability across the different kinds of transitions and determining where there were similar and dissimilar processes at work. Again we focused on mothers' perceptions and explanations of what lead to or prevented transitions so that we could understand these transitions from the mothers' perspectives. We used the qualitative data management and analysis software program Atlas.ti to organize our analysis. 2.4. Data quality Data collection and analysis quality were established in several ways. Credibility, or internal validity, was ensured through prolonged field work in several different settings (Krefting, 1991). The Three-City Study ethnographers met with participants on average one to two times per month for 12 to 18 months, and completed interviews and observations in several different settings and during different days of the week, times of day, and months during the year. Spending a prolonged period of time with participants allowed ethnographers to develop a rapport with participants and participants to trust the researcher enough to reveal sensitive information. Additionally, prolonged field work meant that the ethnographers were able to ask participants about the same event on several different occasions which limited social desirability bias and allowed for in-depth exploration of important topics and events. Additionally, by following families for 12–18 months,

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Supportive of General Well-Being Unsupportive of General Well-Being

Child Care Instability Planned Transition

Child Care Stability Averted Transition

Forced Transition

Failed Transition

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Fig. 1. Two dimensions that define the experience of arranging child care for low-income mothers.

triangulation of data sources was possible. For this paper, we were able to use mothers' accounts of their attempts to make child care arrangements over several months. In this way we had access to multiple child care transitions or attempts to maintain stability, rather than focusing on a mothers' experience at one point in time. We also had access to the mothers' understanding of child care transitions at different points in time (e.g., while they were planning for a transition, as it was happening, and after it happened). The credibility of our analysis was established through peer examination. During open and axial coding the first and second authors met and discussed the codes and themes that emerged. When there were discrepancies among these two authors, the third author also read the data and provided additional insight and then all three worked together to resolve the discrepancy. The authors also worked together during selective coding to determine the main “story underlying the analysis” (LaRossa, 2005, p. 850). Moreover, the authors shared their codes, categories and conclusions with two other researchers (not authors on the paper) who are familiar with qualitative methods and the ethnographic component of the Three-City Study. These researchers provided feedback and helped the authors clarify the findings and ensure that they were true to the data. We addressed transferability or external validity by clearly describing how we selected our analytic sample from the larger Three-City Study sample and providing demographic information for our subsample (see Table 1). We addressed confirmability, or reliability, by having the first two authors independently code the data and come to agreement on any discrepancies. We agreed on the kinds of stability and instability reported here as well as the reasons for them. The process of peer examination described above also addressed reliability. 3. Findings 3.1. Types of stability and instability In exploring low-income mothers' experiences of child care transitions we identified four kinds of transitions, two types of child care stability and two types of child care instability. Both stability (continuing to use a care arrangement) and instability (transitioning to a new arrangement) could be supportive or unsupportive of a family's overall wellbeing (see Fig. 1). Child care stability and instability were supportive of the family's overall well-being when they led to the child being in a preferred care arrangement, one that the mother felt provided highquality, safe child care; allowed the mother to work or attend school; and allowed the family to live in housing that was safe and convenient. Child care stability and instability were unsupportive when they resulted in the mother questioning the quality of the care her children received, and the hours or location of her child care arrangement not fitting well with her work location or schedule or the location of the family's home. Below we provide a description of the four kinds of transitions that we identified. We then describe the factors that promoted each of them. 3.1.1. Planned transitions Mothers who experienced instability that was supportive, or planned transitions, were able to make changes to their care arrangements that were planned in advance and resulted in care that they felt

supported their children's development and/or their ability to maintain stable employment. Arlene, an African American mother of two children from Chicago moved one of her daughters from a local Head Start program to the private preschool where her other daughter was enrolled so that both children would be cared for by the same care provider. This mother's care arrangements were improved after this transition because “dropping them off in two different places … made it even more stressful.” Planned transitions allowed mothers to use their preferred type of care. Macy, a non-Latino White Bostonian, explained to her ethnographer that she had planned to have her daughter, Hailey, in family day care until she was one so that she would receive one-onone attention. After her daughter's first birthday, Macy planned to move her to center-based care because she felt “Hailey would benefit from more structure.” With this plan in place, Macy was able to find a center that she felt provided quality care and enroll her daughter. She was satisfied with the care her daughter received at the center. Twenty five of the mothers in our sample (70%) described at least one planned transition. 3.1.2. Averted transitions Some mothers experienced stability that was supportive, these averted transitions allowed mothers to maintain a child care arrangement that provided quality care for their children and allowed them to work or attend school. For Stacey, a Latina mother of two children living in San Antonio, it was important that her sister be able to care for her children. Stacey worked in the cafeteria on an Air Force base from 5:00 AM to noon each day. Stacey liked her job and appreciated that her work schedule meant her children spent most of the time that she was at work sleeping so she only missed “an hour or two” with them each day and “they (didn't) really have time to miss me.” Because of her non-standard work schedule Stacey didn't “think she could find more flexible child care” than her sister. To maintain this care arrangement, Stacey was willing to “pack up the kids' stuff to go to her sister's, and bring her sister food for them” each night. As described below, some mothers were able to easily avert child care transitions while others had to skillfully juggle the different components of their lives (work, transportation, housing, etc.) and at times jeopardize stability in another area to preserve stability in their child care arrangements. Seventeen (47%) of the mothers in our sample described at least one averted transition. 3.1.3. Forced transitions Instability that was unsupportive, or a forced transition, occurred when mothers who were satisfied with their child care arrangements were forced to transition. These changes were unpredictable, meaning mothers were unable to anticipate or plan for them. If unable to quickly find a new care provider, mothers often lost or left their jobs or had to drop out of school to stay home and care for their children. Mothers who were able to find a new care provider usually transitioned to a less preferred or temporary care arrangement. Once the new arrangement was secured mothers often had to reorganize transportation and secondary care arrangements. Debby, a non-Latino White mother of six children from San Antonio, was employed at a fast food restaurant near her apartment and used a local child care center. When her work hours increased, Debby had to find a new care arrangement because the old center did not open

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early enough to allow her to arrive at work on time for her new hours. The change in her work schedule also meant that she lost her child care subsidy after “she was told she was working too many hours and no longer qualified for the assistance.” Unable to use her preferred child care center and without a subsidy, Debby had to piece together child care by “paying somebody to take care of the kids” as well as having her children's father watch them while she worked. She did not see this as an ideal care arrangement and wanted to begin using centerbased care again. However, she was unable to have her subsidy reinstated and eventually had to quit her job when “all of the sudden nobody wanted to take care of (her children), or they wanted more money and Sal wanted me to pay him to take care of his own kids. And I wasn't going for it.” For mothers who had multiple children in different care arrangements being unexpectedly forced to make a change for one child often disrupted the other children's care arrangements as well. Twenty-three (64%) of the mothers in our sample described at least one forced transition. 3.1.4. Failed transitions When mothers experienced stability that was unsupportive, they were dissatisfied with their care arrangement and wanted to make a change, but were unable to transition to a new care arrangement. Unsupportive stability can be thought of as a failed transition or a transition that does not happen. Mothers were unhappy with their current care arrangements for several reasons including concerns about the quality or safety of the care their children were receiving, the care provider being located in an inconvenient location, and care providers being unreliable. Twenty four of the mothers in our sample (67%) described at least one failed transition. The impact of failed transitions on the mother seemed to be related to the reason a mother wanted to make a change to her care arrangement. Mothers who wanted to transition because they worried their children were being mistreated by or were unsafe with their care providers were often distraught by having to continue using their current care providers. Chrissy, a Latino mother of seven children living in Boston, explained that having no option other than leaving her five youngest children with her 13 year old daughter left her “worried about the children at home alone (because) they are all fighting with one another.” She also explained to her ethnographer that “when she is working she goes into the bathroom and cries because she is worried that the neighbors could hear the fighting and call (the Department of Social Services).” Mothers who wanted to change their care arrangement because their provider did not have a convenient location or operating hours had to spend money to maintain their care arrangements (e.g., taking a taxi instead of a public bus to arrive at a child care center before it closed) or sacrifice being late for or missing work or school to drop off or pick up their children. Finally, some mothers who wanted to transition to a new care arrangement because they felt that their children were missing out on an experience or instruction in their current child care arrangement compensated by providing the experience or instruction at home. After being unable to arrange transportation for her son to attend a child care center that she thought would prepare him for kindergarten, Sandy, an African American mother in San Antonio, “taught him how to write his name, his numbers, and do all the things that he'd have to know before he went to kindergarten.” Although Sandy was able to provide at home some of the experiences that her son would have had at the child care center, this is considered a failed transition because this mother was unable to transition to a preferred care arrangement. Many of the mothers in our sample were similarly resilient in that although they experienced a failed transition, they were over time able to regroup and provide their children with what they felt were enriching experiences. Although we discuss each kind of transition separately, most of the mothers in our sample (81%) experienced more than one kind of transition and five of the mothers reported experiencing all four kinds of

transitions. Tess, an African American mother living in Boston, explained that when her daughter Andrea was two weeks old she arranged for her to be cared for in a family day care home because she had to return to school. However, Tess became unsatisfied with this care arrangement after witnessing the family day care provider hit other children, leave the children by themselves while she ran short errands, feed the children “junk food” for breakfast and allow them to watch television all day. Tess was able to plan a transition to a child care center that she felt offered “more stimulating programming and activities” as well as an on-site “computer room, arts and crafts room, and library.” After making this transition Tess was happy with the care her daughter received and worked hard to maintain this care arrangement. She averted having to transition out of this care arrangement by applying for and receiving subsidy to reduce the tuition and arranging for her daughter's godfather to provide care during holidays when the center was closed. However, Tess was forced to remove Andrea from the center after her car broke down and she could not afford to fix it. Without a car the center became too inconvenient to use on a daily basis. Many of the mothers in our sample were similarly able to plan supportive transitions at one point in time but were also forced to leave or unable to transition to a preferred care arrangement at another point in time.

3.2. Factors that promoted planned transitions Planned transitions occurred when mothers had the time, organizational and planning skills, and support to make and act on plans. Mothers needed time to plan transitions from one care arrangement to another. Some mothers created this time by being able to anticipate potential transitions either based on their families' needs or shifts in their provider's abilities. Nancy, an African American mother living in San Antonio, described how planful she was regarding her child care arrangement. In particular, when her son Nathan turned three she decided that he should attend a child care center where he would learn early literacy and numeracy skills. She said he was “intelligent and … (she) wanted him to keep his intelligence.” She also recognized that she “didn't have the patience (to teach him). But in the school they have the patience to sit down and go over it with him, and go over it, and go over it …” She asked about the on-site daycare at the community center where she was taking GED classes and “looked in on the classroom.” When she saw that “the kids looked kind of nice, and (the center) had a camera, so I know if someone hits my child” she decided to enroll her son. The transition was smooth and Nancy was pleased with the program. Having a secondary care provider also allowed mothers time to plan transitions. These back-up providers were usually family and friends who could step in as care providers for short periods of time. When mothers unexpectedly lost a care arrangement, having a secondary provider meant they could spend time exploring their options, rather than having to take the first care provider they found. Additionally, secondary care providers provided care for a day or two at a time, so the mother did not have to change the child's entire arrangement if the primary care provider was suddenly unavailable. In addition to the time to plan, mothers also needed the organizational and planning skills to find and evaluate different care providers. Mothers who were able to organize planned transitions visited programs and providers, consulted with relatives and friends regarding their child care experiences, and considered the fit between different providers and their families' needs. Mothers also worked closely with providers to create arrangements that best met their families' financial and logistical needs. Ruby, a non-Latino White San Antonian mother of two children, described how she needed a child care program that would pick her children up from their elementary school. During her first call to one program the director said that they could not pick up children at the elementary school; however, because other parents

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needed this service, the program began picking children up at the elementary school. Ruby explained:

waited to be paid through the subsidy system. The ethnographer's field notes explain:

I was calling like before school started, I was calling this daycare to find a school that picked them up from that elementary. At first they said no. Then I called back and they said, ‘Yeah, we're gonna go ahead and start taking that because we had some parents that wanted to pick up from Upton Place.’ So I right away switched daycares and got the paperwork going ‘cause I had to like reserve my slot for like a month … you have to make sure you have someone to pick up your child when you're at work. There's not a way that I could get off work and come out to pick them up.

"The issue was the payments." It took almost four months for Jess's mother to receive her first check from the Illinois child care fund. I asked why the delay was so long. She said they had to do background checks on her mother, and "sent this W9 form out, and it was a bunch of hassle." They finished all of the paperwork within the first month, and "it took like three months before she got any payment at all." She said her mother" was ready to quit on me, and that's my mother, so I can just imagine if that was a stranger."

Had Ruby unexpectedly needed to find a new care arrangement, she may not have been able to wait until the center decided to provide transportation and had she not been savvy about arranging child care she may not have called the center more than once or quickly started the paperwork to enroll her child. Caseworkers were also instrumental in helping mothers plan transitions by visiting child care programs with mothers and providing information about how and when child care subsidies might end. This was exemplified by the experiences of Shari, a mother of one child from San Antonio, whose caseworker from a local branch of a national child and family-focused non-profit organization visited multiple child care programs with her and helped her ask specific questions related to her daughter's language development needs. Overall, when mothers were able to, they worked hard to maintain quality care arrangements. Mothers who had time, organizational and planning skills, and strong support networks were able to piece together and maintain supportive child care arrangements and make transitions to better care when necessary. 3.3. Factors that allowed mothers to avert a transition Two strategies that helped mothers maintain care arrangements were being creative in how they paid for child care and finding a care provider whose services matched their needs. Some mothers cut back on other expenses, such as food, to pay for child care. Other mothers utilized, and in many instances compromised, public benefits to support their child care needs. Calista, a non-Latino White San Antonian with two children, described how she used food stamps to pay for child care. “So I had to make some kind of payment … I had no choice. I had to sell food stamps (to pay for child care).” In addition to selling public benefits to pay for care, mothers also exchanged benefits for child care. Claire, an African American mother from Boston, allowed her friend, Keisha, to live in her public housing apartment in exchange for providing child care for her two children. Claire risked being evicted by allowing Keisha to live with her because Keisha exceeded the number of individuals who could live in her subsided apartment. Claire was “willing to take that big of a risk in order to make her childcare arrangements work” and ensure that she could keep a good job that paid $3.00 an hour more than her previous job at a fast food restaurant, allowed her to work standard daytime hours, and provided health care benefits for herself and her children. In addition to having the means to pay for child care, another factor that allowed mothers to avert child care transitions was a match between what mothers needed and wanted from a child care provider and what providers were able to offer. Logistics, as well as mothers' relationships with their children's care providers shaped child care stability. In particular, mothers cited providers' flexible hours, including being open after traditional work hours or on holidays, and a willingness to accept child care subsidy vouchers and work patiently within the confines of the subsidy system as factors that allowed them to avert a transition. Jess, a non-Latino White mother of six living in Chicago, felt she was only able to maintain her care arrangement because her mother cared for her children and was willing to provide care for free while she

Other mothers focused on the ability to work through conflict and misunderstanding with their children's providers. Being able to have open communication in which mothers felt heard and had their feelings validated engendered better relationships with their children's providers and in turn greater child care stability. Arlene described an experience in which her daughter complained that her care provider had not allowed her to eat at the child care center. Arlene met with the director and provider and determined it was a misunderstanding, but in describing this, indicated the importance of advocating for her children. There were many mothers who were not shy about speaking up when they believed that their children were being mistreated; however, mothers who were able to work through disagreements with their provider(s) seemed to more successfully maintain arrangements. 3.4. Factors that contributed to forced and failed transitions Failed and forced transitions were the result of factors that originated with mothers and their children as well as with care providers. For example, mothers experienced failed transitions when they were unable to complete the paperwork necessary to enroll their children in a new care arrangement and when they identified a new care provider, but that provider was not accepting new children. Similarly, mothers experienced forced transitions when their employment or school schedule unexpectedly changed or their care provider unexpectedly ended the care arrangement. Child care transitions were both forced and failed due to multiple reasons including, transportation challenges, scheduling conflicts with the mother's work or school schedule, and the cost of care. A lack of reliable transportation forced some mothers to make changes to their child care arrangements. Vivian, an African American mother of three children from San Antonio, was forced to change child care arrangements after her attempts to drive her children to the center were stymied by a flat tire; an empty gas tank; and being stopped by the police who ticketed Chris, Vivian's husband, for driving without a license, failure to register the car, and being uninsured. Vivian and Chris had attempted to drive their children to child care after the center's bus was out of commission for three weeks. After pulling her children out of the child care center because she was unable to get them to the center, Vivian explained that in the future she might try to find another center, but it would be “somewhere that's closer, where I can walk.” Arranging transportation was more complex for mothers who had multiple children in different care arrangements. The mothers in our sample also experienced failed and forced transitions when they could not find child care for the hours they needed care. Failed transitions occurred when a mother wanted to change her care arrangement and identified a new provider, but that provider did not offer care during all of the hours that the mother needed care or had inconvenient or unworkable pick-up and drop-off times. Melissa, a non-Latino White mother of one child in Chicago, wanted to enroll her son in preschool through the public school system; however, the program ran from “9–11:20 or 11:20 to 2:20.” Frustrated, Melissa explained why this would not work for her: “Who's gonna pick him up after that? I can't do it! I have to work … Who's gonna take him? Who's gonna drop him off? I can't do that, I can't!”

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Other mothers were forced to transition to a new care provider when their work or school schedule shifted. Debby explained: At (the fast food restaurant where Debby worked) they started this breakfast thing. I had to be at work at 6:30 AM. The bus wouldn't come and pick them up until 8:00 AM. So I called the daycare and asked what time they opened and they said 7:00 AM. Well I gotta be in work before then. So I called (my social worker) and I told (her), is there another daycare in my area, or another daycare that will come and pick them up 6:30 AM? Mothers were unable to begin or continue using a care provider whose operating hours did not fit with the mothers' work or school hours. Mothers whose work hours were outside of traditional Monday through Friday, 8:00 AM to 6:00 PM work hours, seemed to have an especially hard time finding or maintaining supportive care arrangements. Mothers also experienced failed and forced transitions when they could not afford quality care. Mothers were often unable to remove their children from a care arrangement because they could not find an alternative they could afford. Stacey had previously used child care associated with a parent education and work training program in which she was enrolled. When she wanted to work one summer rather than attend the program she had to find a new care arrangement. She investigated a local center, but was unable to enroll her children when she realized she could not afford the $75 per child weekly fee. Mothers were also forced to leave care arrangements when they became too expensive, especially following the loss of a job or child care subsidy. After failing to “send in two monthly reports” Macy lost her subsidy money and had to remove her children from a child care center. Fortunately a family member was able to watch her daughter for free so Macy could keep her job at a local fast food restaurant. Some mothers were fortunate to have care providers who would work with them to help them afford care or facilitate their application for subsidies; however, other mothers lost out on preferred care arrangements when they could not afford the fees. The mothers in our sample also found themselves being forced to change care providers when their children displayed difficult behavior patterns. Alejandra, a Latino mother of three children from San Antonio, explained that her son, “used to stay with my next door neighbor, he only stayed with her twice, after that she said she couldn't do it because he kept crying, because he's not used to staying with anybody.” Mothers were also asked to remove their children from formal child care arrangements after their children missed an unacceptable number of days. Heather, a Bostonian mother of one, explained that she had to leave a child care program at the local Boys and Girls Club after: Things kept coming up, and I mean, I don't blame them for not reinstatin' me in there, because I kept saying I'm gonna come, I'm gonna come, make it routine, then I'd just take a week off, and you know they just got sick of hearin' my excuses, and I'm sure, you know, they probably thought half the time it wasn't even true, when it was. Just as a good match between the mother's needs and the services a provider was able to offer promoted planned transitions and allowed mothers to avert undesirable transitions, when there was a lack of fit between the mother's needs and what the provider was able to offer, mothers experienced failed or forced transitions. 4. Discussion Using a sample of 36 low-income mothers from Boston (n = 12), Chicago (n = 12), and San Antonio (n = 12) we explored the experience of child care instability. We found that low-income mothers experience both child care stability and instability and that both can be supportive or unsupportive of a family's overall well-being. We identified four kinds of transitions (see Fig. 1). Planned transitions occurred when mothers wanted to make a change to their child care

arrangement and were able to find and transition to a new arrangement that they felt provided high quality care and supported their ability to work or attend school. Mothers were able to avert a transition when they were able to continue using a preferred care arrangement. Forced transitions occurred when mothers were happy with their care arrangement but forced to transition to a new arrangement. Failed transitions occurred when mothers wanted to make a change to their child care arrangement but were unable to secure a new child care provider. We also identified factors that seemed to support and hinder mothers' efforts to secure and maintain preferred child care arrangements. As detailed below, our findings have implications for research on child care, as well as general, instability and policy and programmatic responses to help low-income families secure high quality child care and maintain stable employment. Our identification of four kinds of child care transitions questions the assumption found in much of the literature that child care instability negatively, and stability positively, impacts young children's development and mother's employment stability. This literature is grounded in attachment theory and suggests that frequent child care transitions may make it difficult for a child to form secure attachment relationships with his/her care providers, including parents and alloparents (Ahnert, 2005). Our findings suggest that considerations beyond the number of transitions, including shifts in quality of interactions with child care providers, are important to consider related to children's multiple and diverse attachment relationships. Additionally, child care instability is thought to challenge mothers' ability to maintain stable employment, especially when a child care provider's unexpected unavailability makes a mother unavailable for work or school. We found that some low-income mothers were able to plan for and successfully execute transitions to a preferred care arrangement. These planned transitions may not negatively impact children because mothers are able to help their children anticipate the change in care providers and move their children into higher quality care. As suggested by Lowe et al. (2003) these planned transitions should be distinguished from forced transitions, and policy and programmatic efforts should assume that families will experience some planned transitions and instead work to eliminate or lessen the impact of forced transitions. We also found that some mothers wanted to transition to a new care arrangement, but were unable to make these changes. These failed transitions question the assumption that stability is always positive. Some mothers in our sample were desperate to leave a child care arrangement that they found to be poor quality or even unsafe for their children, but were unable to find another care provider. Continuing to use poor quality child care may be more detrimental than multiple transitions. Our findings suggest that to understand the impact of child care stability and instability on child and parent outcomes, it is important to consider the quality of the care arrangements the child is transitioned into and out of. Most research on child care instability fails to explicitly consider child care quality, although some researchers have considered the type of care that children are transitioned into and out of (e.g., Pilarz & Hill, 2014). The failure to consider quality is likely due to limitations in existing datasets. Our findings support existing literature that cites the importance of financial resources, transportation and the availability of care during all of the hours that mothers work as important for helping mothers find and maintain preferred care arrangements (Henly & Lambert, 2005; Sandstrom & Chaudry, 2012). Many of the mothers in our sample reported struggling to afford what they felt to be high quality child care. Those who were able to maintain a preferred arrangement often had to go without in other areas to afford child care. Lack of efficient reliable transportation placed geographic limitations on which child care providers mothers were able to use and forced some families to leave otherwise preferred arrangements or not pursue higher quality care. Finally, several of the mothers in our sample were forced to leave a care arrangement or deterred from using one when the care providers' hours did not match the mothers' work or school schedule.

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Findings from this study also suggest that child care instability is closely related to and intertwined with stability and instability in other areas (e.g., employment, transportation, and housing). Mothers were forced to make changes to their child care arrangements when their work or school hours or location changed. When changes to mothers' employment could be anticipated, mothers were often able to plan the transition to a new care arrangement; when they were unanticipated, mothers were often forced from a preferred care arrangement into a temporary or less preferred arrangement. Finally, our findings demonstrate that child care stability can shape instability in other areas of low-income mothers' lives (Adams & Rohacek, 2010). For example, the mothers in our sample who maintained their child care arrangement by selling food stamps and allowing friends to illegally live in their subsidized housing jeopardized food and housing security in order to use a preferred care arrangement. Additionally, when mothers could not find a child care arrangement that provided care for all of the hours they worked or attended school, they had to choose between leaving work early or arriving late to pick up their children from child care. Although several researchers have investigated how instability in one area may lead to instability in another (e.g., Mills & Amick, 2010; Sandstrom & Huerta, 2013), fewer have considered how maintaining stability in one area may lead to instability in another in the context of limited resources.

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kind of stability or instability. A study that explores all three of these variables at once would allow for exploring how they are related and which conditions promote the best outcomes. Further, future work needs to more carefully examine quality of child care both in terms of experts' and families' definitions of quality, and how these shape outcomes for children depending on care used. In particular, parents may have differential ideas about quality and in turn, preferences related to logistics, beliefs, and values that need to be considered in terms of children's outcomes. Work towards examining multiple dimensions of and perspectives on quality in the early childhood education field, is underway. Specifically, the Office of Planning, Research, and Evaluation has released a measure that focuses on families' and providers' ideas of relationship quality (see http://www.acf.hhs.gov/programs/opre/ research/project/development-of-a-measure-of-family-and-providerteacher-relationship-quality-fptrq). Finally, future research could explore how the policy context impacts the type and amount of transitions that families experience. One aspect of child care subsidy policy that may be related to the type and number of child care transitions is whether or not subsidy money can be used to pay family, friend or neighbor care providers. Having access to these informal providers and subsidy money to pay them may expand a mother's network of potential care providers and/or help ease the transition between formal care providers.

4.1. Study limitations and strengths 4.3. Implications for policy and programs There are limitations to the present study that should be considered. The data used in this study were collected in the late 1990s and early 2000s. This timeframe should be taken into consideration when generalizing our findings to current day as policy and programmatic changes (most notably the introduction of quality rating and improvement systems and the expansion of resource and referral agencies) may have changed the experience of transitioning from one care arrangement to another. Additionally, our sample is comprised of families living in three urban centers, therefore our findings may not translate to mothers living in suburban or rural areas where there may be fewer child care providers and limited public transportation. This study's strengths should also be considered. We were able to take advantage of a large sample including three different policy contexts which is something of a rarity for a qualitative study. Using a sample that was collected in three different locations by three different teams of researchers limits bias that may be introduced by having one person or one team collect all of the data. We were also able to use interview and observation data from multiple (rather than a single) points in time. This allowed us to observe child care transitions as mothers were planning them, as they were making the transition, and as they were adjusting to a new care arrangement rather than relying on retrospective or prospective accounts of some aspects of the transition. 4.2. Future research Our findings suggest several areas for future research. As failed transitions have been largely ignored by the literature on child care instability, future research should attempt to understand the impact of longterm use of a non-preferred care arrangement for both children and mothers. Future research should also attempt to explore differences in the impact of planned transitions and forced or unanticipated transitions. Assuming that forced transitions lead to poorer outcomes than planned transitions it would be useful to understand the protective factors that help mothers move into high quality care even when faced with an unanticipated transition, as it is unlikely that forced transitions will ever be eliminated entirely. Additionally, the existing literature has explored the impact of the number of transitions as well as, to a lesser extent, the quality or kind of care that children are transitioned out of and into. Our study suggests that another important variable is the

Our findings have several implications for policy and programing. We found that, when mothers can, they invest time and effort in planning for and maintaining high quality care for their children that also allows them to work or attend school. Their planning should be supported with programs and policies that provide information about how to find, secure and maintain high quality child care. There should also be efforts to identify failed transitions and help mothers move their children into preferred care arrangements. Social workers should be encouraged to ask mothers if they are happy with their current care arrangement during office visits and support them in transitioning if they are not satisfied. Additionally, outreach from child care resource and referral agencies should be designed to help parents understand how to evaluate child care quality (including encouraging parents to use quality rating and improvement systems) and plan for and make transitions to ensure that they are using a preferred care arrangement. Additionally, policies and programs to help low-income families should consider the domino effect that occurs when instability in one area causes instability in other areas by offering services that address many aspects of families' lives (e.g., employment, health care, transportation, nutrition, and housing) or making it easy to access multiple services at once. Programs should work to ensure that mothers can maintain high quality care without sacrificing stability in other areas. The connections between child care and other aspects of low-income families' lives provide the opportunity to identify policy and programmatic solutions that address stability in multiple areas with one program. For example, the mothers in our sample were hindered in their ability to find and maintain preferred care arrangements when they lacked access to reliable and efficient transportation. It is conceivable that improving transportation systems would promote not just child care stability but also employment stability. Finally, child care subsidy policy should work to support planned transitions and mothers' efforts to avert undesirable transitions and reduce the number of failed and forced transitions. Subsidy policies that make subsidy receipt more stable may support child care and employment stability. Policies that may help achieve this goal include making redetermination easier and more efficient and allowing mothers a grace period after a job loss, so that a job loss does not result in a forced child care transition.

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5. Conclusion Stability is important to young children's healthy development and families' overall well-being, especially among low-income families. Child care is just one aspect of children's and families' lives. However, given the connections between child care, employment, transportation, housing and other aspects of low-income families' lives, it is necessary to understand child care stability and instability. This study expands our understanding of the complex dynamics of child care transitions and challenges the assumption in much of the literature that stability is always positive and instability always negative. Acknowledgments These analyses were conducted with support from the W.T. Grant Foundation and the General Review Board at the University of Maryland. We also acknowledge core support to the Three-City Study from the National Institute of Child Health and Human Development through Grants HD36093 and HD25936 as well as the support of many government agencies and private foundations. For a complete list of funders, see www.threecitystudy.johnshopkins.edu. References Adams, G., & Rohacek, M. (2010). Child care instability: Definitions, context, and policy implications. Washington, DC: The Urban Institute. Ahnert, L. (2005). The impact on attachment in humans. In C.S. Carter, L. Ahnert, K.E. Grossmann, S.B. Hrdy, M.E. Lamb, S.W. Porges, & N. Sachser (Eds.), Attachment and bonding: A new synthesis (pp. 229–244). Cambridge, MA: MIT Press. Ansari, A., & Winsler, A. (2013). Stability and sequence of center-based and family childcare: Links with low-income children's school readiness. Children and Youth Services Review, 35, 358–366. Barnas, M.V., & Cummings, E.M. (1994). Caregiver stability and toddlers' attachmentrelated behavior towards caregivers in day care. Infant Behavior and Development, 17, 141–147. Bradley, R.H., & Vandell, D.L. (2007). Child care and the well-being of children. Archives of Pediatrics & Adolescent Medicine, 161, 669–676. Bratsch-Hines, M.E., Vernon-Feagans, L., & Family Life Project Key Investigators (2013). Child care changes, home environment quality, and the social competence of African American children at age 3. Early Education & Development, 24, 1065–1081. Bromer, J., & Henly, J.R. (2009). The work–family support roles of child care providers across settings. Early Childhood Research Quarterly, 24, 271–288. Burger, K. (2010). How does early childhood care and education affect cognitive development? An international review of the effects of early interventions for children from different social backgrounds. Early Childhood Research Quarterly, 25, 140–165. Cahan, E., & Bromer, J. (2003). Trends in the history of child care and family support: 1940–1996. In R.P. Weissberg (Ed.), Long-term trends in the well-being of children and youth (pp. 207–228). Washington, DC: Child Welfare League of America Press. Chaudry, A. (2004). Putting children first: How low-wage working mothers manage child care. New York, NY: Russell Sage Foundation. Daly, K.J. (2007). Qualitative methods for family studies and human development. Thousand Oaks, CA: Sage Publications. Gordon, R.A., & Högnäs, R.S. (2006). The best laid plans: Expectations, preferences, and stability of child‐care arrangements. Journal of Marriage and Family, 68, 373–393. Ha, Y., Magnuson, K., & Ybarra, M. (2012). Patterns of child care subsidy receipt and the stability of child care. Children and Youth Services Review, 34, 1834–1844. Henly, J.R., & Lambert, S. (2005). Nonstandard work and child-care needs of low-income parents. In S.M. Bianchi, L.M. Casper, & B.R. King (Eds.), Work, family, health, and wellbeing (pp. 473–492). Mahwah, NJ: Lawrence Erlbaum Associates. Hofferth, S., & Collins, N. (2000). Child care and employment turnover. Population Research and Policy Review, 19, 357–395. Krefting, L. (1991). Rigor in qualitative research: The assessment of trustworthiness. The American Journal of Occupational Therapy, 45, 214–222.

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