Primary Care

In a primary care system, each child is assigned to one special infant care teacher who is principally responsible for that child’s care. When children spend a longer day in care than their primary care teacher does, a second care teacher is assigned to provide  the primary relationship. Each child should have a special care teacher assigned to him or her at all times during the child care day. Teaming is also important. Primary care works best when teachers team up, support each other, and provide a backup base for security for each other’s primary care children. Primary care does not mean exclusive care. It means, however, that all parties know who has primary responsibility for each child.

Small Groups

Every major research study on infant and toddler care has shown that small group size and good ratios are key components of quality care. PITC recommends primary care ratios of 1:3 or 1:4, in groups of 6-12 children, depending on the age. The guiding principle is the younger the child, the smaller the group. Small groups facilitate  personalized care that infants and toddlers need, and support peaceful exchanges, freedom and safety to move and explore, and the development of intimate relationships.

Continuity of Care

Continuity of care is the third key to providing the deep connections that infants and toddlers need for quality child care. Programs that incorporate the concept of continuity of care keep primary caregivers and children together throughout the three years of the infancy period, or during the entirety of the child’s enrollment in care as an infant. 

Individualized Care

Following children’s unique rhythms and styles promotes well-being and a healthy sense of self. Children need to feel positively about their biological rhythms or needs that may differ from those of other children.

Responding promptly to children’s individual needs supports their growing ability to self-regulate, (i.e., to function autonomously in personal and social contexts). The program adapts to each child, rather than vice versa and the children get the message that each of them is important, that their needs will be met, and that their choices, preferences, and impulses are respected.

Culturally Responsive Care

Children develop a sense of who they are and what is important through life through cultural experiences. Traditionally, the child’s family and cultural community have been solely responsible for the transmission of values, expectations, and ways of doing things, especially during the early years of life. As more children enter child care during the tender years of infancy, their cultural identity and sense of belonging in their own families are influenced by their experience in care. Consistency of care between home and child care, always important for the very young, becomes even more so when the infant or toddler is cared for in the context of cultural practices different from those of the child’s family. Because of the important role of culture in development, infant care teachers who work with families from diverse backgrounds need to:

  • heighten their understanding of the importance of culture in the lives of infants; 
  • develop cultural competencies; 
  • acknowledge and respect cultural differences; and
  • learn to be open and responsive to different culturally based practices, and willing to negotiate with families about child rearing. In working together with families to create cultural continuity between home and the child care program, infant care teachers can facilitate the optimal development of each child.

Inclusive Care

Inclusive care means making the benefits of high-quality care available to all infants through appropriate accommodation and support, so that each child can actively and fully participate in the program.  The PITC’s, relationship-based approach to care, which is individualized and responsive to each child’s cues, needs, and interests, facilitates the inclusion of children with disabilities or delays. Infants who have responsive, enduring relationships develop emotional security, which provides a foundation for social competence and resilience. Individualized care supports inclusion through allowing children to learn and grow in their own way and at their own pace.

Developed by J. Ronald Lally and Peter L. Mangione. © WestEd, The Program for Infant/Toddler Care.