Infant daycare and otitis media: Multiple influences on children's later development

Using a cumulative risk framework, this study explored how chronic middle-ear disease (otitis media), the age at which children first began daycare, and the quality of daycare related to children's social and verbal behavior at 7 years of age: singly, additively, or in interaction with each other. Multiple regression analyses indicated that children with the highest "risks" (low-quality daycare, chronic otitis media, late entry into daycare) for social or behavioral problems were the most shy and withdrawn with their friends at 7 years of age. Verbal behavior and ability were predicted by quality of care and experience with otitis media. Higher quality daycare was related to higher verbal ability, and chronic otitis media was related to lower verbal ability. These results support the hypotheses that children's early experiences have lasting influences into middle childhood.