Early Child Development and Care

Vol. 176, No. 2, February 2006, pp. 157–169

Increasing quality in early care and

learning environments
Nancy S. Fontainea*, L. Dee Torreb, Rolf Grafwallnerc and
Brian Underhillb
aFlorida A&M University, USA; bMGT of America Inc., USA; cMaryland State
Department of Education, USA
Taylor and Francis Ltd
GECD41072.sgm

(Received 24 August 2004)

000
000002005
Early
10.1080/0300443042000302690
0000-0000
Original
Taylor
2005 Childhood
&Article
Francis
(print)/0000-0000
Development
Group Ltd (online)
and Care

High-quality care is essential to the optimal development of young children. While many children
attend childcare away from the home for an average of six hours per day, the environment is not
necessarily of the highest quality. An assessment of the indoor and outdoor space, curriculum and
activities, teacher and child interactions, materials, equipment, nutrition and health factors can
yield critical information for parents and center administrators, teachers and staff. This study
provides outcome information in regard to a state-funded Enhancement Grant project in which
childcare facilities’ personnel were provided with professional development activities to assist them
in evaluating their early care and learning programs, and planning and implementing enhancement
activities. After three years, a significant improvement resulted in several areas critical to high-
quality care for young children.

Keywords: Early care; Learning environments; Quality

Introduction
There is a long-held acceptance of the importance of the stimulating learning oppor-
tunities in regard to the healthy development and physical well-being of children. This
understanding has expanded to include the critical nature of early care on social and
emotional development as well Current emphasis is on a biological basis for the widely
held belief that a loving, safe, stimulating environment fosters healthy development
(Croan et al., 2000). Recent findings substantiate the critical role of the environment
for optimal neurological development, particularly in the early years (Caine, 1998).

*Corresponding author. Preschool and Prekindergarten/Primary Education Program, Florida

A&M University, USA.

ISSN 0300-4430 (print)/ISSN 1476-8275 (online)/06/020157–13

© 2006 Taylor & Francis
DOI: 10.1080/0300443042000302690
158 N. Fontaine et al.

At birth, a child’s brain is about 25% of its approximate weight at adulthood. By age
three, the child’s brain has reached about 90% of its full potential. The major impli-
cation of this information is the realization that early care and learning environments
impact the brain structure and development of skills.
At the same time, nationally, over 60% of children ages five or younger are in child-
care on a regular basis, and more than 40% of infants are in childcare for more than
30 hours a week (Hofferth & Sandler, 1996). Additionally, the number of dual-income
families and single parents is increasing, resulting in less parental care at home and
more use of childcare in centers and family homes. Consequently, it is critical to
ensure the availability of quality childcare and comprehensive developmental
programs that assist families in preparing children to be ready for school and lifetime
opportunities.

Outcomes of quality early care

Results of a recent study (Croan et al., 2000) report that approximately 31% of
kindergarten students had at least one health or physical challenge, 20% lagged
behind in cognitive development, and 31% were behind in social and emotional
development Concurrently, participation in a quality early care and education
program has been shown to enhance child performance outcomes (Peisner-Feinberg
et al., 1999). When childcare settings provide appropriate learning opportunities and
have caregivers who are emotionally supportive and responsive to children’s needs,
children are happier, and have closer and more secure attachments to caregivers
(Burchinal et al., 2000).
According to the NICHD Early Child Care and Research Network (1998) the quality
of early care is the number one predictor of child behavior. Similarly, Booth (2002)
concluded that children with significant developmental delays or biomedical risk
factors, who were exposed to quality early environments, showed more appropriate
adaptive behaviors. It is also widely accepted that high-quality childcare enhances
cognitive developmental and socialization of children, regardless of ethnicity (Burchinal
et al., 2000).
Quality early care and education programs are a precursor to optimal school
readiness Preschoolers who perform well on standardized cognitive tests had caregiv-
ers with higher levels of education and relevant training. These children also have
better language skills, are more persistent in completing tasks and are better prepared
for school (Vandell & Wolfe, 2000). In the Carolina Abecedarian Project
(www.fpq.unc.edu), children from low-income families who received full-time, high-
quality childcare from infancy through age five had higher cognitive test scores
though age 21 than those who did not attend such a program. Specifically, academic
achievement in reading and mathematics was higher for this population, and they
were more likely to continue their education to college. The Perry Preschool Project
(www.highscope.org) provided similar results about the value of comprehensive and
quality care to three to four years olds. This long-term study tracked the participants
through age 27. On average, those in the Project had fewer arrests, earned on average
 Quality in early care and learning environments 159

$2000 more each month, owned their own homes, graduated from high school or
received a GED, and had higher achievement scores at age 14 and literacy scores at
age 19 than their counterparts with similar social and economic challenges.

Quality early education and care components

Moss (1994) states that quality in early childhood programs is a relative concept due
to changes in values, beliefs, needs and definitions. Therefore, quality must be contin-
ually redefined according to how components of quality that have been operational-
ized. In general, all the traits of the standard definitions of quality can be observed.
Core elements that are recognized as being necessary for children’s positive devel-
opment include: safe care where adults supervise activities that are appropriate for chil-
dren’s ages and abilities; healthy care with children having opportunities for rest,
nutritious snacks and meals, and developing self-help skills; choice of developmentally
appropriate and stimulating opportunities; adult interactions where trust, social behav-
iors, language and communication skills can be learned; environments that encourage
children to become independent, cooperative and competent; and peer relationships
with other children that support their social and emotional development (Cryer, 1999)
A critical feature of any high-quality early care and learning program is knowledge-
able and skilled staff. There is increasing evidence that exposure to positive relation-
ships with adults can assist in protecting a child from negative early experiences that
are especially important to early development (NICHD Early Child Care and
Research Network, 1999). Young children who receive continual of care by trained
adults who understand and implement developmentally appropriate curriculum and
activities are better equipped for life’s academic and social emotional experiences
(Schweinhart & Weikart, 1985; Peisner-Feinberg et al., 1999; Howes et al., 2000
Kagan et al (1995) found that formal training in early childhood education yields not
only higher quality teacher behaviors, but can be linked to improved child outcomes.
Teacher training shows more significant results than years in service and education
level in regard to language facilitation, concept promotion and quality caregiving
according to Hirallal and Honig (1998).

Enhancement Grant project

Many state and local agencies have made quality of early care environments a priority
Maryland’s State Department of Education initiated the Enhancement Grant
program to provide funds to state-regulated providers of early childcare and education
services to enhance program quality. Enhancement grants were awarded to lead
agencies that, in turn, distributed funding to center-based and family-based childcare
providers across 17 counties in Maryland. Enhancement Grants made funds available
to early childcare and education service providers to assist them in obtaining accred-
itation, and to provide professional development activities leading to increased staff
competencies and credentials. In the first two years of funding, the Enhancement
Grant awards totaled $1,095,844, which were awarded to 43 agencies. In the second
160 N. Fontaine et al.

year (FY02) and third year (FY03) of funding, awards to the 42 agencies totaled
$495,968 per year.
Center-based programs are operated by private or public providers who are
licensed by the state Center-based staff typically include administrators, teachers and
other support personnel such as assistants. Licensed family childcare programs are
operated by an individual who provides care for children in his/her home (In some
cases, the family childcare programs also include another adult who acts as an assis-
tant to the primary provider). Program quality was monitored and goals for improve-
ment were developed by setting standards for the state’s early childhood programs
and the staff who provide early care and education services.
The grants support a system of consistent, quality early childhood education by:
increasing the number of children who are cared for within stimulating environments
that are conducive to developmental growth and school readiness; improving families’
awareness of quality early care and education; providing professional growth oppor-
tunities for staff working with young children; increasing public recognition of and
access to quality programs; and coordinating national or state program accreditation
processes.
Enhancement Grant funds were used to pay for tuition to colleges, books for classes,
monetary incentives for staff who have completed identified course work, professional
and staff development activities, salary enhancements, equipment and educational
materials, project evaluation and fees for program or center accreditation.

Methods
Description of the sample
On-site observations were conducted for a representative sample of Enhancement.
Grant recipients. The sample was chosen based on the type of grant (family-based or
center-based), the regions of the state, and the round of the grant (Round One’s grant
period extended from 1 January 2001, and Round Two’s grant period extended from
1 April 2002, through 30 September 2002). This regional distribution began with 33
center-based programs and 18 family-based sites that were chosen in the initial
assessment conducted in the first year of the project. Over the two year assessment,
attrition from the program reduced the sample to 29 center-based and 14 family
providers by the third year. For the purpose of this study, only the results of the
center-based program are reported.

Assessment instruments
The Early Childhood Environment Rating Scale (ECERS) instrument, developed by
Thelma Harms, Richard M Clifford, and Debby Cryer from the Frank Porter Graham
Child Development Center, was selected to be used to assess the center-based
programs. This instrument is used nationally and internationally to evaluate the
quality of early care programs ECERS has undergone rigorous field testing, utilization
 Quality in early care and learning environments 161

and revision through focus group discussion by experts in the field High scores on the
ECERS assessment have been associated with later higher student outcomes.
Overall, the ECERS is reliable at the indicator and item level, and at the level of
the total score. The percentage of agreement across the full 470 indicators is 86.1%,
while at the item level the agreement was 48% for exact agreement and 71% of agree-
ment within one point. For the total score, the correlations between two observers
were 0.921 product moment (Pearson) and 0.865 rank order (Spearman). The inter-
class correlation was 0.915. The internal consistency of the scale at the subscale
ranged between 0.71 and 0.88, and that for the total score scale was 0.92. Numerous
tests have resulted in a high content or face validity rating for the ECERS. High scores
on ECERS were found to correlate positively with quality childcare environments.
The ECERS instrument has been used in research to provide feedback on the quality
and needs of early childhood programs. The ECERS instrument provides adminis-
trators, teachers, family providers, other professionals and parents with valuable infor-
mation for program improvement and readiness for accreditation. The instrument
continues to be used by programs for self-assessment and improvement of services for
children and families, accreditation and staff development. States throughout the
nation recommend instruments such as the ECERS to rate programs, as part of a
purchase of care-tiered reimbursement system and to award special enhanced funding
or recognition. Other uses include guiding student field placement experiences, relat-
ing child development to curriculum, and mentoring or assisting staff in applying
scientifically based research practices within their classrooms. The assessment instru-
ment is appropriate for evaluating both inclusive and culturally diverse programs.
The ECERS includes seven subscales that encompass all the standards for program
quality: Space and Furnishings, which provide for the indoor and outdoor environ-
ment; Personal Care Routines such as hand washing, safety and health practices,
nutrition and toileting/diapering; Language-Reasoning, including the use of books,
materials, and activities to enhance communication, language development and early
literacy; Activities, representing areas and curricula that enhance learning and cogni-
tive development and interaction between adult and child and among children,
including working with children with disabilities; Interaction, communication
between adult and child or between child and child; Program Structure, including
routines and daily schedules; and a supplemental subscale for Parents and Staff (not
used in the Enhancement Grant Program assessment).

Results
Figure 1 provides comparison data on the range of composite mean ECERS scores
of classrooms in childcare programs across all six subscales. In fall 2001, programs in
two classrooms were rated as inadequate, 23 were rated as minimal, and eight were
rated as good. By spring 2003, no program was rated as inadequate, 14 were rated as
minimal and 17 were rated as good.
Figure 2 provides a comparison of the mean item scores of the fall 2001 ECERS
Figure 1.Distribution
Source: Range of of
ECERS
Mean composite
ECERS Scores
meanfor
scores
Enhancement
based on observations
Grant Classrooms
of Enhancement
(n = 32), MGT
GrantAmerica
programs
Incin2003
a sample of Maryland school districts

observations of the center-based childcare programs assessed. The data show that the
162 N. Fontaine et al.

Figure 1. Range of ECERS composite mean scores based on observations of Enhancement Grant
programs in a sample of Maryland school districts

overall quality of childcare programs improved significantly as a result of the Enhance-

ment Grant project. (Statistical significance of −3.80 is at the 95% confidence level
with a t-critical value of 2 0395). The overall mean in fall 2001 was 4 18, while the
mean increased to 4.91 in spring 2003 ECERS assessments of 37 items in the six
subscales used (mean difference of 0.73). In addition, the increases of four of six
subscales were statistically significant. These included Space and Furnishings
(increase of 0.96), Personal Care Routines (increase of 0.74) Language and Reasoning
(increase of 0.83), and Activities (increase of 0.97).
All subscale mean scores increased or remained constant from the fall 2001 to spring
Figure 2.Distribution
Source: Distribution
of Mean
of mean
ECERS
subscale
Scores
scores
for on
Enhancement
ECERS based
Grant
on Classrooms
observations(nof=Enhancement
32) MGT of America.
Grant classrooms
Inc. 2003in a sample of Maryland school districts

2003 assessment except Program Structure, which decreased by 0.06 (see Table 1).
None of the subscale mean scores were below 4.00 in the spring 2003 assessment,
while the fall 2001 assessment resulted in two subscale mean scores below 4.00
(Personal Care Routines and Activities). The lowest mean subscale score was in
Activities for both assessments. The spring 2003 mean scores for the six categories
ranged from 4.52 to 5.48, in comparison with the previous mean range of 3.55–5.19.
The mean score for 86% of the 37 items increased in spring 2003 from the initial
fall 2001 assessment. Large increases were noted in the appropriate use of television,
 Quality in early care and learning environments 163

Figure 2. Distribution of mean subscale scores on ECERS based on observations of Enhancement

Grant classrooms in a sample of Maryland school districts

video and/or computer, safety practices, nature/science, schedule, space for privacy
and toileting/diapering. Five items—furnishings for routine care, play and learning;
staff–child interactions; interactions among children; program schedule; and group
time—were rated at least 6.00 in the spring 2003 assessment.
Five items—health practices, nap/rest, supervision of gross motor activities,
provisions for children with disabilities, and staff–child interaction—resulted in a
slightly lower mean rating from the fall 2001 to spring 2003 assessment. No items
scored an inadequate rating in spring 2003 compared with six items from the fall
2001 observation.
Table 2 presents the specific percentage of classrooms scoring in each of the four
rating categories in the fall 2001 and spring 2003 ECERS assessments. In the Space
and Furnishings subscale, there was great improvement in all eight items. This
improvement particularly includes:

● Indoor space—a 25 percentage point increase in the programs rated as excellent,

resulting in a 41 percentage point decrease in those rated as minimal.
● Room arrangement for play—a 15 percentage point increase in the programs rated
164 N. Fontaine et al.

Table 1. Summary of observations using ECERS to measure Enhancement Grant program

quality (mean scores, n = 32)

Mean

Fall Spring
Item 2001 2003 Change Statistic

Space and Furnishings 4.10 5.06 0.96 −5.33*

1. Indoor space 4.78 5.72
2. Furniture for routine care, play and learning 6.19 6.47
3. Furnishings for relaxation and comfort 2.85 4.22
4. Room arrangement for play 4.30 5.38
5. Space for privacy 2.85 4.44
6. Child-related display 4.00 4.44
7. Space for gross motor play 2.74 4.13
8. Gross motor equipment 4.52 5.72
Personal Care Routines 3.91 4.65 0.74 −3.73*
9. Greeting/departing 5.26 5.65
10. Meals/snacks 2.63 3.84
11. Nap/rest 4.81 4.42
12. Toileting/diapering 4.07 5.56
13. Health practices 2.93 2.75
14. Safety practices 3.81 5.69
Language-Reasoning 4.55 5.38 0.83 −2.82*
15. Books and pictures 4.26 5.22
16. Encouraging children to communicate 4.85 5.63
17. Using language to develop reasoning skills 3.81 4.97
18. Informal use of language 4.93 5.72
Activities 3.55 4.52 0.97 −6.10*
19. Fine motor 3.89 5.06
20. Art 3.81 4.69
21. Music/movement 4.07 4.97
22. Blocks 3.67 4.22
23. Sand/water 3.81 4.28
24. Dramatic play 3.52 4.28
25. Nature/science 2.19 3.97
26. Math/numbers 4.19 4.91
27. Use of TV, video, and/or computer 2.57 4.84
28. Promoting acceptance of diversity 3.00 4.13
Interaction 5.19 5.48 0.29 −1.29
29. Supervision of gross motor activities 4.61 3.48
30. General supervision of children (other than 5.11 5.91
gross motor)
31. Discipline 4.89 5.88
32. Staff-child interactions 6.11 6.00
33. Interactions among children 5.19 6.26
 Quality in early care and learning environments 165

Table 1. Continued

Mean

Fall Spring
Item 2001 2003 Change Statistic

Program Structure 4.76 4.70 −0.06 −0.10

34. Schedule 4.37 6.00
35. Free play 4.70 5.65
36. Group time 4.74 6.16
37. Provisions for children with disabilities** 4.00 3.25
Overall mean 4.18 4.91 0.73 −3.80*

Source: MGT of America Inc., spring 2003.

*Statistical significance at the 95% confidence level (a t-critical value of 2.0395)
**This item had very few respondents: two in fall 2001; five in spring 2003

as excellent and those rated as good, resulting in an 18 percentage point decrease

in the programs rated as minimal.
● Space for gross motor play—a 19 percentage point increase in the programs rated
as excellent or good, resulting in a decrease in a 35 percentage point decrease in
the programs rated as inadequate, or minimal.
Several items in the Space and Furnishings subscale, while still rated in the lower
categories (inadequate to minimal), merit further consideration.
● Furnishings for relaxation and comfort—a 47 percentage point decrease in the
programs rated as inadequate, resulting in an increase in those rated as minimal,
good or excellent.
● Space for privacy—a 38 percentage point decrease in the programs rated as inade-
quate, resulting in an increase in the percentage rated as minimal, good and excellent.
For the Personal Care Routine, five of the six items showed improvement in the
spring 2003 assessment. There was particular improvement in one item.
● Safety practices—a 59 percentage point increase in the programs rated as excellent,
resulting in a substantial decrease in those rated as inadequate, minimal or good
A high percentage of programs still scored low in one item for Personal Care Routine
● Health practices—a 12 percentage point increase in the programs rated as inade-
quate (from 72% in fall 2001 to 84% in spring 2003)
For the Language-Reasoning subscale, ratings improved in all four items. A similar
gain was shown for three items. An increase was particularly evident in the following
item.
● Encouraging children to communicate, Books and pictures, and Informal use of
language—programs rated as excellent increased by 16 percentage points.
166 N. Fontaine et al.

Table 2. Summary of observations using ECERS to measure Enhancement Grant program

quality (score distribution, n=32)

Not
Inadequate Minimal Good Excellent Applicable

Fall Sprg Fall Sprg Fall Sprg Fall Sprg Fall Sprg
2001 2003 2001 2003 2001 2003 2001 2003 2001 2003

Space and Furnishings

1. Indoor space 13% 16% 44% 3% 16% 28% 28% 53% 0% 3%
2. Furniture for routine 6% 0% 6% 13% 22% 16% 66% 72% 0% 0%
care, play, and learning
3. Furnishings for 50% 3% 34% 66% 9% 22% 6% 9% 0% 0%
relaxation and comfort
4. Room arrangement for 0% 0% 66% 41% 16% 25% 19% 34% 0% 0%
play
5. Space for privacy 44% 6% 41% 59% 6% 9% 9% 25% 0% 0%
6. Child-related display 19% 13% 53% 41% 28% 44% 0% 3% 0% 0%
7. Space for gross motor 66% 47% 16% 0% 16% 31% 3% 22% 0% 0%
play
8. Gross motor equipment 19% 19% 34% 3% 6% 9% 41% 69% 0% 0%
Personal Care Routines
9. Greeting/departing 16% 6% 6% 31% 25% 3% 53% 56% 0% 3%
10. Meals/snacks 63% 34% 19% 34% 13% 19% 6% 13% 0% 0%
11. Nap/rest 13% 9% 41% 63% 13% 9% 31% 16% 3% 3%
12. Toileting/diapering 47% 22% 6% 6% 9% 3% 38% 69% 0% 0%
13. Health practices 72% 84% 6% 3% 13% 0% 9% 13% 0% 0%
14. Safety practices 44% 19% 19% 6% 22% 3% 13% 72% 3% 0%
Language-Reasoning
15. Books and pictures 13% 0% 50% 56% 19% 9% 19% 34% 0% 0%
16. Encouraging children 6% 9% 38% 13% 41% 47% 16% 31% 0% 0%
to communicate
17. Using language to 25% 22% 50% 13% 9% 38% 16% 28% 0% 0%
develop reasoning skills
18. Informal use of 9% 3% 41% 31% 13% 13% 38% 53% 0% 0%
language
Activities
19. Fine motor 19% 0% 47% 56% 22% 13% 13% 31% 0% 0%
20. Art 16% 0% 69% 63% 6% 13% 9% 25% 0% 0%
21. Music/movement 28% 13% 28% 25% 38% 44% 6% 19% 0% 0%
22. Blocks 25% 6% 53% 66% 22% 28% 0% 0% 0% 0%
23. Sand/water 13% 19% 63% 41% 16% 28% 9% 13% 0% 0%
24. Dramatic play 19% 6% 69% 66% 13% 28% 0% 0% 0% 0%
25. Nature/science 59% 31% 38% 41% 3% 9% 0% 19% 0% 0%
26. Math/number 3% 0% 69% 63% 16% 13% 13% 25% 0% 0%
 Quality in early care and learning environments 167

Table 2. Continued

Not
Inadequate Minimal Good Excellent Applicable

Fall Sprg Fall Sprg Fall Sprg Fall Sprg Fall Sprg
2001 2003 2001 2003 2001 2003 2001 2003 2001 2003

27. Use of TV, video, and/ 28% 13% 19% 19% 6% 6% 3% 22% 47% 41%
or computers
28. Promoting acceptance 31% 13% 50% 53% 13% 31% 6% 3% 0% 0%
of diversity
Interaction
29. Supervision of gross 6% 44% 34% 9% 41% 34% 6% 9% 13% 3%
motor activities
30. General supervision of 13% 6% 25% 13% 34% 22% 38% 59% 0% 0%
children (other than gross
motor)
31. Discipline 3% 3% 34% 19% 44% 19% 19% 59% 0% 0%
32. Staff–child interactions 9% 13% 9% 6% 25% 6% 56% 75% 0% 0%
33. Interactions among 13% 3% 34% 13% 9% 13% 44% 69% 0% 3%
children
Program Structure
34. Schedule 31% 13% 31% 9% 3% 6% 34% 69% 0% 3%
35. Free Play 9% 3% 44% 22% 19% 38% 28% 34% 0% 3%
36. Group time 22% 3% 16% 9% 16% 22% 47% 63% 0% 3%
37. Provisions for children 0% 13% 3% 6% 0% 0% 3% 6% 94% 75%
with disabilities

Source: MGT of America, Inc. spring 2003

Totals for each reporting period may not equal 100% due to rounding

The majority of programs in this subscale are still rating low in the following item.
● Books and pictures—56% of programs are scoring minimal
Inadequate scores still remain constant for programs in one area.
● Using language to develop reasoning skills—22% of programs is still inadequate in
this area.
For the Activities subscale, 9 of 10 items showed improvement for many programs in
either the good or excellent ratings. The largest change resulted for two items.
● Nature/science—an increase from no programs scoring excellent in fall 2001 to
19% in spring 2003
● Use of televisions, video, and/or computers—an increase from 3% to 22% of
programs scored as excellent, resulting in a decrease in those scored as minimal.
168 N. Fontaine et al.

Even though there was improvement for most of the items in the Activities subscale,
the majority of programs are still rating as inadequate or minimal. Particularly low is
Blocks, which had 72% of the programs scoring as inadequate or minimal in spring
2003. Two items, blocks and dramatic play, had no programs scoring as excellent for
both assessment periods.
For the Interaction subscale, programs scoring excellent increased in all five items
by between 3 percentage points (supervision of gross motor activities) and 40
percentage points (discipline).
All four of the scored items in Program Structure showed improvement in the
excellent category. Increases ranged from 3 percentage points (provisions for children
with disabilities) to 35 percentage points (schedule).

Conclusions
Analysis of the data, particularly those of the comparison of the pre–post assessments,
results in several conclusions. Overall, improvement in quality resulted for center-
based programs participating in the Enhancement Grant program. The vast majority
of Enhancement Grant providers improved greatly on most items included on the both
the ECERS assessment. The items that were measured are essential elements of a
developmentally appropriate program. In turn, programs that scored high are of higher
quality and better prepared for a successful state or national accreditation process.
Program providers were rated high in the Adult Needs subscale on the assessment.
Included in this subscale is the item that reflects opportunities for professional growth
(e.g. the overall purpose of Maryland’s Enhancement Grant project).
Enhancement Grant programs improved the quality of the learning environment
for children in their care ECERS scores for center-based programs indicate that there
was a statistically significant increase in Language and Reasoning (helping children
understand and use language), which is a primary focus area for enhancing school
readiness (from 3.55 to 4.52—indicating a 0.97 percentage point increase).
Individual items on which to particularly concentrate future improvement efforts
are on one of the lowest and most essential items—that is, diapering/toileting (specif-
ically adult and child hand washing) and program structure for childcare programs.
Care should also be taken with ensuring that programs continue to provide training
and support to providers in the provision of appropriate basic care, while improving
on promoting early learning.

Summary
The Enhancement Grant project was one effort to improve the quality of early child-
hood programs. All participating childcare centers were committed to undergoing
several assessments; to using the assessment results to improve their curricula,
activities and practices; to enhancing their programs through professional develop-
ment opportunities for staff and administrators; and to preparing for state and
national accreditation. As a result of this initiative of professional development and
 Quality in early care and learning environments 169

support, the quality of early learning and care environments increased to better serve
young children and their families. Continued assessment using the ECERS or other
reliable instruments can provide valuable information to the participating childcare
centers in regard to future improvement activities needed.

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