Caregiver-infant/toddler interactions during diapering: associations with well-being and involvement

Abstract

Diaper changes, as an aspect of care for implementing quality caregiver-child interactions in infant and toddler non-parental care settings is examined. First, this study proposes a theory of care that specifically addresses bodily care routines as a main tenet of infant and toddler curriculum and pedagogy guided by elements of theories that relate to child well-being and developmental support. Using elements of Bronfenbrenner's (2001) Proximal Processes (PPCT), Nodding's (1984) Care theory, Vygotsky's (Goldstein, 1999) Zone of Proximal Development (ZPD),and Pikler's approach to infant and toddler caregiving provide a framework to re-envision diapering routines, caregiver practices, and child involvement. Second, two standardized tools were used during 226 classroom observations of diaper changes by 49 caregivers, with 113 infants' and toddlers' in 30 infant and toddler classrooms in a Midwest US city. The Parenting Interactions with Children: Checklist of Observations Linked to Outcomes and The Process-Oriented Self- Evaluation Instrument for Care Settings (PSIC) were used to examine caregiver interactions and child well-being and involvement. Strong positive correlations between caregiver interactions and child well-being and involvement were found with differences between caregiver roles. Caregiver responsiveness and encouragement strongly predict child well-being and involvement. Extant data on global measures of quality were available and analyzed. Third, two diaper change vignettes, one using questions from The Newborn Behavior Observation (NBO) and the PICCOLO are used to re-envision and explore how diapering can be transformed from a hurried routine to an opportunity to enhance child well-being and involvement.