Health Reports
Child care for young children with disabilities

Abstract

Background

More than half (56%) of Canadian children aged 0 to 5 years are in non-parental child care, but data on child care attendance among children with disabilities is limited. This study examines child care participation among young children with disabilities in Canada, with a focus on different disability types.

Data and methods

Analyses were conducted on 1,189 children aged 0 to 5 years identified with disabilities from Statistics Canada’s 2023 Survey on Early Learning and Child Care Arrangements – Children with Long-term Conditions and Disabilities. Rates of child care participation, difficulties finding child care, difficulties within child care, and whether parents reported that their child had ever been denied a child care space because of their condition were examined. Logistic regression models tested for differences in the main child care arrangement and difficulty finding child care based on the child’s disability while controlling for sociodemographic variables.

Results

Among children aged 0 to 5 years with disabilities, 45%  attended a daycare centre, preschool, centre de la petite enfance, or before or after school care as their main child care arrangement; 17% attended another type of child care, such as a family child care home or care by a relative; and 38% did not regularly attend non-parental child care. The parents of nearly half of children with disabilities reported difficulty finding a child care arrangement, particularly for children with emotional conditions. Close to 1 in 10 parents of children with disabilities who were using child care reported that their child had been denied a child care space because of their condition.

Interpretation

These findings highlight the need for information to support inclusive policies, practices, and resources for children with disabilities within the Canada-wide early learning and child care system.

Keywords

young children, child care, disabilities, inclusion, Canada

Authors

Stacie Kerr and Leanne Findlay are with the Health Analysis Division at Statistics Canada. Rubab Arim is with the Social Analysis and Modelling Division at Statistics Canada.

 

What is already known on this subject?

• Recent and nationally representative statistics are available on child care for the overall population of Canadian children aged 0 to 5 years (e.g., rates of participation, types of arrangements used, and difficulties finding care).
• The Multilateral Early Learning and Child Care Framework and provincial and territorial agreements and action plans for a Canada-wide early learning and child care system outline a commitment to inclusive and accessible child care. However, little is known about the child care participation of children with disabilities.

What does this study add?

• Just over 6 in 10 children aged 0 to 5 years with disabilities were attending non-parental child care.
• Parents of children with disabilities reported experiencing difficulties in finding and using child care, and about 1 in 10 parents of children with disabilities who were using child care reported that their child had been denied a space in child care because of their condition.
• Results suggested that the main child care arrangement did not differ by disability type, although parents of children with emotional conditions were particularly likely to report having difficulty finding child care.

Introduction

Before formal schooling, child care is the primary environment in which young children spend their time outside the family, with 56% of Canadian children aged 0 to 5 years participating in non-parental child care.^Note 1 The United Nations Convention on the Rights of the Child (CRC) recognizes that children with physical or mental disabilities have the right to actively participate in society, including in child care settings. Bill C-35, the Canada Early Learning and Child Care Act, sets out a vision for a Canada-wide early learning and child care (CWELCC) system, emphasizing a rights-based approach in line with the CRC, the Convention on the Rights of Persons with Disabilities (CRPD), and other human rights frameworks.^Note 2, ^Note 3

Despite human rights commitments and the numerous benefits of inclusive child care for children with disabilities and their families, very little is known about child care participation among children with disabilities in Canada. High-quality inclusive child care has been shown to have advantages for children’s development, specifically for children with disabilities.^Note 4, ^Note 5, ^Note 6 Moreover, access to child care can benefit children with disabilities and their families by providing children with opportunities to participate in early learning programs and social activities with their peers in an inclusive environment. It also offers parents access to supports for their child, and enables them to work.^Note 7, ^Note 8, ^Note 9

In Budget 2021, the Government of Canada pledged over $27 billion over five years to build a CWELCC system, although regulations, subsidies, and policies and supports for inclusion fall under provincial and territorial jurisdiction. The Multilateral Early Learning and Child Care Framework states that provinces and territories will build child care systems by addressing priorities that affect families “more in need,” such as those with “children with varying abilities.”^Note 10 Apart from Quebec, which has an asymmetrical agreement with the Government of Canada, all jurisdictions specify objectives relating to the inclusion of children with disabilities and other underserved population groups in their agreements and action plans with the federal government.^Note 11 The 2022 Federal Budget’s Enabling Accessibility Fund designated funds to create accessible child care spaces nationwide.

National data on young children with disabilities in Canada

National data sources to identify and study young Canadian children with disabilities are limited.^Note 12, ^Note 13 The last disability survey to cover young children, the 2006 Participation and Activity Limitation Survey, found that 2% of children aged 0 to 4 years had a disability, and 52% of these children were attending some form of child care.^Note 14 More recently, the 2019 Canadian Health Survey on Children and Youth indicated that 4% of children aged 2 to 4 years had at least one functional difficulty, and 56% of these children attended child care on a regular basis.^Note 15

Child and family characteristics related to child care use

Canadian studies show that children from low-income households, with immigrant parents, and with parents with less formal education are less likely to be in child care.^Note 16, ^Note 17 Children in lone-parent families are more likely to attend child care centres than home-based care, but are not more or less likely to be in child care overall.^Note 16, ^Note 18 Age is also related to child care use; approximately 20% of children younger than 1 year attended non-parental child care, compared with 60% of 1- to 3-year-olds.^Note 19, ^Note 20 In the United States, children with disabilities are less likely to attend informal care than centre-based care, compared with children without disabilities.^Note 21

Children with disabilities also differ from children without disabilities in terms of their sociodemographic characteristics. Children with disabilities are more likely to live in low-income or lone-parent families, and have parents with lower levels of education or other barriers to employment.^Note 8, ^Note 22, ^Note 23, ^Note 24, ^Note 25, ^Note 26 They are also more likely to be older, possibly because of increased opportunities for identification at school rather than in the early years.^Note 7, ^Note 27 These intersectional factors may affect the child care use and experiences of families of children with disabilities (e.g., low-income families may be unable to afford specialized care or therapies).

The literature suggests that the type of disability affects access to and experiences in child care.^Note 28 For instance, accessible physical layouts and specialized equipment may be needed for children with physical disabilities. However, many child care arrangements, particularly home-based arrangements, are not accessible, and attitudes towards providing care to children with disabilities may vary by disability.^Note 29, ^Note 30 Children with different kinds of functional difficulties may require tailored supports, accommodating environments, and different types of assistance to participate in child care.

Objectives

This study explores child care use among children with disabilities using the Survey on Early Learning and Child Care Arrangements – Children with Long-term Conditions and Disabilities (SELCCA-CLCD).^Note 31 It examines overall child care participation rates, difficulties in finding child care, and specific challenges reported by parents. This study also investigates whether the parent perceived that their child had been denied a child care space because of their child’s condition. Findings are presented by disability type. Because the survey sample included only children with disabilities, direct comparisons with children without disabilities cannot be made.

Data and methods

Data source

The SELCCA-CLCD collected information on child care arrangements for children aged 0 to 5 years who were reported by their parent to have a long-term condition or disability. Using a cross-sectional design, a sample of 20,005 children was derived from two sources: the 2021 Census (random sample of children aged 3 to 5 years) and the Canada Child Benefit file (to capture younger children who were born after the 2021 Census collection period). Conducted from April to June 2023 across Canada’s 10 provinces, the survey had a 62% response rate. A parent, guardian, or person most knowledgeable about the child’s child care arrangements (hereafter referred to as “parent”) responded.

Respondents (n=12,411) completed four disability measures: 1) the filter questions of the Disability Screening Questions (DSQ) module, 2) the Global Activity Limitation Indicator (GALI), 3) the presence of a long-term condition, and 4) the presence of different types of disabilities.^Note 32, ^Note 33 Only the parents of children identified as having a long-term condition or a disability by at least one measure completed the full survey (n=2,016) (see Appendix A for a description of the identification criteria for each of the four measures).

As the focus of the current study was children with disabilities whose participation in child care may be restricted because of their condition, the analytical sample included only children identified with activity limitations (as identified by GALI) or those who met at least two of the other three measures (n=1,189). Specifically, children were excluded from the sample if they were identified solely by the DSQ module filter questions, the presence of a long-term condition, or disability type. See Arim et al. (forthcoming) for further information on the study sample.^Note 34

Measures

Disability

All children in the study sample (n=1,189) were considered children with disabilities. The DSQ module filter questions were used to identify physical (e.g., walking, using their fingers); sensory (i.e., seeing and hearing); and learning, remembering or concentrating (hereafter termed “learning”) difficulties. These questions also capture the presence of emotional, psychological or mental health conditions (hereafter termed “emotional conditions”), or any other health problems or long-term conditions experienced for six months or more. Most children (1,142 of 1,189) were identified by the DSQ module filter questions.

Almost half of parents reported multiple disabilities for their child (two or more of the five disability types), with learning disabilities and emotional conditions having the highest comorbidity (phi coefficient = 0.39). Thus, comparisons between disabilities were not meaningful. Rather, each disability type was compared with the other types combined (see Appendix A for more information on the identification of the five disability types).

Child care

Parents indicated whether their child usually attended any non-parental child care arrangement in the past three months. If so, the parent identified the main type of arrangement, including 1) daycare centre, preschool, or centre de la petite enfance (CPE); 2) care by a relative other than a parent or guardian; 3) family child care home; 4) before or after school program; 5) care by a non-relative in the child’s home; or 6) other. Although it was possible to report multiple arrangements (11% of the sample), the main arrangement was used to create two groupings: “group care,” which includes daycare centres, preschools, CPEs, and before or after school care, and “other arrangements.” Results were not disaggregated by licensing status because of sample size limitations.

Parents were asked whether they had difficulty finding child care (“yes,” “no,” or “did not look for child care”). Those using child care were asked: “Because of their condition, has this child ever been denied a space in a child care arrangement?” Additionally, parents who used child care were asked to what extent they faced specific types of difficulties within their arrangements because of their child’s condition. For example, parents indicated the extent to which they had experienced inadequate access to therapeutic services, such as occupational therapies or autism support services, within child care (“not at all,” “to some extent,” “to a great extent,” or “not relevant to this child’s condition”).

Covariates

Several child and family characteristics were considered: school attendance, geographic region of residence (Quebec versus other provinces), household income (above or below the low-income measure [LIM] threshold based on tax data from the 2021 T1 Family File), marital or partner status (based on the 2023 Canada Child Benefit file), and the parent’s main activity (working at a paid job or business during the past three months or otherwise). Quebec was considered separately given its existing universal child care program and higher rates of child care participation.^Note 19 School attendance was included, as provinces and territories have different ages of entry and hours of attendance for 4- and 5-year-olds.

Statistical Analyses

Descriptive statistics explored the types of child care arrangements used, the difficulties finding child care, and the types of difficulties experienced in child care because of the child’s condition. They also explored whether the parent felt that the child had ever been denied a child care space because of their condition. Multinomial logistic regression tested for differences in the main child care arrangements between children with and without specific types of disabilities, controlling for confounding variables. Logistic regression examined the relative odds of experiencing difficulty finding child care based on disability and child and family characteristics. Weighted estimates were produced using survey and bootstrap weights. Cases with missing data (<1% on any variable) were excluded.

Results

The sociodemographic characteristics of children aged 0 to 5 years with disabilities and their parents and households are presented in Table 1. The most frequently reported disabilities were learning disabilities (51%) and other health problems or conditions (63%), followed by emotional conditions (29%), and sensory (19%) and physical (17%) disabilities. The SELCCA-CLCD contained a smaller proportion of children aged 0 to 1 year (15%) than the general population of children aged 0 to 5 years (32% according to the 2023 Canadian Survey on Early Learning and Child Care [CSELCC]).



About 6 in 10 children with disabilities attended non-parental child care

Overall, 62% of children with disabilities attended child care, representing approximately 176,000 children aged 0 to 5 years in Canada. More specifically, 45% of children with disabilities were in group care and 17% were in another type of child care, such as a family child care home or care by a relative, as their main child care arrangement (Table 2). Among children with disabilities whose main arrangement was group care, before or after school care was the main arrangement for 10% of them (data not shown). Children with disabilities aged 0 to 3 years were more likely to be in child care than those aged 4 to 5 years (65% versus 58%), with 47% of 0- to 3-year-olds having group care as their main arrangement, compared with 42% of 4- to 5-year-olds (data not shown).



Table 3 shows multinomial logistic regression results for child care arrangements by disability type. In unadjusted models, children with physical disabilities and those with learning disabilities were less likely than children with other types of disabilities to have group care as their main arrangement rather than not being in child care (odds ratio [OR]: 0.62; 95% confidence interval [CI]: 0.43, 0.91, and OR: 0.58; 95% CI: 0.44, 0.78, respectively). However, after controlling for other variables, no significant associations were found between the type of disability and the main child care arrangement. In adjusted models, children with disabilities who did not attend school and whose parents worked had higher odds of being in child care. Children with disabilities in Quebec were more likely than children in other provinces to have group care as their primary child care arrangement.



Parents of children with disabilities, particularly children with emotional conditions, reported difficulty finding child care

Table 4 demonstrates that the parents of 45% of children with disabilities had difficulty finding child care (52% of child care users and 33% of those not using child care—data not shown). Parents of approximately one-quarter of children with disabilities did not look for child care, and 32% did not have difficulty finding a child care arrangement. Among children with emotional conditions, 56% of parents had difficulty finding child care (60% of child care users and 50% of those not using child care—data not shown).



Regression models predicting difficulty finding child care are presented in Table 5. The odds of having difficulty finding child care were more than twice as high for the parents of children with emotional conditions than for those of children with other types of disabilities, even after controlling for covariates (OR: 2.27; 95% CI: 1.57, 3.27). Parents in low-income families were less likely to report having difficulty finding child care than those in families above the LIM threshold, but were also more likely to have not looked for child care (39% versus 19%—data not shown).



Approximately one-third of parents of children with disabilities in child care reported issues accessing therapeutic services within child care

The top two difficulties that parents of children with disabilities reported experiencing because of their child’s condition were inadequate access to therapeutic services within child care (32%) and difficulty finding an alternate arrangement when required (31%) (Table 6). Over half of parents of children with physical (51%) and learning (50%) disabilities and with emotional conditions (56%) reported inadequate access to therapeutic services within child care. Difficulty finding an alternate child care arrangement was reported by about three in five parents of children with emotional conditions (59%) and just over half of parents of children with physical disabilities (52%).



Parents of about one in four children with physical disabilities or emotional conditions in child care reported that their child had been denied a child care space

Close to 1 in 10 (9%) children with disabilities in child care were reportedly denied a space in a child care arrangement because of their condition (Chart 1). Parents of children with physical disabilities (25%) and emotional conditions (22%) were the most likely to report that their child had been denied a child care space.

Description of Chart 1



Data table for Chart 1
Table summary
This table displays the results of Data table for Chart 1. The information is grouped by Disability (appearing as row headers), percent and 95% confidence interval, calculated using from and to units of measure (appearing as column headers).

Disability	percent	95% confidence interval
		from	to
Other health problem or long-term condition	10	3	3
Emotional condition	22	7	7
Learning disability	14	5	5
Sensory disability	18	9	9
Physical disability	25	10	10
Full sample	9	3	3
Source: Statistics Canada, Survey on Early Learning and Child Care Arrangements – Children with Long-term Conditions and Disabilities, 2023.

Discussion

The SELCCA-CLCD revealed that 62% of children with disabilities aged 0 to 5 years participated in non-parental child care in 2023. Among children with disabilities in child care, over two-thirds had group care as their main arrangement. Collected during a similar time period, data from the CSELCC indicated that 56% of the general Canadian population of children aged 0 to 5 years were in child care. While it might appear that participation was higher among children with disabilities, follow up analyses of the two datasets revealed that the SELCCA-CLCD included a smaller proportion of children younger than 1 year of age, who are less likely to be in child care, as parents may be on parental leave. When children younger than 1 were excluded from the analyses, child care participation estimates were similar for the CSELCC (64%) and the SELCCA-CLCD (65%).

The CRC, CRPD, and Accessible Canada Act highlight the significance of access to early education and social services, including child care services, for children with disabilities as an opportunity to interact, develop, and actively participate in society.^Note 35, ^Note 36, ^Note 37, ^Note 38 Given this, it is important to monitor the participation of children with disabilities in child care, particularly among those who are most at risk for participation restrictions.

Novel to the SELCCA-CLCD dataset is the ability to explore child care participation by disability type. Initially, children with physical and learning disabilities were less likely to be in child care, particularly group care. However, these differences disappeared after accounting for known child and family factors associated with the type of disability and participation in child care. For example, children living in Quebec were more likely to be in child care, while children attending school, those living in low-income families, and children with parents who were not working were less likely to be in non-parental child care for both groups of children.^Note 16, ^Note 17, ^Note 18, ^Note 39

About half of parents of children with disabilities reported difficulties finding child care. Parents of children with emotional conditions were more likely to report such difficulties, even after controlling for covariates. This underscores the need to facilitate equitable child care access for children with disabilities, including addressing the unique challenges faced by children with emotional conditions in finding appropriate child care. Parents of children with disabilities in low-income families were less likely to report difficulties finding child care, but were also less likely to use it, with 40% of low-income families using child care, compared with 68% of families above the LIM threshold. Child care costs are often a barrier for low-income families, and subsidies to lower these costs vary across provinces. 

Social participation for children with disabilities includes attendance and involvement. Therefore, child care attendance alone cannot be assumed to fully meet the needs of children with disabilities or their families.^Note 40, ^Note 41 Investigating the difficulties parents face when using child care can highlight barriers to inclusion. Nearly one-third of parents of children with disabilities reported difficulty finding alternative child care when required, and close to one-quarter reported difficulty with flexibility to fit their schedule. Parents of children with physical disabilities and emotional conditions were particularly likely to report these difficulties. This speaks to the need for short-notice or back-up care for children with disabilities, and the potential effects on the employment of parents of children with disabilities (e.g., working fewer hours or changing work hours).^Note 14

About one in three parents of children with disabilities reported inadequate access to therapeutic services within child care, especially for children with physical disabilities, emotional conditions, and learning disabilities. This highlights the importance of collaboration between child care providers, healthcare professionals, and parents to ensure the effective delivery of therapeutic services within child care.

The parents of approximately 1 in 10 children with disabilities in child care reported having been denied a child care space because of their child’s condition. While these findings may reflect parental perceptions, and the actual reason for denial may differ, children with physical disabilities and those with emotional conditions were most frequently reported as having been denied access. This suggests that child care providers are less equipped to care for children with these types of disabilities. Recent efforts to increase the capacity of the child care system with infrastructure funding may assist in this regard, particularly for children with physical disabilities (e.g., ramps, accessible washrooms). However, for children with emotional conditions, specialized staff training and additional staff or supports may be required. Given the right supports, child care service providers may play an important role in mental health service delivery for children with emotional or behavioural challenges.^Note 42

Strengths and limitations

The SELCCA-CLCD is the first representative Canadian survey to focus on child care participation among children with disabilities; however, several limitations exist. Comparisons with typically developing children are limited, as the survey excluded children without disabilities. Non-response bias is possible, as the likelihood of responding may have varied based on the severity of the child’s disability and their participation in child care. Parent-reported information may be subject to recall bias and subjective interpretation. Additionally, limitations in sample size reduced the precision of estimates and statistical power, preventing follow-up analyses on the reasons why children with disabilities were reported as having been denied a child care space.

Conclusion

Participation in child care is a primary means by which children can participate in developmentally stimulating programs and social activities in their community, experiences that are especially important for young children with disabilities. Results from the SELCCA-CLCD suggest that approximately 6 in 10 children with disabilities participated in child care in 2023, with 45% having group care as their main arrangement. However, parents of about half of these children experienced difficulties finding child care, and many also experienced difficulties within child care, such as increased costs for care and difficulties finding a caregiver with the appropriate training and support to benefit their child. As provinces and territories continue to implement a CWELCC system, it is important to undertake research to benchmark current practices and inform future action plans to promote the successful inclusion of children with disabilities.

Acknowledgements

This study was funded by Employment and Social Development Canada (ESDC). The authors would like to thank the peer reviewers, and the reviewers at ESDC and Statistics Canada for their insightful and constructive comments. Additionally, we are grateful to a group of experts in child disability and child care who provided valuable input in the development of the Survey on Early Learning and Child Care Arrangements – Children with Long-term Conditions and Disabilities.