Access to Early Care and Education for Nevada’s Infants and Toddlers: A Mixed Methods Examination

• In Event: Access and Quality in Infant-Toddler Care: State-Level Initiatives to Build Stronger Systems

Abstract

Introduction
Early care and education (ECE) during the infant/toddler years supports long-term development (Pilarz et al., 2019), yet access to high-quality ECE is critically low for infants/toddlers in Nevada (Children’s Cabinet, 2022). Multidimensional challenges interfere with parents’ ability to, within reasonable effort, enroll their child in an affordable program that supports child development and meets parents’ needs (Friese et al., 2017), causing disparate access to infant/toddler ECE in Nevada (First Five Years Fund, 2024).

Purpose
We explore ECE programs’ enrollment decision-making and provide data on improving equitable ECE access. We asked:
1) What individual and program-level factors are associated with the enrollment and prioritization of infants and toddlers in Nevada's ECE programs?
2) How do Nevada's ECE programs make decisions about enrolling infants and toddlers?
3) In what ways do decision-making strategies expressed by programs shape ECE access for infants and toddlers?

Methods
Using an explanatory sequential mixed methods research design (Creswell & Plano Clark, 2018), we partnered with the Nevada Department of Education to send electronic surveys to licensed ECE providers across Nevada between November 2023 and March 2024. Surveys asked about enrollment and prioritization of infants/toddlers and program characteristics. We received 261 complete responses and conducted two logistic regressions examining the association between enrollment and prioritization of infants/toddlers and a series of program characteristics. 

Interview participants were selected using survey responses. We virtually interviewed 39 providers using a semi-structured protocol between April 2024 and January 2025. We used reflexive thematic analysis (Braun & Clarke, 2022) to analyze transcripts.

We integrated quantitative and qualitative results in a joint display, noting areas of confirmation, expansion, and discordance (Fetters et al., 2013).

Results
The probabilities of programs serving infants/toddlers accepting subsidies (financial support for low-income families) and receiving state pre-K funds was 78% (p=0.04) and 17% (p=0.01), respectively. The probabilities of programs prioritizing infants/toddlers accepting subsidies and operating in an area of low opportunity were 86% (p=0.01) and 76% (p=0.04), respectively.  

We identified four themes: (1) degree of reasonable effort to address availability - providers were aware families need infant/toddler care but did not actively recruit these ages, (2) addressing affordability for families and programs - operational costs were a barrier to serving infants/toddlers, (3) child development-related supports and concerns - small class ratios were important for quality, and (4) meeting family needs by supporting enrollment and retention - providers indicated commitment to enrolling underserved children and promoting family confidence. 

Integrated results suggest programs attempt to offer infant/toddler care that is available with reasonable effort, affordable, supports child development, and meets family needs, but more resources and financial support are needed.

Conclusion
Despite the sparsity of infant/toddler slots in Nevada, programs were unwilling to compromise quality, low ratios, and qualified staff to make infant/toddler slots more available - even if that meant higher operational costs. Understanding systemic, multidimensional access barriers for infants/toddlers in Nevada can provide additional insights into how policymakers can direct funds and support in Nevada and nationwide.

Author

• Gerilyn Slicker, University of Nevada - Las Vegas
  Presenting Author