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Makita, Moderator:
In the last part of her presentation, Dr. Friedman referred to the role of government. Fortunately, I hear that we have Mr. Shimizu in the audience today, the head of Child Care Division of the Children and Families Bureau, Ministry of Health and Welfare. May I ask Director Kobayashi of CRN to introduce Mr. Shimizu?

Kobayashi: Introduction of Mr. Shimizu of the Ministry of Health and Welfare
We learned that Mr. Shimizu is here today. He heads the Child Care Division of MHW, which is in charge of child care issues. He has kindly accepted our request to make a few comments. Since Dr. Friedman has shared her views on how to create a better child rearing and child care system in the 21st century, which we believe will be useful in all countries, we would like to hear from Mr. Shimizu by all means. Could you say a few words, please?

Shimizu: Greetings
I am here today in a private capacity. I am in charge of the Child Care Division of the Ministry of Health and Welfare. The weather is so nice today, but all of us are here, instead of doing housework or enjoying time with loved ones. However, after listening to Dr. Friedman's very valuable presentation and other speakers, I think you will agree that this symposium has been a satisfying one for everyone. I think this is because we have seen that child care is a matter of balance, that is, balancing what is gained and lost by it.

Child care is a matter of balance. Day and night, people in the field of child care struggle with how to balance the parents' situation and children's situation. Those who are responsible for the child care system in the national and local governments consider how to strike a balance between economic efficiency and quality of care.

Some important points were raised in Dr. Friedman's presentation. In particular, she referred to the negative influence of extensive child care. As I recall, she used the word, "slightly." Although I cannot reach a definite conclusion before having a detailed look at the data, I interpreted this as some negative impact which was not irreparable. We are promoting child care while taking this into account, and it does not make any sense to simply discontinue it just because there are some negative factors. What is important is that we should always keep in mind how we can repair any damage while minimizing these negatives and promoting the system as a whole. If possible, it is desirable to use a very analytical and persuasive approach like Dr. Friedman's research.

Lastly let me make some personal comments. In relation to balance, when people talk about parents and their relationship to their children, they mean mothers in most cases. One of the questions in the afternoon session was about fathers and I thought that it would be better if there were more research on the relationship between fathers and parenting.

This is my brief comment as one of the participants. Thank you.

Makita: Call for questions
We are getting into a heated session now and we would like to proceed more with our discussion. From the speakers' remarks, we have heard some important concepts about high-quality child care. Now I would like to open the floor for questions and answers and more concepts as a way of moving toward high-quality child care. Any questions or comments?

Ms. A: Question on child care support in the future
I write for child care magazines. Many thanks to the panelists for their interesting presentations. Dr. Friedman, in particular, said that families and family characteristics such as family income, maternal education, marital status, separation anxiety, and maternal depression are more related to the quality of the mother-child interaction than the child's child care experience. This may be true not only in the United States, but also in Japan. There are some things that mothers cannot do by themselves. This is exactly where there should be teamwork, such as support from child care providers and doctors. What do you think about this? Can I ask each one of the panelists, please?

Imai: Response to Ms. A's question
I have been involved in supporting maternal child care at children's home support centers or nursery schools when I do not teach in the morning. We distributed questionnaires to the mothers before they came to the support centers, and our findings indicate that they are more anxious about how to raise children than the findings presented by Professor Takaki earlier. On average, about 60% of mothers are very concerned about child rearing. However, when they make friends with others and share their concerns in those centers, the situation is reversed; they say that they enjoy raising children now although they still feel anxiety sometimes.

Looking at these statistics, I really felt the strong sense of isolation of these mothers. For this reason, it is important that not only child care centers but also various kinds of child care support facilities should be established in cities, towns and villages. There was a time when I confronted inexperienced mothers who were not raising their children well. Using good arguments, I criticized them for not taking good care of their children. I was very young then, but I thought of myself as a spokeswoman for children and this was the stance I took.

At that time, I was not able to establish a good relationship with these mothers themselves, who were the ones mainly responsible for child care. I have learned more since then. I now understand their concerns and worries, and I realize that their circumstances are difficult, and unlike what I have experienced myself. When I encourage them to talk about anything so that we can work together, they express their opinions very frankly.

For example, mothers dislike getting into confrontations with children, but I show them a video and tell them that arguing is important. Many mothers say "No!" when their children pick things in their mouths or drop all the toys on a shelf. But I tell them that children of this age want to drop things, or they like dropping things again after their mothers have picked them up. When mothers can talk to each other in a relaxed manner, they seem to understand their children better. So I think that child care support by working together is very important.

Matsumoto: Response to Ms. A's question
Let me respond to your question based on my experience. As I mentioned earlier, the analysis of data based on infant medical checkups by the Fukuoka City Medical Association takes a prospective approach. One of the findings indicates that mothers are most anxious about their firstborn child. The data clearly shows that their anxiety does not increase, but rather decreases with the second or the third child. So, I hold a child care session once a month for those mothers with one child, who tend to be rather anxious. Some mothers say that raising children is really enjoyable, while others say that it is very hard and stifling. I listen to their frank opinions. We make suggestions from various perspectives, telling them not to worry about these issues alone and to make use of various resources like child care circles and day care centers.

Uchida: Response to Ms. A's question
My response has to do with Dr. Matsumoto's comments. Mothers seem to be very anxious about their first child and say that they don't understand them. Many of them read books on child care, and they worry when their babies are not developing as described in books, and when they see a baby who is developing much faster, they become even more worried.

In such a case, as Prof. Imai mentioned, society should be more aware of this and work to create an atmosphere to support child care in some way or another. I think that there is extremely little investment in child care in Japan as well as in the United States.

In the past I had a chance to visit several countries for some months to do a survey on infant education. The city government of London, for example, organizes the "One O'clock Club." Social workers who specialize in children's play go around by car to community meeting centers and take various toys with them. This is arranged by the local government. Social welfare professionals go there and arrange play sessions for mothers with pre-kindergarten children. Mothers and children get together at the time listed in the Gazette. While play experts were playing with children so children of different ages can interact one another, mothers and even the women with no children were asking experienced mothers for advice over a cup of tea with some home-made cookies in the kitchen area. This system made me feel that their culture was very mature in terms of their thinking about children.

These days, it is unfortunate that adults do not talk to or scold other children even though they are doing something dangerous. This may be because mothers themselves are too isolated and obstinate to accept the opinions of others, or because they want to protect themselves from social criticism. I feel a slight sense of crisis at this low awareness of child rearing. There are fewer children now and we should think about how we as a society can raise children together and pass on values that enhance culture and human beings. As Dr. Friedman mentioned earlier, we should actively provide senior or junior high school students with opportunities to learn about family life and families in home economics or health classes.

Thank you very much. Any other questions or comments?

Mr. B: Question on the best age for a child to enter child care
While talking about child care to support working mothers, we should also think about infant care as well. Listening to Dr. Friedman's presentation and being a pediatrician myself, I think that there is a period of sensitivity when attachment is formed through mother-child interaction. The American Academy of Pediatrics submitted a new recommendation that children should be breast-fed until they are one year old. At a conference the other day, I was shocked very much by a question from a mother who was breast-feeding her baby. She asked at what age she should place her child in child care since she was going back to work.

As a pediatrician, I would like to know the best age to place a child in child care. May I ask this question to Professor Imai as well as Dr. Uchida and Dr. Friedman, please?

Imai: Response to Mr. B's question
The mother wants to work, and your question is when she can place her child in child care.

If the mother could stay at home, I personally think that it would better to do so until her child is about two years old. Two-year old children sometimes panic, and child care is very difficult at this age because they become so irritable. If two-year olds are only left to their parents to handle, the parents may tend to be too authoritarian or too lenient. However, regarding the child care provider's attitude and involvement, the Guideline on Child Care at Nursery Schools says that it is important to allow children to let their feelings out in this way. This kind of selfish, explosive expression and loud crying are part of the process of ego development. We would like to work together with mothers in this process. Mothers also are most worried about two-year-old children. When a child becomes two years old, he or she begins to develop an interest not only in the parent-child relationship at home but also in friends and others. It used to be about at three years of age in the past. According to some data, two-year old children at home watch television the longest. Since two-year old children seem to want social interaction with friends, I think that children can be placed in day care at the age of two.

Uchida: Response to Mr. B's question
As Professor Imai mentioned, in terms of their development, children do not necessarily have to go to nursery school if there are other opportunities to make friends. They can be cared for at home as long as there is an environment where they can play together with others, in a nearby park, for instance. However, it seems that many mothers do not know what to do when their children become defiant. It is difficult for them to be anything other than authoritarian. So when there are no relatives or grandmothers nearby, I think that it is desirable to put children into an environment where they can be brought up with other children when they become two years old and start to form their own ego. I am not saying that they must be placed in nursery school but this seems to be desirable when one considers the benefits to their development.

Friedman: Response to Mr. B's question
Mothers who are the sole breadwinner in their family need to go to work in order to support their family. Other mothers work to facilitate better economic conditions for their family. Still others work to assure their independence or to pursue a career for which they trained for many years. The decision to place a child in child care is frequently determined by the necessity of maternal employment. Therefore, the question that should be asked, is not when is the appropriate time to begin child care, but rather how to make sure that the child care arrangements for children are adequate, and maybe better than adequate. How to make sure that child care arrangements for children are of good quality so the children will develop optimally no matter how early or late they are placed in child care.

When asking about the best time to first place a child in child care we cannot ignore the needs of the family and of the society. We need to think about child care as an integral part of child rearing in general. And child rearing must be construed in the context of the family and societal goals. Child care is a tool that parents use to help them rear children while they do their best to meet the needs of the family and of the different individuals within the family. Historical and cross-cultural analyses suggest that there is more than one way to rear physically and psychologically healthy children. The ways that are chosen need to fit the needs of the particular family and society into which the child is born. If we consider the decision about when the child should enter child care without considering the context in which the child grows up, we are missing something.

But, what if you insist on coming to me with your question as you stated it, that is, when should children begin childcare? What if you assure me that you ask that questions as it pertains to a context in which life conditions are, from your and many others' perspective, entirely optimal? -You tell me that the mother doesn't have to work; she doesn't need the money; there is no question of career; there is nothing to bar the mother from providing exclusive maternal care-then I cannot give you a scientifically informed answer. I don't know when is the optimal time. I really don't.


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