美國託兒所實施雙標準 幼兒安全難以保障(2)

Tighter enforcement?

增強執行力度？

To aid providers who are struggling with safety and quality, advocates believe Minnesota needs tougher standards and enforcement.

爲幫助那些盡力保證託兒所質量和安全的負責人，倡導者認爲明尼蘇達州需要設定更高的標準和增強執行力度。

Many child deaths reviewed by the Star Tribune involved providers who didn't follow even basic safe-sleeping rules. At least 10 deaths since 2007 involved infants placed to sleep on their stomachs -- a clear violation of guidelines -- or on unsafe surfaces. Several deaths involved napping infants who weren't checked for long periods of time -- in one case three hours.

《星論壇報》查看的衆多幼兒死亡事件中，很多都是由於負責人無法執行基本的安全睡眠法則。2007年以來，至少有10起幼兒死亡事件涉及到嬰兒背朝天睡覺——明顯違反了標準——或在不安全的表面睡覺。數起死亡事件涉及到嬰兒睡覺時，長時間無人查看——有一例中，三個小時內，無人查看嬰兒。

The state requires that in-home providers and center workers be within sight or hearing of sleeping infants. But only at child-care centers are workers required, in most cases, to visually check sleeping infants every 15 minutes.

明尼蘇達州要求嬰兒睡覺時，家庭託兒所負責人和託兒所中心員工必須能看到或聽到孩子的動靜。但是往往只有託兒所中心要求員工每15分鐘檢查一下熟睡中的嬰兒。

In Kansas, which overhauled its child-care rules in 2010, in-home caregivers must check on sleeping children every 15 minutes. It is one of at least six states that require in-home providers to observe children during their nap times.

2010年，堪薩斯州全面修訂了照看兒童的規定，要求家庭託兒所負責人每15分鐘查看一次熟睡中的幼兒。至少有六個州要求家庭託兒所在孩子小睡期間查看幼兒，堪薩斯州就是其中的一個。

In a May 3 letter to family providers, Minnesota Department of Human Services Inspector General Jerry Kerber said his agency would examine the "vast differences" in death figures between centers and licensed homes, and whether additional training or supervision is needed.

5月3日，明尼蘇達州人類服務部監察長傑裏·科伯給家庭託兒所負責人寄了一封信，信中說道，人類服務部將查看託兒所中心和獲得許可的家庭託兒所之間幼兒死亡率差別如此之大的原因，看看是否需要給家庭託兒所負責人提供額外的培訓或監督。

In addition, some advocates believe Minnesota needs better day-care inspections. Child Care Aware of America, a research and watchdog group, estimates that Minnesota has one county inspector for every 150 family child care homes -- 10th worst in the nation.

另外，一些倡導者認爲明尼蘇達州需要更好的日託所視察。據研究與監督機構美國兒童看護意識估計，在明尼蘇達州，每150個家庭託兒所配有一名縣級視察員，這在全美倒數前十之列。

Actual rates vary widely by county. In Anoka County, three inspectors have caseloads of more than 200 providers and aren't able to spend as much time with individual providers as they would like.

真實的比率根據不同的縣而不同。在安諾卡縣，超過200名負責人僅配有3名視察員，視察員無法給每個負責人那裏安排儘可能多的時間。

"If we're really wanting to know what's going on in a home, the best way ... is to be there in person, eyeball to eyeball," said Evelyn Nelson, who supervises the Anoka office. "We don't have the people power to do that."

“如果我們真的想知道家庭託兒所的真實情況，最好的辦法是派個人在那裏看着，”伊芙琳·內爾遜說，“我們沒有那麼多人力。”內爾遜是安諾卡縣視察辦公室的負責人。

In 26 states, inspections occur at least once a year, with 14 states inspecting in-home providers twice a year or more, according to Child Care Aware of America's survey. Four states inspect at least quarterly, including Wyoming, where there is an inspector for every 66 home child care providers.

據美國兒童看護意識的調查，全美有26個州每年至少視察一次家庭託兒所，其中有14個州是每年2次以上，包括懷俄明州在內的4個州每個季度至少視察一次。在懷俄明州每68家家庭託兒所配有1名視察員。

Better training?

改善培訓？

Better training of child care providers also can improve the quality of care, according to several research studies.

多項研究顯示，爲家庭託兒所負責人提供更好的培訓也能改善看護兒童的質量。

Minnesota requires in-home providers to be trained in first aid and CPR before they are licensed, but no training in child development is required until after they open. The state's requirement of eight hours of annual training was 33rd lowest among 42 states that license small child care homes, according to Child Care Aware.

美國兒童看護意識的調查顯示，在明尼蘇達州，家庭託兒所負責人獲得執照前必須接受急救和心肺復甦術的培訓，但是要等到家庭託兒所開業後纔要求其負責人接受兒童發展的培訓。明尼蘇達州要求每年接受8小時的培訓，這在給小型家庭託兒所頒發執照的42個州中排名第33位。

Wisconsin requires at least 40 hours of initial training, including child development, and then 18 hours annually.

威斯康星州要求最少要接受40小時的前期培訓，其中包括兒童發展方面的培訓，並且每年必須接受18小時培訓。

"We think [training] increases the likelihood children will be safer in care," said Grace Reef, Child Care Aware's public policy director. "But it's also about healthy [child] development."

“我們覺得增加培訓可以提高孩子看護的安全度，”美國兒童看護意識的公共政策主管格蕾絲·麗芙說，“同時還關乎到兒童的健康成長。”

Responding to the Star Tribune's ongoing investigation, state regulators recently recommended increased training in safe sleep positioning and CPR.

明尼蘇達州對《星論壇報》的調查做出了迴應，管理機構最近建議增加在安全睡眠姿勢和心肺復甦術方面的培訓。

Yet proposals to increase training can face political resistance. In 2006 Minnesota increased its annual training requirement from six hours to eight after lawmakers opposed increasing the total to 12.

但是增加培訓的提議可能會遇到政治上的阻力。2006年，明尼蘇達州的立法者反對將培訓時間增加到12小時，結果只從6小時增加到了8小時。

"Conservatives railed against 'the nanny state,' " said John Hottinger, a former DFL state senator who sponsored the training bill.

“保守派反對保姆式國家。”支持家庭託兒所培訓法案的前參議員約翰·豪廷傑說。

Some legislators remain skeptical of more regulation. "It never ends. We add regulation on regulation, training on training," said Rep. Steve Gottwalt, R-St. Cloud. "Unless you've got real good evidence that six hours results in 'X' amount of better safety for kids, then why not 12 hours? Why not 36 hours? Why not require day-care providers to have a master's degree?"

一些立法者對更多管控持懷疑的態度。“管控無止境。我們在管控上加新的管控，在培訓上加新的培訓，”共和黨員史蒂夫·哥特瓦特說，“除非你有鐵證證明六個小時爲孩子增加了多少安全度。爲何不增加到12小時？爲何不增加到36小時？爲什麼不要求家庭託兒所負責人獲得碩士學位？”

Training isn't a cure-all, Wrigley said. Her deaths study concluded that the environment of family child care was more problematic than a lack of education. And Stenseng, the provider who lost her license because she used breast-suckling to control behavior, had college training in psychology and social work.

裏格勒說，培訓不是萬能鎖。她的幼兒死亡研究結果是家庭託兒所的環境比其負責人缺乏教育問題更大。斯坦森因爲用讓孩子吮吸乳房的方法控制他們的行爲而被吊銷執照，但她本人接受過心理和社會工作的大學培訓。

Stenseng said she created her own licensed child care because she was dissatisfied with options for her children and wanted to create a facility that supported alternatives such as cloth diapers, attachment parenting and extended breast-feeding. She disagreed with the state report, arguing that most parents were aware of her "comfort nursing" practice. "To them," she said, "it was a very natural fit" with their parenting philosophies.

斯坦森說她辦了自己的託兒所是因爲她不滿意看護孩子方法的限制性，她想要辦個支持額外做法的託兒所，如布尿布、親密育兒和延長母奶餵養等。她不贊同明尼蘇達州的報告，反駁道大多數父母都知道她的安慰式撫養法。“大多數父母覺得，”她說，“我的做法很自然地吻合了”他們的育兒理念。

Katy Chase of the Family Child Care Association believes providing more mentors would raise child-care quality. Public funding covers mentoring for only five providers a year, she noted.

家庭託兒所協會的成員凱蒂·蔡斯認爲提供更多的培訓會提高育兒的質量。她還提到，公共資助每年只覆蓋5名家庭託兒所負責人。

Payne, the author of national child-care guidelines, said ultimately it's up to states to ensure safety at home-based day care.

《全美育兒指導》的作者佩恩說最終還是要靠各個州來保證家庭託兒所的安全。

"This is their house," she noted. "But is it safe enough for kids? That's the bottom-line question."

“這是家庭託兒所的家，”她寫着“但是對孩子來說安全嗎？這是我們的底線。”