Continuity of Care: Primary Caregiving in Singapore


Child care centres in many developed countries have expanded exponentially due to the increased participation of women in the workforce. Consequently, children are spending long hours in child care settings, and hence the issue of quality of provision has come under scrutiny. Given the vulnerable age of children, particularly those birth to 3 years, researchers investigated parents’ views of a primary caregiving system in Singapore, which is an approach that aims to foster children’s holistic growth and development. Within the system, three to four infants are cared for, in the main, by one caregiver within an early childhood educational setting and supported by a team of other staff. Parents were asked specifically about their level of satisfaction with the primary caregiving system and were also asked about their level of understanding. Findings showed that 49% of the sample were satisfied and 51% were very satisfied. In relation to the second question three major themes emerged in the qualitative data from responding parents—meeting children’ needs, supporting safe and secure relationships, and improving home school communication. As primary caregiving is not used widely in Singapore it is deemed important to disseminate findings to policy makers and practitioners working in child care centres. Given the importance of primary caregiving and its application in many other countries, the findings have relevance internationally.

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  1. Ainsworth, M., & Bell, S. (1974). Mother-infant interaction and the development of competence. In K. J. Connelly & J. Bruner (Eds.), The growth of competence (pp. 97–118). London and New York: Academic.

    Google Scholar 

  2. Andrews, E., & Coyne, J. (2018). Travelling the circle together, solo: An individual protocol for the Circle of Security intensive intervention. Journal of Clinical Psychology, 74(8), 1333–1345.

    Article  Google Scholar 

  3. Australian Bureau of Statistics. (2018). 4402.0—Childhood Education and Care, Australia, June 2017. Retrieved August 31, 2020 from

  4. Baker, A. C., & Manfredi/Petitt, L. A. (2004). Relationships, the heart of quality care: Creating community among adults in early care settings. Washington, D.C.: NAEYC.

    Google Scholar 

  5. Bell, T. (2018). Childcare workers deserve better pay—this is what I do all day. Retrieved August 31, 2020 from

  6. Bernhardt, J. L. (2000). A primary caregiving system for infants and toddlers: Best for everyone involved. Young Children, 55(2), 74–80.

    Google Scholar 

  7. Bowlby, J. [1969] (2000). Attachment. In Attachment and loss (Vol. 1). New York: Basic.

  8. Bowlby, J. [1973] (2000). Separation: Anxiety and anger. In Attachment and loss (Vol. 2). New York: Basic.

  9. Bowlby, J. [1980] (2000). Loss: Sadness and depression. In Attachment and loss (Vol. 3). New York: Basic.

  10. Bowlby, J., & Bowlby, R. (2005). The making and breaking of affectional bonds. New York: Routledge.

    Google Scholar 

  11. Burns, J. (2020). Early-years workers quit ‘underpaid and undervalued’ jobs. Retrieved August 31, 2020 from

  12. Center on the Developing Child at Harvard University. (2011). Building the brain’s “air traffic control” system: How early experiences shape the development of executive function (Working Paper No. 11). Retrieved August 31, 2020 from

  13. Centre for Education Statistics and Evaluation. (2018). A review of the effects of early childhood education. Retrieved August 30, 2020 from

  14. Child Care State Capacity Building Center. (2017). Program for infant/toddler care (PITC) six essential program practices for relationship-based care: Primary care. Retrieved August 30, 2020 from

  15. Colmer, K., Rutherford, L., & Murphy, P. (2011). Attachment theory and primary caregiving. Australasian Journal of Early Childhood, 36(4), 16–20.

    Article  Google Scholar 

  16. Cooper, G., Hoffman, K., & Powell, B. (2017). Circle of Security in child care: Putting attachment theory into practice in preschool classrooms. Zero to Three, 37, 27–34.

    Google Scholar 

  17. Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). Los Angeles: SAGE.

    Google Scholar 

  18. Cryer, D., Hurwitz, S., & Wolery, M. (2000). Continuity of caregiver for infants and toddlers in center-based child care: Report on a survey of center practices. Early Childhood Research Quarterly, 15(4), 497–514.

    Article  Google Scholar 

  19. Cryer, D., Hurwitz, S., & Wolery, M. (2003). Continuity of caregiver for infants and toddlers. Retrieved December 22, 2020 from

  20. Davie, S. (2020). Singapore’s 15-year-olds top OECD’s Pisa global competence test. The Straits Times. Retrieved October 22, 2020 from

  21. Early Childhood Development Agency. (2012). Guideline for maximum staff-child ratio for infant and child care. Retrieved September 2, 2020 from

  22. Early Childhood Development Agency. (2013). Early years development framework for child care centres. Retrieved April 1, 2020 from

  23. Early Childhood Development Agency. (2017). New early childhood development centres bill passed in parliament to raise quality of pre-school sector. Retrieved from

  24. Early Childhood Development Agency. (2020b). Statistics on ECDCs. Retrieved August 31, 2020 from

  25. Early Childhood Development Agency. (2020a). How to be an educator? Retrieved September 2, 2020 from

  26. Ebbeck, M. (2001). Cultural continuities: An Australian perspective. Early Child Development and Care, 17(1), 33–46.

    Article  Google Scholar 

  27. Ebbeck, M., & Gokhale, N. (2004). Child-rearing practices in a selected sample of parents with children in childcare in Singapore. Contemporary Issues in Early Childhood, 5(2), 194–206.

    Article  Google Scholar 

  28. Ebbeck, M., Phoon, D. M. Y., Tan-Chong, E. C. K., Tan, M. A. B., & Goh, M. L. M. (2015). A research study on secure attachment using the primary caregiving approach. Early Childhood Education Journal, 43(3), 233–240.

    Article  Google Scholar 

  29. Ebbeck, M., & Waniganayake, M. (Eds.). (2016). Play in early childhood education: Learning in diverse contexts (2nd ed.). South Melbourne, Victoria: Oxford University Press.

    Google Scholar 

  30. Ebbeck, M., & Yim, H. Y. B. (2008). Fostering relationships between infants, toddlers and their primary caregivers in child care centres in Australia. In M. R. Jalongo (Ed.), Enduring bonds: Educating the young child (pp. 159–177). New York: Springer.

    Google Scholar 

  31. Ebbeck, M., & Yim, H. Y. B. (2009). Rethinking attachment: Fostering positive relationships between infants, toddlers and their primary caregivers. Early Child Development and Care, 179(7), 899–909.

    Article  Google Scholar 

  32. Ebbeck, M., Yim, H. Y. B., Chan, Y. Y. Y., & Goh, M. (2016). Singaporean parents’ views of their young children’s access and use of technological devices. Early Childhood Education Journal, 44(2), 127–134.

    Article  Google Scholar 

  33. Fantuzzo, J., Perry, M. A., & Childs, S. (2006). Parent satisfaction with educational experiences scale: A multivariate examination of parent satisfaction with early childhood education programs. Early Childhood Research Quarterly, 21(2), 142–152.

    Article  Google Scholar 

  34. Friedman, B. A., Bobrowski, P. E., & Markow, D. (2007). Predictors of parents’ satisfaction with their children’s school. Journal of Educational Administration, 45, 278–288.

    Article  Google Scholar 

  35. Hargraves, V. (2019). Eight features of quality caregiving for infants and toddlers. Retrieved August 31, 2020 from

  36. Horm, D. M., File, N., Bryant, D., Burchinal, M., Raikes, H., Forestieri, N., et al. (2018). Associations between continuity of care in infant-toddler classrooms and child outcomes. Early Childhood Research Quarterly, 42, 105–118.

    Article  Google Scholar 

  37. Howes, C., & Smith, E. W. (1995). Relations among child care quality, teacher behavior, children’s play activities, emotional security, and cognitive activity in child care. Early Childhood Research Quarterly, 10(4), 381–404.

    Article  Google Scholar 

  38. Johnson, B., & Christensen, L. (2012). Educational research: Quantitative, qualitative, and mixed approaches (4th ed.). Thousand Oaks, CA: Sage.

    Google Scholar 

  39. Kelesidou, S. (2017). The role of parents’ educational level and centre type in parent satisfaction with early childhood care centres: A study in Greece. European Early Childhood Education Research Journal, 25(5), 768–783.

    Article  Google Scholar 

  40. Kumar, R. (2014). Research methodology: A step-by-step guide for beginners (4th ed.). Thousand Oaks, CA: Sage.

    Google Scholar 

  41. Lally, J. R. (2009). The uniqueness of infancy: How infants and toddlers develop and how development is best facilitated. Melbourne: WestEd.

    Google Scholar 

  42. Lally, J. R. (2010). School readiness begins in infancy: Social interactions during the first two years of life provide the foundation for learning. Phi Delta Kappa, 92(3), 17–21.

    Article  Google Scholar 

  43. Lee, S. Y., Shin, M., & Recchia, S. L. (2015). Primary caregiving as a framework for preparing early childhood preservice students to understand and work with infants. Early Education and Development, 27(3), 336–351.

    Article  Google Scholar 

  44. Lim, C. (2019). Singaporean educarers’ reflections about their role and practices in the education and care of infants. Journal of Early Childhood Teacher Education, 40, 74–95.

    Article  Google Scholar 

  45. Lim-Lange, C. (2020). Commentary: How to sabotage your child’s future – five dangerous notions about life, careers and education. The Straits Times. Retrieved October 28, 2020 from

  46. Livingstone, R. (2019). Each child, every child—Building positive relationships and supportive environments. Retrieved August 30, 2020 from

  47. Margetts, K. (2005). Responsive caregiving: Reducing the stress in infant toddler care. International Journal of Early Childhood, 3, 77–84.

    Article  Google Scholar 

  48. McMullen, M. B. (2018). The many benefits of continuity of care for infants, toddlers, families, and caregiving staff. Young Children, 73(3), 38–39.

    Google Scholar 

  49. McMullen, M. B., Yun, N. R., Mihai, A., & Kim, H. (2016). Experiences of parents and professionals in well-established continuity of care infant toddler programs. Early Education and Development, 27, 190–220.

    Article  Google Scholar 

  50. Melhuish, E., & Gardiner, J. (2020). Study of early education and development (SEED): Impact study on early education use and child outcomes up to age five years. Retrieved August 31, 2020 from

  51. Mustard, J. F. (2008). Early childhood development: The best start for all South Australians. The State of South Australia: Department of Education and Children’s Services.

    Google Scholar 

  52. Mustard, J. F. (2008b). Investing in the early years: Closing the gap between what we know and what we do. Retrieved August 31, 2020 from

  53. National Institute of Child Health and Human Development Early Child Care Research Network. (2005). Duration and developmental timing of poverty and children’s cognitive and social development from birth through third grade. Child Development, 76(4), 795–810.

    Article  Google Scholar 

  54. Ng, K. G. (2020). Singapore students top maths, science rankings for second consecutive edition of international study. The Straits Times. Retrieved December 8, 2020 from

  55. Omar, N. A., Nazri, M. A., Abu, N. K., & Omar, Z. (2009). Parents’ perceived service quality, satisfaction and trust of a childcare centre: Implication on loyalty. International Review of Business Research Papers, 5(5), 299–314.

    Google Scholar 

  56. Organisation for Economic Co-operation and Development. (2017). Starting strong 2017: Key OECD indicators on early childhood education and care. Retrieved August 31, 2020 from

  57. Paulo, D. A., & Tolentino, A. (2019). Parents know best, or do they? In today’s Asia, the dilemmas of overparenting.

  58. Payne, S. C., Cook, A. L., & Diaz, I. (2012). Understanding childcare satisfaction and its effect on workplace outcomes: The convenience factor and the mediating role of work-family conflict. Journal of Occupational and Organizational Psychology, 85, 225–244.

    Article  Google Scholar 

  59. Raikes, H. (1993). Relationship during in infant care: Time with a high-ability teacher and infant-teacher attachment. Early Childhood Research Quarterly, 8(3), 309–325.

    Article  Google Scholar 

  60. Raikes, H. H., & Edwards, C. P. (2009). Extending the dance in infant and toddler caregiving: Enhancing attachment and relationships. Baltimore, USA: Paul H. Brookes Publishing Co.

    Google Scholar 

  61. Read, V. (2014). Developing attachment in early years settings: Nurturing secure relationships from birth to five years. New York: Routledge.

    Google Scholar 

  62. Ruprecht, K., Elicker, J., & Choi, J. Y. (2016). Continuity of care, caregiver–child interactions, and toddler social competence and problem behaviors. Early Education and Development.

    Article  Google Scholar 

  63. Singapore Department of Statistics. (2015). General household survey 2015: Key findings. Retrieved August 31, 2020 from

  64. Singapore Department of Statistics. (2019). Population and Population Structure. Retrieved August 31, 2020 from

  65. Singapore Ministry of Social and Family Development. (2018a). Baby bonus scheme. Retrieved September 1, 2020 from

  66. Singapore Ministry of Social and Family Development. (2018b). Child care/infant care subsidy. Retrieved September 2, 2020 from

  67. Singapore Ministry of Social and Family Development. (2018c). Quarterly report statistics on child care services. Retrieved August 31, 2020 from

  68. Skallerud, K. (2011). School reputation and its relation to parents’ satisfaction and loyalty. International Journal of Educational Management, 25, 671–686.

    Google Scholar 

  69. Sylva, K., Melhuish, E., Sammons, P., Siraj-Blatchford, I., & Taggart, B. (2012). Preschool quality and educational outcomes at age 11: Low quality has little benefit. Journal of Early Childhood Research, 9, 109–124.

    Article  Google Scholar 

  70. Sylva, K., Melhuish, K., Sammons, P., Siraj-Blatchford, I., Taggart, B., & Elliot, K. (2003). The effective Provision of Preschool (EPPE) Proejct: Findings from the pre-school period. Retrieved February 18, 2020 from

  71. Tai, J. (2016). More parents put babies in infant care centres. Retrieved April 1, 2020 from

  72. Tan, P. L. (2019). Commentary: Be concerned about unhealthy mindsets about dating and marriage, not fewer babies. Channel News Asia. Retrieved July 28, 2019 from

  73. Thang, L. L., & Mehta, K. K. (2012). Conclusion: Change and continuity of grandparenting in contemporary Asia. In K. K. Mehta & L. L. Thang (Eds.), Experiencing grandparenthood: An Asian perspective (pp. 145–157). New York: Springer.

    Google Scholar 

  74. Toh, E. M. (2016). The Big Read: Changing lifestyles and societal attitudes feed infant-care boom. Today. Retrieved December 16, 2016 from

  75. US Department of Health & Human Services. (2020). Primary Caregiving. Retrieved August 31, 2020 from

  76. World Health Organisation. (2020). Nurturing Care Framework: Why nurturing care? Retrieved August 31, 2020 from,are%20emotionally%20supportive%20and%20responsive.

  77. Wu, S., & Perisamy, A. (2020). Infant-toddler care in Singapore: Journey towards quality. Policy Futures in Education.

    Article  Google Scholar 

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Ebbeck, M., Yim, H.Y.B., Ho, S.Y. et al. Continuity of Care: Primary Caregiving in Singapore. Early Childhood Educ J (2021).

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  • Infants
  • Toddlers
  • Singapore
  • Primary caregiving
  • Early childhood