Primary Care

In a primary care system, each child is assigned to one special infant/toddler care teacher who is principally responsible for that child’s care. When children spend a longer day in care than their primary infant/toddler care teacher, a second infant/toddler care teacher is assigned to be the primary relationship. Each child should have a special infant/toddler care teacher assigned to him or her at all times during the child care day. Teaming is also important. Primary care works best when infant/toddler care teachers team up and support each other and provide a back-up base for security for each other’s primary care children. Primary care does not mean exclusive care. It means, however, that all parties know who has primary responsibility for each child.

Small Groups

Every major research study on infant and toddler care has shown that small group size and good ratios are key components of quality care. PITC recommends primary care ratios of 1:3 or 1:4, in groups of 6-12 children, depending on the age. The guiding principle is this: the younger the child, the smaller the group. Small groups facilitate the provision of personalized care that infants and toddlers need, supporting peaceful exchanges, freedom and safety to move and explore, and the development of intimate relationships.


Continuity of care is the third key to providing the deep connections that infants and toddlers need for quality child care. Programs that incorporate the concept of continuity of care keep primary infant/toddler care teachers and children together throughout the three years of infancy period., or for the time during that period of the child’s enrollment in care.

Individualized Care

Following children’s unique rhythms and styles promotes well-being and a healthy sense of self. It’s important not to make a child feel bad about him or herself because of biological rhythms or needs that are different from those of other children. Responding promptly to children’s individual needs supports their growing ability to self-regulate, i.e., to function independently in personal and social contexts. The program adapts to the child, rather than vice versa, and the child gets the message that he or she is important, that her/his needs will be met, and that his choices, preferences, and impulses are respected.

Cultural Continuity

Children develop a sense of who they are and what is important within the context of culture. Traditionally, it has been the child’s family and cultural community that have been responsible for the transmission of values, expectations, and ways of doing things, especially during the early years of life. As more children enter child care during the tender years of infancy, questions of their cultural identity and sense of belonging in their own families are raised. Consistency of care between home and child care, always important for the very young, becomes even more so when the infant or toddler is cared for in the context of cultural practices different from that of the child’s family. Because of the important role of culture in development, infant/toddler care teachers who serve families from diverse backgrounds need to:

  1. heighten their understanding of the importance of culture in the lives of infants,
  2. develop cultural competencies,
  3. acknowledge and respect cultural differences, and
  4. learn to be open and responsive to, and willing to negotiate with families about child rearing practices. In this way, families and infant/toddler care teachers, working together, can facilitate the optimal development of each child.

Inclusion of Children With Special Needs

Issues already embraced by the PITC – a relationship–based approach to the provision of care that is individualized, and a responsiveness to the child’s cues and desires to learn – is equally important for children with disabilities or other special needs. Infants who have responsive, enduring relationships develop emotional security, which gives them the foundation for becoming socially competent and resilient. Inclusion means making the benefits of high quality care available to all infants through appropriate accommodation support in order for the child to have full active program participation.