Kentucky’s child advocates are pointing to recent increases in injuries of children in licensed child care centers as more evidence that the workforce is overworked, underpaid and each worker is responsible for too many children.
From 2022 to 2024, the number of children who suffered serious injuries increased from 466 to 764, according to the Cabinet for Health and Family Services. During that time, licensed child care capacity increased from nearly 159,000 children in 2022 to 164,000 in 2024.
Additionally, cases of substantiated abuse and neglect increased from 37 in 2022 to 47 in 2023 and 64 in 2024. Those numbers are for licensed centers, certified family child care homes and registered providers.
A paper from Kosair for Kids and Kentucky Youth Advocates, published last week, blames this increase on low wages, inadequate training, an entry-level workforce, staff stress and more.
Several recent incidents of mistreatment made headlines. A Leitchfield child care worker was arrested in March after reportedly pulling a child’s hair out, resulting in a bald spot. In Richmond, a child care worker — one of several arrested — was accused of restraining a child and covering the child’s nose and mouth, according to April news reports.
Sarah Vanover, the study author and policy and research director for Kentucky Youth Advocates, said too many classrooms are maxed out on their adult-to-child ratios, another key point of stress for many teachers. At the same time, many child care centers are operating at a loss because their cost is more expensive than what many families can afford.
“The same way that we see parents who have higher stress situations at home, they escalate to abuse,” Vanover said. “The same thing happens in child care programs.”
The children at highest risk of suffering from this “perfect storm” of negative factors are kids with disabilities, she said.
About 1 in 5 children has a diagnosed disability, Vanover said, which comes with its own unique challenges. Neurodivergent children may have a strong fight or flight reaction, she said, which could lead them to run away from the classroom.
“We could see children that have speech delays and may become aggressive because they don’t know how to verbally communicate, so they may communicate physically with their peers,” she said.
Some children may not have the tools to self-soothe and, as a result, cry constantly.
“When you listen to crying nonstop, all day long, that can be a huge stressor and very overwhelming,” Vanover said. “So there’s a wide variety of those behaviors, but a lot of the most challenging ones relate to kiddos that have a hard time calming down, so they stay upset, and they may be aggressive with teachers or peers.”
Kentucky’s staff-to-child ratio requirements for licensed centers vary by age and are set at:
- Infants (6 weeks to 12 months) — 1:5
- Toddlers (12 months to 24 months) — 1:6
- Two-year-olds (24 months to 36 months) — 1:10
- Three-year-olds (36 to 48 months) —1:12
- Four-year-olds (48 to 60 months) — 1:14
- School-age children (kindergarten+) — 1:15
The National Association for the Education of Young Children recommends slightly lower ratios, which Vanover said would be ideal.
Kentucky’s adult-to-child ratio for 2-year-olds is the nation’s worst at 1:10 with a maximum group size of 20, says the paper. Children this age are typically still not independent in the bathroom and may need help at meal times while the provider is still required to implement curriculum.
“When you think about a parent just bringing home a new baby and feeling overwhelmed with one child,” she said, “then try to imagine an adult in a room with four infants trying to feed them and take care of them and meet all those needs.”
The downstream effects
When abuse happens in child care facilities, Vanover said, it harms not only the child, but families, the community and the child care infrastructure. Abuse leaves families without the support that allows many to work, for example.
“A parent is easily going to quit work compared to leaving their child in some place that they don’t feel is safe,” she said. “And when a family member leaves the workplace, whether it’s a two parent family, one parent family, there’s that additional financial struggle. It could mean that a family loses their health care. It could mean that a family needs to apply for SNAP and TANF and Medicaid and resources that are already really sparse right now. When we’re thinking about the family being independent and autonomous, we really want them to be able to have accessible child care so that they can go to work and support their family and make sure that all the family needs are met, whether that’s housing, food or medical care.”
Policy recommendations
Kentucky could improve conditions in centers for children, Vanover said, if child care workers were required to spend three of their 15 annual professional development training hours on special education training. There is currently no requirement that they get special education training, she said. This requirement could be codified in law without an extra cost for the state, she said.
With more funding, child care centers could also raise wages and have tighter teacher-student ratios. Wages are one of the biggest barriers to child care staffing, the paper says. One study found that the median wage for child care providers in Kentucky was just under $14.00 per hour, or $29,060 annually, with many child care programs unable to offer health insurance or other benefits to staff.
KYA isn’t making a specific budget request of the General Assembly for this item in 2026, Vanover said, but is calling on more businesses to participate in the Employee Child-Care Assistance Partnership program, or ECAP, which incentivizes employers to help employees pay for child care.
“We were thrilled with the additional investment that the General Assembly put in two years ago during the last budget session,” Vanover said, “and it’s a priority for us to make sure that we maintain those funds.”
This article was originally published by the Kentucky Lantern.
