An innovative training program to improve the quality of child care for all children including those with disabilities was developed, implemented, and evaluated over a 5-year time span with child caregivers working primarily in inner city child care programs. A total of 283 directors and child caregivers participated in 1 of 15 courses that used the infant-toddler (n = 8) or preschool (n = 7) curricula of the training program. Each training curricula presented age-specific content in didactic class sessions scheduled across a 3- to 4-month time period. These class sessions were combined with three on-site consultation visits and an out-of-class assignment. Following participation in the training program, quality of care increased in infant-toddler and preschool classrooms. Before and after training, caregivers' interactions with children were characterized as neither punitive nor detached but with only moderate levels of positive interaction and permissiveness.
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