From the abstract: "Non-parental child care prior to kindergarten is a normative experience for the majority of children in the United States, with children commonly experiencing multiple arrangements, or more than one concurrent child care arrangement. The experience of multiple arrangements has predominantly been shown to be negatively related to young children’s health and behavioral outcomes. The present study examined the use of multiple concurrent arrangements for children in the Family Life Project, a representative sample of families living in six high-poverty rural counties. Using the full sample of 1292 children who were followed from six months to kindergarten, this study examined the associations between the number of child care arrangements averaged across six time points and children’s behavioral and academic outcomes in kindergarten. After including a number of control variables, regression results suggested that a greater number of arrangements prior to kindergarten were related to higher levels of teacher-reported negative behaviors, but not positive behaviors, and letter-word decoding skills, but not mathematics skills, though effect sizes were small. Moderation analyses by child care type and quality were conducted, with no evidence emerging that findings varied by type or quality of care."