The rate of diarrheal disease in children cared for out of the home is two to three times that in children cared for at home. One study puts the mean cost per episode of diarrhea at $289, while another finds an average cost of $172 per child-year. Several studies show that training in hygienic practices including handwashing and diapering techniques resulted in a decrease in severe diarrhea in classrooms caring for children under 24 months.