A strong physical development program for young children may have lifelong benefits including a reduction in obesity, injury, death, communicable diseases, and undiagnosed special needs. If a child’s physical well-being and motor development are missing critical pieces, he may be left behind and be unable to take part in activities with energy and stamina on a regular basis.

Five pieces of the physical well-being and motor development puzzle in early care and education programs are health histories of enrolled children, design of the environment and furnishings, staff knowledge, communication with families and community resources, and adherence to policies, procedures and standards.

Health Histories and Assessments

A central piece of the puzzle is information gathered from medical professionals and families about each child’s health status. A child’s initial health history should document information such as:

• Results of dental, vision, hearing, lead, and motor development screenings/assessments and remediation, and immunization status;
• Family history of chronic health conditions;
• Requirements for medications or special care; and
• Allergies and other health conditions.

Because of the rapid physical growth and development of young children, programs should require yearly health assessment updates.

Safe and Healthy Indoor &Outdoor Environments

This puzzle piece includes developing and maintaining indoor and outdoor environments that are safe, easy to clean, attractive, and comfortable for all children. Environments should be arranged to provide:

• Adequate supervision by staff to decrease the potential for injury;
• Appropriately-sized equipment, furnishings, learning materials, and toys;
• Safe and easy access to materials and equipment by children to encourage physical development; and
• Ease in maintenance of clean and sanitary conditions.

In the outdoor environment, safety is a primary concern. Resilient surfacing, adequate supervision, and age-appropriate playground equipment can dramatically reduce the number and severity of injuries.

Designing outdoor environments with large, open areas encourages activities that contribute to physical fitness and motor development, such as running, using riding toys, and engaging in free play.

Indoor environmental concerns such as air quality, humidity, temperature, and ventilation affect child health. If improperly addressed, these factors can increase the spread of communicable disease and influence the well-being of children with allergies and asthma.

Provide appropriately-sized tables and chairs that are easily cleaned and sanitized. Arrange furnishings to facilitate socialization and position them to allow close supervision and quick response to emergencies.

Equipment and furnishings in diapering and toileting areas should be safe and easy to clean and sanitize. Equally important for older children is easy access to sinks, soap, warm water, and hand drying materials to encourage good health habits.

Learning materials such as toys, books, art supplies, and dramatic play aids should be clean, nontoxic, in good repair, and both developmentally- and age-appropriate.

Staff Knowledge and Resources

The staff knowledge puzzle piece includes understanding the influence of a child’s developmental stage on environmental design, learning materials, and activities. Use of appropriately-sized climbing equipment, riding toys, and other equipment is important, and activities should reflect the developmental age of the children in the setting.

Caregivers modeling good health habits combined with health education in daily activities help children develop healthy personal care, eating, and physical activity habits.

Your awareness of community health resources can help you to assist children and their families. Services often used by families of young children included Women, Infants, Children (WIC) food program, well-child clinics, early intervention and special education services and supports, and public health clinics.

Communication with Families

Consistent, timely, meaningful and culturally sensitive communication between parents, early care and education providers, and community-based health care providers can help children. Provide communication such as the child’s health status, program goals for the child in health-related areas like nutrition and fitness, and protection from disease outbreaks.

An annual parent-childcare provider conference might include discussion of changes in the child’s health and motor development. Communication between community-based health care providers and childcare providers helps caregivers understand the needs of the child as well as make appropriate changes to your program design to meet the physical health needs of the children enrolled.

Policies and Procedures

This puzzle piece includes the development and adherence to policies, procedures, and practices to mirror the National Health and Safety Standards for Out-of-Home Child Care and reflect the diversity of the children in your program.

Policies should be in place to address issues such cleaning and sanitation, food preparation and nutrition, emergency situations, injury and illness, transportation, toileting, and rest.

There are resources available to guide childcare programs through policy and procedure development. Policy and procedure components should include:

• Person(s) responsible for carrying out the policy and the expectations of staff members;
• Situations when the policy applies;
• Resources used in the development of the policy;
• The communication plan for staff and parent notification of the policy;
• The date the policy becomes effective and the date for review of the policy;
• Signatures of those involved in the policy development and review.

Your local childcare resource and referral agencies and local and national health and safety professionals and organizations, and federal programs and guidelines like the National Health and Safety Standards offer resources and information to help you provide healthy and safe childcare environments.

Patricia Cole, MPH
Research AssociateEarly Childhood Center, Indiana Institute on Disability and Community

Internet Resources

Bright Futures, www.brightfutures.org

Healthy Kids, Healthy Care, www.healthykids.us/caregiver.htm

University of California, hr.ucsb.edu/worklife/child_care_guidelines.php

Wisconsin Child Care Improvement Project, www.wccip.org/tips/health_safety/health_safe.html

Resources

National Health and Safety Standards for Out-of-Home Child Care, National Resource Center for Health and Safety in Child Care and Early Education, Anschutz Medical Campus, Campus Mail Stop F541; PO Box 6508, Aurora, CO 80045-0508; 800-598-KIDS; nrc.uchsc.edu/CFOC/index.html