Early Childhood. 1 4 Years

Transcription

1 Early Childhood 1 4 Years

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3 EARLY CHILDHOOD During early childhood (ages 1 to 4), a child s world expands to include friends, schoolmates, and others in the community. The child s physical, cognitive, social, and emotional development are tightly linked. For this reason, physical activity affects not only the physical health of children but also their overall health status. Early childhood is divided into two stages: the toddler stage, ages 1 to 2, and the young child stage, ages 3 to 4. The toddler stage can be stressful for parents as toddlers develop a sense of independence. As they get older, children become more interested in trying new activities. Early childhood is a key period for promoting physical activity. During these years, fundamental motor skills, basic movement patterns that all children tend to develop (e.g., walking, running, galloping, jumping, hopping, skipping, throwing, catching, striking, kicking, balancing), begin to develop. If children are encouraged to be physically active, these skills can develop into advanced patterns of motor coordination that can last a lifetime. Unfortunately, many children barely acquire fundamental motor skills and some will not develop advanced patterns of motor coordination because they are not encouraged to participate in physical activities that provide opportunities to practice these skills. Participation and instruction in various physical activities help children develop motor skills. Although other factors (e.g., genetics) influence whether a child will become an athlete, physical activity in early childhood helps ensure that children will have the motor skills they need throughout life. Children will not develop motor skills without intervention. Children of this age usually play and explore; however, many spend only 10 to 20 percent of their time participating in gross motor physical activities, which require whole-body participation (e.g., walking, running, climbing). Many children spend too much time participating in sedentary behaviors (e.g., watching television and videotapes, playing computer games, playing with toys that do not require the child to move). Children benefit from physical activity in a number of ways. Physical activity can Give children a feeling of accomplishment. Reduce the risk of certain diseases (e.g., coronary heart disease, hypertension, colon cancer, diabetes mellitus), if children continue to be active during adulthood. Promote mental health. Growth and Physical Development A child s birthweight quadruples by 2 years of age. Between the ages of 2 and 5, children gain an average of 4 1 /2 to 6 1 /2 pounds per year and grow 2 1 /2 to 3 1 /2 inches per year. The child s head and trunk size are large in proportion to the rest of the body, making locomotion more difficult. However, as the legs grow, the child is able to move faster and more easily. Skeletal growth is steady in early childhood, and nonintensive physical activity does not damage growing 33

4 bones. Joints are flexible, and they get even more flexible during this period. During early childhood, other physical changes take place that enhance the child s ability to move and participate in physical activity: Muscles continue to grow. The nervous system continues to develop. Vision and visual perception improve. (Children s vision does not fully mature before ages 6 or 7. Imprecise eye movements limit their ability to track and judge the speed of moving objects.) Kinesthesia the sense that detects body position, weight, and movement of the muscles, tendons, and joints improves. Sense of balance improves. Cognition improves. Healthy Lifestyles Early childhood is a key time for promoting the development of motor skills and physical activity behaviors. Most children are active but may not have the opportunity to play and explore because of space or safety concerns, or because their parents do not encourage them to be physically active. Children in early childhood should be encouraged to participate in physical activity. Simple games such as Simon Says, chase, and tag are 34

5 appropriate. Physical activities (e.g., tumbling, gymnastics, dancing) tailored to the developmental needs of children are also appropriate. Because most children need to develop motor skills, they are not ready for organized sports, which require visual acuity, control, and balance. Building Partnerships Partnerships among health professionals, families, and communities are essential for ensuring that families receive guidance on physical activity. Health professionals need to give parents the opportunity to discuss physical activity issues and concerns affecting their children, and need to identify and contact community resources to help parents promote physical activity in their children. The community can help promote physical activity by providing programs that Encourage families to promote physical activity in children. Teach families about physical and motor skill development during early childhood. Give children the opportunity to be physically active. In addition, communities can provide (1) affordable, skilled child care providers who promote physical activity in children, (2) safe environments for physical activity, and (3) support for families of children with special health care needs. Many children spend time with child care providers or participate in Head Start or other preschool programs that provide opportunities for physical activity. Children in community programs can be introduced to new activities and may try them more readily if their peers seem to be enjoying them. Strengths, and Issues and Concerns During health supervision visits, health professionals should emphasize the physical activity strengths of the child, family, and community (Table 5) and address any physical activity issues and concerns (Table 6). 35

6 Table 5. Physical Activity Strengths During Early Childhood Child Family Community Participates in physical activity Enjoys physical activity Enjoys playing with parents, siblings, grandparents, and others Enjoys playing with objects and toys In addition to walking, often runs, gallops, jumps, and skips Enjoys throwing, catching, hitting, and kicking a ball Enjoys climbing and balancing activities Encourages the child to participate in physical activity Provides opportunities for the child to participate in physical activity Supervises the child during physical activity Ensures that the child uses appropriate safety equipment (e.g., helmet) during physical activity Participates in physical activity with the child Provides positive role model by participating in physical activity Promotes physical activity Provides programs that teach families about physical and motor skill development Provides opportunities for children to participate in physical activity Provides affordable, skilled child care providers who promote physical activity in children Maintains policies (e.g., preservation of green space) and provides environmental support (e.g., well-maintained sidewalks) that promote physical activity Provides safe environments for indoor and outdoor physical activity (e.g., walking and biking paths, playgrounds, parks, recreation centers) Provides support for families of children with special health care needs 36

7 Table 6. Physical Activity Issues and Concerns During Early Childhood Child Family Community Has health problems Experiences motor skill or developmental delays Experiences discomfort with physical activity Is afraid to try new physical activities Is more interested in sedentary behaviors (e.g., watching television and videotapes, playing computer games) Lacks friends or siblings to be physically active with Lacks knowledge of physical and motor skill development Does not encourage the child to participate in physical activity Does not advocate for physical education in programs Does not provide positive role model by participating in physical activity Does not participate in physical activity with the child Has health problems that affect the amount of time spent with the child Has a work schedule or other commitments that reduce the amount of time spent with the child Lacks space or equipment for physical activity Lacks programs that promote physical activity in children Lacks affordable, skilled child care providers who promote physical activity in children Lacks safe environments for indoor and outdoor physical activity (e.g., walking and biking paths, playgrounds, parks, recreation centers) Lacks policies (e.g., preservation of green space) and does not provide environmental support (e.g., well-maintained sidewalks) that promote physical activity Does not provide support for families of children with special health care needs 37

8 EARLY CHILDHOOD PHYSICAL ACTIVITY SUPERVISION A child s level of physical activity should be assessed as part of health supervision visits. (For more information on health supervision, see Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, listed under Suggested Reading in this chapter.) Health professionals can begin by gathering information about the child s level of physical activity. This can be accomplished by selectively asking key interview questions (listed in this chapter), which provide a useful starting point for identifying physical activity issues and concerns. Health professionals can then use this chapter s screening and assessment guidelines, and counseling guidelines, to provide families with anticipatory guidance. Interview questions, screening and assessment, and counseling should be used as appropriate and will vary from visit to visit, child to child, and family to family. Desired outcomes for the child, and the role of the family, are presented to assist health professionals in promoting physical activity. Interview Questions The following questions are intended to be used selectively to gather information, to address the family s issues and concerns, and to build partnerships. Do you have any concerns about Benita s development? How often do you play with her? How often does he get a chance to run? How often does Benita play with a ball? How does her development compare to that of your other children when they were her age? How much television do you allow Ethan to watch each day? Is your neighborhood safe enough for him to play outside? Do you participate in physical activity? If so, which ones? Did you participate in physical activity when you were a child? What are some physical activities you do with Ethan? 38

9 Screening and Assessment Counseling Measure the child s length or height and weight, and plot these on a standard growth chart (see Tool H: CDC Growth Charts). Deviation from the expected growth pattern (e.g., a major change in growth percentiles on the chart) should be evaluated. This may be normal or may indicate a problem (e.g., difficulties with eating). Assess the child s visual acuity and eye movement. Vision problems hinder the development of motor-visual (hand-eye) coordination, an important component of physical activity. Assess the child s coordination. Poor coordination may result from lack of physical activity or other factors, or it may be a symptom of developmental coordination disorder (DCD). If DCD is suspected, refer the child for neurodevelopmental assessment. (See the Developmental Coordination Disorder chapter.) Assess the child s motor skill development (Table 7). Children usually acquire fundamental motor skills by a particular age. 1 General Children should be physically active every day or nearly every day, as part of play, games, physical education, planned physical activities, recreation, and sports, in the context of family, school, and community activities. Encourage parents to promote daily physical activity (e.g., walking, running, riding a tricycle or bike, dancing, playing with a ball or at the playground, playing on equipment that requires balance, playing games such as Simon Says ). Developmentally appropriate organized activities such as tumbling, gymnastics, and dancing are excellent for children if they are taught by qualified, experienced instructors. Encourage parents to wait until their children are 6 years old before beginning organized sports. In early childhood, children are too young to understand rules and strategies and to handle the emotional and social stress sometimes associated with organized sports. Table 7. Motor Skill Development During Early Childhood Motor Skill Running Galloping Jumping Hopping Skipping Age Range 1 1 /2 to 2 years 2 to 2 1 /2 years 2 1 /2 to 3 years 3 to 4 years 4 to 5 years Encourage parents to let children do things for themselves (e.g., letting them climb up into the child safety seat). Explain to parents how to encourage their children to participate in physical activity. For example, parents can play with their children before watching television, then gradually extend playtime and decrease television time. Encourage parents to participate in physical activity with their children and to be positive 39

10 role models by participating in physical activity themselves. Discuss with parents the importance of using child care providers who promote physical activity and have the space and equipment for it. Physical Development Children do not develop catching, throwing, and kicking skills by a specific age. However, if children have not attempted any of these activities by age 4, they may have difficulties keeping up with their peers. Tell parents that organized sports, which require visual acuity, control, and balance, are inappropriate for children less than 6 years old because they need time to develop their motor skills. Injury Prevention Emphasize that children should be supervised when they participate in physical activity. Emphasize the importance of safety equipment (e.g., helmets, goggles) when children participate in physical activity. (See the Injury chapter.) Emphasize the importance of reducing children s exposure to sunlight while playing outdoors and thus their risk of developing skin cancer. Recommend that parents practice preventive strategies such as (1) applying a broad-spectrum sunscreen with a sun protection factor (SPF) rating of 15 or greater to children s exposed skin 30 minutes before they go outdoors, (2) reapplying sunscreen every 2 hours, and (3) ensuring that children wear broad-spectrum child-sized sunglasses and brimmed hats and clothing that protect the skin as much as possible. Safety If the safety of the environment or neighborhood is a concern, help parents find other settings for physical activity (e.g., Boys and Girls Clubs of America, recreation centers, churches and other places of worship). Remind parents that children can do many activities indoors with soft equipment that can be used in tight spaces (e.g., playing tag or hide-andseek, tossing a ball, crawling through an obstacle course). 40

11 Table 8. Desired Outcomes for the Child, and the Role of the Family Child Educational/Attitudinal Behavioral Health/Physical Status Enjoys physical activity Participates in daily physical activity Improves motor skills, coordination, and muscle tone Educational/Attitudinal Promotes physical activity Understands the importance of developmentally appropriate physical activity Has resources that allow the child to participate in physical activity Uses appropriate safety equipment (e.g., helmet, goggles) during physical activity Family Behavioral Provides opportunities and safe places for the child to participate in physical activity Participates in physical activity with the child Provides positive role model by participating in physical activity Grows and develops at an appropriate rate Maintains good health Health/Physical Status Maintains good health Advocates for physical education in programs 41

12 Reference 1. Gabbard CP Lifelong Motor Development (3rd ed.). Needham Heights, MA: Allyn and Bacon. Suggested Reading Association of State and Territorial Directors of Health Promotion and Public Health Education How to Promote Physical Activity in Your Community (2nd ed.). Washington, DC: Association of State and Territorial Directors of Health Promotion and Public Health Education. Clark JE Motor development. In Ramachandran VS, ed., Encyclopedia of Human Behavior (pp ). San Diego, CA: Academic Press. Clements RL, Lee M Parent s Guide to Physical Play. New York, NY: American Association for the Child s Right to Play. Gabbard CP Lifelong Motor Development (3rd ed.). Needham Heights, MA: Allyn and Bacon. Green M, Palfrey JS, eds Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents (2nd ed.). Arlington, VA: National Center for Education in Maternal and Child Health. Hammett CT Movement Activities for Early Childhood. Champaign, IL: Human Kinetics. Haywood KM Life Span Motor Development. Champaign, IL: Human Kinetics. Malina RM, Bouchard C Growth, Maturation and Physical Activity. Champaign, IL: Human Kinetics. McCall RM, Craft DH Moving with a Purpose: Developing Programs for Preschoolers of All Abilities. Champaign, IL: Human Kinetics. Payne VG, Isaacs LD Human Motor Development: A Lifespan Approach. Mountain View, CA: Mayfield Publishing. Pellegrini AD, Smith PK Physical activity play: The nature and function of a neglected aspect of play. Child Development 69(3): Rowland T Exercise and Children s Health. Champaign, IL: Human Kinetics. Sanders SW Designing Preschool Movement Programs. Champaign, IL: Human Kinetics. Torbert M, Schneider LB Follow Me Too: A Handbook of Movement Activities for Three- to Five-Year-Olds. Menlo Park, CA: Addison Wesley. U.S. Department of Health and Human Services; U.S. Department of Education Promoting Better Health for Young People Through Physical Activity and Sports: A Report to the President from the Secretary of Health and Human Services and the Secretary of Education. Atlanta, GA: U.S. Department of Health and Human Services. Virgilio SJ Fitness Education for Children: A Team Approach. Champaign, IL: Human Kinetics. 42

13 Why Isn t Charlie Developing Motor Skills? Dr. Higgs explains that Charlie needs the opportunity to try out various activities that are appropriate for his skill level. Charlie Spooner, a quiet 4- year-old boy, and his mother are going to see Dr. Higgs, the family physician. Dr. Higgs notices that Charlie is content to sit in a chair and gaze at whomever is speaking. He has no interest in getting up and looking around or playing with the toys in the room. Charlie s mother is concerned that Charlie is lagging behind his sister in motor skill development. Dr. Higgs reassures Charlie s mother that boys usually take longer than girls to develop motor skills. Dr. Higgs discovers that Charlie and his sister go to different child care providers. Charlie s provider does not promote physical activity, and the children are allowed to spend hours watching television and playing with toys that do not require much physical activity. On the weekends, Charlie s parents run and bike; however, they place him in a stroller or bike seat. Charlie s mother and father wonder why their child does not seem interested in running or learning how to ride a bike. Dr. Higgs explains that Charlie needs the opportunity to try out various activities that are appropriate for his skill level. Dr. Higgs suggests that rather than focusing on running and biking, Charlie s parents should encourage him to try other activities (e.g., playing with a ball, climbing, jumping) and to make these activities fun. Dr. Higgs also provides two additional suggestions: (1) changing child care providers to one who promotes physical activity and (2) allowing Charlie to participate in organized, supervised activities (e.g., gymnastics programs, play groups). Charlie s mother agrees to give these suggestions a try. 43

14 FREQUENTLY ASKED QUESTIONS ABOUT PHYSICAL ACTIVITY IN EARLY CHILDHOOD How can I help my 3-year-old learn new skills, such as throwing a ball? Children go through stages as they learn something new, whether it s learning to feed themselves or to coordinate their arms and legs. Some children learn more quickly than others. Some may need extra help from an adult. All children need practice when they are learning new skills, just like adults do. What physical activities are appropriate for my child? Physical activities (for example, running, jumping, climbing, and throwing, catching, or hitting a ball) and simple games (for example, Simon Says, chase, and tag) are appropriate for children. Your child can also participate in developmentally appropriate organized activities (for example, tumbling, gymnastics, and dancing). Children less than 6 years old do not have the motor skills, or mental and emotional capabilities, to participate in organized sports. How often should my child participate in physical activity? Your child will benefit most from daily physical activity. Children tend to be active in spurts and know when they need to rest. My neighborhood isn t very safe. How can my child be active if he can t play outdoors? Community organizations, recreation centers, and churches and other places of worship provide opportunities for children to participate in physical activity. Work with community leaders to ensure that your child has safe places for participating in physical activity (for example, walking and biking paths, playgrounds, parks, and recreation centers). Also, your child can do many activities at home such as hopping, dancing, playing tag or hide-and-seek, tossing a ball, or crawling through an obstacle course. Why is my daughter afraid of playing on playground equipment? Be patient, and try holding on to her when she is on the equipment. If this doesn t work, try to find other activities that do not frighten her. My son is lagging behind my daughter in motor skill development even though my daughter is a year younger. Why? Boys often take longer than girls to develop motor skills. However, once boys learn a skill, they usually perform it as well as girls. Boys tend to perform better than girls in activities requiring strength (for example, throwing), and girls tend to perform better in activities requiring balance and fine motor skills (for example, tap dancing). 44

15 Should I enroll my child in a gymnastics or dancing class? Classes taught by qualified and experienced instructors can be excellent for children. Always check on instructors qualifications, and observe the classes as much as possible. Our child care provider does not encourage physical activity. What should I do? Talk to your child care provider and encourage her to incorporate physical activity into the day. If lack of space or equipment is the problem, work with her to come up with creative ideas to provide physical activity opportunities for the children. If this is not possible, consider changing child care providers to one who promotes physical activity. Resources for Families See Tool F: Physical Activity Resources for contact information on national organizations that can provide information on physical activity. State and local departments of public health and education and local libraries are additional sources of information. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion Promoting Physical Activity: A Guide for Community Action. Champaign, IL: Human Kinetics. Cooper KH Fit Kids! The Complete Shape-Up Program for Birth Through High School. Nashville, TN: Broadman and Holman Publishers. Corbin CB, Pangrazi RP Physical Activity for Children: A Statement of Guidelines. Reston, VA: National Association for Sport and Physical Education. Institute for Research and Education HealthSystem Minnesota, Health Education Center Building Your Activity Pyramid. Minneapolis, MN: Institute for Research and Education HealthSystem Minnesota, Health Education Center. Kalish S Your Child s Fitness: Practical Advice for Parents. Champaign, IL: Human Kinetics. Katzman CS, McCary R, Kidushim-Allen D Helping Your Child Be Healthy and Fit with Activities for Children Aged 4 Through 11. Washington, DC: U.S. Department of Education, Office of Educational Research and Improvement. Koch T, Kamberg M Cabin Fever Relievers: Hundreds of Games, Activities, and Crafts for Creative Indoor Fun. St. Paul, MN: Redleaf Press. Kranowitz CS Activities for Kids in Tight Spaces. New York, NY: St. Martin s Press. Landy J, Burridge K Simple Things You Can Do to Raise a Child Who Is Physically Fit. New York, NY: Macmillan. 45

16 National Association for Sport and Physical Education Help Your Child Achieve a Fit and Healthy Lifestyle. Reston, VA: National Association for Sport and Physical Education. National Association for Sport and Physical Education Developmentally Appropriate Practice for Young Children, Ages 3 5. Reston, VA: National Association for Sport and Physical Education. National Institutes of Health, National Heart, Lung, and Blood Institute Asthma and Physical Activity in the School: Making a Difference. Bethesda, MD: National Institutes of Health, National Heart, Lung, and Blood Institute. President s Council on Physical Fitness and Sports Kids in Action: Fitness for Children. Washington, DC: President s Council on Physical Fitness and Sports. Shisler J, Killingsworth R, Schmid T Kidswalk-to- School: A Guide for Community Action to Promote Children Walking to School. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. 46