Physical Activity for Early Years Start Early, Stay Active for Life - - PowerPoint PPT Presentation

Physical Activity for Early Years

Start Early, Stay Active for Life

What is Physical Activity?

Any bodily movement Physical Activity for Pre 5s is usually Active Play

What is Physical Activity?

For Babies < 1 year

• Tummy time
• Reaching for or

grasping balls or

• ther toys
• Playing or rolling on

the floor

• Crawling around

the home

• Supervised water

based play For Toddlers

• Standing up and

crawling or walking

• Rolling, skipping,

hopping, running and jumping.

• Playing in water
• Chasing games
• Playing in the park
• Dancing

For Pre-Schoolers

• Walking or running
• Rolling, skipping,

hopping, running and jumping.

• Ball Games
• Swimming
• Jumping on a

trampoline

• Playing in the park
• Riding a bike or a

scooter

Varied activities appropriate to developmental stage

Benefits of Physical Activity for Early Years

• At no other point will children learn as many skills as

they do in the first 5 years of life

• Is this a ‘teachable moment’ to instil healthy family

habits more generally?

• Physical activity is crucial for physical development

and beneficial for cognitive development

Physical Activity and Motor Skill Development

• Physical Activity is crucial for gross and fine

motor skill development

– We can think of this as ‘physical literacy’ e.g. a trial of passive cycling in infants showed improved body control, balance, grasping and hand-eye coordination. (Timmons et al 2012)

Gross Motor Skill Developmental Milestones

• texy

There are wide ranges in which healthy babies achieve developmental milestones

Physical Activity and Health in Early Years

Systematic Review evidence for PA in Early Years suggests PA improves:

• Skeletal health (those in trial showed increased leg bone

circumference, but no change in bone mineral content)

• Psychosocial Health (those in PA trials showed greater

gains in social competence, externalizing behaviour, were less withdrawn & more outgoing)

• Cardio-metabolic Health (Some evidence PA improves

blood pressure, insulin resistance, cholesterol, blood lipid profiles even amongst pre school age children) (Timmons et al, 2012; Metcalf et al 2008; Saakslahti et al , 2004)

Physical Activity and Cognitive Development

• Early years is one of the most critical and

intensive period of brain development

• Healthy brain development at this stage

lays the foundations for cognitive development throughout life (Khan et al,

2014)

• Strong links in older children and adults

for developing cognitive & neural functioning and growing evidence amongst early years (Carson et al 2016)

• It is likely that the mechanism this is via

the development of new neurons, neural pathways and vascularization (Clark et al,

2009)

• Systematic Review Evidence suggests increased PA in

early years had significant beneficial effects on cognitive development (improving 67% of outcomes in the

executive function domain and 60% of outcomes in the language domain)

• Emerging evidence in early years for improvement in:

– Language – Flexibility of ideas – Sustained attention – Self regulation – better behavioural control (Carson et al , 2016)

Physical Activity and Cognitive Development

Physical Activity and Sleep

• More outdoor play is associated with better sleep
• utcomes in pre-schoolers
• More (TV) screen time associated with worse sleep
• utcomes in pre-schoolers
• Sleep Guidance for early years will be included in

forthcoming UK CMO physical activity guidance

Summary of PA Benefits

• Fundamental Motor Skills

Development

• Social and cognitive

development

• Development of brain

structures

• Sensory development
• Strong bones, muscles

and heart

• Maintaining a healthy

weight

• Self confidence for

parents & child

• Communication skills
• Language development
• Social & emotional

bonding with family &

• ther children
• Learn about their bodies

and their environment

• Improves sleep

Physical Activity Guidelines for Early Years

• Non – walkers

– Physical activity should be encouraged from birth, particularly through floor based play and water-based activities

Physical Activity Guidelines for Early Years

• Walkers

– Should be physically active daily for at least 180 minutes (3 hours) throughout the day

Early Intervention Needed

• Common misconception that this age group are physically

active

• Physical activity declines and sedentary behaviour

increases when children start school, so cannot wait until then to intervene (Cooper, et al 2015; Janssen et al , 2016; Farooq

et al , 2018)

• Growing concern about low fitness and poor motor skills of

those beginning school. We need to support children to be healthy and ‘school ready’

How Active is Scotland?

Source: Scottish Health Survey 2017 annual report https://www.gov.scot/publications/scottish-health-survey-2017-volume-1-main-report/

10 20 30 40 50 60 70 80 90 100 5-7 8-10 11-12 13-15 16-24 25-34 35-44 45-54 55-64 65-74 75+

Percentage Achieving Recommended Levels of Physical Actvity Age

Boys Girls Men Women

How Active are Children in Scotland?

How Active are Pre School Children?

• There is no national data set measuring physical activity for infants
• r toddlers, but PA declines with age
• 2-4 years olds need to do 80 mins more PA per day

Children aged 2-4 years in Scotland participate in only 104 mins PA per day – almost 80 mins below recommended levels (Scottish Health Survey, 2017)

• Only half 2-4 year olds participate in active play for more than 2

hours per day

47% on weekdays, 53% weekends. This declines rapidly with age (Scottish Health Survey, 2017)

• Only 20% of nursery day is physically active

In an Australian Study, children spent 48 % of their time at childcare sitting, 33% standing, and 19% in PA. Boys spent significantly more time in PA compared to girls (20.8% vs 17.7%; P = 0.003). Toddlers (< 3 years) spent significantly more time in PA compared to pre-schoolers (≥ 3 years) (22.2% vs 18.3%; P < 0.001). (Ellis et al, 2016)

Sedentary Behaviour

• Sedentary behaviour is any sitting, lying or reclining whilst awake
• No specific guideline on maximum amounts (yet)
• All under 5s should minimise the amount of time spent sedentary
• Screen time is not recommended for those < 1 year
• For toddlers and pre-schoolers, no more than 1 hour per day screen

time is recommended, less is better

• For older children, no more than 2 hours per day screen time is

recommended

How Sedentary are Scottish Children?

• Most children have higher screen time than recommended.

83% 2-4yr olds watch more than 1 hour a day on weekdays and 87% watch more than recommended on weekends.

• Screen time is higher for those living in areas of high

deprivation

On weekdays, 58% children in least deprived areas watch too much screens compared to 78% in most deprived areas.

• Children spend most of their day sitting down

50% of their waking day sitting down by age 6-7 years. This increases with age to over 75% of waking time by age 15 years. As children get older, the bouts of sitting become much longer with fewer breaks in sitting.

Source: Active Healthy Kids Scotland Report Card, 2018 https://www.activehealthykidsscotland.co.uk/files/2018/11/2018_Data_Sources.pdf

Universal Signposting

Universal Resources

• Book Bug Sessions go

alongside the book bags which are given out for free

• Held in Libraries across

Scotland

• The sessions are fun, with

stories, rhymes and play

• Play @ Home programme

designed to encourage parents and carers to help the development of children

• Free books available from

PHRU for Health or Education Staff

Common Concerns and Support

Lack of Tummy Time Universal Message:

• Daily tummy time is vital for

all babies for their

• development. Allow them
• pportunity to move and

explore a safe space which is free from clutter Resources: Play @ Home & Tummy Time Leaflets, inc tips for Tummy Time and videos. Avoid: keeping baby strapped in

• r seated for too long.

My baby doesn’t like being on his tummy She’s happier strapped in the seat, and it lets me watch the

• lder children

My other children didn’t crawl at all, so there’s no point in putting her on her tummy just now

I don’t really know how to play with a baby this young

4 m

Common Concerns and Support

Lack of weight bearing / Not walking Universal Message:

• All babies are develop at different

rates

• As babies learn to move they will be a

bit wobbly to start, so give them a bit

• f support and a safe environment to

explore.

• Often bottom shufflers will be later to

walk than those who crawl

• Minimise sedentary and screen time

Avoid: The use of Baby Walkers is not

• recommended. They do not help healthy

development and can be unsafe See Pathway for Support: if concerned re general developmental delay, asymmetric development, or regression

• f development

I’ve put him in a baby walker to help him learn how to walk She’s shuffling along on her bum, but isn’t interested in standing up yet

She’s very unsteady on her feet, I’m worried she might hurt herself

Everyone else’s babies are walking at this age at playgroup

13 – 15 m

Common Concerns and Support

Lack of fine motor skills Universal message:

• Children will learn these skills by

practicing them lots! It may take longer and/or be a bit messier, but it’s important that children have

• pportunity to try to use their hands

when eating, playing, getting dressed etc

• Toys which help might inc building

blocks, sorting /stacking toys, crayons, toddler books, etc Resources: Play @ Home & local groups Avoid: Limit screen use – this may inhibit development of fine motor control. See Pathway for Support: if concerned re general developmental delay, asymmetric development, or regression of development

We’ve got an iPad, why would she want to play with crayons? He can’t use a spoon to feed

• himself. He

makes such a mess, it’s easier for me to do it.

He’s not interested in books – he can’t turn the pages yet

I’m worried she’ll make a mess

13 – 15 m

Common Concerns and Support

Flat Feet or Different Gaits Universal Message

• The majority of children aged 1-5 years

have flat feet. Flat feet in older children does not usually cause any problems. Some may not develop an arch, but this is not usually a problem.

• In-toeing gait in very common in normal,

healthy children and can be seen in one foot or both. Resource: leaflets by APCP Avoid: Baby walkers are not recommended. They do not help support walking and can be unsafe. See Pathway for Support: if the condition is associated with foot, ankle or knee pain or if the child has poor balance or stamina in walking. 13 – 15 m Her feet are flat – they have no arches at all He is so clumsy – I’m worried it’s because he is pigeon toed

His toes turn in when he walks. Other children don’t walk like that.

Will a baby walker help her learn the right way to walk?

Health Visitor identifies concerns with development. Universal support & advice Ongoing concerns Are the concerns … Signpost

• www.nhsggc.org.uk

/kids

• Play@home
• Play Talk Read
• Local groups

Uni-professional? Concern in one area of development. Discuss concerns with appropriate uni-professional team. Outcomes Reassure

• Concerns being

well managed.

• Highlight Red Flags

for future. Advise and Educate

• Advice offered.
• Monitor

development and make further contact if no/little progress made. Investigate

• Further discussion

with team around the child.

• Uni-professional

triage appointment. Intervene

• Uni-professional AHP

assessment /intervention

• Paediatric

assessment/ intervention

• Joint Assessment

Clinic or Joint Appointment. Escalat

• Acute
• Social Work

Global? Concern in multiple/all areas of developm Discuss concern with Disability Pathway nurse

Pathway for Raising Concerns with Specialist Children’s Service

References

• Timmons, et al (2012) Systematic review of physical activity and health in the early years

(aged 0–4 years) Applied Physiology, Nutrition, and Metabolism, 37:773-792

• Metcalf, et al (2008). Physical activity at the government-recommended level and obesity-

related health outcomes: a longitudinal study (Early Bird 37). Arch Dis Child, 93(9): 772

• Sääkslahti, et al, (2004) Physical activity as a preventive measure for coronary heart disease

risk factors in early childhood. Scandinavian Journal of Medicine & Science in Sports, 14: 143-149

• Khan & Hillman (2014) The Relation of Childhood Physical Activity and Aerobic
• Fitness to Brain Function and Cognition: A Review. Pediatric Exercise Science, 2014, 26: 138-

146

• Clark et al (2009) Functional analysis of neurovascular adaptations to exercise in the

dentate gyrus of young adult mice associated with cognitive gain. Hippocampus, 19:937- 950

• Carson et al, 2016 Systematic review of physical activity and cognitive development in early
• childhood. Journal of Science and Medicine in Sport, 19 (7): 573-578
• Cooper et al. (2015) Objectively measured physical activity and sedentary time in youth: the

International children’s accelerometry database (ICAD) IJBNPA 12:113

• Janssen et al, (2016) Development of sedentary behavior across childhood and

adolescence: longitudinal analysis of the Gateshead Millennium Study. IJBNPA 13:88

• Farooq et al (2018) Timing of the decline in physical activity in childhood and adolescence:

Gateshead Millennium Cohort Study . Br J Sports Med;52:1002-1006.