Recommendations for promoting physical activity in the early years and levers to influence policy

Key recommendations for promoting physical activity Early years Planning and developing physical activity initiatives. Working with parents and carers. Increasing physical activity in early years settings. Current available evidence suggests key components of successful interventions to promote physical activity in the early years fall into these three categories: Planning and developing physical activity initiatives: These slides outline the evidence-based recommendations for actions that should be taken or components that should be put into place when planning and developing physical activity initiatives for the early years. Working with parents and carers: These slides outline the evidence-based recommendations for working directly with parents and carers in either a community or early years setting which are essential for ensuring children in the early years have sufficient opportunities to be physically active. Increasing physical activity in early years settings: These slides outline the evidence-based recommendations to help those working in early years settings effectively increase physical activity and decrease sedentary behaviour in children under five.

Planning and developing physical activity initiatives Recommendation 1 Develop initiatives that target adults who interact with children in the early years. Recommendation 2 Consult with parents and carers to identify their needs and barriers. These evidence-based recommendations are suggestions for actions that could be taken or components that could be put into place when planning and developing physical activity initiatives for the early years. Recommendation 1 Target activities and resources at those who have responsibility for the child and their day to day activities. Work with those who have high levels of contact with children in the early years, such as early years practitioners, parents and carers. Recommendation 2 Provide practical solutions for issues that might hinder attendance, for example, provide options for childcare at the venue or make the session child friendly. Work with parents and carers during sessions to help identify what may be hindering their child from being active and provide them with practical examples of how to overcome these barriers. For example, if the child is shy or reluctant to play in groups, they may need gentle encouragement from an adult to play with them or another child.

Planning and developing physical activity initiatives Recommendation 3 Use an integrated approach to help target information at parents and carers. Recommendation 4 Use multi-component approaches when delivering information. Recommendation 3 Use nurseries, children’s centres and schools to provide information to parents and carers on the importance and benefits of physical activity and provide ideas on what they can do with their children to help them be more physically active. Work in partnership with local medical, health and social services in order to send consistent messages on physical activity to parents and carers. Recommendation 4 Use a variety of different communications, such as leaflets, posters or texts to relay physical activity messages to parents and carers. Work in partnership with local services to provide parents and carers with consistent physical activity messages, eg, agree with health visitors or early years settings about how and what information is provided to parents and carers.

Working with parents and carers Recommendation 1 Provide parents and carers with information on the importance of physical activity and the adverse effects of too much sitting time. Recommendation 2 Educate parents and carers about what counts as physical activity. Recommendation 3 Create age inclusive promotional materials for education and activity sessions. Recommendation 1 Provide parents/carers with a leaflet from a school or trusted source or include it as an element of a parenting class. Where appropriate, provide informational materials for parents and carers in multiple languages and at a suitable reading level for the target population. Verbal communication may be more appropriate for some parents. Recommendation 2 Provide parents with concrete examples of what physical activity looks like at different stages of development, eg, tummy time for non-walkers Motivate parents and carers to critically evaluate the types of activities their children participate in, eg, sedentary vs. energetic activities Provide parents and carers with a range of stage appropriate indoor and outdoor activity ideas for their child. Work with parents to identify how long their child participates in each type of activity and provide parents with ideas on how they can balance sedentary activities with more energetic ones. Recommendation 3 Use an inclusive title and description when creating promotional materials, e.g. ‘Do you want a baby/child that sleeps well at night? Find out how physical activity can help’. Use the age or stage, eg, babies or non-walkers, of the child as the only inclusion criteria on promotional materials, eg, use stage not weight status.

Increasing physical activity in early years settings Recommendation 1 Ensure appropriate levels of practitioner training and support are in place. Recommendation 2 Partner with external agencies to help practitioners develop their physical activity knowledge and expertise. Recommendation 1 Consult with setting managers to ensure appropriate levels of practitioner support are in place. Work with practitioners at each setting to identify and fulfil training and support needs. Provide ‘booster’ training and information sessions to refresh practitioners’ skills and knowledge for promoting physical activity and reducing sedentary behaviour within their setting which may help to develop their confidence. Provide practitioners with a range of activity ideas for both outdoors and indoors. Recommendation 2 Identify community based support systems, such as a physical activity co-ordinator or local authority health improvement team, which can work with practitioners to help provide physical activity sessions for the children or can facilitate practitioners’ training sessions. Consider the individual needs of the setting and practitioners to determine how best to provide support.

Increasing physical activity in early years settings Recommendation 3 Involve parents and carers both directly and indirectly in the activities to ensure they are also carried out in the home environment. Recommendation 4 Offer more frequent short periods of outdoor play. Recommendation 5 Provide more ‘activity friendly’ portable equipment. Recommendation 3 Get parents involved directly through the setting, eg, invite them for a ‘Stay and play session’ or put on educational sessions. Provide practitioners with specific training on how to promote physical activity for children in the early years to parents and carers Involve parents and carers indirectly by speaking with them or providing visual prompts which let them know what physical activities their child has been doing during the day. Provide parents and carers with physical activity ideas for the home environment. Recommendation 4 Modify break times in order to provide shorter breaks, eg, 10-15 minutes, and more frequent outdoor play sessions rather than fewer, longer breaks, eg, 2 x 30 minutes. Recommendation 5 Provide a variety of smaller objects for children to play with, such as balls, push or pull toys and tricycles rather than just large fixed equipment. Provide parents with physical activity ideas along with a ‘take home bag’ of activity friendly equipment or list of everyday household items which can be used to promote physical activity, such as lengths of materials with different textures, eg, chiffon, scrunched paper, cotton wool, or balls of different sizes and colours.

Increasing physical activity in early years settings Recommendation 6 Include adult-led activities to improve motor skills. Recommendation 7 Use physical activity as a medium through which to integrate all areas of learning and development. Recommendation 8 Ensure a balance of free play and adult-led physical activity opportunities. Recommendation 6 Provide adult-led activity sessions throughout the day which offer children an opportunity to practise and improve motor skills Work towards providing older children (pre-schoolers) with longer activity sessions. Recommendation 7 Consider, when planning any activities, how they can be made more active. Use physical activity to support other areas of the curriculum, eg, language and communication development by using lots of movement vocabulary in the activities played. Recommendation 8 Provide specific opportunities for appropriate stage of physical development, such as tummy time and crawling activities for babies and movement games for walkers, within the early years setting’s daily routine. Assess indoor and outdoor environments, and if possible rearrange them to offer more free space for active play. Balance adult-led activity sessions with opportunities for indoor and outdoor free play. Repeat activities to allow for lots of ‘practice time’, so young children have ample opportunities to master their environment and refine their newly learned skills.

Policy levers Health risk of sedentary behaviour Sedentary behaviour in the early years is associated with overweight and obesity and lower cognitive development. Overweight and obesity Children who are overweight and obese in the early years are more likely to grow up to be overweight and obese as adults. A policy lever is a feature/angle which can be used to gain government interest and support and which is already aligned to their agenda priorities. Programmes are more likely to gain funding/support if the government recognises these features as important. Health risk of sedentary behaviour Beginning to know that patterns of sedentary behaviour (especially TV viewing) are relatively stable over time. There is a need to establish healthy patterns of behaviour during the early years to protect against possible health detriments in the future. Accepted that sedentary behaviour displaces time to be physically active. Being less active gives less time for young children to develop cognitively through the physical activities they would otherwise be engaged in. Overweight and obesity There is growing awareness that early life experiences impact on future health outcomes. The National Child Measurement programme data for 2014/2015 highlights in England how the incidence of children who are overweight and obese in reception increases from 21.9% in reception to 33.2% by year 6. Data on the patterns of physical activity among children and young people suggest that they decline as they age. Therefore it would seem critical to encourage a high level in the early years to help offset the inevitable decline and associated health detriments.

Policy levers Health and wellbeing benefits Physical activity is central to optimal growth and development in the under fives. Physical development Physical development is now recognised as being important to children’s overall development in the early years in all four UK early years curriculums. Health and wellbeing benefits Physical activity in the early years provides immediate and long term benefits for physical health and psychological wellbeing. Studies have shown that physical activity in the early years is important for developing motor skills, promoting healthy weight, enhancing bone and muscular development and for the learning of social skills. One study has suggested that by acquiring basic motor skills in the early years, this can lead to children developing more confidence and wanting to participate in more physical activity. Physical development Early movement opportunities and physical activities are the primary activity which enables babies and young children to develop physically, especially their gross motor skills. In the Early Years Foundation Stage in England, physical development is one of the three prime areas of learning (along with communication and language and personal, social and emotional development). In the Foundation stage/phase in Northern Ireland and Wales, respectively, physical development is a statutory area of learning. In the Curriculum for Excellence (age 3-18 years) in Scotland, development in movement skills, competencies and concepts are an experience and outcome expected in the Health and wellbeing curriculum area.

Policy levers Brain development Physically active play can contribute to the development of many important brain structures ‘In the early life period, interactions and experiences determine whether a child’s brain architecture provides a strong or weak foundation for their future health, wellbeing and development’18 Brain development Development of neural structures (the ‘firing up’ of synapses and connections) between birth and the age of three is an important ‘window’ for development. When babies are born, 25% of their brains are developed. By age 3, their brains are 80% developed. This neural development is considered to be especially important for their social and emotional development. Aspects of social and emotional development can include: behavioural flexibility confidence self esteem and sense of self belief resilience language and communication - listening attentively, responding with comments, questions or actions, speaking in a familiar group co-operation - taking turns, sharing, appropriate behaviour in group play.

Implications for policy makers Promote physical activity through new policy measures. Review early years curriculums and consider how to incorporate physical activity sessions. Ensure all families are able to use suitable play areas in the local communities. Consider appropriate training and support to early years practitioners and teachers to help successfully deliver physical activity programmes.

Implications for practitioners Provide children with opportunities to learn new skills. Ensure children have regular access to equipment and the outdoor environment/space. Modify break times to encourage more focused sessions of outdoor play. Practitioners can also: utilise training courses and resources to increase knowledge and understanding work with parents to help them understand the importance of early movement experiences. Children learn by copying and modelling behaviour so it is important that adults (including practitioners) are seen to be physically active throughout the day.

Implications for parents/carers Provide opportunities for children to be active daily, in a variety of outside environments. Be an active role model by participating in physical activity with and without their child. Give both boys and girls the same chance to try a variety of active play experiences. Further implications for parents/carers Work with their child’s early years setting to: stay informed about the physical activity experiences their child is having provide similar/new movement opportunities at home send their child suitably dressed to participate in both indoor and outdoor activities whatever the weather.