Children’s Well-being and Early Childhood Education

Chapter 1: Learning Objectives

Evidence shows that experiences in childhood are extremely important for a child’s healthy development and lifelong learning. How a child develops during this time affects future cognitive, social, emotional, language, and physical development, which in turn influences school readiness and later success in life. Research on a number of adult health and medical conditions points to pre-disease pathways that have their beginnings in early and middle childhood.

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During early childhood, the human brain grows to 90 percent of its adult size by age 3. Early childhood represents the period when young children reach developmental milestones that include:

• Emotional regulation and attachment
• Language development
• Cognitive development
• Physical development (motor skills)

All of these milestones can be significantly delayed when young children experience inadequate caregiving, environmental stressors, and other negative risk factors. These stressors and factors can affect the brain and may seriously compromise a child’s physical, social-emotional, and cognitive growth and development.

More than any other developmental period, childhood sets the stage for:

• School success
• Health literacy
• Self-discipline
• The ability to make good decisions about risky situations
• Eating habits
• Conflict negotiation and healthy relationships with family and friends^[3]

Understanding Childhood Health Concerns

Although young children are typically healthy, it is during this time that they are at risk for conditions such as:

• Developmental and behavioral disorders
• Child maltreatment
• Asthma and other chronic conditions
• Obesity
• Dental caries (cavities)
• Unintentional injuries

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While typically nonfatal, these conditions affect children, their education, their relationships with others, and the health and well-being of the adolescents and adults they will become. ^[5]

Social Determinants of Health 

Part of your role as an educator is to identify health and safety issues encountered in early learning settings. First, you’ll need to understand the definition of health and the ways health and safety can be impacted for children in your programs. Children arrive at early childhood programs from all types of backgrounds and experiences. It’s important to understand each family you work with so that you can support them in achieving health and well-being. You can also be a strong advocate for children and families in promoting good health. In this book, you’ll study potential health and safety issues in early learning programs. You’ll be offered tools to support your work in health promotion with young children and their families.

Environment and social factors that impact children and their families’ overall well-being are known as social determinants of health (SDH).  If you google social determinants of health you will find that lists of SDH will differ slightly from source to source.  For our purposes, we will focus on twelve (12) of the more common SDHs, that influence and impact our health ^[6].

If any SDH is challenging or lacking for a child and their families, then issues around health and safety can arise.  As stated earlier one of our many roles as Early Childhood Educators is to promote health.  To do this we need to understand some of the factors or SDH that the families of the children we care for, might face and how they impact their overall health.

The twelve social determinants of health (SDH) are identified in the interactive image below, tap on the plus sign (+) to see information about each of the 12 SDHs.   As you are reading, consider if and how each SDH impacts you. You’ll notice that each SDH may have more impact at different times in your life.

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In their groundbreaking work, Goran Dahlgren and Margaret Whitehead (1991) put forth the “Rainbow Model” of the determinants of health.  Their focus was on health policies, but the process created a model that goes beyond the healthcare system.  In general terms, SDH falls into 4 layers that influence an individual’s health.  Dahigren and Whitehead’s model of SDH helps to visually explain how health inequities impact the overall health of individuals. ^[8]

In their model, Dahlgren & Whitehead illustrated the main influences on health.  The first layer is the outer layer is the general socio-economic, cultural and environmental conditions layer and it depicts the major structural environments such as government policies, the economy and agreements between countries.  The 2nd  layer is the material and social conditions and they incorporate everything related to a person’s life including where they live and work.  The 3rd layer is the social and community network – this layer runs on mutual support from family, friends and the community.  The 4th layer is the individual lifestyle which represents the actions and choices made by the individual.   In the centre is an individual’s genetic makeup (sex, age etc.).  These factors are fixed and we have little control over them. ^[9]

Watch the following video that outlines the health inequities in Canada. As you watch, think about what your role could be in supporting children and young families in trying to make health more accessible to all.

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The Five Most Relevant SDH in the Field of Early Childhood Education

Now that we have a general understanding of SDH, you are probably thinking why do I need to know this?  You need to know about SDH, so you can identify where a child and their family may be struggling and provide resources.  A child is more than what you can see.   As we just learned there are many unseen factors (SDH) that impact children and their families.  These factors are not necessarily visible and they differ from child to child and their family.   As stated above “the majority of the work you’ll do with children and families is based on health and wellness”, to do this you need to get to know the families and their unique situations.  Above it mentions how SDH acts like dominoes falling, you as an early childhood educator have an opportunity to interrupt the cascade and redirect a child and their family onto a different path in life, which may have better outcomes.

The five (5) most relevant SDHs you will encounter in your work as an early childhood educator and see how we can improve the health outcome for a child and their family.

• • Healthy Child Development
  • Income and Social Status
  • Education and Literacy
  • Social Support Networks
  • Culture

Emerging Issues in Childhood Health

The keys to understanding childhood health are recognizing the important roles these periods play in adult health and well-being and focusing on conditions and illnesses that can seriously limit children’s abilities to learn, grow, play, and become healthy adults.

Prevention efforts in early and middle childhood can have lasting benefits. Emerging issues in early and middle childhood include implementing and evaluating multidisciplinary public health interventions that address social determinants of health by:

• Fostering knowledgeable and nurturing families, parents, and caregivers
• Creating supportive and safe environments in homes, schools, and communities
• Increasing access to high-quality health care^[11]

Early Childhood Development and Education

Early childhood, particularly the first 5 years of life, impacts long–term social, cognitive, emotional, and physical development. Healthy development in early childhood helps prepare children for the educational experiences of kindergarten and beyond. Early childhood development and education opportunities are affected by various environmental and social factors, including:

• Early life stress
• Socioeconomic status
• Relationships with parents and caregivers
• Access to early education programs

Early life stress and adverse events can have a lasting impact on the mental and physical health of children. Specifically, early life stress can contribute to developmental delays and poor health outcomes in the future. Stressors such as physical abuse, family instability, unsafe neighbourhoods, and poverty can cause children to have inadequate coping skills, difficulty regulating emotions, and reduced social functioning compared to other children their age.

Additionally, exposure to environmental hazards, such as lead in the home, can negatively affect a child’s health and cause cognitive developmental delays.

The socioeconomic status of young children’s families and communities also significantly affects their educational outcomes. Specifically, poverty has been shown to negatively influence the academic achievement of young children. Research shows that, in their later years, children from disadvantaged backgrounds are more likely to need special education, repeat grades, and drop out of high school. Children from communities with higher socioeconomic status and more resources experience safer and more supportive environments and better early education programs.

Early childhood programs are a critical outlet for fostering the mental and physical development of young children. According to the Center on the Development Child at Harvard University’s A Science-Based Framework for Early Childhood Policy,

“ The principal elements that have consistently produced positive impacts include:

• highly skilled educators;
• small class sizes and high adult-to-child ratios;
• age-appropriate curricula and stimulating materials in a safe physical setting;
• a language-rich environment;
• warm, responsive interactions between staff and children; and
• high and consistent levels of child participation.”^[15]

The National Association for the Education for Young Children (NAEYC) says that high-quality programs:

• Create caring communities of learners in which children develop relationships with each other and the educators and where each child and family are included.
• Teach to support children’s development and learning by being intentional with the environmental design, materials, and activities and by providing positive guidance for children’s behaviour.
• Have a developmentally appropriate curriculum that helps children learn and grow that sets challenging, yet achievable goals for children, balances adult instruction and group activities with play and child-chosen experiences, provides enough time for deep engagement, and is based on the children’s interests, abilities, and knowledge.
• Regularly assesses children’s development and learning to inform their environmental design, curriculum, and interactions with children and their families.
• Is founded on partnerships with families in which families are respected and valued, share their goals and concerns, are encouraged to participate, and with clear communication (in a family’s home language whenever possible).^[16]

Importance of Considering Holistic Development

Early childhood education (ECE) is not a singular concept, but rather a holistic concept that focuses on several aspects of a child’s development, including their cognitive, social, emotional, moral, spiritual, and physical well-being (American Academy of Pediatrics 2012; Chisholm 2004; Tinajero & Loizillon 2012). According to Shonkoff, et al. (2011), debates about early childhood education often focus on education and the enhancement of children’s cognitive skills and later academic progress. However, these authors stress the importance of viewing children in a holistic manner as part of a bigger system. In this manner, early childhood education becomes a vehicle for enhancing the physical, cognitive, mental, social and economic well-being of individuals and the societies in which they live. Early care and education programs should enhance multiple interrelated dimensions of a child’s life; including health and safety, nutrition, emotional well-being, and social competence.^[17]

Focus on Wellness

Rather than waiting for health issues to arise, families and early childhood education programs should focus on supporting children’s wellness. “Wellness describes the entirety of one’s physical, emotional, and social health; this includes all aspects of functioning in the world (physiological, intellectual, social, and spiritual), as well as subjective feelings of well-being. A child who is doing well frequently experiences joy, delight, and wonder, is secure and safe in his/her family and community, and is continually expanding and deepening his/her engagement with the world around him/her.”^[18]

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Wellness is an active process. It requires awareness and directed, thoughtful attention to the choices we make. Early care and education programs can play a critical role in helping children, families and staff commit to and implement healthy lifestyle choices that promote both physical and mental well-being. The two, in fact, are closely linked. Our feelings, thoughts, and behaviours directly impact our physical health. Similarly, our physical health status has a direct impact on our feelings, thoughts, and behaviours.^[20]

We must also support children’s mental well-being and help them navigate everyday stress and adversity as well as trauma and significant sources of stress. The American Psychological Association shares that “[b]uilding resilience — the ability to adapt well to adversity, trauma, tragedy, threats or even significant sources of stress — can help our children manage stress and feelings of anxiety and uncertainty.”^[21]

It is important that children are in an environment that keeps them physically and emotionally safe and healthy and provides sound nutrition. As an early childhood educator, providing these requires attention, planning, and intention.

Introduction to Safety, Health, and Nutrition

This course has 3 components.  These include:

• Safety
• Health
• Nutrition

Safety

Children are curious and eager to learn. They depend on their caregivers to keep them safe by making sure that nothing within a child’s reach can harm them. Injuries are a serious health risk to young children. But most injuries are predictable and preventable.^[22]

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ECE programs can prevent risks and unnecessary harm to children by committing to a culture of safety. A culture of safety prioritizes safety at all levels. It encourages programs to learn from past problems and prevent them in the future.^[24] Programs should not assume that nothing will ever go wrong. In fact, they should plan that something is going to go wrong. And their goal is to make it as hard as possible for things to go wrong.^[25]

Chapters 2 through 5 will focus on ways programs can protect children’s safety.

• Chapter 2 discusses active supervision and creating a culture of safety
• Chapter 3 covers creating safe indoor environments
• Chapter 4 examines creating safe outdoor environments
• Chapter 5 addresses caring for minor injuries and managing emergencies
• Chapter 6 discusses child maltreatment (abuse and neglect)

Health

“Health is more than merely the absence of disease—it is an evolving human resource that helps children and adults adapt to the challenges of everyday life, resist infections, cope with adversity, feel a sense of personal well-being, and interact with their surroundings in ways that promote successful development.”^[26]

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As mentioned at the beginning of the chapter, research is showing that many adult health issues, such as high blood pressure, heart disease, and diabetes, are linked to what happens during early childhood (and even prenatally!). We also know that during early childhood there are biological systems that are more sensitive to environmental factors (such as child maltreatment, malnutrition, and recurring issues to infectious disease).^[28]

It is vital for children and their families to have support for children’s physical, oral, and mental health. This happens through promoting health and protection from illness.

Chapters 7 through 11 focus on children’s health.

• Chapter 7 examines promoting health
• Chapter 8 looks at preventing illness
• Chapter 9 addresses supportive healthcare
• Chapter 10 describes special healthcare needs during childhood
• Chapter 11 discusses children’s mental health

Nutrition

Healthy eating and being active are essential to a child’s well-being. Children who are under or over-nourished are at risk for chronic health problems.^[29] Early childhood is an important time for developing healthy habits for life. Children’s bodies grow and develop in ways that affect the way they think, eat, and behave.^[30]

A healthy diet not only affects growth, but also immunity, intellectual capabilities, and emotional well-being. Families and educators must ensure that children receive an adequate amount of needed nutrients to provide a strong foundation for the rest of their lives.^[31]

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Chapters 12 through 15 focus on nutrition for children.

• Chapter 12 delves into basic nutrition for children
• Chapter 13 examines protecting nutrition and wellness
• Chapter 14 discusses providing good nutrition
• Chapter 15 addresses menu planning and food safety

	Pause to Reflect As you progress through this book and course, what connections can you make about how being knowledgeable about health, safety, and nutrition will support early childhood educators in both following licensing and other applicable regulations and ensuring they provide high-quality care for young children and their families?

Summary

Early childhood is a critical time in development. Many outcomes, both positive and negative, have their beginnings in these years. It is vital that children’s health and safety be protected. High-quality early care and education programs can play a valuable role in improving outcomes for children.

Resources for Further Exploration

• National Resource Center For Health and Safety In Child Care and Early Education: https://nrckids.org/
• Caring for our Children 4th edition): https://nrckids.org/files/CFOC4%20pdf-%20FINAL.pdf
• Caring for our Children Checklist: https://eclkc.ohs.acf.hhs.gov/sites/default/files/pdf/no-search/caring-for-our-children-basics-self-assessment-tool.pdf
• Healthy Child Care: https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/healthy-childcare/Pages/default.aspx
• National Scientific Council on the Developing Child: https://developingchild.harvard.edu/science/national-scientific-council-on-the-developing-child/
• American Institute of Stress: http://www.stress.org
• National Center for Children in Poverty: http://www.nccp.org
• Children’s Mental Health: https://www.cdc.gov/childrensmentalhealth/
• Embedding Health and Safety in Your Program’s Culture Head Start webinar: https://eclkc.ohs.acf.hhs.gov/video/embedding-health-safety-your-programs-culture
• Licensing help for child care providers: https://mn.gov/dhs/partners-and-providers/licensing/child-care-and-early-education/
• Parent Aware Minnesota:Offers tools and resources to help early learning programs help families with young children succeed.
• NAEYC Early Learning Program Accreditation: https://www.naeyc.org/accreditation/early-learning-program-accreditation
• A Science-Based Framework for Early Childhood Policy: http://developingchild.harvard.edu/wp-content/uploads/2015/05/Policy_Framework.pdf