Before You Go - February 2012
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Stumbling Blocks
Kids in Child Care Centers Not Getting Adequate Exercise

By Deborah L. Vence

Many parents today must place their young children in child care facilities because of work or other commitments. In fact, three-fourths of preschool-age children in the United States attend child care. However, at issue is the fact that many of those children are not getting enough outdoor physical activity.

And, who's at fault? Possibly, parental and societal values about injury prevention and kindergarten readiness, according to a study, "Societal Values and Policies May Curtail Preschool Children's Physical Activity in Child Care Centers," which was published in the February 2012 issue of Pediatrics.

Kristen Copeland, MD FAAP, assistant professor of pediatrics and director of the Primary Care Fellowship in Child and Adolescent Health Division of General and Community Pediatrics Cincinnati Children's Hospital Medical Center, led the team that conducted a focus group study of 53 child care providers from 34 child care centers in Cincinnati to examine their perceptions of potential barriers to children's physical activity in child care.

"We conducted this study because there had been some other research, published by Dr. Russ Pate and colleagues, that indicated that children were not getting enough physical activity in child care centers," Copeland said. "They were sedentary for up to 83 percent of the time they spent in these settings, even excluding time spent during nap, and they were only vigorously active—running, jumping, climbing—for 2 to 3 percent of the time. We sought to understand what potential barriers might be to children participating in physical activity in these settings."

The study's results showed three main barriers to children's physical activity: injury concerns, a focus on academics over outdoor play, and financial restraints. With regard to finances, several of the study's participants cited budgetary reasons as the reason why their centers could not offer children the best physical activity opportunities. Most centers had tight operating margins, and could not afford equipment for the children to play on.

Besides financial concerns, though, child care providers interviewed for the study indicated that they felt pressure from parents to make sure that their children did not get injured while playing outside, and, at times, were asked to keep children from participating in vigorous activity to keep them from being injured. In addition, they said stricter licensing codes have resulted in playgrounds being less physically challenging and interesting to children. The new play equipment that was safe according to these standards became boring to children as they quickly mastered it. Teachers indicated that children would then start to use equipment in unsafe ways for which it was not intended, according to a January press realease.

"It was also interesting to hear that a focus on safety, and preventing injury, may be a barrier to children's physical activity. Teachers told us that out of concern for injury, some parents asked that their child not participate in vigorous activities on the playground, and just 'read a book instead,'" Copeland said. "We also heard from teachers that stricter licensing codes had made playgrounds very safe, but all the fixed-play equipment—climbers/jungle gyms—were more or less the same, and quickly became boring to the children.

"After the children mastered this equipment, it would no longer be effective in encouraging physical activity. Or alternatively, children tried to use the equipment in potentially unsafe ways, and in ways it was not intended to be used, such as climbing up the slide, or climbing over a railing," Copeland said. "Of course, other studies have shown that this fixed equipment is actually inversely associated with children's physical activity, and not effective at promoting it. Our study may offer an explanation for why this is the case."

But, the fact is, Copeland noted, that "children don't need climbers to be physically active. They just need to be given the time, space and freedom to run, which is what they are naturally inclined to do. With children spending long hours in child-care centers, this may be their only opportunity to be physically active.

"The playgrounds in these settings are regulated such that with proper supervision, they are safe for children in this age group. So, fear of injury need not be a barrier to children being physically active," she added. "And, in the setting of a national childhood obesity epidemic, the consequences of preventing—rather than promoting—physical activity for children in this age group may be dire."

Besides the fear of injuries, child care providers also said they felt pressured by parents (both upper- and lower-income) and early-learning state standards to prioritize academic classroom learning over outdoor and active playtime.

"Teachers told us that they did not feel that parents valued physical activity and gross motor development as much as their child's cognitive development," Copeland said.

"We were surprised about this, that parents were more concerned about classroom learning than outdoor play for children as young as 3," she said. "Several teachers commented that parents wanted to know what their child 'learned' that day, but were not interested in whether they had gone outside, or had mastered fundamental gross motor skills."