Allergies An introduction  Current Problem: Introduce the topic and support it with statistics on this issue         Why did you choose this topic or why is important to

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Safety, Health, and Nutrition in Early Childhood Education

Jennifer Paris

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Safety, Health, and Nutrition in Early Childhood Education

An Open Educational Resources Publication by College of the Canyons

Created by Jennifer Paris

Peer Reviewed by Rebecca Laff

Edited by Lauren Adams, Alex Gavilan, Alexa Johnson, and Trudi Radtke

Cover Image: "Image", CDC is in the Public Domain

Version 1.0

2020

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Acknowledgments

College of the Canyons would like to extend appreciation to the following people and organizations for allowing this textbook to be created:

California Community Colleges Chancellor’s Office Chancellor Dianne G. Van Hook

Santa Clarita Community College District College of the Canyons Online Education

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© 2018, California Community Colleges, Chancellor’s Office. Except where otherwise noted, the content in this book is licensed under a

Creative Commons Attribution 4.0 International License.

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Further Acknowledgements I would like to thank: My department including my full-time faculty colleagues, Cindy Stephens and Wendy Ruiz, who supported me in pursuing the grant that funded this book and who believe in the purpose of our OER work. James Glapa-Grossklag, Brian Weston, Joy Shoemate, Chloe McGinley, Alexa Johnson, Trudi Radtke, Lauren Adams, and Alex Gavilan for their support to make this work possible. The peer reviewer, Rebecca Laff, for bringing a fresh set of eyes to the book and her work to make the book better. My family, especially my children Ashlynn and Aidan, for being understanding of the time and energy commitments that this book, the larger project it is part of, and my advocacy for OER have taken. Amanda Taintor, for being such a great collaborator and ally in developing and promoting OER in Early Childhood Education. The larger OER community that keeps me thinking and pushing my understanding of what open is, what it should be, and what role I can play in that.

Jennifer Paris

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Table of Contents Preface ………………………………………………………………………………………………………………………. 6

Section I: Introduction …………………………………………………………………………………………….. 9

Chapter 1: Children’s Well-Being and Early Childhood Education …………………………………….. 10

Section II: Safety …………………………………………………………………………………………………… 26

Chapter 2: Preventing Injury & Protecting Children’s Safety ……………………………………………. 27 Chapter 3: Creating Safe Indoor Environments ……………………………………………………………… 49 Chapter 4: Creating Safe Outdoor Environments …………………………………………………………… 90 Chapter 5: Caring for Minor Injuries and Preparing for and Managing Emergencies ………… 116 Chapter 6: Child Maltreatment ………………………………………………………………………………….. 145

Section III: Health ……………………………………………………………………………………………….. 163

Chapter 7: Promoting Good Health & Wellness …………………………………………………………… 164 Chapter 8: Prevention of Illness …………………………………………………………………………………. 191 Chapter 9: Supportive Health Care …………………………………………………………………………….. 220 Chapter 10: Children with Special Health Care Needs …………………………………………………… 245 Chapter 11: Children’s Mental Health ………………………………………………………………………… 278

Section IV: Nutrition ……………………………………………………………………………………………. 308

Chapter 12: Basic Nutrition for Children ……………………………………………………………………… 309 Chapter 13: Protecting Good Nutrition and Physical Wellness ………………………………………. 336 Chapter 14: Providing Good Nutrition ………………………………………………………………………… 360 Chapter 15: Menu Planning and Food Safety ………………………………………………………………. 387 Appendix A: 15 Must Haves for All Child Care Programs Checklist………………………………….. 423 Appendix B: Title 22 Licensing Regulation Highlights ……………………………………………………. 425 Appendix C: Health and Safety Checklist …………………………………………………………………….. 443 Appendix D: Example Injury/Incident Report Form ………………………………………………………. 444 Appendix E: Example Playground Inspection Form ……………………………………………………….. 445 Appendix F: Example Emergency Self-Assessment Form ……………………………………………….. 448 Appendix G: Example Emergency Response Plans ………………………………………………………… 449 Appendix H: Emergency Mitigation Checklist ………………………………………………………………. 453 Appendix I: Developmental Milestones ………………………………………………………………………. 455 Appendix J: Exclusion Form ……………………………………………………………………………………….. 468 Appendix K: Notice of Exposure to Contagious Disease…………………………………………………. 469 Appendix L: Individualized Health Care Plan………………………………………………………………… 470 Appendix M: Infectious Disease Information ……………………………………………………………….. 473 Appendix N: Self-Assessment for Positive and Healthy Meals and Snacks ……………………….. 495 Appendix O: Growth Charts ………………………………………………………………………………………. 498 Appendix P: Food Allergy Management and Prevention Plan Checklist …………………………… 504

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Preface

Licensing of Source Content Wherever possible, source content with licenses that are compatible (either public domain or CC-BY) with license of this overall text (CC-BY) were used. But there is limited content, mostly images, that may have more restrictive licensing. To allow readers to effectively source content and determine licensing, footnotes were used liberally throughout this book. If you choose to use this content to remix or create a derivative, please check the licensing carefully.

Language Choices Throughout This Book Language has power and word choice matters. Please see the following about some of the language choices made for this book.

Terminology As source content for this book was compiled from hundreds of sources, terminology doesn’t always match up, even after efforts were made to provide consistency across the text. You may notice there are several ways programs that provide care and education for young children are referred to in this book. In general, these all refer to programs in which children are cared for in groups by non-family members and are used interchangeably.

• Early care and education programs

• Early childhood education programs

• Child care centers or child care programs

• Out-of-home care

• And at times, just programs or centers The adults that care for children in these programs may be referred to as:

• Early childhood educators or professionals

• Teachers

• Caregivers

• Staff (although this term is often used when including other employees that may work in an early childhood education program outside of the classroom).

Gendered Language At times you may notice that a child or adult is referred to with the pronoun they or them. This is to be more gender inclusive. Unless specifically stated, when children or adults are gendered, it is not to be exclusionary (and likely is due to the language used in the source content).

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Family Structures and Forms Throughout this book, the word families has been used in place of parents in most places. This is to be as inclusive as possible of the different family structures in which the adults responsible for caring for children may not fit the label of parents. When the source content used the word parents (referring specifically to the adults that are responsible for a child), efforts were made to also use the words caregivers or guardians to be inclusive of all families.

Person First Language Because people are not the situations they encounter (such as poverty) or may experience (such as disabilities or medical conditions), person-first language is used. This is not intended to discount characteristics that may be part of a person’s identity but in an attempt to be respectful.

Special Features Throughout the Book There are a few callout boxes throughout the chapters that help highlight information and offer you opportunities to think more about the content you’ve read. Here is a description of what each of these boxes is.

Licensing Regulations In this box, you will find licensing regulations (and other legal requirements that relate to the chapter.

Pin It! These boxes are used to share examples and focused or specific information that relates to a topic in the chapter.

Pause to Reflect These boxes feature questions for you to consider and allow you to make connections with and apply the content.

These boxes call your attention to important information.

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These boxes feature direct quotes related to the content.

Engaging Families These boxes feature ways to engage families in the topics featured in the chapter.

In the Classroom These boxes provide hands on ways to use the information in the classroom with young children. You might find activities to do and/or books to read with children here. (these will be added to later versions of this book)

Resources for Further Exploration These boxes provide online sources of content that you can explore further that relate to the topics covered in the chapter.

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Section I: Introduction

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Chapter 1: Children’s Well-Being and Early Childhood Education

A culture of wellness exists when staff and child health and safety are valued, supported, and promoted through health & wellness programs, policies, and environment.1

Objectives

At the end of this chapter, you should be able to:

• Explain why health and well-being in early childhood is so important.

• Describe qualities and benefits of high-quality early care and education programs.

• Outline what the book will be addressing in regards to safety, health, and nutrition.

• Discuss what licensing is and its role in keeping children safe and healthy.

• Compare and contrast Title 22 and Title 5 licensing requirements.

Introduction

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.

Figure 1.1 – What happens when children are young can have a lifelong effect.2

1 Embedding Health and Safety in Your Program’s Culture by the Office of Head Start is in the public domain. 2 Sanderlin, R. (2020). How to Find a Military Daycare. Military.com. Retrieved from https://www.military.com/spouse/relationships/child-care-and-elder-care/how-to-find-a-military-daycare.html

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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 periods, 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 friends3

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

Figure 1.2 – Young children may develop dental caries (cavities).4

3 Early and Middle Childhood from the Office of Disease Prevention and Health Promotion is in the public domain. 4 Scott AFB dentists, assistants help ‘Give Kids A Smile’, by Airman 1st class Isaiah Gonzalez, is in the public domain.

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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

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 home, schools, and communities

• Increasing access to high-quality health care6

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 neighborhoods, 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. Research shows that lead exposure disproportionately affects children from minority and low–income households and can adversely affect their readiness for school. 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

5 Early and Middle Childhood by the Office of Disease Prevention and Health Promotion is in the public domain. 6 Early and Middle Childhood by the Office of Disease Prevention and Health Promotion is in the public domain.

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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.

The Effects of Poverty on Education “Despite being one of the most developed countries in the world, the United States has one of the highest rates of childhood poverty globally.”7 “Poverty has a particularly adverse effect on the academic outcomes of children, especially during early childhood.”8 Research has shown that children from families in poverty enter school with a readiness gap. Contributions to this gap include:

• Poor physical development and health (due to poor nutrition and lack of access to medical care)

• Challenges with concentration, memory, attentiveness, curiosity, and motivation9 due to the chronic stress of living in poverty

• Greater risk for behavioral and emotional problems

• Exposure to environmental hazards (such as lead paint) and violence in their communities.

Two additional things that are important to note:

• This gap disproportionately affects Black and Latinx children.

• Families experiencing poverty have challenges finding affordable, high-quality early care and education programs and are often in districts with under-resourced schools. 10

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 teachers;

• small class sizes and high adult-to-child ratios;

• age-appropriate curricula and stimulating materials in a safe physical setting;

7 ChildFund International. (2013). The Effects of Poverty on Education in the United States. Retrieved from https://www.childfund.org/Content/NewsDetail/2147489206/ 8 American Psychological Association. (2020). Effects of Poverty, Hunger and Homelessness on Children and Youth. Retrieved from https://www.apa.org/pi/families/poverty 9 ChildFund International. (2013). The Effects of Poverty on Education in the United States. Retrieved from https://www.childfund.org/Content/NewsDetail/2147489206/ 10 American Psychological Association. (2020). Effects of Poverty, Hunger and Homelessness on Children and Youth. Retrieved from https://www.apa.org/pi/families/poverty

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• a language-rich environment;

• warm, responsive interactions between staff and children; and

• high and consistent levels of child participation.”11 The National Association for the Education for Young Children says that high quality programs:

• Create caring communities of learners in which children develop relationships with each and the teachers and 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 behavior.

• Have 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