Health, Safety, and Nutrition for the Young Child [11 ed.] 0357765761, 9780357765760

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Health, S a f e t y, & Nutrition for the Young Child

11e

Lynn R. Marotz

NAEYC PROFESSIONAL PREPARATION STANDARDS *

Correlation Grid

Health, Safety, and Nutrition for the Young Child (11e) by Lynn Marotz (2024) Standards

Chapters

Standard 1: Child Development and Learning in Context

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19

1A

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19

1B

1, 2, 3, 4, 7, 8, 9, 10, 11, 12, 13, 15, 16, 17, 18, 19

1C

1, 2, 3, 4, 7, 8, 10, 11, 15, 16, 17, 18, 19

1D

1, 2, 3, 4, 7, 8, 10, 11, 15, 17, 18, 19

Standard 2: Family-Teacher Partnerships and Community Connections

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19

2A

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19

2B

1, 2, 3, 4, 5, 6, 7, 8, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19

2C

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 15, 16, 18, 19

Standard 3: Child Observation, Documentation, and Assessment

1, 2, 3, 4, 5, 6, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19

3A

1, 2, 3, 4, 5, 6, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19

3B

1, 2, 3, 4, 5, 6, 8, 9, 11, 12, 13, 19

3C

1, 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 13, 15, 19

3D

1, 2, 3, 4, 5, 6, 8, 9, 10, 11, 16, 19

Standard 4: Developmentally, Culturally, and Linguistically Appropriate Teaching Practices

1, 3, 4, 7, 10, 11, 13, 15, 16, 18, 19

4A

1, 3, 4, 7, 10, 11, 13, 15, 16, 18, 19

4B

1, 3, 4, 10, 11, 15, 16, 18, 19

4C

1, 3, 10, 11, 13, 18, 19

Standard 5: Knowledge, Application, and Integration of Academic Content in the Early Childhood Curriculum

1, 3, 8, 10, 11, 15, 16, 18, 19

5A

1, 3, 10, 11, 15, 16, 18, 19

5B

1, 3, 8, 11, 18, 19

5C

3, 8, 10, 11, 18, 19

Standard 6: Professionalism as an Early Childhood Educator

1, 2, 3, 7, 8, 9, 10, 11, 12, 15, 16, 17, 18, 19

6A

1, 8, 9, 10, 11, 12, 17, 18, 19

6B

1, 2, 3, 7, 8, 10, 11, 12, 15, 16, 17, 18, 19

6C

1, 2, 3, 7, 8, 10, 11, 17, 18, 19

6D

1, 8, 9, 10, 11, 14, 15, 16, 17, 18, 19

6E

8, 9, 10, 11, 15, 16, 18

*Based on 2020 Professional Standards and Competencies. For full explanations on each standard and competency please visit NAEYC.org.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

National Health Education Standards (NHES)* Correlation Grid

Health, Safety, and Nutrition for the Young Child (11e) by Lynn Marotz (2024) Standards

Chapters

Standard 1: Students will comprehend concepts related to health promotion and disease prevention to enhance health.

2, 3, 4, 5, 6, 8, 11, 12, 13, 15, 16, 17, 18, 19

Standard 2: Students will analyze the influence of family, peers, culture, media, technology, and other factors on health behaviors.

1, 15, 19

Standard 3: Students will demonstrate the ability to access valid information and products and services to enhance health.

11

Standard 4: Students will demonstrate the ability to use interpersonal communication skills to enhance health and avoid or reduce health risks.

1, 10, 11

Standard 5: Students will demonstrate the ability to use decision-making skills to enhance health.

8, 9, 11

Standard 6: Students will demonstrate the ability to use goal-setting skills to enhance health.

6, 13, 14, 15

Standard 7: Students will demonstrate the ability to practice health-enhancing behaviors and avoid or reduce health risks.

11, 13, 14, 18, 19

Standard 8: Students will demonstrate the ability to advocate for personal, family, and community health.

7, 12

*Joint Committee on National Health Education Standards. (2007). National Health Education Standards, Second Edition: Achieving Excellence. Washington, D.C.: The American Cancer Society. Currently undergoing revision.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Health, Safety Nutrition and

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Health, Safety, and Nutrition for the Young Child, Eleventh Edition Lynn R. Marotz

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ISBN: 978-0-357-76576-0 Cengage 200 Pier 4 Boulevard Boston, MA 02210 USA Cengage is a leading provider of customized learning solutions. Our employees reside in nearly 40 different countries and serve digital learners in 165 countries around the world. Find your local representative at: www.cengage.com. To learn more about Cengage platforms and services, register or access your online learning solution, or purchase materials for your course, visit www.cengage.com.

Printed in the United States of America Print Number: 01 Print Year: 2023

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Brief Contents

Unit 1

Promoting Children’s Health: Healthy Lifestyles and Health Concerns

Chapter 1

Chapter 6

Children’s Well-Being: What It Is and How to Achieve It 2 Daily Health Observations 41 Assessing Children’s Health 55 Caring for Children with Medical Conditions 83 The Infectious Process and Environmental Control 114 Childhood Illnesses: Identification and Management 138

Unit 2

Keeping Children Safe

Chapter 7

Chapter 11

Creating High-Quality Environments 172 Safety Management 207 Management of Injuries and Acute Illness 239 Adverse Childhood Experiences (ACEs): Maltreatment 271 Planning for Children’s Health and Safety Education 297

Unit 3

Foods and Nutrients: Basic Concepts

Chapter 12 Chapter 14

Nutrition Guidelines 326 Nutrients that Provide Energy (Carbohydrates, Fats, and Proteins) 346 Nutrients that Promote Growth and Regulate Body Functions 363

Unit 4

Nutrition and the Young Child

Chapter 15

Feeding Infants 388 Feeding Toddlers, Preschoolers, and School-Age Children 411 Meal Planning and Service 434 Food Safety 461 Nutrition Education: Rationale, Concepts, and Lessons 491

Chapter 2 Chapter 3 Chapter 4 Chapter 5

Chapter 8 Chapter 9 Chapter 10

Chapter 13

Chapter 16 Chapter 17 Chapter 18 Chapter 19

1

171

325

387

iii Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

iv

Brief Contents

Epilogue

514

Looking Ahead . . . Making a Difference 514

Appendices A National Health Education Standards 517 B Monthly Calendar: Health, Safety, and Nutrition Observances C Federal Nutrition Programs 523 D Children’s Book List 526

516 520

Glossary

532

Index

540

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Contents

Unit

1

Promoting Children’s Health: Healthy Lifestyles and Health Concerns

Chapter 1 Children’s Well-Being: What It Is and How to Achieve It 2 The Preventive Health Concept

1-2

Health, Safety, and Nutrition: An Interdependent Relationship 8

1-2a 1-2b 1-2c 1-2d

What Is Health? 8 What Factors Influence Children’s Health? Safety 10 Nutrition 10

3

4

Promoting a Healthy Lifestyle Being Physically Active Injury Prevention 18 Body Mechanics 19

2-5

Health Education

49

49

Digital Download Partnering with Families Promoting Children’s Oral Health 50

Classroom Corner 51 Summary 52 Terms to Know 52 Chapter Review 52 Case Study 53 Application Activities 53 Stop and Check Responses 54 Additional Resources to Explore 54 References 54

11

17

Chapter 3 Assessing Children’s Health 55

18

Digital Download Teacher Checklist 1–1 Proper Body Mechanics for Adults

1-4d Oral Health

47

Digital Download Teacher Checklist 2-3 Supporting Family Referrals

9

1-3 Children’s Growth and Development 1-3a Growth 12 1-3b Development 14 1-4 1-4a 1-4b 1-4c

2-3b Recording Observation Results 47 2-3c Confidentiality of Health Information 2-3d Health Observation Benefits 47 2-4 Family Involvement 48 2-4a The Family’s Responsibility 48

1-1 1-1a

National Health Initiatives

1

20

20

3-1 3-1a 3-1b

Children’s Health Records

56

Health History Questionnaire 57 Medical and Dental Examinations 58

Digital Download Teacher Checklist 1–3 Strategies for Managing Teacher Stress 24

3-2 Screening Procedures 3-2a Height and Weight 59 3-2b Body Mass Index 59 3-2c Vision 60

Digital Download Teacher Checklist 1–4 Strategies for Increasing Children’s Resilient Behaviors 30

Digital Download Teacher Checklist 3-1 Early Signs of Visual Abnormalities in Infants and Toddlers 61

1-4f

Digital Download Teacher Checklist 3-2 Signs of Visual Acuity Problems in Older Children 61

Digital Download Teacher Checklist 1–2 Promoting Children’s Tooth Brushing 21

1-4e Mental Health and Social-Emotional Competence

Resilient Children

22

31

Digital Download Partnering with Families Growing Your Child’s Brain

32

Classroom Corner 33 Summary 33 Terms to Know 34 Chapter Review 34 Case Study 35 Application Activities 35 Stop and Check Responses 35 Additional Resources to Explore 36 References 36

Chapter 2 Daily Health Observations 41 2-1 Promoting Children’s Well-Being 2-1a Gathering Information 43 2-2

Observation as a Screening Tool

2-3 Daily Health Checks 2-3a Method 45

43 44

45

Digital Download Teacher Checklist 2-1 Health Observation Checklist

3-2d Hearing

59

65

Digital Download Teacher Checklist 3-3 Behavioral Indicators of Children’s Hearing Loss 66 Digital Download Teacher Checklist 3-4 Early Signs of Hearing Loss in Infants and Toddlers 67

3-2e

Speech and Language

68

Digital Download Teacher Checklist 3-5 Strategies for Communicating with Children Who Are Hearing-Impaired 69

3-2f

Nutritional Status

3-3

Referrals

71

74

Digital Download Partnering with Families Children’s Eye Safety 45

Digital Download Teacher Checklist 2-2 Warning Signs of Potential Mental Health Problems 46

75

Classroom Corner 76 Summary 77 Terms to Know 77 Chapter Review 77 Case Study 79 Application Activities 79 Stop and Check Responses 80 Additional Resources to Explore 80 References 80

v Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

vi

Contents

Chapter 4 Caring for Children with Medical Conditions 83 Inclusive Education: Supporting Children’s Success

84

4-2 Common Chronic Diseases and Medical Conditions 4-2a Allergic Diseases 86

85

4-1

Digital Download Teacher Checklist 4-1 Cold or Allergy: How to Tell?

4-2b Asthma

91

92

4-2c Anemia 93 4-2d Childhood Cancers 94

4-2f 4-2g 4-2h 4-2i

96

96

Digital Download Teacher Checklist 4-5 Children with Diabetes

98

Digital Download Teacher Checklist 4-7 Information to Include in a Child’s Seizure Report 104

Sickle Cell Disease

105

Digital Download Teacher Checklist 4-8 Children with Sickle Cell Disease

106

Digital Download Partnering with Families Children with Medical Conditions and Physical Activity 106

Classroom Corner 107 Summary 108 Terms to Know 108 Chapter Review 109 Case Study 109 Application Activities 110 Stop and Check Responses 110 Additional Resources To Explore 110 References 111

Chapter 5 The Infectious Process and Environmental Control 114 5-1

Risk Factors

115

5-2

Communicable Illness

5-3

Stages of Illness

5-4 Control Measures 5-4a Observations 118 5-4b Policies 119

117 118

2

Classroom Corner 132 Summary 133 Terms to Know 133 Chapter Review 134 Case Study 134 Application Activities 134 Stop and Check Responses 135 Additional Resources To Explore 135 References 136

138

6-1

Common Communicable Childhood Illnesses

6-2 6-2a 6-2b 6-2c 6-2d 6-2e 6-2f 6-2g 6-2h 6-2i 6-2j 6-2k

Colds 147 Diaper Rash (Diaper Dermatitis) Diarrhea 149 Dizziness 150 Earaches 150 Fainting 152 Fever 153 Headaches 155 Heat Rash 155 Lyme Disease 156 Sore Throat 156

Common Acute Childhood Illnesses

139

147

148

Digital Download Teacher Checklist 6-1 Measures to Prevent Tick Bites

173

7-2 Early Childhood Program Licensure 7-2a Obtaining a License 176 7-2b Federal Regulations 176

175

Features of High-Quality Programs

176

156

6-2l Stomachaches 157 6-2m Sudden Unexpected Infant Death (SUID) and Sudden Infant Death Syndrome (SIDS) 158 Digital Download Teacher Checklist 6-2 Practices to Reduce the Risk of Sudden Unexpected Infant Death (SUID) and Sudden Infant Death Syndrome (SIDS) 159

Teething 160 Toothache 160 Vomiting 161 West Nile Virus 162 163

Classroom Corner 163 Summary 165 Terms to Know 165 Chapter Review 165 Case Study 166 Application Activities 166 Stop and Check Responses 167 Additional Resources to Explore 167 References 167

Keeping Children Safe

7-1 Identifying High-Quality Programs 7-1a Educating Families 173 7-1b Resource and Referral Services 174 7-1c Professional Accreditation 174

7-3

131

Digital Download Partnering with Families When to Call the Doctor

Chapter 7 Creating High-Quality Environments 172

129

Digital Download Partnering with Families Administering Medication to Children 132

6-2n 6-2o 6-2p 6-2q

115

Digital Download Teacher Checklist 5-1 Administering Medications to Children 121

Unit

Digital Download Teacher Checklist 5-4 Sanitary Diapering Procedure

Chapter 6 Childhood Illnesses: Identification and Management

Eczema 98 Excessive Fatigue 99 Lead Poisoning 100 Seizure Disorders 102

Digital Download Teacher Checklist 4-6 Strategies for Working with Children Who Have a Seizure Disorder 102

4-2j

Digital Download Teacher Checklist 5-3 How and When to Wash Hands 128

5-4e Education

Digital Download Teacher Checklist 4-3 Children with Allergies and Asthma

4-2e Diabetes

125

Digital Download Teacher Checklist 5-2 Universal Precautions for Handling Body Fluids 126

Digital Download Teacher Checklist 5-5 Readiness Indicators for Toilet Learning/Training 130

87

Digital Download Teacher Checklist 4-2 Strategies for Managing Children’s Asthma Attacks 92

Digital Download Teacher Checklist 4-4 Children with Cancer

5-4c Immunization 123 5-4d Environmental Control

171 7-3a 7-3b 7-3c 7-3d 7-3e

Teacher Preparation 177 Staffing Ratios 178 Group Size and Composition Program Curriculum 179 Health Services 180

178

Digital Download Teacher Checklist 7-1 Principles of Emergency Preparedness 181

7-4 Guidelines for Safe Environments 7-4a Indoor Safety 182

182

Digital Download Teacher Checklist 7-2 Teachers’ Safety Checklist: Indoor and Outdoor Spaces 183

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

vii

Contents Digital Download Teacher Checklist 7-3 Inventory Checklist: Planning for Program Security 189 Digital Download Teacher Checklist 7-4 How to Conduct a Fire Drill

7-4b Outdoor Safety

190

191

Digital Download Teacher Checklist 7-5 General Guidelines for Purchasing Outdoor Play Equipment 194 Digital Download Teacher Checklist 7-6 Teacher Checklist: Sandbox Care and Maintenance 195

7-4c Transportation

198

Digital Download Partnering with Families How to Identify High-Quality Programs 200

Classroom Corner 201 Summary 201 Terms to Know 202 Chapter Review 202 Case Study 203 Application Activities 203 Stop and Check Responses 204 Additional Resources to Explore 204 References 204

Chapter 8 Safety Management 207 8-1

What Is Unintentional Injury?

8-2

Risk Management: Principles and Preventive Measures 211

208

8-2a Advanced Planning 212 8-2b Establishing Safety Policies and Behavioral Guidelines

213

Digital Download Teacher Checklist 8–1 Guidelines for the Safe Use of Play Equipment 213

8-2c Active Supervision

215

Digital Download Teacher Checklist 8–2 Positive Strategies for Managing Children’s Inappropriate Behavior 215

8-2d Safety Education

216

8-3 Implementing Safety Practices 8-3a Toys and Equipment 217

216

Digital Download Teacher Checklist 8–3 Guidelines for Selecting Safe Toys and Play Equipment 217 Digital Download Teacher Checklist 8–4 Examples of Appropriate Toy Choices for Infants, Toddlers, and Preschoolers 218

8-3b Classroom Activities

221

Digital Download Teacher Checklist 8–5 Guidelines for the Safe Use of Electrical Appliances 222 Digital Download Teacher Checklist 8–6 Safe Substitutes for Hazardous Art Materials 223

8-3c Field Trips 223 8-3d Pets 224 8-3e Teacher Safety 224 Digital Download Teacher Checklist 8–7 Personal Safety Practices for the Home Visitor 225

8-3f Legal Considerations and Safety Management

225

8-4 Emergency and Disaster Preparedness 227 8-4a Planning for Disasters and Emergencies: Where to Begin Digital Download Teacher Checklist 8–8 Emergency Supply Kit

227

229

8-4b Preparing for Action 229 8-4c Practice and Revise 230 8-4d Helping Children After A Disaster or Emergency 231 Digital Download Partnering with Families Sun Safety

232

Chapter 9 Management of Injuries and Acute Illness 239 Responding to Medical Emergencies

9-3 Life-Threatening Conditions 243 9-3a Absence of Breathing and Pulse (CPR) 243 Digital Download Teacher Checklist 9–3 Foods Commonly Linked to Childhood Choking 246

9-3b Foreign Body Airway Obstruction (Heimlich Maneuver)

246

Digital Download Teacher Checklist 9–4 Objects Commonly Linked to Childhood Choking 246

9-3c 9-3d 9-3e 9-3f 9-3g

Anaphylaxis: Life-Threatening Allergic Reaction Shock 250 Asthma 250 Bleeding 251 Diabetes 251

249

Digital Download Teacher Checklist 9–5 Signs and Symptoms of Hyperglycemia and Hypoglycemia 252

9-3h 9-3i 9-3j 9-3k 9-4 9-4a 9-4b 9-4c 9-4d 9-4e

Drowning 252 Electrical Shock 253 Head Injuries 253 Poisoning 255

Non-Life-Threatening Conditions

256

Abrasions, Cuts, and Minor Skin Wounds Bites 257 Blisters 258 Bruises 258 Burns 258

256

Digital Download Teacher Checklist 9–6 Teacher Checklist: Burns—When to Call for Emergency Medical Assistance (911) 258

9-4f 9-4g 9-4h 9-4i 9-4j 9-4k 9-4l 9-4m 9-4n 9-4o

Eye Injuries 259 Fractures 260 Frostbite and Hypothermia 260 Heat Exhaustion and Heat Stroke Nosebleeds 262 Seizures 263 Splinters 263 Sprains 263 Tick Bites 264 Tooth Emergencies 264

261

Digital Download Partnering with Families Poison Prevention in the Home 264

Classroom Corner 265 Summary 266 Terms to Know 266 Chapter Review 266 Case Study 267 Application Activities 267 Stop and Check Responses 268 Additional Resources to Explore 268 References 269

Chapter 10 Adverse Childhood Experiences (ACEs): Maltreatment 271 10-1

Historical Developments

10-2

Discipline vs. Punishment

10-3

Abuse and Neglect

272 273

274

Digital Download Teacher Checklist 10-2 Identifying Symptoms of Common Sexually Transmitted Diseases (STDs) 277

10-4 10-4a 10-4b 10-4c

Understanding the Risk Factors for Maltreatment Adult Perpetrators 280 Vulnerable Children 281 Family and Environmental Stresses

281

10-5 Protective Steps for Programs and Educators 10-5a Professional Development 282

282

Digital Download Teacher Checklist 10-3 Strategies for Positive Behavior Management 283

240

Digital Download Teacher Checklist 9–1 Basic First Aid Supplies for Schools 241 Digital Download Teacher Checklist 9–2 Modified First Aid Kits

242

Digital Download Teacher Checklist 10-1 Identifying Signs of Abuse and Neglect 275

Classroom Corner 232 Summary 233 Terms to Know 234 Chapter Review 234 Case Study 235 Application Activities 235 Stop and Check Responses 235 Additional Resources to Explore 236 References 236

9-1

Emergency Care vs. First Aid

9-2

241

10-6 Reporting Laws 283 10-6a Program Policy 284

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

280

viii

Contents

Digital Download Teacher Checklist 10-4 What to Include in a Written Child Abuse/Neglect Report 284

10-7

Trauma-Informed Practices and the Teacher’s Role 285

10-7a 10-7b 10-7c 10-7d

Early Identification and Reporting 285 Creating Trauma-Supportive Environments Fostering Children’s Resilience 287 Reaching Out to Families 288

286

Digital Download Partnering with Families Anger Management

Professional Development

11-3 11-3a 11-3b 11-3c

Topic Selection 300 Behavioral Objectives 302 Content Presentation 303

299

Effective Instructional Design

300

Digital Download Teacher Checklist 11-1 How to Evaluate Printed Resource Material 303 289

Classroom Corner 290 Summary 291 Terms to Know 292 Chapter Review 292 Case Study 293 Application Activities 293 Stop and Check Responses 293 Additional Resources to Explore 294 References 294

Chapter 11 Planning for Children’s Health and Safety Education 297 11-1

11-2

11-3d Assessment 11-4

304

Activity Lesson Plans

305

Digital Download Partnering with Families Evaluating Health and Safety Information on the Internet 320

Classroom Corner 320 Summary 320 Terms to Know 321 Chapter Review 321 Case Study 322 Application Activities 322 Stop and Check Responses 323 Additional Resources to Explore 323 References 323

Family Involvement in Health and Safety Education 298

Unit

3

Foods and Nutrients: Basic Concepts

Chapter 12 Nutrition Guidelines 326 12-1

Dietary Reference Intakes

12-2

Dietary Guidelines for Americans

12-3 12-3a 12-3b 12-3c 12-3d 12-3e 12-3f 12-3g

Vegetables 331 Fruits 332 Grains 333 Protein Foods 333 Dairy 334 Oils 335 Empty Calories 335

12-4

Additional Nutrition Guidelines

MyPlate

328 328

331

325

Digital Download Partnering with Families Healthy Families

357

Classroom Corner 358 Summary 358 Terms to Know 359 Chapter Review 359 Case Study 360 Application Activities 360 Stop and Check Responses 360 Additional Resources to Explore 361 References 359

Chapter 14 Nutrients That Promote Growth and Regulate Body Functions 363 14-1

Children’s Nutrient Deficiencies

14-2 Proteins 365 14-2a Proteins for Growth

336

364

365

Digital Download Teacher Checklist 14-1 Plant-based Food Sources of Essential Nutrients 367

12-5 Food Labels 337 12-5a Calories from Fat 339 Digital Download Partnering with Families Reducing Children’s Sugar Consumption 340

14-2b Proteins as Regulators 368 14-2c Protein Requirements 368 14-3 14-3a 14-3b 14-3c 14-3d 14-3e 14-3f

Vitamins

Minerals

13-1 Food as an Energy Source 347 13-1a Energy Utilization 347 13-1b Excess Energy and Obesity 349

14-4 14-4a 14-4b 14-4c 14-4d 14-4e

Digital Download Teacher Checklist 13-1 Health Improvement Tips for Children Who Are Overweight 350

14-5 Water and Growth 14-5a Water as a Regulator

13-2 Carbohydrates as an Energy Source 350 13-2a Sugars (Simple Carbohydrates) 350 13-2b Starches and Dietary Fiber (Complex Carbohydrates)

Digital Download Partnering with Families A Weighty Problem: Sugary Drinks Or Water? 380

Classroom Corner 341 Summary 342 Terms to Know 342 Chapter Review 342 Case Study 343 Application Activities 343 Stop and Check Responses 344 Additional Resources to Explore 344 References 344

Chapter 13 Nutrients That Provide Energy (Carbohydrates, Fats, and Proteins) 346

13-3 13-3a 13-3b 13-3c

Fats as an Energy Source Saturated Fats 355 Unsaturated Fats 355 Proteins as Energy Sources

354

357

14-6 353

369

Vitamins that Support Growth 372 Vitamins and Blood Formation 372 Vitamins that Regulate Bone Growth 373 Vitamins that Regulate Energy Metabolism 373 Vitamins that Regulate Neuromuscular Function 373 Vitamin Requirements 373

374

Minerals that Support Cell Growth 374 Minerals that Build Bones and Teeth 376 Minerals and Blood Formation 376 Minerals that Regulate Energy 377 Minerals that Regulate Neuromuscular Function

377

378 378

Nutrient Functions: A Review Summary

378

Classroom Corner 380 Summary 381 Terms to Know 382 Chapter Review 382 Case Study 383 Application Activities 383 Stop and Check Responses 383 Additional Resources to Explore 384 References 384

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

ix

Contents

Unit

4

Nutrition and the Young Child

Chapter 15 Feeding Infants 388

16-4

Profile of an Infant

15-2

Meeting the Infant’s Nutritional Needs for Growth and Brain Development 389

389

16-5 16-5a 16-5b 16-5c 16-5d 16-5e 16-5f

Digital Download Teacher Checklist 15-1 Recommended Infant Meal Pattern 390

15-2a Prenatal Influence on Infants’ Nutritional Needs and Brain Development 390 15-2b The First 6 Months 391 15-2c The Teacher and the Breastfeeding Mother 393 Digital Download Teacher Checklist 15-2 Supporting the Nursing Mother

393

The Feeding Relationship

394

395

Burping 397 Water 397 Vitamin and Mineral Supplements

15-5 15-5a 15-5b 15-5c 15-5d 15-5e 15-5f 15-5g 15-5h 15-5i 15-5j

Common Feeding Concerns

400

17-4

448

Meal Service

450

Digital Download Teacher Checklist 17-1 Making Mealtime a Pleasant Experience 452

405

Classroom Corner 405 Summary 406 Terms to Know 406 Chapter Review 407 Case Study 407 Application Activities 408 Stop and Check Responses 408 Additional Resources to Explore 408 References 408

Chapter 16 Feeding Toddlers, Preschoolers, and School-Age Children 411 Developmental Profiles: Toddlers, Preschoolers, and School-Age Children 412 413

16-2b Mealtime Patterns 415 16-2c Creating An Enjoyable Mealtime Environment

Feeding Preschoolers and School-Age Children

Planning the Menu within Budget

452

Menu Planning 452 Food Purchasing 453 Food Preparation 453 Food Service 454 Recordkeeping 454

Digital Download Partnering with Families Planning Healthy Meals

454

Classroom Corner 455 Summary 456 Terms to Know 457 Chapter Review 457 Case Study 458 Application Activities 458 Stop and Check Responses 459 Additional Resources to Explore 459 References 459

Chapter 18 Food Safety 461 18-1 Food-Related Illness 462 18-1a Foodborne Contaminants 463 18-1b Conditions that Promote Bacterial Growth

463

464

Digital Download Teacher Checklist 18-1 Correct Hand Washing Technique

417

Guidelines for Feeding the Preschooler 418 Nutrient Requirements of School-Age Children 419 Feeding Children who have Special Needs 419

17-5 17-5a 17-5b 17-5c 17-5d 17-5e

18-2 Measures to Keep Food Safe 18-2a Examine Food Carefully 465 18-2b Maintain Clean Conditions 465

Digital Download Teacher Checklist 16-1 MyPlate Daily Food Group Recommendations 414

16-3 16-3a 16-3b 16-3c

Menu Style

17-3 Nutritious Snacks 449 17-3a Suitable Snack Foods 450

Food Allergies 401 Colic 402 Vomiting and Diarrhea 402 Anemia 403 Baby Bottle Tooth Decay 403 Ear Infection 403 Obesity 403 Choking 404 Teething 404 Constipation 404

16-2 Feeding Toddlers 413 16-2a Foods To Serve and How Much

Digital Download Partnering with Families Feeding Toddlers and Young Children 427

17-2

401

Digital Download Partnering with Families Feeding Your Infant

16-1

421

Dental Caries 422 Obesity 422 Hypertension 423 Cardiovascular Disease 424 Diabetes 424 Common Feeding Challenges 424

17-1 Menu Development 435 17-1a Well-Designed Menus Meet Children’s Nutritional Needs 435 17-1b Well-Designed Menus Meet Funding and/or Licensing Requirements 437 17-1c Well-Designed Menus Are Appealing 442 17-1d Well-Designed Menus Include Familiar and New Foods 444 17-1e Steps in Menu Planning 445

398

Digital Download Teacher Checklist 15-4 Age-Related Infant Eating Behaviors 399

15-4c Infants Who Have Special Needs

Health Conditions Related to Dietary Patterns

Chapter 17 Meal Planning and Service 434

397

15-4 Introducing Complementary Foods 15-4a Developmental Readiness 398 15-4b Physiological Readiness 398

420

Classroom Corner 428 Summary 429 Terms to Know 429 Chapter Review 429 Case Study 430 Application Activities 430 Stop and Check Responses 431 Additional Resources to Explore 431 References 431

Digital Download Teacher Checklist 15-3 Thawing Frozen Breast Milk Safely 394

15-3 15-3a 15-3b 15-3c

Promoting Healthy Eating Habits

Digital Download Teacher Checklist 16-2 Introducing New or Unfamiliar Foods 421

15-1

15-2d The Teacher and the Formula-Fed Infant 15-2e Formula Preparation 394

387

417

18-2c Separate Foods 469 18-2d Food Storage 469 Digital Download Teacher Checklist 18-2 Checklist for Evaluating Sanitary Conditions in Food Service Areas 470

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Contents

18-2e Cook and Serve Foods Correctly 18-2f Discard Spoiled Food 476

474

18-3

Hazard Analysis and Critical Control Point

18-4

Foodborne Illnesses

18-5

National and International Food Supply Safeguards 479

479

18-5a Commercial Food Production 18-6

476

483

Teaching Children About Food Safety

484

Digital Download Partnering with Families Wash Those Hands!

485

Classroom Corner 486 Summary 487 Terms to Know 487 Chapter Review 487 Case Study 488 Application Activities 488 Stop and Check Responses 488 Additional Resources to Explore 489 References 489

Chapter 19 Nutrition Education: Rationale, Concepts, and Lessons 491

Planning a Nutrition Education Program

19-2 19-2a 19-2b 19-2c

Basic Nutrition Education Concepts Planning Guidelines 497 Safety Considerations 498

19-3

Developing Nutrition Lesson Plans

19-4 19-4a 19-4b 19-4c 19-4d

Family Influence 507 Teachers 507 Peer Groups 508 Television and the Media

494

495

500

Where Else Do Children Learn About Nutrition?

506

509

Digital Download Partnering with Families More Fruits and Vegetables Please 509

Classroom Corner 510 Summary 510 Terms to Know 510 Chapter Review 510 Case Study 511 Application Activities 511 Stop and Check Responses 512 Additional Resources To Explore 512 References 512

19-1 Rationale for Teaching Children About Nutrition 492 19-1a The School’s Role in Children’s Nutrition Education 493 19-1b Family Involvement in Children’s Nutrition Education 494

Epilogue Looking Ahead . . . Making a Difference

514 514

Appendices

516

A National Health Education Standards 517 B Monthly Calendar: Health, Safety, and Nutrition Observances 520 C Federal Nutrition Programs 523 D Children’s Book List 526

Glossary

532

Index

540

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Preface

xi

Preface

Children’s state of wellness has an unquestionable effect on their development and ability to learn. Our understanding of the factors that shape and influence a child’s well-being, including nutrition, environmental conditions, and emotional and social development continues to improve as a result of ongoing research and new discoveries. In turn, this information has led to noteworthy changes in our views about health, approaches to health care, and the critical importance of addressing health education during the early years. It has also contributed to the development of numerous resources (e.g., National Health Education Standards, MyPlate, Healthy People 2030, NAEYC’s Professional Standards and Competencies for Early Childhood Professionals, National Health and Safety Performance Standards for Child Care) that currently guide personal and classroom practices. Additionally, our knowledge of wellness and the importance of promoting healthy lifestyle behaviors draws increasing attention to the pivotal role that teachers play in identifying children’s health needs, creating high-quality environments that support learning and are safe, and providing comprehensive health education in schools. Health, Safety, and Nutrition for the Young Child, now in its eleventh edition, has become the standard text in the early childhood field. Its comprehensive approach and well-documented student/teacher-oriented focus continue to make it the best-selling, full-color textbook about children’s well-being. Most importantly, this book provides students and teachers with a functional understanding of children’s health, safety, and nutritional needs and guides them in implementing effective classroom practices. It also emphasizes the importance of respecting and partnering with all families to help children establish healthy lifestyles and achieve their learning potential. Health, Safety, and Nutrition for the Young Child accomplishes this by addressing all three essential components of children’s wellness in one book: ◗

◗ ◗

promoting children’s health through awareness, assessment, and the early identification and intervention of acute and chronic health conditions; supporting the positive development of all children across all developmental domains; and, providing meaningful preventive health education creating and maintaining safe indoor and outdoor learning environments and fostering children’s understanding and development of protective safety behaviors meeting children’s essential nutritional needs by planning healthy meals, providing safe and nutritious food, and educating children about the importance of consuming a nutritious diet and being physically active.

The book’s attractive layout and beautiful color photographs bring the material to life. Extensive resources, lesson plans, teacher checklists, references, case studies, classroom application features, and educational materials for families are provided throughout the book to aid busy students and practicing teachers in making a difference in children’s lives.

The Intended Audience First and foremost, Health, Safety, and Nutrition for the Young Child is written on behalf of young children everywhere. Ultimately, it is the children who benefit from having families and teachers xi

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who know how to protect and promote their safety and well-being. The term families is used throughout the text in reference to the diverse caring environments in which children of all races, ethnicities, and abilities are currently being raised and that may or may not include their biological parents. The term teachers is used inclusively to recognize all adults who care for and work with young children—including educators, therapists, coaches, camp leaders, administrators, health care providers, legislators, and concerned citizens—whether they work in early childhood centers, home-based programs, camps and recreation activities, public or private schools, community agencies, or after-school programs. The term teacher also includes families and acknowledges the important educational role they play in children’s daily lives. Health, Safety, and Nutrition for the Young Child is written for several primary audiences: ◗ ◗

◗ ◗

students and preservice teachers who have chosen a career in early childhood education experienced teachers in community schools, home-based programs, early childhood centers, Head Start programs, before- and after-school programs, clinics, and agencies that serve young children and their families allied health professionals and child advocates who work in any role that touches children’s lives families, who are children’s most important teachers!

Organization and Key Content The eleventh edition of Health, Safety, and Nutrition for the Young Child maintains its original purpose which is to focus attention on the three critical areas that influence children’s well-being: promoting children’s health (Unit 1); creating high-quality, safe learning environments (Unit 2); and, supporting children’s nutrition (basic and applied), healthy eating behaviors, and nutrition education (Units 3 and 4). This arrangement maximizes student learning and offers instructors flexibility in designing their courses. However, the interrelatedness of these three subject areas must not be overlooked despite their artificial separation in the book. Chapter content is presented in a clear, concise, and thought-provoking manner. It reflects the latest research developments and applications regarding children and wellness within a culturally diverse and family-oriented framework. Information about many key topics, including national health initiatives, children’s mental health, bullying, fostering resilience and social-emotional competence, brain development, childhood obesity, emergency and disaster preparedness, and food safety have been updated. Additional information about children who have special health challenges and school-aged children has also been provided. Without a doubt, this comprehensive book is a resource that no teacher (new or experienced) should be without!

New and Updated Features The eleventh edition continues to include numerous pedagogical features, including tables, figures, checklists, summaries, review questions, and application activities designed to engage students, reinforce learning, and enhance their ability to apply the information in contemporary educational settings: ◗

Chapter Content Linked to the new National Association for the Education of Young Children Professional Standards and Competencies for Early Childhood Educators—NAEYC standards and relevant competencies, identified at the onset of each chapter, are provided to help students understand how chapter content relates to the association’s professional education framework and affects their role as early childhood educators.

◗

Learning Objectives—are identified at the beginning of each chapter. The objectives describe what students can expect to learn in each major chapter section and how they will demonstrate and apply newly acquired knowledge and skills.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Preface ◗

Connecting to Everyday Practice—this feature presents contemporary issues that challenge students’ ability to analyze and apply information they have learned in each chapter. Thoughtprovoking questions encourage self-reflection and group discussion.

◗

Case Studies—engage students in applying what they have learned to address common everyday experiences they are likely to encounter as teachers.

◗

New Stop and Check feature—offers multiple, thought-provoking questions dispersed throughout each chapter. Students can use this feature to measure their understanding of chapter content and performance against the learning objectives. Answers to the questions are provided in the Stop and Check Responses section at the end of each chapter.

◗

Updated Teacher Checklists—are a well-received feature that provides teachers with quick, efficient access to critical information and best practices. Beginning practitioners will find these concise reference lists especially helpful for learning new material. Experienced teachers and administrators will appreciate their simplicity and easy access for classroom use and staff training purposes. Many of the Teacher Checklists are available as Digital Downloads.

◗

Classroom Corner Teacher Activities—showcase lesson plans aligned with the National Health Education Standards. Learning objectives, materials lists, and step-by-step procedures are provided to present children with meaningful learning experiences and save teachers preparation time.

◗

Did You Know?—offers interesting factoids in a marginal feature that are intended to peak student curiosity and interest in the chapter content.

◗

Monthly Calendar of National Health, Safety, and Nutrition Observances—provides a month-by-month listing of national observances and related website resources that teachers can use when planning learning experiences for children. This information is located in Appendix B.

◗

Children’s Book List—is an extensive, updated collection of children’s books that teachers and families can use to promote children’s literacy skills while also teaching about various health, safety, and nutrition topics. This resource is located in Appendix D and includes titles that address a variety of subjects, including dental health, illness/germs, mental health, self-care, safety, nutrition, special needs, and physical activity/fitness.

◗

Partnering with Families—is a feature provided in every chapter to underscore the importance of engaging and including families in children’s health, safety, and nutrition education. Information is provided in a letter format that busy teachers can download, copy, and send home or share with families in a newsletter, program handbook, website posting, family conference, or bulletin board display.

◗

New Chapter References—guide readers to the latest empirical research articles and relevant publications. Students are encouraged to locate and continue reading about topics discussed in each chapter.

◗

New Additional Resources to Explore—identify URLs for websites that offer additional indepth information about topics discussed in each chapter.

xiii

Chapter-by-Chapter Changes Chapter 1 Children’s Well-Being: What It Is and How to Achieve It ◗

◗

New information and data on national health programs and initiatives, including Healthy People 2030, Children’s Health Insurance Program, Every Student Succeeds Act (ESSA), Whole School Whole Community Whole Child (WSCC), and Active People, Healthy NationSM . Emphasis placed on teacher wellness and health promotion practices that influence children’s learning, development, and lifelong behavior.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

xiv

Preface ◗ ◗

New information about stress and its damaging effect on DNA, media and social violence, cultural influences on health, and children’s mental health. New Connecting to Everyday Practice feature that addresses early childhood suspension and expulsion practices.

Chapter 2 Daily Health Observations ◗ ◗ ◗

Teacher Checklists that detail important observations related to children’s health. New references that emphasize the teachers’ role in early identification and intervention. New Connecting to Everyday Practice feature that draws attention to the link between children’s health and the academic achievement gap.

Chapter 3 Assessing Children’s Health ◗ ◗ ◗

Continued emphasis is placed on the teacher’s role in identifying health disorders (e.g., vision, hearing, language, speech, nutrition) that affect children’s learning. New research information about children’s vision disorders, immunizations, and revised immunization schedules. New Connecting to Everyday Practice feature that raises awareness about cultural competence and the implications for children’s well-being.

Chapter 4 Caring for Children with Medical Conditions ◗ ◗

Updated references and information regarding the signs, symptoms, and management strategies for common chronic childhood disorders and medical conditions. Connecting to Everyday Practice feature that draws attention to meeting children’s medical needs in school settings.

Chapter 5 The Infectious Process and Environmental Control ◗ ◗ ◗

Updated information on childhood immunizations and the new recommended immunization schedule (and chart). New illustrations and classroom infection control practices, including hand washing, diapering procedures, classroom pets, water tables, and green cleaning products. New Connecting to Everyday Practice feature that raises awareness about the potential for communicable disease epidemics, such as COVID-19, and the importance of implementing preventive control procedures in school settings.

Chapter 6 Childhood Illnesses: Identification and Management ◗ ◗ ◗

Updated information on infant sleep guidelines, thermometer use, and management of children who are ill. New Connecting to Everyday Practice feature that draws attention to recommendations for the use of over-the-counter cold and flu remedies with children. New Case Study on infectious disease control.

Chapter 7 Creating High-Quality Environments ◗ ◗

Updated references and information for creating high-quality indoor and outdoor learning environments that are safe for young children. Emphasis placed on the importance of engaging children in outdoor play and physical activity to reduce childhood obesity, chronic diseases, and behavior problems.

Chapter 8 Safety Management ◗

◗ ◗ ◗

New regulations that govern the manufacturing of children’s furniture and toys, including imported products, as well as updated safety features to consider when purchasing children’s equipment. New information on safe art materials. Updated information on emergency and disaster preparedness and school safety, including strategies to help children cope following a traumatic event. New Connecting to Everyday Practice feature that addresses building security.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Preface

xv

Chapter 9 Management of Injuries and Acute Illness ◗ ◗

Updated emergency and first aid techniques from the American Heart Association and American Red Cross. New Connecting to Everyday Practice feature that addresses concussions and traumatic brain injury (TBI).

Chapter 10 Adverse Childhood Experiences (ACEs): Maltreatment ◗ ◗ ◗

Updated research regarding the immediate and long-term physical, emotional, cognitive, and economic effects that ACEs and maltreatment have on children’s development. New information on creating trauma-supportive environments and fostering children’s resilience. New Connecting to Everyday Practice feature on child sexual exploitation and the Internet.

Chapter 11 Planning for Children’s Health and Safety Education ◗ ◗ ◗

New information about the teacher’s role in the learning environment. Additional teacher resources and children’s book lists to use for lesson planning. New lesson plan on water safety.

Chapter 12 Nutrition Guidelines ◗

◗

New information about the revised Dietary Guidelines for Americans, Canadian Food Guide, and Healthy People 2030 initiatives. The new food label, menu labeling laws, and front-ofpackage (FOP) options are also discussed. Continued emphasis is placed on eating locally and the role of physical activity in health promotion.

Chapter 13 Nutrients that Provide Energy (Carbohydrates, Fats, and Proteins) ◗ ◗ ◗

New information about the use of artificial sweeteners and plant-based milk alternatives in children’s diet. New recommendations regarding children and low-fat diets. New Connecting to Everyday Practice feature that raises questions about sugar and its role in obesity.

Chapter 14 Nutrients that Promote Growth and Regulate Body Functions ◗ ◗ ◗

New information about children’s diets and nutrient deficiencies. Additional information on plant-based diets and children. New Connecting to Everyday Practice regarding water availability and human survival.

Chapter 15 Feeding Infants ◗ ◗

New emphasis on the feeding relationship and its effect on infants’ biological, learning, and developmental needs. New CACFP meal planning guidelines for infants.

Chapter 16 Feeding Toddlers, Preschoolers, and School-Age Children ◗ ◗ ◗ ◗

New CACFP meal planning guidelines for preschool- and school-age children aligned with the national standards. Updated information regarding children’s dietary practices and their relationship to the early development of hypertension, cardiovascular heart disease, and diabetes. Additional information on promoting children’s food acceptance and the media’s influence on children’s food preferences and eating habits. New Connecting to Everyday Practice feature about the reliability of nutrition information on the Internet.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Chapter 17 Meal Planning and Service ◗ ◗ ◗

New meal planning guidelines based on revised National School Lunch Program and CACFP requirements. New meal reimbursement rates. New Connecting to Everyday Practice feature on food insecurity and children’s nutrition programs.

Chapter 18 Food Safety ◗ ◗ ◗ ◗

New food safety concerns, research, and practices. Updated information about national and international efforts to improve food supply safety, including commercial food production practices. New Connecting to Everyday Practice feature regarding food safety and climate change. New section on teaching children about food safety.

Chapter 19 Nutrition Education: Rationale, Concepts, and Lessons ◗ ◗ ◗

New resources for teaching children about nutrition. Emphasis on family engagement and educating children about healthy eating and physical activity. Lesson plans that include updated children’s book lists.

Pedagogy and Learning Aids Each chapter includes pedagogical features based on sound educational principles that encourage active student-centered learning, mastery, and application. The features also reflect student differences in learning needs, abilities, and styles. ◗

Bulleted lists are used extensively throughout the book to present important information in a concise, easy-to-access format.

◗

Multicultural color photographs show children as they work and play in developmentally appropriate settings.

◗

Full-color illustrations and tables draw attention to and reinforce important chapter content.

◗

A concise Summary concludes each chapter and recaps the main points of discussion.

◗

Terms to Know are highlighted in color throughout the chapters and defined on the page where they initially appear. Each term is also included in a comprehensive glossary located at the end of the book.

◗

Stop and Check questions encourage students to periodically assess their understanding of chapter content.

◗

Chapter Reviews offer thought-provoking questions to reinforce student learning and comprehension. Questions can also be used for group discussion.

◗

Case Studies present real-life situations that require students to analyze and apply basic theory to solving everyday situations.

◗

Application Activities provide in-class and field projects that encourage students to practice and reinforce what they have learned in each chapter.

◗

Additional Resources To Explore encourage students to take advantage of technology and extend learning beyond the pages of this book by accessing valuable online resource materials.

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Preface

xvii

Teaching and Learning Resources Student Resources MindTap Learn on your terms with MindTap for Marotz’s Health, Safety, and Nutrition for the Young Child, Eleventh Edition. INSTANT ACCESS IN YOUR POCKET Take advantage of the Cengage mobile app to learn on your terms. Read or listen to your eTextbook online or offline; check your grades; study with the help of flashcards, practice quizzes and instant feedback from your instructor and receive due date reminders anywhere, anytime, from your smartphone or tablet. MINDTAP HELPS YOU SUCCEED IN YOUR CLASS Track your scores and stay motivated to achieve your goals. MindTap helps you identify areas in need of improvement and where you need to focus your efforts. MAKE YOUR TEXTBOOK YOUR OWN Highlight key text, add notes and create custom flashcards. When it’s time to study, you can easily gather everything you’ve flagged or noted into an organized, effective study guide.

Instructor Resources MindTap Today’s leading online learning platform, MindTap for Marotz’s Health, Safety, and Nutrition for the Young Child, Eleventh Edition, gives you complete control of your course to craft a personalized, engaging learning experience that challenges students, builds confidence, and elevates performance. MindTap introduces students to core concepts from the beginning of your course using a simplified learning path that progresses from understanding to application and delivers access to eTextbooks, study tools, interactive media, auto-graded assessments, and performance analytics. Use MindTap for Health, Safety, and Nutrition as-is, or personalize it to meet your specific course needs. You can also easily integrate MindTap into your Learning Management System (LMS). ACCESS EVERYTHING YOU NEED IN ONE PLACE Cut down on prep with preloaded, organized course materials in MindTap. Teach more efficiently with interactive multimedia, assignments, quizzes, and more. Give your students the power to read, listen, and study on their smartphone or tablet, so they can learn on their terms. EMPOWER YOUR STUDENTS TO REACH THEIR POTENTIAL Distinct metrics give you actionable insights into student engagement. Identify topics troubling your entire class and instantly communicate with struggling students. Students can track their scores to stay motivated toward their goals. PERSONALIZE YOUR COURSE TO YOUR OBJECTIVES Only MindTap gives you complete control of your course. You have the flexibility to reorder textbook chapters, add your own notes and embed a variety of content, including Open Education Resources (OERs) and third-party content. Personalize course content to your students’ needs—they can even read your notes, add their own, and highlight key text to aid progress.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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COUNT ON OUR DEDICATED TEAM, WHENEVER YOU NEED THEM MindTap isn’t simply an online learning tool—it’s a network of support from a personalized team eager to further your success. We’re ready to help, from setting up your course, to tailoring MindTap resources to meet your specific objectives. You’ll be ready to make an impact from day one. And we’ll be right here to help you and your students throughout the semester—and beyond.

Instructor’s Manual An online Instructor’s Manual accompanies this book. It contains information to assist the instructor in course design, including sample lectures, discussion questions, teaching and learning activities, field experiences, and additional online resources.

Online Test Bank Extensive multiple choice, true/false, short answer, and essay questions accompany each chapter and provide instructors with varied strategies for assessing student learning.

Online PowerPoint Slides These vibrant PowerPoint lecture slides for each chapter assist with your lectures by providing concept coverage using images, figures, and tables directly from the textbook!

Cengage Testing Powered by Cognero ◗ ◗ ◗

Author, edit, and manage test bank content from multiple Cengage Learning solutions. Create multiple test versions in an instant. Deliver tests from your LMS, your classroom, or wherever you want.

Acknowledgments A special thank you is extended to the instructors, students, and colleagues who use Health, Safety, and Nutrition for the Young Child in their classes and professional endeavors. Their suggestions continue to influence and improve each new edition. I would also like to recognize the contributions of dedicated teachers, advocates, and families everywhere who strive to better children’s lives. Once again, I am grateful to have worked with so many amazingly talented individuals at Cengage. Christy Frame, my content manager, was a delight and pleasure to work with on this project. Her insightful contributions and prompt responses with information I often needed to proceed was appreciated more than she will know. Christy was also a master at keeping things moving forward and on schedule despite unpredictable and challenging circumstances. I want to express a special thank you to Manas Pant for his prompt communications, responsiveness to many last-minute requests, and skill in transforming volumes of draft manuscript into an attractive and meaningful book. I also want to acknowledge Calum Ross for his outstanding and meticulous editing. There are also many “behind-the-scenes” individuals who contributed so much to producing and marketing another successful edition. Thank you. Your efforts have not gone unnoticed. Finally, I want to thank my husband and family for their patience and understanding during times when writing took precedence over times spent together. They are my pillar of strength and motivation, and I am grateful for their loving support.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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About the Author Lynn R. Marotz received a Ph.D. from the University of Kansas, a M.Ed. from the University of Illinois, and a B.S. in Nursing from the University of Wisconsin. She served as the health and safety coordinator and associate director of the Edna A. Hill Child Development Center (University of Kansas) for 35 years. She worked closely with students in the Early Childhood teacher education program and taught undergraduate and graduate courses in the Department of Applied Behavioral Science, including Health/safety/nutrition for the young child, Issues in parenting, Administration, and Foundations of early childhood education. She has provided numerous trainings on first aid, children’s safety, child maltreatment, childhood obesity, nutrition, and conducting health observations for early childhood students and community educators. Lynn has authored invited chapters on children’s health and development, nutrition, and environmental safety in national and international publications and law books. In addition, she is the author of Developmental Profiles—Pre-Birth through Adolescence, Parenting Today’s Children: A Developmental Perspective, and Early Childhood Leadership: Motivation, Inspiration, & Empowerment. She has been interviewed for articles about children’s nutrition and well-being that have appeared in national trade magazines and has served as a consultant for children’s museums and training film productions. She has presented extensively at international, national, and state conferences and held appointments on national, state, regional, and local committees and initiatives that advocate on behalf of children and their families and early childhood teachers. However, it is her daily interactions with children and their families, students, teachers, colleagues, and her beloved family that bring true insight, meaning, and balance to the material in this book.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Unit

1

Promoting Children’s Health: Healthy Lifestyles and Health Concerns 1

Children’s Well-Being: What It Is and How to Achieve It

2

Daily Health Observations

3

Assessing Children’s Health

4

Caring for Children with Medical Conditions

5

The Infectious Process and Environmental Control

6

Childhood Illnesses: Identification and Management

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Children’s Well-Being: What It Is and How to Achieve It Professional Standards Linked to Chapter Content

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#1a, b, c, and d Child development and learning in context #2a, b, and c Family–teacher partnerships and community connections #3a, b, c, and d Child observations, documentation, and assessment #4a, b, and c Developmentally, culturally, and linguistically appropriate teaching practices #5a and b Knowledge, application, and integration of academic content in the early childhood curriculum #6a, b, c, and d Professionalism as an early childhood educator

Learning Objectives After studying this chapter, you should be able to:

LO 1-1 Define the preventive health concept and describe several national programs that address children’s health needs. LO 1-2 Explain how health, safety, and nutrition are interrelated and discuss factors that influence the quality of each. LO 1-3 Describe typical growth and developmental characteristics of infants, toddlers, preschool-age, and school-age children. LO 1-4 Discuss ways that teachers can be proactive in promoting children’s wellness in the areas of injury prevention, oral health, physical activity, and mental health.

2 Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Children’s Well-Being: What It Is and How to Achieve It

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Our ideas about health, disease, and the health care system have undergone a significant change. Individuals are realizing that they must assume a more proactive role in maintaining their personal health and that they cannot rely on the medical profession to always make them well. In part, this change has been fueled by escalating medical costs, a lack of health insurance, and disabling conditions for which there are no current cures. In addition, and perhaps even more significant, are research findings that demonstrate positive health outcomes when people adapt healthy lifestyle behaviors (Cho & Kim, 2022; Peña & Payne, 2022; Smith et al., 2022). 1-1

The Preventive Health Concept

The concept of preventive health recognizes that individuals are able to reduce or eliminate many factors that threaten personal wellness (Figure 1–1). It implies that children and adults are able to make choices and engage in behaviors that improve their quality of life and lessen the risk of developing chronic disease. This includes practices such as establishing healthful dietary habits (eating more fruits, vegetables, whole grains, and low-fat dairy products), implementing safety behaviors (wearing seat belts, limiting sun exposure), engaging in daily physical activity, and seeking early treatment for occasional illness and injury. The early years are a critical time for children to establish preventive behaviors. Young children are typically more receptive to new ideas, curious, eager to learn, and have fewer unhealthy habits to overcome. Teachers, families, and health care providers can capitalize on these qualities and help children to develop practices that will foster a healthy, safe, and productive lifetime.

Figure 1–1

Examples of preventive health practices.

A preventive health approach involves a combination of personal practices and national initiatives. On a personal scale: – eating a diet low in animal fats and added sugars; incorporating more plant-based foods – consuming a wide variety of fruits, vegetables, and grains – engaging in aerobic and muscle-strengthening activities regularly – practicing good oral hygiene – using proper hand washing techniques – avoiding substance abuse (e.g., alcohol, tobacco, drugs) – maintaining immunizations up-to-date On a national scale: – regulating vehicle emissions – preventing chemical dumping – establishing food safety standards and inspecting food supplies – measuring and reducing air pollution – providing immunization programs – regulating water safety; fluoridating drinking water – monitoring disease outbreaks and setting policy

preventive health – personal and social behaviors that promote and maintain well-being.

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Although the preventive approach emphasizes an individual role in health promotion, it also implies a shared responsibility for addressing social and environmental issues that affect the quality of everyone’s well-being, including: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

poverty and homelessness food insecurity inequitable access to medical and dental care mental health services and suicide prevention adverse effects of media advertising substance abuse (e.g., alcohol, tobacco, drugs) food safety air and water pollution discrimination based on diversity violence and unsafe neighborhoods

In addition to helping children learn about these complex issues, adults must also demonstrate their commitment by supporting social actions, policies, and programs that contribute to healthier environments and lifestyles for society as a whole. 1-1a

National Health Initiatives

The positive health outcomes that are achievable through preventive practices continue to attract increased public interest, especially with respect to young children. Poor standards of health, safety, and nutrition have long been known to interfere with children’s ability to learn and to ultimately become healthy, productive adults. As a result, a number of large-scale programs have been established to address children’s health needs and to improve their access to preventive services. Descriptions of several initiatives follow; information about federal nutrition programs for children is located in Appendix C. Healthy People 2030 The nation’s master plan for improving the standard of health for its citizens is outlined in the Healthy People 2030 initiative (U.S. HHS, 2022). It supports and strengthens the same underlying philosophy of health promotion and disease prevention presented in earlier versions. The current plan challenges communities to increase public health awareness and improve accessibility to preventive health services by encouraging better collaboration and coordination among agencies. It urges individuals to assume a more active role in achieving personal wellness, especially with regard to the prevention of obesity, diabetes, mental health, and substance use. The Healthy People 2030 model recognizes that social factors, including housing, racism, and education, have a significant and determining effect on a person’s health (Figure 1–2). Figure 1–2 Social determinants of health.

Source: CDC. Retrieved from https://www.cdc.gov/publichealthgateway/sdoh/index.html.

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Chapter 1

Consequently, a major goal of the initiative is directed specifically at reducing health inequities by creating “social, physical, and economic environments that promote attaining the full potential for health and well-being for all.” Many topics and behavioral indicators identified in the Healthy People 2030 plan have direct application for schools and early childhood programs (Table 1–1). For example, teaching anger management skills, increasing outdoor play and physical activity in children’s daily schedules, serving nutritious foods, providing more health and nutrition education, and creating safe learning environments are activities that reflect teachers’ commitment to the Healthy People 2030 ideals.

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▼ Early childhood is a prime time for teaching preventive health practices.

Children’s Health Insurance Program The Children’s Health Insurance Program (CHIP) provides low-cost health insurance to approximately 10 million children whose families earn too much to qualify for Medicaid but cannot afford private insurance coverage. The program is aimed at improving children’s health and ability to learn through early identification and access to preventive health care (Reinbold, 2021). Services covered by the program include free or low-cost medical and dental care, immunizations, prescriptions, mental health treatment, and hospitalization. CHIP is administered in each state through a combination of state and federal appropriations. Each state establishes its own rules for administering the program, and must submit a Child Health Plan describing how the program will be implemented, how eligibility will be determined, and how eligible children will be located. National Health and Safety Performance Standards for Child Care National concern for children’s welfare led to a collaborative project among the American Academy of Pediatrics (AAP), the American Public Health Association (APHA), and the National Resource Center for Health and Safety in Child Care and Early Education (NRC) to develop health, safety, and nutrition guidelines for out-of-home child care settings. The resulting document, Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care (4th ed.), continues to identify quality standards and procedures for ensuring children’s health and safety while they attend organized out-of-home care (Table 1–2) (AAP, APHA, & NRC, 2019). The complete document can be accessed at www.nrckids.org. The current oversight system allows individual states to establish their own child care licensing standards, which has resulted in significant differences in program quality. The National Health Table 1–1 Healthy People 2030 Leading Health Indicators

Areas targeted for improving individual’s health and well-being include the following: • • • • • •

access to health services clinical preventive services environmental quality injury and violence maternal, infant, and child health mental health

• • • • • •

nutrition, physical activity, and obesity oral health reproductive and sexual health social determinants substance abuse tobacco

Source: Healthy People 2030 Leading health indicators. (2018). U.S. Department of Health & Human Services.

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Table 1–2 National Health and Safety Performance Standards

Comprehensive guidelines address the following areas of child care: • staffing – child staff ratios, recruitment and screening, qualifications, professional development and training, staff health • program activities for healthy development – supervision and discipline, parent/guardian relationships, health education • health promotion and protection – sanitation and hygiene practices, safe sleep, illness and medication management • nutrition and food services – nutritional requirements, meal service and supervision, food safety, nutrition education • facilities, supplies, equipment, and environmental health – furnishings, space and equipment, indoor/ outdoor settings, maintenance • play areas, playgrounds and transportation – size, water areas, toys, transportation safety • infectious diseases – respiratory, enteric, blood-borne, and skin conditions, immunizations, antibiotic use • children with special health care and disability needs – inclusion, eligibility for special services, facility modifications, assessment, service plans • administration – policies, human resource management, recordkeeping • licensing and community action – regulatory agencies, teacher/caregiver support Source: Adapted from AAP, APHA, & NRC. (2019). Caring for our children: National health and safety performance standards (4th ed.). Itasca, IL: American Academy of Pediatrics; Washington, DC: American Public Health Association. The complete document is available at https://nrckids.org.

and Safety Performance Standards attempt to address regulatory inconsistencies by proposing a uniform set of standards based on what researchers have identified as best practices. The National Association for the Education of Young Children (NAEYC) has endorsed and aligned their accreditation criteria with the National Health and Safety Performance Standards (NAEYC, 2020). Every Student Succeeds Act (ESSA) The Every Student Succeeds Act (ESSA) (2015) amended the Elementary and Secondary Education Act (ESEA) of 1965 and replaced the former No Child Left Behind (NCLB) Act of 2001. The law’s intention is to assure American children a high-quality education that prepares them to succeed in college and careers (U.S. Department of Education, 2015). It supports improved educational outcomes for all children, especially those who are economically disadvantaged and/or high-need (e.g., migratory, homeless, neglected, delinquent), and shifts authority for compliance in achieving these objectives from the federal government to individual states. The law also addresses schools’ role in meeting children’s health needs (e.g., drug and violence prevention, mental health services, bullying and harassment, healthy lifestyle skills education, positive behavior supports, teachers’ sexual abuse awareness) and creating safe school conditions. It continues to acknowledge families as children’s first and most important teachers, the educational contributions of early childhood programs, and the importance of fostering early literacy skills to ensure children’s readiness for, and success in, school. Significant federal funding is provided annually to strengthen and coordinate early childhood programs with early elementary grades. Whole School, Whole Community, Whole Child (WSCC) The WSCC model acknowledges the significant effect that health has on children’s development and learning ability (Figure 1–3). It assumes an ecological preventive, and comprehensive approach, and aims to address children’s health, safety, and academic needs in community school settings (CDC, 2018). The WSCC model identifies 10 program components and places a strong emphasis on cooperation and collaboration among schools, families, government agencies, and community partners in achieving these objectives. The ultimate goal is to support children in attaining personal, academic, and lifetime success. ecological – a systems approach that acknowledges the ways in which people and their environment relate to, interact with, and influence, one another.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Figure 1–3 Whole school, whole community, whole child model.

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Source: https://www.cdc.gov/healthyyouth/wscc/

Active People, Healthy NationSM Concerns about the high obesity and chronic disease rates in this country led the CDC to establish the Active People, Healthy NationSM initiative (CDC, 2022a) (Figure 1–4). The overarching goal is to increase the number of youth and adults who are aerobically active each day to 27 million by the year 2027. Communities play a key role in achieving

Stop and Check #1 Who is eligible to participate in the CHIP program?

Figure 1–4 Active people, healthy nationSM.

Source: CDC. Available from https://www.cdc.gov/physicalactivity/activepeoplehealthynation /index.html.

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Promoting Children’s Health: Healthy Lifestyles and Health Concerns

this objective by providing safe traveling routes (e.g., sidewalks, trails, transit), facilities, and programs that are inclusive and accessible to individuals of all ages and abilities (Fulton et al., 2022).

▼ Active play is essential for children’s health and development.

Olga Enger/Shutterstock.com

1-2

Health, Safety, and Nutrition: An Interdependent Relationship

Health, safety, and nutrition are closely intertwined and dependent upon one another. The status of each has a direct effect on the quality of the others. For example, children who receive all essential nutrients from a healthful diet are more likely to reach their growth potential, benefit from learning opportunities, experience fewer illnesses, and have ample energy for play. In contrast, children whose diet lacks critical nutrients such as protein and iron may develop anemia, which can lead to fatigue, diminished alertness, growth and academic failure, and loss of appetite. When children lack interest in eating, their iron intake is further compromised. In other words, nutritional status has a direct effect on children’s health and safety, and, in turn, influences the dietary requirements needed to restore and maintain well-being. A nutritious diet also plays an important role in injury prevention. The child or adult who arrives at school having eaten little or no breakfast may experience low blood sugar, which can cause fatigue, decreased alertness, and slowed reaction times and, thus, increase an individual’s risk of accidental injury. Similarly, overweight children and adults are more likely to sustain injuries due to excess weight, which may restrict physical activity, slow reaction times, and increase fatigue with exertion. 1-2a

What Is Health?

Definitions of health are as numerous as the factors that affect it. In years past, the term referred strictly to an individual’s physical well-being and the absence of illness. Contemporary definitions view health from a broader perspective and recognize it as a state of physical, emotional, social, economic, cultural, and spiritual well-being. Each interactive component is assumed to make an equally important contribution to health and to affect the functional activity of the others. For example, a stressful home environment may be contributing to a child’s asthma attacks, stomachaches, or headaches. In turn, a child’s repeated illnesses or chronic disability can profoundly affect the family’s emotional, financial, social, and physical stability and well-being. The current health concept also recognizes that children and adults do not live in isolation, but are active participants in multiple groups, including family, peer, neighborhood, ethnic, cultural, recreational, religious, and community. Children’s health, development, and opportunities for learning are directly influenced by the positive and negative experiences that occur in each setting. For example, children growing up in a poor, urban neighborhood may be at greater risk for becoming obese because they have fewer safe places for outdoor play and limited access to fresh fruits and vegetables. In other words, children’s health and development must be considered in the context of their social and environmental conditions. health – a state of wellness. Complete physical, mental, social, and emotional well-being; the quality of one health element affects the state of the others.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Children’s Well-Being: What It Is and How to Achieve It

What Factors Influence Children’s Health?

continuously changing state.

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Health is a dynamic and complex state. It is a product of continuous interactions between an individual’s genetic makeup, environmental conditions, and personal experiences (Figure 1–5). For example, an infant’s immediate and long-term health and cognitive development are influenced by their mother’s personal lifestyle practices during pregnancy: her diet; use or avoidance of alcohol, tobacco, and certain medications; routine prenatal care; and exposure to communicable illnesses or toxic stress. Mothers who fail to maintain a healthy lifestyle during pregnancy are more likely to give birth to infants who are born prematurely, have low birth weight, or experience a range of special challenges (CassidyVu, Way, & Spangler, 2022; Di et al., 2022). These children also face a significantly greater risk of developing chronic health problems and early death. In contrast, a child who is born healthy, raised in a nurturing family, consumes a nutritious diet, lives in a safe environment, and has numerous opportunities for learning and recreation is more likely to enjoy a long, healthy life.

Figure 1–5 Health is an interactive and

Physical

Chapter 1

Heredity Characteristics transmitted from biological parents to their children at the time of conception determine all of the genetic traits of a new, unique individual. Heredity sets the limits for growth, development, and health potential. It explains, in part, why children in one family are short while those from another family are tall, or why some individuals have allergies or require glasses while others do not. Understanding how heredity influences health can also be useful for assessing an inherited tendency, or predisposition, to certain health problems such as heart disease, deafness, cancer, diabetes, lactose intolerance, or mental health disorders. Although a family history of heart disease or diabetes may increase one’s risk, it does not imply that an individual will necessarily develop the condition. Many lifestyle factors, including physical activity, diet, sleep, and stress levels, interact with genetic material (genes) and may alter the child’s chances of developing or not developing heart disease or any number of other chronic health disorders. Environment Although heredity provides the basic building materials that predetermine the limits of one’s health, environment plays an equally important role. Environment encompasses a combination of physical, psychological, social, economic, and cultural factors that collectively influence the way individuals perceive and respond to their surroundings. In turn, these experiences shape an individual’s behavior and potential health outcomes. Examples of several environmental factors that support and promote healthy outcomes include: ◗ ◗ ◗ ◗ ◗

▼ Heredity sets the limits for a child’s growth, development, and health potentials.

consuming a nutritious diet participating in daily physical and recreational activities obtaining 8 to 9 hours of uninterrupted nighttime sleep having access to quality medical and dental care reducing stress levels

heredity – the transmission of certain genetic material and characteristics from biological parents to a child at the time of conception. predisposition – having an increased chance or susceptibility.

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Promoting Children’s Health: Healthy Lifestyles and Health Concerns

residing in homes, child care facilities, schools, and workplaces that are clean and safe forming stable and meaningful relationships

There are also many environmental factors that have a negative effect on health. For example, exposure to chemicals and pollution, abuse, illness, obesity, prenatal alcohol exposure, sedentary lifestyles, poverty, acute and chronic stress, food insecurity discrimination, violence, or unhealthy dietary choices can interfere with children’s optimal growth and development. 1-2c

Safety

The term safety refers to behaviors and measures that are taken to protect an individual(s) from unnecessary harm. It is especially important that adults who work with young children view this responsibility seriously. Unintentional injuries are the leading cause of death among children from birth to 14 years in the United States and Canada (CDC, 2021). Sadly, many of these instances are avoidable. Young children are especially vulnerable to unexpected and serious injury because their developmental skills seldom match their level of enthusiasm and curiosity. Every adult who works with, or cares for, young children has a significant responsibility to maintain the highest standards of supervision and environmental safety. Factors Affecting Children’s Safety Protecting children’s safety requires a keen awareness of their skills and abilities at each developmental stage (Marotz, 2023). For example, knowing that toddlers enjoy hand-to-mouth activities should alert teachers to continuously monitor the environment for small objects or poisonous substances that could be ingested. Understanding that preschoolers are spontaneous and exceedingly curious should cause adults to take extra precautions to prevent children from wandering away or straying into unsupervised water sources. Children who have developmental disabilities or sensory disorders are at increased risk of sustaining unintentional injury and must be monitored continuously (Jones et al., 2021; O’Donnell & Canares, 2021). In-depth discussions of environmental safety and safety management are presented in Chapters 7 and 8. 1-2d

Nutrition

The term nutrition refers to the science of food, its chemical components (nutrients), and their relationship to health and disease. It includes all processes involved in obtaining nutrients from foods—from the ingestion, digestion, absorption, transportation, and utilization of nutrients to excretion of unused by-products. Nutrients are essential for life and have a direct effect on a child’s nutritional status, behavior, health, and development. Nutrients play critical roles in a variety of vital body functions, including: ◗ ◗ ◗ ◗

supplying energy promoting growth and development improving resistance to illness and infection building and repairing body tissue

A wide variety of foods must be consumed in the recommended amounts to meet the body’s needs for essential nutrients. However, many family and environmental conditions, including financial resources, transportation, geographical location, cultural and religious preferences, convenience, and nutrition knowledge, can affect the quality of a child’s diet. Most children in the United States live in a time and place where food is reasonably abundant. Yet, there is increasing concern about the number of children who may not be getting enough to eat or whose diets do not include nutritious foods (Leung et al., 2022; McCurdy et al., 2022). Also, because many young children spend the majority of their waking hours in out-of-home child care programs or school classrooms, efforts must be made to ensure that their nutrient needs are being met in these settings. sedentary – unusually slow or sluggish; a lifestyle that implies inactivity. food insecurity – uncertain or limited access to a reliable source of food. nutrients – the chemical substances in food. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Kornnphoto/Shutterstock.com

Nutrition’s Effect on Children’s Behavior, ▼ Children’s diet influences their health, learning, and behavior. Learning, and Well-being Children’s nutritional status has a significant effect on their behavior and cognitive development. Well-nourished children are typically more alert, attentive, physically active, and better able to benefit from learning experiences. Poorly nourished children may appear quiet and withdrawn, or exhibit aggressive and disruptive behaviors in the classroom (Gallegos et al., 2021; Hatsu et al., 2022). They are also more prone to injury because of decreased alertness and slower reaction times (Men, Urquia, & Tarasuk, 2021). Children who are overweight also face a range of social, emotional, and physical challenges, including difficulty participating in physical activities, ridicule, emotional stress, and peer exclusion. Additional information about children’s specific nutrient needs and challenges associated with over- and under-consumption of foods is presented in Chapters 12 through 19. Children’s resistance to infection and illness is also directly influenced by Stop and Check #2 their nutritional status (Calder et al., 2020; Padhani et al., 2022). Well-nourished children experience fewer illnesses and recover more quickly when they are sick. In what ways does environment Children who consume an unhealthy diet are more susceptible to infections and influence the quality of a person’s health? illness and often require longer time to recuperate. Frequent illness can interfere with a child’s appetite, which may limit their intake of nutrients that are important for the recovery process. Thus, poor nutrition can create a cycle of increased susceptibility to illness and infection, nutritional deficiency, and prolonged recovery. Teachers have an exceptional opportunity to protect and promote children’s wellbeing. Their knowledge of children’s development and health, safety, and nutritional Did You Know... needs can be applied when planning learning activities, classroom environments, meals that children who and snacks, and supervision. In addition, teachers can implement sanitation and early eat breakfast have better identification practices to reduce children’s unnecessary exposure to illness and infecproblem-solving skills, more tion. Furthermore, they can support the concept of preventive health by serving as energy, lower obesity positive role models and providing children with learning experiences that encourage rates, and feel more a healthy lifestyle. cheerful? 1-3

Children’s Growth and Development

When teachers understand typical growth and developmental patterns, they are better able to identify and address children’s diverse needs and to help children master critical skills. They can create learning experiences and set developmentally appropriate goals for children that foster positive self-esteem. They are able to design high-quality environments that are safe and encourage children’s mastery of new skills. In addition, they are able to use this knowledge to promote children’s well-being by identifying health problems and atypical behaviors and teaching healthy practices. The terms “average” or “normal” are often used to describe children’s growth and development. However, such a child probably does not exist. Every child is a unique individual—a product of diverse experiences, environments, interactions, and heredity. Collectively, these factors can lead to significant differences in the rate at which children grow and acquire various skills and behaviors. resistance – the body’s ability to avoid infection or illness.

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Norms provide a useful reference for understanding, monitoring, and promoting children’s growth and development. They represent the average or approximate age when the majority of children demonstrate a given skill or behavior. Thus, the term normal implies that although many children are able to perform a given skill by a specific age, some will be more advanced whereas others may take somewhat longer, yet they are still considered to be within the normal range. 1-3a

Growth

The term growth refers to the many physical changes that occur as a child matures. Although the growth process takes place without much conscious control, there are many factors that affect its quality and rate: ◗ ◗ ◗ ◗ ◗ ◗ ◗

genetic potential emotional stimulation and attachment cultural influences socioeconomic factors adequate nutrition caregiver responsiveness and nurturing health status (i.e., illness, developmental disorders)

Infants (0–12 months) The average newborn weighs approximately 7 to 8 pounds (3.2–3.6 kg) at birth and is approximately 20 inches (50.8 cm) in length. Growth is rapid during the first year; an infant’s birth weight nearly doubles by the fifth month and triples by the end of the first year. For example, an infant who weighs 8 pounds (3.6 kg) at birth will weigh approximately 16 pounds (7.3 kg) at 5 months and 24 pounds (10.9 kg) at 12 months. An infant’s length increases by approximately 50 percent during the first year. Thus, an infant measuring 21 inches (53.3 cm) at birth should reach an approximate length of 31.5 inches (80 cm) by 12 months of age. A majority of this gain occurs during the first 6 months when an infant may grow as much as 1 inch (2.54 cm) per month. An infant’s head appears large in proportion to the rest of the body due to rapid brain growth. Head circumference is measured at regular intervals to ensure that brain growth is proceeding at a rate that is neither too fast nor too slow. Measurements should reflect a gradual increase in size so that, by age 1, the head and chest circumferences are nearly equal. Additional changes that occur during the first year include the growth of hair and eruption of teeth (four upper and four lower). The infant’s eyes begin to focus and move together as a unit by the third month, and vision becomes more acute. Special health concerns for infants include the following: ◗ ◗ ◗ ◗ ◗ ◗

meeting nutritional requirements assuring adequate provisions for sleep supporting attachment fostering early brain development providing safety and injury protection identifying birth defects and health disorders

At no other time in children’s lives will they grow as much or as quickly as they do during the first year. A nutritious diet, adequate sleep, a nurturing environment, and responsive caregiving are especially important to foster growth during this critical period. (See Chapter 15.)

norms – an expression (e.g., weeks, months, years) of when a child is likely to demonstrate certain developmental skills. normal – average; a characteristic or quality that is common to most individuals in a defined group. growth – increase in size of any body part or of the entire body. head circumference – distance around the largest part of the head; used to monitor brain growth and development. attachment – an emotional connection established between infants and their parents and/or primary caregivers.

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Toddlers (12–30 months) Toddlers continue to make ▼ Toddlers need plenty of sleep to meet their high steady gains in height and weight, but at a much slower rate energy demands. than during infancy. Their weight increases an average of 6 to 7 pounds (2.7–3.2 kg) per year; by 2 years, toddlers have nearly quadrupled their birth weight. They also grow approximately 3 to 5 inches (7.6–12.7 cm) in height per year. Their body proportions begin to change and contribute to a more erect appearance. Eruption of “baby teeth,” or deciduous teeth, is complete by the end of the toddler period. (Deciduous teeth consist of a set of twenty temporary teeth.) Toddlers can begin learning how to brush their new teeth with close adult supervision. Special attention should also be paid to additional preventive measures such as providing foods that promote dental health; are colorful, appealing, and easily chewed; and, include all of the essential nutrients. Foods from all food groups—fruits, vegetables, dairy, protein, whole-grains—should always be part of the toddler’s daily meal pattern. High activity levels make it essential for toddlers to get at least 10 to 12 hours of uninterrupted nighttime sleep and 1 to 2 hour-long naps each day. Insufficient sleep has been linked to an increase in learning and behavior problems, risk of injury, and a variety of health problems including obesity (Simon et al., 2022). Safety awareness and injury prevention continue to be major concerns that demand close adult supervision. Preschoolers/Early School-age (2½–8 years) During the preschool and early school-age years, a child’s appearance becomes more streamlined and adult-like in form. Head size remains relatively constant, while the child’s trunk (body) and extremities (arms and legs) continue to grow. The head gradually appears to separate from the trunk as the neck lengthens. Legs grow longer and at a faster rate than the arms, adding extra inches to the child’s height. The toddler’s characteristic chubby body shape becomes more defined as muscle tone and strength increase, giving the preschooler a flatter abdomen and straighter posture. Gains in weight and height are relatively slow but steady throughout this period. By 3 years of age, children weigh approximately five times their birth weight. Ideally, preschoolers should gain no more than 4 to 5 pounds (1.8–2.3 kg) per year. They begin to grow taller during this period and gain an average of 2 to 2.5 inches (5.1–6.4 cm) in height per year. By 6 years, children have nearly doubled their original birth length (from approximately 20 inches to 40 inches [50.8–101.6 cm]). By age 7, girls are approximately 42 to 46 inches (106.7–116.8 cm) tall and weigh 38 to 47 pounds (17.2–21.3 kg); boys are 44 to 47 inches (111.8–119.4 cm) tall and weigh 42 to 49 pounds (19.1–22.2 kg). This combination of rapid growth and muscle development contributes to children’s longer, leaner, and more adult-like appearance. It is important that preschool-age children continue to consume a nutritious diet. High activity levels replace the rapid growth of earlier years as the primary demand for calories. A general rule for estimating a child’s daily caloric needs is to begin with a base of 1,000 calories and add an additional 100 calories per birthday. (For example, a 7-year-old would need approximately 1,700 calories). Adults should carefully monitor children’s food intake and encourage healthy eating habits because decreased appetite, inconsistent eating habits, and considerable media influence are often evident during the preschool years. Adequate sleep continues to be essential for children’s optimal growth and development. When days are long and tiring or unusually stressful, children’s need for sleep may be even greater. deciduous teeth – a child’s initial set of teeth; these teeth are temporary and gradually begin to fall out at around 5 years of age.

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▼ Preschoolers’ fine motor skills are improving in control, accuracy, and speed.

1-3b

Most preschool and school-aged children require 8 to 12 hours of uninterrupted nighttime sleep in addition to daytime rest periods, although bedtime and afternoon naps often become a source of adult–child conflict. Preschool children may become so involved in play activities that they are reluctant to stop for sleep. Nevertheless, young children benefit from brief rest breaks during their normal daytime routine. Planned quiet times, with books, puzzles, quiet music, or a small toy, may be an adequate substitute for older children. By the time children reach school-age, they begin to enjoy one of the healthiest periods of their lives. They generally experience fewer colds and upper respiratory infections. Children’s visual acuity continues to improve, they grow taller at a fairly rapid rate, their muscle mass increases, hair becomes darker, and permanent teeth begin to erupt.

Development

In the span of 1 year, remarkable changes take place in the infant’s development. The child progresses from a stage of complete dependency on adults to one marked by the acquisition of language and the formation of rather complex thought patterns. Infants also become more mobile, social, and outgoing near the end of the first year. The toddler and preschool periods reflect a continued refinement of language, perceptual, motor, cognitive, and social achievements. Improved motor and verbal skills enable the toddler to explore, test, and interact with the environment for the purpose of determining personal identity, or autonomy. Preschool-age children are becoming more self-sufficient and able to perform self-care and fine motor tasks with improved strength, speed, accuracy, control, and ease. Friends and friendships are increasingly important as preschool children expand their sphere of acquaintances beyond family members. Children are now able to participate in the socialization process as they begin to develop a conscience and gain emotional control. A strong desire to achieve motivates most 6-, 7-, and 8-year-olds. Participation in sports and other vigorous activities provides opportunities for children to practice and improve their motor skills. Adult approval and rewards continue to serve an important role in helping children build self-confidence and self-esteem. During this stage, children also begin to establish gender identity through meaningful social interactions. A summary of major developmental achievements is presented in Table 1–3. It should be remembered that such a list represents accomplishments that a majority of children can perform at a given age. It should also be noted that not every child achieves all of these tasks. Many factors, including nutritional adequacy, opportunities for learning, access to appropriate medical and dental care, a nurturing environment, cultural expectations, and family support, exert a strong influence on the nature and rate of children’s skill acquisition. Early Brain Development An infant’s brain begins to form during the earliest weeks of a pregnancy. Its genetic composition is affected by various maternal and paternal practices (e.g., diet, sleep, prenatal care, physical activity, weight gain, smoking, alcohol or drug use, stress, mental health) prior to and during this period (Bodden, Hannan, & Reichelt, 2021; Chetty-Mhlanga et al., 2022). development – commonly refers to the process of intellectual growth and change.

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Table 1–3 Major Developmental Achievements

Age

Achievements

2 months

• • • • • • •

lifts head up when placed on stomach follows moving person or object with eyes imitates or responds to smiling person with occasional smiles turns toward source of sound begins to make simple sounds and noises grasps objects with entire hand; not strong enough to hold on enjoys being held and cuddled

4 months

• • • • • • •

has good control of head reaches for and grasps objects with both hands laughs out loud; vocalizes with coos and giggles waves arms about holds head erect when supported in a sitting position rolls over from side to back to stomach recognizes familiar objects (e.g., bottle, toy)

6 months

• grasps objects with entire hand; transfers objects from one hand to the other and from hand to mouth • sits alone with minimal support • reaches for, grasps, and holds objects (e.g., rattles, bottle) in a deliberate manner • plays games and imitates (e.g., peek-a-boo) • shows signs of teeth beginning to erupt • prefers primary caregiver to strangers • babbles using different sounds • raises up and supports weight of upper body on arms

9 months

• sits alone; able to maintain balance while changing positions; picks up objects (e.g., bits of cracker, peas) with pincer grasp (first finger and thumb) • begins to crawl • attempts to say words such as “mama” and “dada” • hesitates when unfamiliar persons approach • explores new objects by chewing or placing them in mouth

12 months

• • • • • • •

pulls up to a standing position may “walk” by holding on to objects stacks several objects one on top of the other responds to simple commands and own name babbles using jargon in sentence-like form uses hands, eyes, and mouth to investigate new objects can hold own eating utensils (e.g., cup, spoon)

18 months

• • • • • •

crawls up and down the stairs one at a time walks unassisted; has difficulty avoiding obstacles in pathway is less fearful of strangers enjoys being read to; likes toys for pushing and pulling has a vocabulary consisting of approximately 5–50 words; can name familiar objects helps feed self; manages spoon and cup

2 years

• runs, walks with ease; can kick and throw a ball; jumps in place • speaks in two- to three-word sentences (e.g., “dada,” “bye-bye”); asks simple questions; knows about 200 words • displays parallel play • achieves daytime toilet training • voices displeasure

3 years

• • • • • •

climbs stairs by using alternating feet hops and balances on one foot feeds self helps dress and undress self; washes own hands and brushes teeth with help is usually toilet trained asks and answers questions; is quite curious

(continued)

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Table 1–3

Major Developmental Achievements (continued )

Age

Achievements • enjoys drawing, cutting with scissors, painting, clay, and make-believe • throws and bounces a ball • states name; recognizes self in pictures

4 years

• dresses and undresses self; helps with bathing; manages own tooth brushing • enjoys creative activities: paints, draws with detail, models with clay, builds imaginative structures with blocks • rides a tricycle with confidence, turns corners, maintains balance • climbs, runs, and hops with skill and vigor • enjoys friendships and playing with small groups of children • enjoys and seeks adult approval • understands simple concepts (e.g., shortest, longest, same)

5 years

• • • • • • • •

expresses ideas and questions clearly and with fluency has vocabulary consisting of approximately 2,500–3,000 words substitutes verbal for physical expressions of displeasure dresses without supervision seeks reassurance and recognition for achievements engages in active and energetic play, especially outdoors throws and catches a ball with relative accuracy cuts with scissors along a straight line; draws in detail

6 years

• • • • • • •

plays with enthusiasm and vigor develops increasing interest in books and reading displays greater independence from adults; makes fewer requests for help forms close friendships with several peers exhibits improved motor skills; can jump rope, hop and skip, ride a bicycle enjoys conversation sorts simple objects by color and shape

7 and 8 years

• • • • •

enjoys friends; seeks their approval shows increased curiosity and interest in exploration develops greater clarity of gender identity is motivated by a sense of achievement begins to reveal a moral consciousness

9–12 years

• • • • • •

uses logic to reason and problem-solve energetic; enjoys team activities, as well as individual projects likes school and academic challenge, especially math learns social customs and moral values is able to think in abstract terms enjoys eating any time of the day

Adapted from Marotz, L. (2023). Developmental profiles: Pre-birth through adolescence (9th ed.). Boston, MA: Cengage Learning.

At birth, an infant’s brain weighs approximately 25 percent of what their adult brain will eventually weigh and contains more than 100 billion brain cells or neurons. At this point, the brain is relatively unorganized and dysfunctional because few meaningful pathways have been established. This explains why young infants are not able to walk, talk, or care for themselves. Complex electrical connections begin to form between neurons in response to positive and negative experiences. Each time the same experience is repeated, the neural pathway becomes stronger (Figure 1–6). Connections and pathways that are seldom used undergo a process called pruning and gradually fade away. This process of adding and deleting neural connections reaches peak activity between the ages of 3 and 16 years and transforms the brain’s architecture from an otherwise disorganized system into one capable of profound thought, emotions, movement, and learning. neurons – specialized cells that transmit electrical impulses or signals.

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The majority of brain development occurs during the first Figure 1–6 Everyday experiences cause new neural 2 to 5 years of a child’s life, when the brain’s plasticity makes connections to be formed and strengthened. it more receptive to shaping and change. Note how quickly young children learn to speak another language and how adults often struggle to do the same, and you will understand how this concept works. Researchers have also identified what they believe to be sensitive periods, or “windows of opportunity,” during which neural connections in certain regions of the brain are thought to form more readily than they will later on (Wen et al., 2020). For example, vision and hearing connections peak between 2 and 4 months, whereas those governing emotional regulation begin to form months later. Sensory and learning pathways established during these sensitive periods are critical to the normal development of more advanced skills, such as learning to read or playing t-ball (Sanchez-Alonso & Aslin, 2022). An infant raised in a darkened room with few visual opportunities (e.g., mobiles, pictures, toys) will not form the network connections in the brain’s sensory region that are conducive to the same quality of learning. 1 Month 2 Years Adult Neuroscientists have contributed significantly to our understanding of brain development and the practices that optimize its performance. Nutrition, especially during a mother’s pregnancy and Stop and Check #3 the first two years of a child’s life, is of critical importance. Healthy brain and central What are neural connections nervous system development require specific proteins, minerals, and fats supplied and how do they occur? in breast milk and formula (Franklyn et al., 2022). Malnutrition that occurs during infancy and toddlerhood can cause an irreversible decrease in brain cell production (and intelligence) and interfere with normal nervous system development, learning, and behavior. Although the brain’s genetic foundation is in place at birth, it is the ongoing experiences in a child’s environment that shape and determine how well the brain will ultimately perform. Safe, responsive caregiving enables infants to form strong attachments and neural connections that are important for learning and emotional regulation. Children’s environments and the quality of available learning opportunities also exert a direct influence on brain development. When children are surrounded with language, encouraged to explore and be creative, presented with varied and enriching play experiences, and reinforced for their efforts, they are building strong neural pathways that are linked directly to cognitive development, self-esteem, and school success. 1-4

Promoting a Healthy Lifestyle

Today, concern for children’s health and welfare is a shared vision. Changes in current lifestyles, family structures, cultural diversity, philosophies, and expectations have necessitated the collaborative efforts of families, teachers, and service providers to address children’s well-being. Communities are also valued members of this partnership and must assume a proactive role in creating environments that are safe, enriching, and healthy places for children to live. How can families and teachers determine whether or not children are healthy? What qualities or indicators are commonly associated with being a healthy or a well child? Growth and developmental norms always serve as a starting point. Again, it must be remembered that norms simply represent an average, not exact, age when most children are likely to achieve a given skill. Healthy children are more likely to exhibit characteristic behaviors and developmental skills plasticity – the brain’s ability to organize and reorganize neural pathways. well child – a child who enjoys a positive state of physical, mental, social, and emotional health.

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appropriate for their age. They tend to be well-nourished, have energy to play, experience continued growth, and have fewer illnesses. Developmental norms are also useful for anticipating and addressing children’s special health needs, including injury prevention, body mechanics and physical activity, oral health, and mental well-being. 1-4a

Being Physically Active

Vigorous physical activity should be an essential part of every child’s day. Scientists have repeatedly shown that it has a positive effect on children’s growth, mental health, learning, weight management, and behavior (Lundy & Trawick-Smith, 2021; McGowan et al., 2022). Added benefits are realized when time is spent in outdoor play activities, including more diverse motor challenges, novel learning experiences, and increased energy and stress reduction (Lee et al., 2021; Peacock et al., 2021; Squillacioti et al., 2022). Current guidelines recommend that: ◗

◗

preschool-age children engage in a variety of different activities and remain physically active throughout the day, with at least 60 minutes of the time spent in moderately vigorous activity (CDC, 2022c). older children (6 years and up) participate in a minimum of: ◗ moderate aerobic activity (e.g., running, walking briskly) 60 minutes each day, and ◗ vigorous-intensity activity (e.g., swimming, biking, soccer, jumping rope), musclestrengthening activity (e.g., climbing, stretching, yoga), and bone-strengthening (e.g., running, jumping) at least 3 days a week.

Introducing children to a variety of sports, games, and other forms of aerobic activities provides them with early opportunities to discover those they enjoy and are likely to continue. It is also important that families and teachers serve as positive role models for children by participating in a variety of physical activities every day. Teachers should review classroom schedules and always look for ways to incorporate more physical activity into daily routines. 1-4b

Injury Prevention

iStock.com/Ildar Abulkhanov

Unintentional injuries, especially those involving firearms and motor vehicles, pose the greatest threat to the lives of young children (Lee, Douglas & Hemenway, 2022). They are responsible for more than one-half of all deaths among children under 14 years of age in the United States. Each year an additional 1 million children sustain injuries that require medical attention, and many are left with permanent disabilities (CDC, 2020). An understanding of normal growth and ▼ Adults must always supervise children closely to ensure their safety. development is essential when planning for children’s safety. Many characteristics that make children delightful to work with are the same qualities that make them prone to injury. Children’s skills are seldom as well developed as their determination, and in their zealous approach to life, they often fail to recognize inherent dangers (Xia et al., 2022). Their inability to judge time, distance, and speed accurately contributes to many injuries, especially those resulting from falls, as a pedestrian, or while riding a bike. Limited problem-solving abilities make it difficult for children to anticipate the consequences of their actions. This becomes an even greater challenge when infants or children with developmental disabilities are present. For these Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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reasons, adults have an obligation to provide active, continuous supervision and to maintain safe environments for all children at all times. Safety considerations and protective measures will be discussed in greater detail in Chapter 7. 1-4c

Body Mechanics

Correct posture, balance, and proper body alignment are necessary for many physical activities that children engage in, such as walking, jumping, running, skipping, standing, and sitting. Teaching and modeling appropriate body mechanics can help children avoid problems related to poor posture that may develop later in life. Orthopedic problems (those relating to skeletal and muscular systems) are not common among young children. However, there are several conditions that warrant early diagnosis and treatment: ◗ ◗ ◗ ◗ ◗ ◗ ◗

birth injuries, such as hip dislocation, fractured collarbone abnormal or unusual walking patterns, such as limping or walking pigeon-toed bowed legs knock-knees flat feet unusual curvature of the spine unequal length of extremities (arms and legs)

Some irregularities of posture disappear spontaneously as young children mature. For example, it is not uncommon for infants and toddlers to have bowed legs or to walk slightly pigeon-toed. However, by age 3 or 4, these problems should correct themselves. If they do persist beyond the age of 4, children should be evaluated by a health professional to prevent permanent deformities. Children’s posture and body mechanics serve as excellent topics for classroom discussions, demonstrations, rhythm and movement activities, games, and art projects. Sharing this information in newsletters or posting it on bulletin boards or a website enables families to reinforce correct practices at home. ▼ Children should be discouraged from sitting in the “W” position. Children can begin to learn basic body mechanics, including: ◗ ◗

◗

◗

Sitting squarely in a chair, resting the back firmly against the chair back and with both feet flat on the floor. Sitting on the floor with legs crossed (in front) or with both legs extended straight ahead. Children should be discouraged from kneeling or sitting in a “W” position because this can place additional stress on developing joints. Have children sit in a chair with feet planted firmly on the ground or provide a small stool that they can straddle with one leg on each side; this position forces children to sit correctly. Alternative seating supports may be required for children who have muscular or neurological disorders. Standing with the shoulders square, the chin up, and the chest out. Body weight should be distributed evenly over both feet to avoid placing stress on one or the other hip joints. Lifting and carrying heavy objects by using the stronger muscles of the arms and legs rather than weaker back muscles. Standing close to an object that is to be lifted with feet spread slightly apart provides a wider support base. Stooping down to lift (with your legs); bending over at the waist when lifting places strain on back muscles and increases the risk of injury.

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Checklist 1–1 ✓✓✓ Teacher Proper Body Mechanics for Adults ●

● ● ●

● ● ● ●

Use the correct technique when lifting children; flex the knees and lift using leg muscles; avoid lifting with back muscles, which are weaker. Adjust the height of children’s cribs and changing tables to avoid bending over. Provide children with step stools so they can reach water fountains and faucets without having to be lifted. Bend down by flexing the knees rather than bending over at the waist; this reduces strain on weaker back muscles and decreases the risk of possible injury. Sit in adult-sized furniture with feet resting comfortably on the floor to lessen strain on the back and knees. Transport children in strollers or wagons rather than carrying them. Lift objects with arms kept close to the body versus extended; this also reduces potential for back strain. Exercise regularly to improve muscle strength, especially back muscles, and to relieve mental stress.

Correct posture and body mechanics are also important skills for parents and teachers to practice (Teacher Checklist 1–1). Because they perform many bending and lifting activities throughout the day, using proper technique can reduce chronic fatigue and work-related injury. Exercising regularly also improves muscle strength and makes it easier to complete demanding physical tasks. 1-4d

Oral Health

Children’s oral health continues to be a major priority in the Healthy People 2030 objectives. Yet, there are many children who seldom visit a dentist because their families cannot afford dental insurance or costly preventive care. Children from low-income and minority groups encounter numerous barriers in obtaining dental treatment and, thus, experience significantly higher rates of tooth decay (Lopez et al., 2022; Song et al., 2021). Neglected dental care can result in painful cavities and infected teeth, interfere with concentration and academic performance, and affect children’s behavior and self-esteem. There are many adults who erroneously believe that “baby teeth,” or deciduous teeth, do not require treatment because they will eventually fall out (Figure 1–7). This is an unfortunate assumption because children’s temporary teeth are necessary for: ◗ ◗ ◗ ◗

Figure 1–7

chewing proper spacing for permanent teeth shaping the jaw bone speech development

Approximate age when teeth erupt and are lost.

Primary teeth

Central incisor

Appear Lost 8–12 mos. 6–7 yrs.

Lateral incisor

9–13 mos. 7–8 yrs.

Canine (cuspid) 16–22 mos. 10–12 yrs. Upper teeth

Lower teeth

First molar

13–19 mos. 9–11 yrs.

Second molar

25–33 mos. 10–12 yrs.

Second molar

23–31 mos. 10–12 yrs.

First molar

14–18 mos. 9–11 yrs.

Canine (cuspid) 17–23 mos. 9–12 yrs. Lateral incisor

10–16 mos. 7–8 yrs.

Central incisor

6–10 mos. 6–7 yrs.

Advancements in pediatric dentistry and educational efforts have resulted in significant improvements in children’s dental health. Practices, such as consuming a nutritious diet during pregnancy, scheduling regular dental visits, the use of sealants, adding fluoride to drinking water supplies and toothpastes, and applying fluoride directly to teeth have collectively reduced the incidence of children’s dental caries and gum disease. Diet also has an unquestionable effect on children’s dental health. Proper tooth formation depends on an adequate intake of protein and minerals, particularly calcium and fluoride. Highly refined and sticky carbohydrates should be consumed in moderation to limit their negative effect

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on healthy teeth. These types of carbohydrates are commonly found ▼ Improving children’s oral health is an important in cakes, cookies, candies, gum, soft drinks, sweetened cereals, and goal of Healthy People 2030. dried fruits (e.g., raisins, dates, apricots, prunes). Replacing sweets in children’s diet with fresh fruits and vegetables reduces the risk of dental caries and also promotes healthier eating habits. Children’s medications and chewable vitamins are often sweetened with added sugars, so it is important that tooth brushing follow their ingestion. Dietary practices also play an important role in the prevention of baby bottle tooth decay (BBTD). Extensive cavity development can occur when sugars in formula, breast milk, juices, and/or sweetened drinks come in frequent or prolonged contact with a child’s teeth or gums. Practices that increase the risk of developing BBTD include putting an infant to bed with a bottle, lengthy breastfeeding at night, and allowing toddlers to carry around a sippy cup containing fruit juice, soda, or other sweetened drink. Oral hygiene practices implemented early in children’s lives also contribute to healthy tooth development. For example, a small, wet washcloth can be used to remove milk and food particles from an infant’s gums and teeth. A small, soft brush and water can be used to clean an older infant’s teeth. Most toddlers can begin to brush their own teeth with a soft brush and water at around 15 months of age (Teacher Checklist 1–2). However, the use of toothpaste is not recommended before age 2; most toddlers do not like its taste and are unable to spit it out after brushing. When a child is first learning tooth brushing skills, an adult should brush over the teeth after at least one of the brushings each day to be sure all areas are clean. Teeth can also be kept clean between brushings by rinsing with water after meals and eating raw foods, such as apples, pears, and celery, that provide a natural cleansing action. Preschool children are generally able to brush their teeth with minimal supervision, but it may still be advisable for an adult to provide a quick follow-up brushing. Although children’s technique may not always be perfect, they are beginning to establish a lifelong tooth brushing

Checklist 1–2 ✓✓✓ Teacher Promoting Children’s Tooth Brushing Make tooth brushing appealing and fun for children by: ● ● ●

letting children pick out their favorite tooth brush (color and/or character) and label it with their name placing tooth brushes where they are accessible to children providing a footstool or chair so children can comfortably reach the sink

Caution Supervise children closely to prevent them from slipping or falling. ● ● ●

● ●

demonstrating the correct tooth-brushing procedure and having children imitate setting a timer and brushing your teeth together on occasions recording a favorite song (e.g., “London Bridge,” “Itsy Bitsy Spider,” or “Wheels on the Bus”) and play it while each child brushes their teeth. (Check the Internet for free song downloads.) This can make tooth brushing fun for children making a habit of having children wash their hands and brush their teeth following a meal/snack designing a chart where children can place a check mark or sticker each time they brush

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habit. Proper brushing technique and fluoride-based toothpastes (pea-size application) have proven to be effective in reducing dental cavities. However, children must be supervised closely so they do not swallow the toothpaste. Ingesting too much fluoride over time can result in dental fluorosis which causes white or brown spots to form on developing teeth. The question of whether young children should learn to floss their teeth is best answered by the child’s dentist. Although the practice is regarded as beneficial, much depends on the child’s maturity and fine motor skills. Flossing is usually recommended once the permanent teeth begin to erupt and spaces between teeth disappear. Adults should assist children who are too young to manage this procedure by themselves. Routine dental checkups are also an important component of preventive health care, but they are not a substitute for daily oral hygiene practices and a healthful diet. Children’s first visit to the dentist should be scheduled at around 12 to 15 months of age and every 6 to 12 months thereafter. Initial visits should be pleasant experiences that acquaint a child with the dentist, routine examinations, and cleanings without undergoing painful dental work. Children are more likely to maintain a favorable attitude toward dental care and to approach visits with less fear and anxiety if early experiences are positive. During routine visits, dentists clean, apply a fluoride varnish, and inspect the child’s teeth for potential problems. They also review the child’s toothStop and Check #4 brushing technique, diet, and personal habits, such as thumb sucking or What oral health practices grinding that may affect tooth development. The fluoridation of municipal should caregivers implement water supplies and use of sealants (a plastic-like material applied to permanent during infancy? molar groves) have also made significant contributions to a decline in childhood tooth decay (Campos & Fontana, 2022; Munteanu et al., 2022). 1-4e

Mental Health and Social-Emotional Competence

The wellness model recognizes a close relationship between a child’s social-emotional and physical well-being. This association continues to receive greater attention due to the increase in children’s behavior problems, school dropout rates, substance abuse, violence, gang membership, depression, and suicide. Approximately one in six children in the United States experiences mental health problems, and one in ten have disorders that seriously interfere with learning (CDC, 2022b). Children who live in dysfunctional or economically challenged families, or who have a disability, are at the highest risk for developing mental health problems (Michel, Kindler, & Kaess, 2022; Lacey et al., 2022). A strong positive relationship exists between a child’s mental health status and self-concept. Young children typically view themselves solely in terms of physical qualities, such as having brown hair, blue eyes, or being tall. By age 5 or 6, children begin to include social comparisons with peers as part of their self-definition; they can run faster than Jalen, build higher towers than Mei, or draw flowers better than Abetzi. Note that 9- and 10-year-olds exhibit a higher order of self-evaluation that is more analytical: “I like to play baseball, but I don’t field or hit the ball as well as Tori, so I probably won’t be asked to play on a team.” A child’s self-image and mental health are continuously being shaped and reshaped by complex interactions among biological (e.g., personality traits, physical well-being, illness, disability) and environmental factors (e.g., family structure, ethnicity, culture, poverty, household conditions). Each experience yields information that has a positive or negative influence on a child’s outlook and behavior. For example, a child who has cerebral palsy and is teased because they do not walk like other children may withdraw from group activities, develop a negative self-concept, and become depressed unless positive support is provided. In contrast, a child who is athletically talented, outgoing, and frequently befriended is likely to be confident and to have a positive self-concept. fluorosis – white or brown spots that form on children’s teeth due to excessive fluoride intake. self-concept – a person’s belief about who they are, how they are perceived by others, and how they fit into society.

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▼ Teachers have many opportunities to promote children’s mental health by teaching important social skills.

Supporting Children’s Social and Emotional Development Families and teachers play a major role in promoting children’s social-emotional development. They improve children’s chances for achieving positive outcomes by providing learning opportunities that build on individual strengths and interests. Children are more likely to experience success, take pride in their accomplishments, and feel good about themselves when adults set realistic goals and expectations. Their efforts should be acknowledged even when the results are unsuccessful. Failures and mistakes must be accepted as opportunities for learning and for offering positive guidance and support. In doing so, children begin to learn important lifelong lessons about initiative, risk-taking, problem-solving, and handling adversity. However, caution must be exercised never to judge children solely on their accomplishments (or failures) or to make comparisons with other children, but to recognize each child as a unique and valued individual. Teachers occupy a strategic position for reinforcing children’s development of social-emotional competence. They are able to provide opportunities for children to acquire and practice effective communication, self-control, problem-solving, and decision-making skills in a supportive environment. Teachers also foster children’s social-emotional competence by creating safe and respectful classrooms that convey acceptance, positive attitudes toward others, address children’s individual needs, provide constructive feedback, and are conducive to learning. In addition, they play an integral role in: ◗ ◗ ◗ ◗ ◗ ◗

modeling positive mental health behaviors implementing sound mental health principles by being accepting, responsive, and supportive preventing emotional problems by teaching children effective social, communication, anger management, and problem-solving skills identifying and referring children who may exhibit signs of emotional problems, such as excessive or uncontrollable frustration, aggressive behavior, or difficulty making and keeping friends working collaboratively with families to locate community resources advocating for community mental health services

When children develop positive self-esteem and confidence in their own abilities, they are more likely to experience a trajectory of personal and academic success. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Promoting Children’s Health: Healthy Lifestyles and Health Concerns

Teachers as Role Models Adults must never overlook their importance as role models for young children. Their personal behaviors and response styles exert a powerful and direct influence on children’s social-emotional development. Teachers must carefully examine their own emotional state if they are to be successful in helping children achieve positive self-esteem. They, too, must have a strong sense of self-worth and confidence in what they are doing. They should be aware of personal biases and prejudices, be able to accept constructive criticism, and recognize their strengths and limitations. They must have effective communication skills and be able to work collaboratively with families of diverse backgrounds, community service providers, health care professionals, and other members of the child’s educational team. If teachers are to serve as positive role models, they must also exercise the same control over their emotions that they expect of children. Personal problems and stressors must remain at home so that full attention can be focused on the children. Teachers must respect children as individuals—who they are, and not what they are able or not able to do—because every child has qualities that are endearing and worthy of recognition. Teachers must also be impartial in their treatment of children; favoritism cannot be tolerated. Working with young children can be rewarding, but it can also be stressful and demanding in terms of the patience, energy, and stamina required. Noise, children’s continuous requests, long hours, staff shortages, mediocre wages, and occasional conflicts with families or co-workers are everyday challenges. Physical demands and unresolved stress can gradually take their toll on teachers’ health, commitment, and daily performance. Eventually, this can lead to job burnout and negative interactions with colleagues and children (Ansari et al., 2022; Souto-Manning & Melvin, 2022). For these reasons, it is important that teachers identify sources of stress in their jobs and take steps to address, reduce, or eliminate them to the extent possible (Collie & Mansfield, 2022; Marotz, 2021). (See Teacher Checklist 1–3.) Emotional Atmosphere A classroom’s emotional atmosphere—the positive or negative feelings one senses—can have a significant impact on children’s social-emotional development. Consider the following situations and decide which classroom you would find most inviting: Kate enters the classroom excited and eager to tell her teacher about the tooth she lost last night and the quarter she found under her pillow from the “tooth fairy.” Without any greeting, the teacher hurries to check Kate in and informs her that she is too busy to talk right now, but maybe later. When the teacher is finished checking Kate, she instructs her “to find something to do without getting into trouble.” Kate quietly walks away to put her coat in her cubby.

Checklist 1–3 ✓✓✓ Teacher Strategies for Managing Teacher Stress ● ● ●

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● ●

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Seek out training opportunities where you can learn new skills and improve your work effectiveness. Learn and practice time management techniques. Develop program policies and procedures that improve efficiency and reduce sources of tension and conflict. Join professional organizations; expand your contacts with other teachers, acquire new ideas, and advocate for young children. Take steps to improve your personal well-being—get plenty of sleep, eat a nutritious diet, and participate in some form of physical activity (outside of work) each day. Develop new interests, hobbies, and other outlets for releasing tension. Practice progressive relaxation techniques. Periodically, concentrate on making yourself relax and think about something pleasing. Plan time for yourself each day—read a good book, watch a movie or favorite TV program, go for a long walk, paint, go shopping, play golf, or participate in some activity that you enjoy.

self-esteem – an individual’s sense of personal value or self-worth.

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Ted arrives and seems reluctant to leave his mother for some reason this morning. The home provider immediately senses his distress and walks over to greet Ted and his mother. “Ted, I am so glad that you came today. We are going to learn about farm animals and build a farm with the wooden blocks. I know that blocks are one of your favorite activities. Perhaps you would like to build something small for your mother before it is time for her to go home.” Ted eagerly builds a barn with several “animals” placed in the yard around it and proudly looks to his mother for approval. When Ted’s mother is ready to leave, he waves good-bye.

Clearly, the teacher’s actions in the two examples created a classroom atmosphere that had a different effect on each child’s behavior. Children are generally more receptive and responsive to teachers who are warm, nurturing, and sensitive to their needs. Exposure to negative adult responses, such as ridicule, sarcasm, or threats is harmful to children’s emotional development and simply teaches inappropriate behaviors. However, an emotional climate that fosters mutual cooperation, respect, trust, acceptance, and independence will promote children’s social-emotional skill development. A teacher’s communication style and understanding of cultural differences also affect the emotional climate of a classroom. Treating all children as if they were the same is insensitive and can encourage failure, especially if a teacher’s expectations are inconsistent or incompatible with the child’s cultural background. For example, knowing that children in some Hispanic cultures are taught primarily through non-verbal instruction (modeling) may explain why a child who is only given verbal directives may not respond to this approach. Some children are reluctant to participate in group activities, make eye contact, or to answer a teacher’s question because this is counter to the way they have been raised. Unless the teacher understands these Did You Know... cultural differences, such behaviors could easily be misinterpreted as defiance or inatthat time spent outdoors tention. When teachers make an effort to learn about individual children and their in natural environments families, they are able to create a climate that supports each child’s learning style and improves attention and healthy social-emotional development. attitude while reducing The way in which the curriculum is planned and implemented also contributes stress, behavior problems, and crime? to the emotional climate. Children’s chances for achieving success are improved when learning activities are developmentally appropriate and matched to children’s individual needs and interests. Stress All children experience a host of stressful situations as they learn to master new skills, understand social convention, and/or encounter minor conflict. Examples of typical developmental stress include: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

separation from families new experiences—for example, moving, enrolling in a new school, having a mother return to work, being left with a sitter, or the birth of a sibling illness parental divorce death of a pet, family member, or close friend conflict of ideas; confrontations with family, friends, or teachers overstimulation due to hectic schedules; participation in too many activities learning challenges

Many of these stressors are a natural occurrence in children’s lives. They can provide valuable opportunities to help children learn healthy coping and problem-solving skills when experienced in a safe, secure, and supportive environment. Scientists have gained a better understanding of intense stress and its effects on children’s physical and mental well-being. The term adverse childhood experiences (ACEs) describes toxic situations that elicit strong emotional reactions and increase children’s risk of developing adverse childhood experiences (ACEs) – events over which children have no control or adult support; these experiences may be intense, frequent, and/or prolonged.

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Promoting Children’s Health: Healthy Lifestyles and Health Concerns

▼ The classroom atmosphere has a direct effect on children’s behavior and development.

long-term physical, behavioral, and mental health disorders (Bernard, Smith, & Lanier, 2022; Leiva, Torres-Cortés, & Antivilo-Bruna, 2022; Pickett et al., 2022). Such stressors can include abusive treatment, neglect, poverty, chronic illness, experiencing or witnessing violence, discrimination, natural disasters, and war. Chronic food insecurity, maternal depression, and parental substance abuse are also known to cause children significant distress and contribute to psychological problems that may last for years. Even more troubling are research findings that show permanent brain and genetic (DNA) damage linked to children’s early exposure to traumatic, intense, frequent, and/or chronic stress (Moore et al., 2022). Children’s immature brain development, limited experience and coping skills, and temperamental differences influence their understanding and ability to manage stress in a healthy manner. Sudden behavior changes are often an early indication that a child is experiencing significant tension or inner turmoil. Observable signs can range from less serious behaviors—nail biting, hair twisting, excessive fear, crying, prolonged sadness, and anxiety—to those that are of significant concern—repeated aggressiveness, destructiveness, withdrawal, depression, nightmares, psychosomatic illnesses, or poor performance in school. Brief episodes of these behaviors are usually not cause for concern, but children should be referred for professional evaluation if they persist. Teachers can help children who are experiencing acute or chronic stress by Stop and Check #5 showing additional patience, understanding, and support. Children also find Why is it important that comfort in knowing they are safe, secure, and able to count on teachers, parents teachers practice good and caregivers to be accepting, even at times when their emotional control may stress management? fail. Additional coping strategies are outlined in Table 1–4. Bullying Most school-age children report that they have been subjected to occasional verbal or physical bullying from their peers. Bullying differs from occasional name-calling and social rejection in that it is usually intentional, repetitive, and ongoing. Girls are more likely to engage in verbal taunting directed toward another girl whereas boys tend to use physical aggression to intimidate other males. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Table 1–4 Stress Management for Children 1. 2. 3. 4.

Encourage children to talk about what is causing them to feel tense or upset. Empower children by helping them to identify and express feelings appropriately. Nurture positive thinking and an “I know I can do this” attitude. Prepare children for stressful events (e.g., doctor’s visit, moving, flying for the first time, attending a new school) by role-playing or rehearsing what to expect. Practice “what if’s”: “What should you do if you get lost?,” “What can you do if you are afraid?” 5. Maintain predictable schedules, including mealtimes and bedtimes as much as possible. 6. Make sure children are receiving a nutritious diet and engaging in brief periods of vigorous physical activity (an effective stress reliever). 7. Schedule unstructured play time when children are free to do what they want.

Connecting to Everyday Practice

➥➥

Early Childhood Suspension and Expulsion

Dominic’s preschool teacher is frustrated with his disruptive and hurtful behavior toward the other children. She arranged a meeting with his parents and the program director. She explained that Dominic, age 4, seemed “troubled and was becoming increasingly more aggressive.” Just this morning he had pushed another child off of their tricycle because “he wanted the bike” and had thrown sand and toys at the other children despite multiple warnings to stop. This wasn’t the first time that his teacher had discussed her concerns with Dominic’s mother and the program director. Dominic’s parents were reminded about the school’s “three-times and you-are-out” policy and that his “unruly and noncompliant” behavior could no longer be tolerated. They agreed to a two-week suspension after which he would be allowed to return. However, if Dominic’s behavior did not improve, he would be permanently expelled from the program. These developments presented a troublesome dilemma for Dominic’s parents who both work long hours at a local packing company and cannot afford to lose their jobs. Dominic’s situation is not unusual. Thousands of young children are expelled or suspended from preschool and kindergarten programs every year for behaviors that teachers describe as “unmanageable.” As a result, this group experiences the highest expulsion and suspension rates among children of all ages. Boys, especially those of color, and children who have a developmental disability or have experienced personal trauma (e.g., abuse, household dysfunction, poverty, violent communities) are most likely to be involved (An & Horn, 2022; Wymer, Corbin, & Williford, 2022). Researchers have noted that teachers’ perceptions of children’s behavior, their lack of training in positive behavior guidance, and challenging classroom environments often play a significant role in this escalating trend (Loomis & Panlilio, 2022). School expulsions and suspensions are disruptive for families and the affected children. For example, Dominic’s parents must now decide how to juggle their work and parental responsibilities. They must consider whether Dominic does indeed have a behavior problem that requires treatment. They must also try to quickly locate another program that might accept him temporarily or friends who would be willing to watch him while they work. In the meantime, Dominic is missing out on important learning opportunities. Studies have shown that children who are repeatedly expelled or suspended from school tend to develop poor self-esteem and social outcomes (Novak, 2022; Sabol et al., 2022). They are also more likely to form negative attitudes toward school, experience academic failure, repeat grades, drop out of school, and engage in antisocial behaviors. (continued)

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Promoting Children’s Health: Healthy Lifestyles and Health Concerns

Connecting to Everyday Practice

➥➥

Early Childhood Suspension and Expulsion (continued)

Think About This: ◗ Would you consider Dominic’s behavior to be typical or atypical for a child of his age? Explain. ◗ How might personal stress and group size potentially influence a teacher’s decision to expel

a child from the program? What other school-related factors might also contribute to the teacher’s decision? ◗ In what ways may expulsion and suspension practices affect children’s brain development? ◗ What effective strategies could Dominic’s teacher use to address his “unacceptable” behav-

iors and support positive social-emotional development?

Researchers have identified two types of bullies: those who are self-assured, impulsive, lacking empathy, angry, and controlling; and, those who are passive and willing to join in once another child initiates the bullying (D’Urso et al., 2022; Veronica, 2022). Children who bully often come from environments where poverty, domestic violence, inconsistent supervision, and a lack of social support or parental concern are more common. As a result, they have had limited opportunities to develop effective interpersonal skills, impulse control, and problem-solving abilities. Children who are targeted by bullies may be singled out because they are perceived to be socially withdrawn or loners, passive and lacking in self-confidence, having a disability or special needs, not likely to stand up for themselves, and easily hurt (emotionally). They are more often from economically disadvantaged families, smaller in physical size than their peers, and seen as having fewer friends. Warning signs that a child is being victimized may include frequent complaints of health problems, change in eating and/or sleeping habits, reluctance to attend school or to participate in group activities, and declining academic performance. Prevention programs have been implemented in many schools to reduce bullying behavior and to create environments where children feel safe. Educational efforts address both the victims and perpetrators and are designed to teach mutual respect, reinforce effective social and communication skills, reduce harassment, and improve children’s self-esteem (Herkama et al., 2022; Rettew & Pawlowski, 2022). Children who are bullied can learn how to best respond in these situations by avoiding bullies, walking away, practicing conflict resolution, and always informing a trusted adult. Childhood Depression Some children are unsuccessful or unable to cope with acute anxiety or chronic stress. They may develop a sense of persistent sadness and hopelessness that begins to affect the way they think, feel, and act. These may be early signs of childhood depression and can include: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

apathy or disinterest in activities or friends loss of appetite difficulty sleeping complaints of physical discomforts, such as headaches, stomachaches, vomiting, diarrhea, ulcers, repetitive tics (twitches), or difficulty breathing lack of energy or enthusiasm indecision poor self-esteem uncontrollable anger

Children who have learning and/or behavior disorders or a family history of mental health disorders are at an increased risk for developing depression. Children as young as 3 may show early signs of depression, particularly when their mothers also suffer from this condition (Roubinov et al., 2022). The onset of childhood depression may occur abruptly following a traumatic event, such as parental divorce, death of a close family member or friend, abusive treatment, or chronic illness. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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However, it may also develop slowly over time, making the early signs more difficult to notice. In either case, teachers must be knowledgeable about the behaviors commonly associated with childhood depression so children can be identified and referred for professional care. Depression requires early identification and treatment to avoid serious and debilitating effects on children’s social, emotional, and cognitive development and to prevent long-term mental health disorders. Childhood Fears Most childhood fears and nightmares are a normal part of the developmental process and are eventually outgrown as children mature (Marotz & Kupzyk, 2018). Basic fears are relatively consistent across generations and cultures, although they vary somewhat from one developmental stage to the next. For example, a 3-month-old infant seldom displays any fear, whereas a 3-year-old is often fearful of the dark, loud noises, or “monsters under the bed.” Fears that reflect real-life events, such as fire, kidnapping, thunderstorms, or homelessness, are more common among 5- and 6-year-olds, whereas 10- and 11-year-olds may express fears related to appearance and social rejection. Some fears are unique to an individual child and may stem from personal experiences, such as witnessing a shooting, vicious dog attack, or being involved in a car accident. Fears and nightmares often peak during the preschool years, a time when children have a heightened imagination and are attempting to make sense of their world. Children’s literal interpretation of the things they see and hear can also contribute to misunderstanding and fear. For example, children are likely to believe that an adult who says, “I am going to give you away if you misbehave one more time” will actually do so! It is important for adults to acknowledge children’s fears and accept that they are real to the child. Children need consistent adult reassurance and trust to overcome their fears, even though it may be difficult to remain patient and supportive when a child repeatedly awakens at 2:00 every morning! Children also find comfort in talking about things that frighten them and rehearsing what they might do, for example, if they were to become lost at the supermarket or if it begins to thunder. Poverty and Homelessness Approximately 16.1 percent of all U.S. children currently live in families that fall below the national poverty level; 45 percent or approximately 30 million of children under age 18 live in low-income families (Haider, 2021; U.S. Census Bureau, 2021). Children of color account for almost 60 percent of those living in poverty. The adults in many low-income families are either unemployed, working in low-wage jobs, recent immigrants, classified as minorities (especially Hispanic, Native American, and African American), or a single parent, usually a mother. Living in a single- versus two-parent family places children at the highest economic risk for poverty. Children residing in rural areas also experience a high poverty rate and comprise an often overlooked group (Clark, Harper, & Weber, 2022). Economic problems, high housing costs, and high unemployment have forced many families into bankruptcy. As a result, families and their young children have become a majority of the homeless population. Poverty places additional burdens on the already challenging demands of parenting. Increased stress, fear, and conflict add to families’ struggles to provide children with basic food, clothing, shelter, health care, and nurturing. Ultimately, these pressures can lead to family tensions, chaos, domestic violence, child maltreatment, and an inability to provide the love and support that children require. Poverty’s impact on children’s growth and development has both immediate and long-term consequences. Children born into poverty experience a higher rate of birth defects, early death, and chronic illnesses such as anemia, asthma, and lead poisoning (Grant, Croce, & Matsui, 2022; Yuan et al., 2022). In addition, the quality of their diet, access to health and dental care, and mental health status are often compromised. Children living in poverty are also more likely to experience abuse or neglect, learning and behavior problems, teen pregnancy, substance abuse, high dropout rates, and reduced earning potential as adults (Shanahan et al., 2022). Ultimately, the cumulative effects of poverty can threaten children’s chances of growing up to become healthy, educated, and productive adults. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Promoting Children’s Health: Healthy Lifestyles and Health Concerns

Violence Children today live in a world where daily exposure to violence is not uncommon. Incidences of crime, substance abuse, gang activity, and access to guns tend to be greater in neighborhoods where poverty exists and can result in unhealthy urban environments where children’s personal safety is at risk. Children living in these settings are also more likely to become victims of child abuse or to witness domestic violence. Their families exhibit a higher rate of dysfunctional parenting skills, are often less responsive and nurturing, and use discipline that is either lacking, inconsistent, or punitive and harsh (Maguire-Jack et al., 2021; Sasan, Kaligid, & Villegas, 2022). Families living in these situations are also less likely to be supportive of children’s education or to assume an active role in school activities (Piscitello et al., 2022). As a result, many children who grow up in poverty are at greater risk of experiencing learning problems, engaging in criminal activity as adults, and developing serious mental health disorders (Mennen, Weybright, & Aldridge, 2022). Teachers who understand this potential can be instrumental in helping children to overcome some adversity by reaching out and strengthening their resiliency skills as well as assisting families in locating supportive community resources (Teacher Checklist 1–4). Children growing up in violent and disadvantaged environments face challenges not only at home but also at school. Younger children are more likely to attend child care programs and schools that are of poorer quality than their counterparts in higher income neighborhoods (Beasley et al., 2022; Morais et al., 2021). Many of these children also have fewer opportunities to engage in learning and enrichment experiences at home. Researchers have Stop and Check #6 found that children living in disadvantaged households are more likely to How does growing up in have delayed language development and literacy skills due to a lower rate of poverty influence children’s parent–child interactions and lack of available literacy materials (Lurie et al., development? 2021). This combination sets many children up for early school failure. Media Violence Children are frequently exposed to sources of extreme violence and death in movies, video games, cartoons, on television, and on the Internet. Researchers have observed an increase in aggressive behaviors after children have viewed violent media entertainment (Burkhardt & Lenhard, 2022). Although no singular link has been established with adult criminal

Checklist 1–4 ✓✓✓ Teacher Strategies for Increasing Children’s Resilient Behaviors ●

● ● ● ● ●

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● ●

● ● ● ● ●

Be a positive role model for children; demonstrate how you expect them to behave in challenging situations. Avoid displays of anger and the use of physical punishment. Accept children unconditionally; avoid being judgmental. Help children to use effective communication skills. Listen carefully to children; show them that you value their thoughts and ideas. Establish developmentally appropriate expectations for children’s behavior and enforce them consistently. Use positive behavior guidance strategies that are developmentally appropriate and based on natural or logical consequences. Help children to understand and express their feelings; encourage them to have empathy for others. Help children to establish realistic goals, set high expectations for themselves, accept failure, and have a positive outlook. Promote problem-solving skills; help children make informed decisions. Reinforce children’s efforts with acknowledgment and encouragement. Give children responsibility; assign household tasks and classroom duties. Encourage families to involve children in activities outside of the home. Help children to believe in themselves, to feel confident rather than seeing themselves as failures or victims.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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activity, repeated exposure to media violence and death has been shown to significantly reduce children’s empathy and sensitivity to this behavior (Brockmyer, 2022). For these reasons, families are encouraged to limit media viewing to one hour of high-quality educational programming daily for children 2 to 5 years, choose and monitor content carefully, and help children to understand media as a form of fantasy entertainment (AAP, 2019). Television and other media entertainment formats (e.g., streaming movies, video games, smartphones, tablets) with the exception of video-chatting are not recommended for children under 18 months. Young children learn best through hands-on experience and have considerable difficulty understanding abstract content viewed on an electronic screen. 1-4f

Resilient Children

Children face many challenges as they grow up in this complex world. Stress, violence, uncertainty, and negative encounters are everywhere. What makes some children more vulnerable to the negative effects of stress and aversive treatment or more likely to engage in inappropriate behaviors? Many factors, including genetic predisposition, malnutrition, prenatal exposure to drugs or alcohol, poor attachment to primary caregivers, physical and/or learning disabilities, and/or an irritable personality, have been suggested as possible explanations. Researchers have also studied home environments and parenting styles that make it difficult for some children to achieve normal developmental tasks and positive self-esteem. Most findings suggest that children experience positive self-efficacy, empathy, and cognitive and social skill competence when raised with an authoritative parenting style (Hayek et al., 2022; Pali, Marshall, & DiLalla, 2021). Why are some children better able to overcome the negative effects of an impoverished, traumatic, violent, or stressful childhood? This question continues to be a focus of study as researchers attempt to learn what conditions or qualities enable some children to be more resilient in the face of adversity. Although much remains to be understood, several important protective factors have been identified. These include having certain personal characteristics (such as aboveaverage intelligence, positive self-esteem, and effective social and problem-solving skills), having a strong and dependable relationship with a parent or parent substitute, and having a social support network outside of one’s immediate family (such as a church group, organized sports, Boys & Girls Clubs, or various youth groups) (Marotz & Kupzyk, 2018). Competent parenting is, beyond a doubt, one of the most important factors necessary for helping children to cope with and overcome adversity and its potentially damaging consequences. Children who grow up in an environment where families are caring and emotionally responsive, provide meaningful supervision and positive behavioral guidance that is consistent and developmentally appropriate, and help children learn to resolve problems in a peaceful way are more likely to demonstrate resilient behavior (Adnan et al., 2022; Chowbey & Barley, 2022; Doan et al., 2022). Teachers, likewise, can promote resiliency by establishing classrooms where children feel accepted, respected, and supported in their efforts. Management Strategies Understandably, all children undergo occasional periods of emotional instability or undesirable behavior. Short-term or one-time occurrences are usually not cause for concern. However, when a child consistently demonstrates abnormal or antisocial behaviors, an intervention program or counseling therapy may be necessary.

self-efficacy – a person’s confidence in their ability to accomplish a goal or task. authoritative parenting– a parenting style in which adults set clear expectations, boundaries, and rules (structure) in a supportive, nurturing, and non-punitive environment. resilient – the ability to withstand or resist difficulty or challenge.

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At times, it may be difficult for families to recognize or acknowledge abnormal behaviors in their own children. Some emotional problems develop slowly over time and may therefore be difficult to distinguish from normal behaviors. Some families find it difficult to talk about or to admit that their child has an emotional disturbance. Others, unknowingly, may be contributing to their children’s problems because of dysfunctional (e.g., abusive, unrealistic, inconsistent, or absent) parenting styles. For whatever reasons, it may be teachers who first identify children’s abnormal social and emotional behaviors based on their understanding of typical development, careful observations, and documentation of inappropriate conduct. They also play an instrumental role in promoting children’s emotional health by providing stable and supportive environments that foster children’s self-esteem and self-confidence. They model and help children develop socially appropriate behaviors. They teach conflict resolution, problem-solving, and communication skills so children will be able to cope effectively with daily problems. In addition, teachers can use their expertise to help families acknowledge children’s problems, counsel them in positive behavior management techniques, strengthen parent–child relationships, and assist them in arranging professional counseling or other needed services. Although most families welcome an opportunity to improve their parenting skills, the benefit to high-risk or dysfunctional families may be even greater.

Partnering with Families Growing Your Child’s Brain Dear Families, Your child’s brain is much like a flower or plant in your garden. It requires daily nourishment and attention, especially in the early stages, and is affected by positive and negative conditions in the environment. There are many things you can do every day to encourage your child’s healthy brain growth and development: ◗ Read, sing, and talk often to your infant or young child. Encourage your child to make up

silly songs, rhymes, and stories. Read your child’s favorite books over and over, have them turn the pages, point to pictures, and name objects. ◗ Provide nutritious meals and snacks to build healthy brain cells. ◗ Make sure your child gets sufficient sleep. ◗ Respond to your child’s needs in a consistent, caring, and constructive manner. Harsh

words, physical punishment, and abusive treatment can have a damaging effect on the brain’s structure over time. ◗ Encourage your child to be physically active every day. Change an infant’s position fre-

quently so they use different muscles and see different things in the environment. ◗ Allow children time to try solving their own problems; intervene only if they become overly

frustrated and then help guide their solution by providing choices. ◗ Encourage your child’s curiosity and provide safe learning opportunities for exploring and

experimenting. ◗ Help your child learn to recognize and manage their feelings. Be a positive role model and

show your child how to appropriately respond to difficult situations. ◗ Give children meaningful tasks/responsibilities to build their confidence, pride, and positive

self-esteem. ◗ Most importantly, tell and show your child often that they are loved.

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Classroom Corner Teacher Activities Making and Keeping Friends (NHES PreK–2, National Health Education Standard 4.2.1)

Concept: Having fun with friends.

Learning Objectives ◗ Children will learn that there are many activities to do with friends. ◗ Children will learn that friendship requires sharing and turn-taking. ◗ Children will learn that working together can be a lot of fun.

Supplies ◗ A variety of colored construction paper cut into large hearts (each heart should then be cut

in half in a variety of ways so that the two heart pieces can be put back together to form a large heart); glue sticks; various art supplies (glitter, feathers, puff balls, foam shapes, etc.); adhesive tape; large piece of bulletin board paper (large enough to display all of the hearts)

Learning Activities ◗ Read and discuss one of the following books: ●

● ●

●

A Little Spot of Belonging: A Story About Being True to Yourself and Making Friends by Diane Alber A Friend for Henry by Jenn Bailey (children’s friendship and autism) The Little Book of Friendship: The Best Way to Make Friends Is to Be a Friend by Laurie Friedman and Zack Bush Teach Your Dragon to Make Friends by Steve Herman

◗ Explain to the children that they are going to make a friendship quilt. ●

Have the children come up and pick one-half of a heart. After they have all selected a piece, help the children form pairs by matching their heart with the child who has the other half. Provide art supplies and one glue stick per pair of children to encourage sharing and cooperation. When each pair of children has finished decorating their heart half, tape the two halves together. Label each heart set with the names of both children. Arrange the completed hearts on a large sheet of bulletin board paper to create a friendship quilt that can be hung up in your classroom.

◗ Talk about the experience, including what it means to work with a partner and to make a

friendship quilt.

Assessment ◗ Children will work together and take turns. ◗ Children will name activities they like to do with their friends.

Summary ◗

The concept of preventive health care: recognizes that health attitudes and practices are learned behaviors. ● encourages individuals to assume an active role in developing and maintaining practices that promote health. A child’s health is determined by the interplay of genetic makeup and environment. ● Health is a dynamic state of physical, mental, and social well-being that is continuously changing as a result of lifestyle decisions. ●

◗

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Promoting Children’s Health: Healthy Lifestyles and Health Concerns

Children’s growth and developmental potentials are determined, in part, by genetics, and the interactions of multiple health, safety, and nutrition factors. ● Health promotion begins with a sound understanding of children’s growth and development. Several aspects of children’s health require special adult attention: safety and injury prevention; body mechanics and physical activity promotion; oral health; and mental health, including fostering selfesteem, social-emotional competence, and resilience.

◖◗ Terms to Know preventive health p. 3 ecological p. 6 health p. 8 heredity p. 9 predisposition p. 9 sedentary p. 10 food insecurity p. 10 nutrients p. 10 resistance p. 11

norms p. 12 normal p. 12 growth p.12 head circumference p. 12 attachment p. 12 deciduous teeth p. 13 development p. 14 neurons p. 16 plasticity p. 17

well child p. 17 fluorosis p. 22 self-concept p. 22 self-esteem p. 24 self-efficacy p.31 authoritative parenting p. 31 resilient p. 31

◖◗ Chapter Review A. By Yourself: 1. Define each of the Terms to Know listed above. 2. Explain how genetics and environment influence the quality of a child’s well-being. 3. Describe how singing, talking, and reading to an infant promote early brain development. 4. Explain why young children are at high risk for unintentional injury. 5. Identify several preventive practices that promote children’s oral health. 6. Explain why children living in poverty may experience low self-esteem. 7. Describe several ways that families can help children to build resilience. B. As a Group: 1. Discuss how an individual’s lifestyle decisions can have either a positive or negative effect on health. 2. Describe how teachers can use their knowledge of children’s development for health promotion. 3. Explain why an abundant food supply does not always ensure a healthy diet. 4. Discuss why it is important to involve and include families in children’s health education activities. What steps can a teacher take to be sure that children’s cultural beliefs are respected? 5. Explain the benefits of physical activity for both children and teachers. Conduct several classroom observations with different age groups to identify ways that teachers can incorporate more aerobic activity into children’s daily schedule. Describe how several of these activities could be modified for children who have limited vision or are confined to a wheelchair. 6. Define the term self-concept. Provide specific examples of teacher behaviors that could have positive effects on children’s self-esteem. Repeat the exercise and identify teacher behaviors that could have a negative effect. 7. Discuss how a teacher’s mental health state can potentially affect children.

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◖◗ Case Study Jose, 7 years old, and his mother live alone in a one-bedroom apartment close to his school. Most afternoons Jose walks home alone, lets himself into their apartment, and watches television until his mother comes home from work. His favorite after-school snack consists of potato chips and a soda or fruit drink. For dinner, Jose’s mother usually brings something home from a local fastfood restaurant because she is “too tired to cook.” She knows this isn’t good for either one of them. Jose’s mother is currently being treated for high blood pressure, and the pediatrician has expressed concern about Jose’s continued weight gain. However, Jose’s mother doesn’t see how she can change anything given her work schedule and limited income. 1. How would you describe Jose’s short- and long-term health potential? 2. What concerns would you have about Jose’s safety? 3. What potential health problems is Jose likely to develop if his current behaviors do not change?

◖◗ Application Activities 1. Observe a small group of preschool-aged children for two 15-minute intervals during free-play or outdoor times. For each observation, select a different child and record the number of times that child engages in cooperative play. Repeat this observation procedure with a group of toddlers or school-age children. Describe the differences. 2. Contact your local public health department. Arrange to observe several routine well-child visits. What preventive health information was given to families? Was it presented in a way that families could understand and use? 3. Select and read ten children’s books from the Mental Health section in Appendix D. Prepare a brief annotation for each book, including the topic, theme, and recommendations. Describe how you would use each book to develop a learning activity that promotes children’s social-emotional competence. 4. Research and read more about the national health initiatives described in this chapter. Find out if they are available in your area and what services are provided. Are the programs and services meeting the needs of children in your community? If not, what recommendations would you offer for improvement? 5. Develop a month-long series of classroom learning activities focused on children’s oral health. Make arrangements to conduct several of your lessons with children in a local school and evaluate their effectiveness. What changes or improvements would you make the next time? 6. Modify the “Classroom Corner” activity on friendship to meet National Health Education Standard 4.5.3. (Demonstrate non-violent strategies to manage or resolve conflict.) Design and describe at least three classroom activities that would teach and reinforce positive resolution techniques.

◖◗ Stop and Check Responses #1. Uninsured children whose family cannot afford private health insurance premiums but earn too much to qualify for Medicaid assistance are eligible to apply for coverage through the CHIP program. #2. Multiple environmental factors influence and shape an individual’s state of health, including economic well-being or poverty, food security or insecurity, stress, housing, exposure to domestic violence, neighborhood safety, access to medical and dental care, recreational opportunities, and many others.

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#3. Neural connections form and are strengthened as a result of repetition and practice, such as when a child learns to walk, talk, write, ride a bike, read, etc. #4. An infant’s gums and teeth should be wiped with a small, wet washcloth after each feeding. An older infant’s teeth can be cleaned with a soft brush and water. Prolonged feeding (of formula or breastmilk) or putting an infant to bed with a bottle or breast can promote early tooth decay. #5. Teachers who do not manage their stress effectively are more likely to engage in negative interactions with children and colleagues and to experience burnout. #6. Poverty can increase the number of adverse childhood experiences (ACEs) a child is likely to experience, including food insecurity, lower quality education, homelessness, lack of medical and dental care, domestic and/or neighborhood violence, stress, discrimination, and dysfunctional parenting among others.

◖◗ Additional Resources to Explore American Institute of Stress Council for Exceptional Children CDC: Adolescent and School Health CDC Healthy Schools Indian Health Service National Association for Child Development Healthy Kids, Healthy Future National Center for Children in Poverty National Center on Early Childhood Health and Wellness Mental Health America StopBullying.gov

https://www.stress.org https://exceptionalchildren.org/ https://www.cdc.gov/HealthyYouth/ https://www.cdc.gov/healthyschools/ https://www.ihs.gov https://www.nacd.org https://healthykidshealthyfuture.org https://www.nccp.org https://www.zerotothree.org/our-work/national -center-on-early-childhood-health-and-wellness https://www.mhanational.org/childrens-mental -health https://www.stopbullying.gov/

◖◗ References Adnan, H., Rashid, S., Aftab, N., & Arif, H. (2022). Effect of authoritative parenting style on mental health of adolescents: Moderating role of resilience. Multicultural Education, 8(4), 225–232. American Academy of Pediatrics (AAP). (2019). Healthy digital media use habits for babies, toddlers & preschoolers. Retrieved from https://www.healthychildren.org/English/family-life/Media/Pages/Healthy-Digital-Media-Use -Habits-for-Babies-Toddlers-Preschoolers.aspx?. American Academy of Pediatrics (AAP), American Public Health Association (APHA), & National Resource Center for Health and Safety in Child Care and Early Education (NCR). (2019). Caring for our children: National health and safety performance standards: Guidelines for early care and education programs. (4th ed.). Itasca, IL: American Academy of Pediatrics. An, Z. G., & Horn, E. (2022). Through the lens of early educators: Understanding the use of expulsion and suspension in childcare programs. Early Childhood Research Quarterly, 60(3), 379–389. Ansari, A., Pianta, R. C., Whittaker, J. V., Vitiello, V. E., & Ruzek, E. A. (2022). Preschool teachers’ emotional exhaustion in relation to classroom instruction and teacher interactions. Early Education and Development, 33(1), 107–120. Beasley, L. O., Jespersen, J. E., Morris, A. S., Farra, A., & Hays-Grudo, J. (2022). Parenting challenges and opportunities among families living in poverty. Social Sciences, 11(3), 119. https://doi.org/10.3390/socsci11030119 Bernard, D. L., Smith, Q., & Lanier, P. (2022). Racial discrimination and other adverse childhood experiences as risk factors for internalizing mental health concerns among Black youth. Journal of Traumatic Stress, 35(2), 473–483. Bodden, C., Hannan, A. J., & Reichelt, A. C. (2021). Of ‘junk food’ and ‘brain food’: How parental diet influences offspring neurobiology and behaviour. Trends in Endocrinology & Metabolism, 32(8), 566–578.

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Brockmyer, J. F. (2022). Desensitization and violent video games. Child & Adolescent Psychiatric Clinics, 31(1), 121–132. Burkhardt, J., & Lenhard, W. (2022). A meta-analysis on the longitudinal, age-dependent effects of violent video games on aggression. Media Psychology, 25(3), 499–512. Calder, P. C., Carr, A. C., Gombart, A. F., & Eggersdorfer, M. (2020). Optimal nutritional status for a well-functioning immune system is an important factor to protect against viral infections. Nutrients, 12(4), 1181. https://doi .org/10.3390/nu12041181 Campos, M. S., & Fontana, M. (2022). Caries management in special care dentistry. Dental Clinics, 66(2), 169–179. Cassidy-Vu, L., Way, V., & Spangler, J. (2022). The correlation between food insecurity and infant mortality in North Carolina. Public Health Nutrition, 25(4), 1038–1044. Centers for Disease Control and Prevention (CDCa). (2022). Active People, Healthy NationSM. Retrieved from https:// www.cdc.gov/physicalactivity/activepeoplehealthynation/index.html. CDC. (2022b). Data and statistics on children’s mental health. Retrieved from https://www.cdc.gov/childrensmentalhealth /data.html. CDC. (2022c). How much physical activity do children need? Retrieved from https://www.cdc.gov/physicalactivity /basics/children/index.htm. CDC. (2021). Injuries among children and teens. Retrieved from https://www.cdc.gov/injury/features/child-injury /index.html. CDC. (2020). Ten leading causes of death and injury. Retrieved from https://www.cdc.gov/injury/wisqars /LeadingCauses.html. CDC. (2018). The Whole School, Whole Community, Whole Child (WSCC) Model. Retrieved from https://www.cdc .gov/healthyyouth/wscc/model.htm. Chetty-Mhlanga, S., Viglietti, P., Röösli, M., & Dalvie, M. A. (2022). Maternal drinking behaviour and co-exposure from smoking during and after pregnancy in relation to the neurocognitive function of school-children in the rural Western Cape. Neurotoxicology, 88, 36–43. Cho, S., & Kim, S. (2022). Does a healthy lifestyle matter? A daily diary study of unhealthy eating at home and behavioral outcomes at work. Journal of Applied Psychology, 107(1), 23–39. Chowbey, P., & Barley, R. (2022). Building resilience: Young children from minority ethnic backgrounds starting school in a multi-ethnic society. British Journal of Sociology and Education, 43(3), 415–432. Clark, S., Harper, S., & Weber, B. (2022). Growing up in rural America. The Russell Sage Foundation Journal of the Social Sciences, 8(4), 1–47. Collie, R. J., & Mansfield, C. F. (2022). Teacher and school stress profiles: A multilevel examination and associations with work-related outcomes. Teaching and Teacher Education, 116, 103759. https://doi.org/10.1016/j.tate.2022.103759 D’Urso, G., Symonds, J., Sloan, S., & Devine, D. (2022). Bullies, victims, and meanies: The role of child and classmate social and emotional competencies. Social Psychology of Education, 25, 293–312. Di, H-K., Gan, Y., Lu, K., Wang, C., Zhu, Y., Meng, X., Xia, W-Q., Xu, M-Z., Feng, J., Tian, Q-F., He, Y., Nie, Z-Q., Liu, J-A., Song, F-J., & Lu, Z-X. (2022). Maternal smoking status during pregnancy and low birth weight in offspring: Systematic review and meta-analysis of 55 cohort studies published from 1986 to 2020. World Journal of Pediatrics, 18(3), 176–185. Doan, S. N., Yu, S. H., Wright, B., Fung, J., Saleem, F., & Lau, A. S. (2022). Resilience and family socialization processes in ethnic minority youth: Illuminating the achievement-health paradox. Clinical Child and Family Psychology Review, 25(1), 75–92. Franklyn, N., Kesavelu, D., Joji, P., Verma, R., Wadhwa, A., & Ray, C. (2022). Impact of key nutrients on brain and executive function development in infants and toddlers: A narrative review. Journal of Food and Nutrition Sciences, 10(1), 19–26. Fulton, J. E., Buchner, D. M., Carlson, S. A., Borbely, D., Rose, K. M., O’Connor, A. E., Gunn, J. P., & Petersen, R. (2022). CDC’s Active People, Healthy NationSM: Creating an active America, together. Journal of Physical Activity and Health, 15(7), 469–473. Gallegos, D., Eivers, A., Sondergeld, P., & Pattinson, C. (2021). Food insecurity and child development: A state-of-theart review. International Journal of Environmental Research and Public Health, 18(17), 8990. https://doi.org/10.3390 /ijerph18178990 Grant, T., Croce, E., & Matsui, E. C. (2022). Asthma and the social determinants of health. Annals of Allergy, Asthma, & Immunology, 128(1), 5–11. Haider, A. (2021). The basic facts about children in poverty. Center for American Progress. Retrieved from https:// www.americanprogress.org/article/basic-facts-children-poverty/. Hatsu, I. E., Eiterman, L., Stern, M., Lu, S., Johnstone, J. M., Leung, B. M. Y., Srikanth, P., Robinette, L., Tost, G., Odei, J. B., Gracious, B. L., & Arnold, L. E. (2022). Household food insecurity is associated with symptoms of emotional dysregulation in children with attention deficit hyperactivity disorder: The MADDY study. Nutrients, 14(6), 1306. https://www.mdpi.com/2072-6643/14/6/1306

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Hayek, J., Schneider, F., Lahoud, N., Tueni, M., & de Vries, H. (2022). Authoritative parenting stimulates academic achievement, also partly via self-efficacy and intention towards getting good grades. PloS One, 17(3), e0265595. https://doi.org/10.1371/journal.pone.0265595 Herkama, S., Kontio, M., Sainio, M., Turunen, T., Poskiparta, E., & Salmivalli, C. (2022). Facilitators and barriers to the sustainability of a school-based bullying prevention program. Prevention Science. Online ahead of print. https://doi .org/10.1007/s11121-022-01368-2 Jones, V., Ryan, L., Rooker, G., Debinski, B., Parnham, T., Mahoney, P., & Shields, W. (2021). An exploration of emergency department visits for home unintentional injuries among children with autism spectrum disorder for evidence to modify injury prevention guidelines. Pediatric Emergency Care, 37(10), e589–e593. Lacey, R. E., Howe, L. D., Kelly-Irving, M., Bartley, M., & Kelly, Y. (2022). The clustering of adverse childhood experiences in the Avon Longitudinal Study of Parents and Children: Are gender and poverty important? Journal of Interpersonal Violence, 37(5-6), 2218–2241. Lee, E. Y., Bains, A., Hunter, S., Ament, A., Brazo-Sayavera, J., Carson, V., Hakimi, S., Huang, W. Y., Janssen, I., Lee, M., Lim, H., Silva, D. A. S., & Tremblay, M. S. (2021). Systematic review of the correlates of outdoor play and time among children aged 3-12 years. International Journal of Behavioral Nutrition and Physical Activity, 18(1), 41. https://doi.org/10.1186/s12966-021-01097-9 Lee, L. K., Douglas, K., & Hemenway, D. (2022). Crossing lines–A change in the leading cause of death among U.S. children. New England Journal of Medicine, 386(16), 1485–1487. Leiva, L., Torres-Cortés, B., & Antivilo-Bruna, A. (2022). Adverse childhood experiences and mental health: When well-being matters. Child Indicators Research, 15, 631–655. https://doi.org/10.1007/s12187-021-09904-2 Leung, C. W., Fulay, A. P., Parnarouskis, L., Martinez-Steele, E., Gearhardt, A. N., & Wolfson, J. A. (2022). Food insecurity and ultra-processed food consumption: The modifying role of participation in the Supplemental Nutrition Assistance Program (SNAP). The American Journal of Clinical Nutrition, 116(1), 197–205. Loomis, A. M., & Panlilio, C. C. (2022). Trauma-informed attitudes, teacher stress, and expulsion decision risk in preschool classrooms. School Mental Health, 14(1), 1–15. https://doi.org/10.1007/s12310-022-09513-6 Lopez, A., Hoeft, K. S., Guerra, C., Barker, J. C., Chung, L. H., & Burke, N. J. (2022). Spanish-speaking MexicanAmerican parents’ experiences while navigating the dental care system for their children. Public Health Dentistry, 82(1), 99–104. Lundy, A., & Trawick-Smith, J. (2021). Effects of active outdoor play on preschool children’s on-task classroom behavior. Early Childhood Education, 49, 463–471. Lurie, L. A., Hagen, M. P., McLaughlin, K. A., Sheridan, M. A., Meltzoff, A. N., & Rosen, M. L. (2021). Mechanisms linking socioeconomic status and academic achievement in early childhood: Cognitive stimulation and language. Cognitive Development, 58, 101045. https://doi.org/10.1016/j.cogdev.2021.101045 Maguire-Jack, K., Font, S., Dillard, R., Dvalishvili, D., & Barnhart, S. (2021). Neighborhood poverty and adverse childhood experiences over the first 15 years of life. International Journal on Child Maltreatment: Research, Policy and Practice, 4, 93–114. Marotz, L. (2023). Developmental profiles: Pre-birth through adolescence. (9th ed.). Boston, MA: Cengage Learning. Marotz, L. (2021). Early childhood leadership: Motivation, inspiration, empowerment. Lanham, MD: Rowman & Littlefield. Marotz, L. R., & Kupzyk, S. (2018). Parenting today’s children. Boston, MA: Cengage Learning. McCurdy, K., Gans, K. M., Risica, P. M., Fox, K., & Tovar, A. (2022). Food insecurity, food parenting practices, and child eating behaviors among low-income Hispanic families of young children. Appetite, 169, 106857. https://doi .org/10.1016/j.appet.2021.105857 McGowan, A. L., Gerde, H. K., Pfeiffer, K. A., & Pontifex, M. B. (2022). Meeting 24-hour movement behavior guidelines in young children: Improved quantity estimation and self-regulation. Early Education and Development. Online ahead of print. https://doi.org/10.1080/10409289.2022.2056694 Men, F., Urquia, M. L., & Tarasuk, V. (2021). Examining the relationship between food insecurity and causes of injury in Canadian adults and adolescents. BMC Public Health, 2, 1557. https://doi.org/10.1186/s12889-021-11610-1 Mennen, O. K., Weybright, W. C., & Aldridge, N. S. (2022). Effects of child abuse on school dropout among students in USA. Journal of Education, 5(2). https://doi.org/10.53819/81018102t5065 Michel, C., Kindler, J., & Kaess, M. (2022). Traumatic experiences in childhood and the development of psychosis spectrum disorders. European Child & Adolescent Psychiatry, 31(2), 211–213. Moore, S. R., Merrill, S. M., Sekhon, B., MacIsaac, J. L., Kobor, M. S., Giesbrecht, G. F., & Letourneau, N. (2022). Infant DNA methylation: An early indicator of intergenerational trauma? Early Human Development, 164, 105519. https:// doi.org/10.1016/j.earlhumdev.2021.105519 Morais, R. L. S., Magalhães, L. C., Nobre, J. N. P., Pinto, P. F. A., Neves, K. R., & Carvalho, A. M. (2021). Quality of the home, daycare and neighborhood environment and the cognitive development of economically disadvantaged children in early childhood: A mediation analysis. Infant Behavior and Development, 64, 101619. https://doi .org/10.1016/j.infbeh.2021.101619

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Children’s Well-Being: What It Is and How to Achieve It

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Munteanu, A., Holban, A-M., Pauna, M-R., Imre, M., Farcasiu, A-T., & Farcasiu, C. (2022). Review of professionally applied fluorides for preventing dental caries in children and adolescents. Applied Sciences, 12(3), 1054. https://doi .org/10.3390/app12031054 National Association for the Education of Young Children (NAEYC). (2020). Accreditation standards. Retrieved from https://www.naeyc.org/accreditation. Novak, A. (2022). The association between adverse childhood experiences, neuropsychological deficits, and experiences of exclusionary discipline in early childhood experiences. Journal of Developmental and Life-Course Criminology, 8, 175–205. O’Donnell, E. P., & Canares, T. L. (2021). Accidents waiting to happen: A review of unintentional household injuries in children. Pediatrics in Review, 42(3), 109–122. Padhani, Z. A., Das, J. K., Akhtar, S., Ismail, T., & Bhutta, Z. A. (2022). Tackling protein-calorie malnutrition during world crises. Annals of Nutrition & Metabolism, 78(supp 1), 27–37. Pali, E. C., Marshall, R. L., & DiLalla, L. F. (2021). The effects of parenting styles and parental positivity on preschoolers’ self-perception. Social Development, 31(2), 356–371. Peacock, J., Bowling, A., Finn, K., & McInnis, K. (2021). Use of outdoor education to increase physical activity and science learning among low-income children from urban schools. American Journal of Health Education 52(2), 92–100. Peña, C. M, & Payne, A. (2022). Parental experiences of adopting healthy lifestyles for children with disabilities living with overweight and obesity. Disability and Health Journal, 15(1), 101215. https://doi.org/10.1016/j. dhjo.2021.101215 Pickett, K. E., Vafai, Y., Mathai, M., & Small, N. (2022). The social determinants of child health and inequities in child health. Paediatrics and Child Health, 32(3), 88–94. Piscitello, J., Kim, Y. K., Orooji, M., & Robinson, S. (2022). Sociodemographic risk, school engagement, and community characteristics: A mediated approach to understanding high school dropout. Children and Youth Services Review, 133, 106347. https://doi.org/10.1016/j.childyouth.2021.106347 Reinbold, G. W. (2021). State Medicaid and CHIP options and child insurance outcomes: An investigation of 83 state options with state-level panel data. World Health & Medical Policy, 13(3), 436–450. Rettew, D. C., & Pawlowski, S. (2022). Bullying: An update. Child & Adolescent Psychiatric Clinics of North America, 31(1), 1–9. Roubinov, D. S., Epel, E. S., Adler, N. E., Laraia, B. A., & Bush, N. R. (2022). Transactions between maternal and child depressive symptoms emerge early in life. Journal of Clinical Child & Adolescent Psychology, 51(1), 61–72. Sabol, T. J., Kessler, C. L., Rogers, L. O., Petitclerc, A., Silver, J., Briggs-Gowan, M., & Wakschlag, L. S. (2022). A window into racial and socioeconomic status disparities in preschool disciplinary action using developmental methodology. Annals of the New York Academy of Sciences, 1508(1), 123–136. Sanchez-Alonso, S., & Aslin, R. N. (2022). Towards a model of language neurobiology in early development. Brain and Language, 224, 105047. https://doi.org/10.1016/j.bandl.2021.105047 Sasan, J. M., Kaligid, M. T. G., & Villegas, M. A. (2022). The deteriorating effect of poor parental skill to children and teens mental health. International Journal of Emerging Issues in Early Childhood Education, 4(1), 42–50. Shanahan, M. E., Austin, A. E., Durance, C. P., Martin, S. L., Mercer, J. A., Runyan, D. K. & Runyan, C. W. (2022). The association of low-income housing tax credit units and reports of child abuse and neglect. American Journal of Preventive Medicine, 62(5), 727–734. Simon, S. L., Ware, M. A., Bowen, A. E., Chandrasekhar, J. L., Lee, J. A., Shoemaker, L. B., Gulley, L. D., Heberlein, E., & Kaar, J. L. (2022). Sleep moderates improvements in mental health outcomes in youth: Building resilience for healthy kids. American Journal of Health Promotion, 36(5), 772–780. Smith, N. D. W., Bradley-Klug, K. L., Suldo, S. M., Dedrick, R. F., & Shaffer-Hudkins, E. J. (2022). Associations between multiple health-promoting behaviors and subjective well-being in high school age youth. Journal of School Health, 92(1), 52–62. Song, J., Tomar, S., Duncan, R. P., Fogarty, K., Johns, T., & Kim, J. N. (2021). The health care utilization model: Application to dental care use for Black and Hispanic children. Public Health Dentistry, 81(3), 188–197. Souto-Manning, M., & Melvin, S. A. (2022). Early childhood teachers of color in New York City: Heightened stress, lower quality of life, declining health, and compromised sleep amidst COVID-19. Early Childhood Research Quarterly, 60(3rd Quarter), 34–48. Squillacioti, G., Carsin, A-E., Bellisario, V., Bono, R., & Garcia-Aymerich, J. (2022). Multisite greenness exposure and oxidative stress in children. The potential mediating role of physical activity. Environmental Research, 209, 112857. https://doi.org/10.1016/j.envres.2022.112857 U.S. Census Bureau. (2021). Income and poverty in the United States: 2020. Retrieved from https://www.census.gov /library/publications/2021/demo/p60-273.html. U.S. Department of Education. (2015). Every Student Succeeds Act (ESSA). Retrieved from https://www.ed.gov /essa?src%3Drn.

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U.S. Department of Health and Human Services (U.S. HHS). (2022). Healthy People 2030. Retrieved from https:// health.gov/healthypeople. Veronica, V. (2022). Bullying in school-age children. Scientia Psychiatrica, 3(2), 258–266. Wen, X., Wang, R., Yin, W., Lin, W., Zhang, H., & Shen, D. (2020). Development of dynamic functional architecture during early infancy. Cerebral Cortex, 30(1), 5626–5638. Wymer, S. C., Corbin, C. M., & Williford, A. P. (2022). The relation between teacher and child race, teacher perceptions of disruptive behavior, and exclusionary discipline in preschool. Journal of School Psychology, 90, 33–42. Xia, M., Poorthuis, A. M. G., Zhou, Q., & Thomaes, S. (2022). Young children’s overestimation of performance: A cross-cultural comparison. Child Development 93(2), e207–e221. https://doi.org/10.1111/cdev.13709 Yuan, B., Huang, X., Li, J., & He, L. (2022). Socioeconomic disadvantages and vulnerability to the pandemic among children and youth: A macro-level investigation of American counties. Children and Youth Services Review, 136, 106429. https://doi.org/10.1016/j.childyouth.2022.106429

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chapter

2

Daily Health Observations Professional Standards Linked to Chapter Content

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◗

◗

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#1a, b, c, and d Child development and learning in context #2a, b, and c Family–teacher partnerships and community connections #3a, b, c, and d Child observations, documentation, and assessment #6b and c Professionalism as an early childhood educator

Learning Objectives After studying this chapter, you should be able to:

LO 2-1 Describe several methods that early childhood programs can use to assess and promote children’s physical and mental well-being. LO 2-2 Explain why it is important to conduct daily health observations. LO 2-3 Perform a daily health check. LO 2-4 Discuss why children’s families should be involved in the health assessment process. LO 2-5 Describe ways that teachers can incorporate health education into daily health checks.

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Promoting Children’s Health: Healthy Lifestyles and Health Concerns

The Healthy People 2030 national initiative reinforces the important relationship that exists between children’s health, development, and ability to learn (HHS, 2021). It also recognizes that not all children have equal access to medical and dental care or to environments that promote a healthy lifestyle. It underscores the collaborative effort necessary for ensuring children’s health and educational success, and challenges professionals and communities to address these problems. Teachers and health care providers play a critical role in implementing the Healthy People 2030 goals to help children achieve their optimal health and development. Only when children are healthy, safe, and well-nourished are they able to fully benefit from learning experiences. Acute and chronic illnesses, undetected health disorders, food insecurity, maltreatment, and mental health problems can interfere with a child’s level of interest, involvement, and performance in school. For example, a mild hearing loss may distort a child’s perception of letter sounds, pronunciations, and responsiveness. If left undetected, it can have a profound and long-term effect on a child’s language development and ability to learn. Health disorders do not have to be obvious or complex to have a negative impact. Even a simple cold, toothache, allergic reaction, or chronic tonsillitis will disrupt a child’s energy level, cooperation, attention span, and learning enjoyment. Teachers are in an ideal position to continuously monitor children’s health, note early signs of problems that can hinder learning, and work with families to obtain the care children need to be successful.

Connecting to Everyday Practice

➥➥

Children’s Health and the Achievement Gap

Children learn best when they are healthy and all sensory systems are functioning properly. Undetected vision, hearing, dental, and/or mental health disorders can interfere with learning processes and limit a child’s ability to experience success in school. Chronic conditions, such as asthma, allergies, lead poisoning, and anemia that have not been diagnosed or are not well-managed also place children at an educational disadvantage. Children who experience economic, environmental, and racial/ethnic disparities may have limited access to essential health care services. As a result, they may be unprepared to begin school, struggle academically and socially once there, and continue to fall behind year after year. Preventive efforts to address children’s health needs, especially among those living in poverty, are essential for reducing the achievement gap. Head Start, Universal Pre-K, Children’s Health Insurance (CHIP) programs, and developmental screenings administered in health care practices have demonstrated positive outcomes associated with the early identification of conditions that interfere with learning (Eisenhower et al., 2021). The results also reinforce the important role that teachers play in assessing children’s health and promoting well-being on a consistent basis.

Think About This: ◗ Why should more professional development and teacher education training be focused on

identifying children’s health conditions and promoting well-being? ◗ In what ways do state childcare licensing regulations encourage teachers to be proactive in

protecting children’s health and safety? ◗ What right does a teacher have to insist that children receive treatment for their health

problems? Explain. ◗ What health care options exist for children whose families cannot afford needed treatments?

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Chapter 2

Daily Health Observations

43

Promoting Children’s Well-Being

2-1

Schools and early childhood programs make significant contributions to children’s well-being by providing on-site health care, educational programs, safe learning environments, and nutritious meals. Highquality programs also require teachers to conduct daily health checks and continuously monitor children’s health to identify potential problems. These ongoing efforts are essential because children’s health status is always changing, as illustrated in the following example:

▼ Changes in children’s appearance and behavior may be early signs of an illness.

When teachers remain alert to changes in children’s appearance and behavior, they are often able to identify an impending illness or undiagnosed health condition in its early stage. This can be especially important for limiting the spread of a contagious disease or the negative impact of a disorder on a child’s growth and development. 2-1a

NatUlrich/Shutterstock.com

Alex, age 3, ran ahead of his mother so he could reach the classroom before she did. He greeted his friends with the usual, “Hi guys” and seemed fine when the teacher checked him in. However, later that morning she noted that Alex had refused snack and was lying in the book area with his blanket. When she touched his arm, it felt warm and was covered with red, raised bumps. She immediately recognized the symptoms as a likely case of chickenpox and called Alex’s mother to come and take him home.

Gathering Information

Information about children’s overall health can be obtained from a variety of resources, including: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

dietary assessment health histories medical assessment teacher observations and daily health checks dental examinations family interviews vision and hearing screenings speech evaluations psychological testing developmental evaluations

Several of these assessment tools can be administered by teachers or volunteers, whereas others require the skills of specially trained health professionals. Often, the process of identifying a specific health impairment requires the cooperative efforts of specialists from several different fields: ◗ ◗ ◗ ◗ ◗ ◗

pediatric medicine psychology nursing speech dietetics dentistry

◗ ◗ ◗ ◗ ◗

psychology education ophthalmology social work audiology

Stop and Check #1 What role do teachers’ have in administering health assessment screening tools?

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Information regarding a child’s health should always be collected from multiple sources before any final conclusions are reached. A single health assessment can present a biased and unreliable picture of the child’s condition (Allen & Cowdery, 2022; Marotz, 2023). Children may behave or respond in atypical ways when faced with new surroundings or an unfamiliar adult examiner. Results obtained from several screening sources yield a more conclusive outcome and are beneficial for determining the next steps to be taken. For example, the need to refer a child to a hearing specialist may be confirmed when screening results are combined with teacher and family observations. PixieMe/Shutterstock.com

▼ Teachers can observe children’s health while engaged in classroom activities.

2-2

Observation as a Screening Tool

Teachers are valuable members of a child’s comprehensive health team. Their interactions with children in the classroom and knowledge of developmental patterns place them in an ideal position to note the early signs of health disorders. Information obtained from daily observations can be used to establish a baseline of typical behavior and appearance for each child. When teachers combine this information with their understanding of growth and development, changes or deviations in children’s physical and emotional health can be easily detected. Health observations provide a simple and effective screening tool that is readily available to teachers. Many skills necessary for making objective health observations are already at their disposal. Sight, for example, is one of the most important senses; much can be learned about children’s health by merely watching them in action. A simple touch can detect a fever, rash, or enlarged lymph glands. Odors may indicate a lack of cleanliness, untreated cavities, or an infection. Careful listening may reveal breathing difficulties or changes in voice quality. Problems with peer relationships, food insecurity, self-esteem, or maltreatment may be detected during a child’s conversation. Utilizing one’s senses to the fullest—seeing children as they really are, hearing what they really have to say, and responding to their needs—is a skill that requires time, patience, and practice to perfect. Conclusions drawn from teacher observations, as with any form of evaluation, should be made with caution. It must always be remembered that a wide range of typical behavior and skill attainment occurs at each developmental stage. Norms merely represent the average age at which most children can perform a given skill. For example, many 3-year-olds can reproduce the shape of a circle, name and match primary colors, and walk across a balance beam. However, there will also be 3-year-olds who will Stop and Check #2 not be able to perform these tasks. This does not imply that they are not “normal.” Some children simply require more time than others to master a What is the primary objective for conducting daily particular skill. However, an abrupt change or prolonged delay in a child’s health checks? physical and/or social-emotional developmental progress should prompt further evaluation. health assessment – the process of gathering and evaluating information about an individual’s state of health. atypical – unusual; different from what might commonly be expected. observation – to inspect and take note of the appearance and behavior of other individuals.

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Chapter 2

2-3

Daily Health Observations

45

Daily Health Checks

Valuable information about children’s health status and readiness to learn can be obtained by conducting daily assessments. Health checks require only a minute or two to complete and they enable teachers to detect the early signs and symptoms of common illnesses and health disorders. Daily health checks also help teachers become familiar with each child’s typical appearance and behavior so that changes are easily recognized. This is especially important in classrooms where children who have chronic conditions or other special health needs are present because their disorders can make them more susceptible to infectious illnesses (Denlinger et al., 2020; de Palmo et al., 2021). Early identification and removal of any child who appears to be ill can help to minimize their exposure to other children. Parents should be encouraged to remain with their child until the health check has been completed. Children often find comfort in having a family member nearby. Families are also able to provide information about conditions or behaviors the teacher may observe. In addition, parents may feel less apprehensive if they have an opportunity to witness health checks firsthand and to ask their own questions. However, if a family member is unavailable, it may be advisable to have a second teacher witness the procedure to avoid any potential allegations of misconduct. 2-3a

Method

A quiet area set aside in the classroom is ideal for performing health checks. A teacher may choose simply to sit on the floor with the children or provide a more structured setting with a table and chairs. Conducting health checks in the same designated area each day also helps children become familiar with the routine. Performing health checks in a systematic manner improves the teacher’s efficiency and ensures that the process will be consistent and thorough each time. Teacher Checklist 2–1 illustrates a simple observation tool that can be used for this purpose. It is organized so that Checklist 2–1 ✓✓✓ Teacher Health Observation Checklist General appearance—note changes in weight (gain or loss), signs of unusual fatigue or agitation, skin (pale or flushed), and size (height, weight) for age group. Scalp—observe for signs of itching, head lice, sores, hair loss, and cleanliness. Face—notice general expression (e.g., fear, anger, happiness, anxiety, frustration), skin tone, or any scratches, bruises, welts, or rashes. Eyes—look for redness, tearing, puffiness, sensitivity to light, frequent rubbing, sties, sores, drainage, or uncoordinated eye movements. Ears—check for drainage, redness, and appropriate/inappropriate responses to sounds or verbal requests. Nose—note any deformity, frequent rubbing, congestion, sneezing, or drainage. Mouth—look inside and at the teeth; note cavities (brown or black spots), sores, red or swollen gums, mouth-breathing, or unusual breath odor. Throat—observe for enlarged or red tonsils, red throat, drainage, or white patches on throat or tonsils. Neck—feel for enlarged glands. Chest—listen to the child’s breathing and note any wheezing, rattles, shortness of breath, or coughing (with or without other symptoms). Skin—observe the chest and back areas for color (pallor or redness), rashes, scratches, sores, bruises, welts, scars, or unusual warmth and perspiration. Speech—listen for clarity, stuttering, nasality, mispronunciations, monotone voice, and appropriateness for age. Extremities—observe posture, coordination; note conditions such as bowed legs, toeing-in, arms and legs of unequal length, limping or unusual gait. Behavior and temperament—note any changes in activity level, alertness, cooperation, appetite, sleep patterns, toileting habits, irritability, or uncharacteristic restlessness.

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observations are conducted from head to foot, first observing the child’s frontside and then the back. However, this procedure can easily be modified to meet a program’s unique needs in terms of the setting and children being served. For example, teachers who work with school-age children may prefer to use the checklist while simply observing children rather than for conducting a hands-on health check. Daily health checks begin by observing children as they first enter the classroom. Clues about a child’s well-being, such as personal cleanliness, weight change, signs of illness, facial expressions, posture, skin color, balance, and coordination can easily be noted at this time. The nature of parent–child interactions can also be observed and may help to explain why some children exhibit certain behaviors. For example, is the parent nurturing and supportive or are they critical of the child’s efforts to take off their own boots or hang up a jacket? Is the child encouraged to answer questions or does the parent always jump in and respond? A flashlight is used to inspect the inside of the child’s mouth and throat for unusual redness, swollen or infected tonsils, dental cavities, or sores. Unpleasant breath odors can also be noted at this time. The child’s hair and face, including the eyes, ears, and nose, should be closely observed for clues about general hygiene and signs of communicable illness. Next, the child’s clothing can be lifted and any rashes, unusual scratches, bumps or bruises, and skin color on the chest, abdomen, and arms noted. These areas should be carefully inspected as many rashes associated with communicable disease often first appear on warmer body areas. Blue-gray discolorations, called Mongolian spots, may be visible on the lower back of children who are of Asian, Native American, and Middle Eastern ethnicities. These spots look like bruises, but they do not undergo the color changes typical of an injury. However, they tend to gradually fade as children approach 8 or 9 years of age. Finally, the child is asked to turn around so their head, hair, and back areas can be inspected. Once this step is completed, teachers should continue their observations. For example, balance, coordination, and posture can easily be noted as a toddler walks away or an older child runs over to join friends. A child’s aggressive tendencies or inability to play cooperatively with other children during outdoor play may provide important clues about their social-emotional development and mental health. (See Teacher Checklist 2–2.) Checklist 2–2 ✓✓✓ Teacher Warning Signs of Potential Mental Health Problems Occasional responses to stress and change are to be expected. However, children who experience excessive or frequent episodes of the following behaviors should be referred for professional evaluation and treatment: ● ● ● ● ● ● ●

● ● ● ●

● ●

tearfulness or sadness—cries easily and often; seldom appears happy preference for being alone—is withdrawn; reluctant to play with others hostility or excessive anger—overreacts to situations; has frequent tantrums difficulty concentrating—has trouble staying focused, remembering, or making decisions aggressiveness—initiates fights; hurts animals or others; destroys property irritability—seems anxious, restless, or overly worried; is continuously fidgeting unexplained change in eating and/or sleeping habits—refuses to eat or eats compulsively; has persistent nightmares and/or difficulty sleeping excessive fear—exhibits fear that is excessive or unwarranted feelings of worthlessness—is often self-critical; has undue fear of failure; is unwilling to try new things refusal to go to school—complains of not feeling well; fails repeatedly to complete assignments complains of physical ailments—experiences frequent stomachaches, headaches, joint aches, or fatigue without any reasonable cause engages in substance abuse (for older children)—uses drugs and/or alcohol talks about suicide—is overly curious about death and suicide

Mongolian spots – patches of blue-gray skin located on the lower back; more common among children of Asian, Native American, and Middle Eastern ethnicities.

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Chapter 2

Daily Health Observations

47

Teachers become skilled in conducting daily health checks and making insightful observations with practice. They can recognize the early signs and symptoms of various communicable illnesses and health disorders and know when it is necessary to send a child home or refer them for further evaluation. 2-3b

Recording Observation Results

Stop and Check #3

Why should teachers Information obtained during daily health checks should be recorded immerecord their findings imdiately following the observation to ensure its accuracy. Checklists are mediately or soon after ideal to use for this purpose because they enable teachers to conduct and conducting daily health record information systematically. Attendance records or a similar form checks? developed for this purpose can also be used to record anecdotal information. These records should be kept in each child’s permanent health file (electronic or hard copy) or a designated notebook so they are easy to locate. Any changes noted in a child’s condition throughout the day, such as a seizure, uncontrollable coughing, or diarrhea, should also be documented on this Did You Know... form and reported to the family. Each year U.S. schools provide services for approximately Observational information is only meaningful and useful to other teachers, 7.3 million children, or administrators, and health care providers when it is recorded in clear, accurate, and 14 percent of students 6 to precise terms. To say that a child “looks sick” is vague and open to individual inter21 years, who have special pretation. However, stating that a child is flushed, has a fever of 101°F (38.3°C), and is health and disability covered with a fine red rash on their torso is definitive and provides a functional descripneeds? tion that can be shared with the child’s family and health care provider.

2-3c

Confidentiality of Health Information

Did You Know...

Information obtained from daily health checks and teacher observations must The Family Education Rights and be treated with utmost confidentiality (Nahum et al., 2022). It should not be Privacy Act (Buckley Amendment) shared with or made accessible to other families, staff, or service personnel. and HIPPA prohibit schools from releasing any information Additionally, this information must never be released to another individual or about a child under 18 years organization without first obtaining written permission from the child’s parent without written parental or legal guardian (U.S. HHS & U.S. DOE, 2019). Anecdotal records and health permission?   checklists should be kept in a notebook or folder to protect children’s identity until the information can be transferred to their personal ▼ Information in children’s health records is confidential and files. However, federal law guarantees families the should only be shared when it is essential to the child’s well-being. right to access information in their child’s health file at any time and to request the correction of any perceived errors. 2-3d

Health Observation Benefits

Continuous monitoring of children’s health status offers several distinct benefits. It enables teachers to uphold their professional and moral obligations to protect the health of all children in a group setting. For example, a teacher may note changes in a child’s appearance or behavior that signal the onset of a communicable illness. This information can then be used to determine if a child is too ill to remain in the classroom based on the program’s exclusion policies. symptoms – changes in the body or its functions that are experienced by the affected individual. anecdotal information – brief notes describing a person’s observations.

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Sending a sick child home can hasten their recuperation time and reduce the risk of exposing other children to an illness. Information gathered during daily observations is also useful Responsibility for interpreting signs and to health care providers for diagnosing and treating a child’s condisymptoms of an illness or health condition tion. Teachers can provide unique information that explains how a and establishing a diagnosis always health problem, such as a vision impairment, hearing loss, or allerbelongs to trained health care professionals. gies, is affecting the child’s behavior and performance in school. Their insights can hasten the diagnostic process and, thus, limit the negative effects an undetermined condition may otherwise have on a child’s development. Daily health checks offer several additional benefits. They provide an opportunity for teachers to interact with children on an individual basis and to talk about a variety of health-related topics, such as why it is important to brush teeth, drink water, wash hands, or play outdoors. These one-on-one occasions convey a powerful message of caring and can empower children to begin developing a personal interest in their own wellness. An impending outbreak or significant change in a child’s behavior over time may be noted when daily health observation data are routinely monitored. For example, knowing that several children have been exposed to chickenpox or head lice should alert teachers to be even more vigilant in the coming weeks.

Caution

2-4

Family Involvement

Health checks provide an ideal opportunity for involving families in children’s health promotion. Teachers can create an atmosphere where families feel comfortable voicing concerns, asking questions, or seeking information about their child’s health needs, behavior, or adjustment to school (Marotz & Kupzyk, 2018). It is unrealistic to assume that teachers will always be able to answer parents’ questions. However, they can begin to build a culturally responsive and trusting relationship with families by showing interest, encouraging their questions and involvement, and helping them to locate resource information and services (Kurian et al., 2022). Teachers can also foster family involvement by sharing information about out-breaks of communicable illness, signs and symptoms to watch for, and effective preventive measures such as hand washing and good nutrition that can be taken to reduce children’s risk. Parents may also be able to provide simple explanations for problems the teacher observes. For example, ▼ Family–school collaboration is essential for promoting children’s well-being. a child’s fatigue or aggressiveness may be the result of a new puppy, a recent move, the birth of a sibling, or a seizure the night before. Allergies or a red vitamin taken at breakfast may explain a questionable red throat. Such symptoms might otherwise be cause for concern without this shared information.

Milatas/Shutterstock.com

2-4a

The Family’s Responsibility

Primary responsibility for a child’s health care always belongs to their family. Families are ultimately responsible for maintaining their child’s well-being, following through with recommendations, and obtaining any necessary evaluations and medical treatments.

diagnosis – the process of identifying a disease, illness, or injury from its symptoms.

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Checklist 2–3 ✓✓✓ Teacher Supporting Family Referrals Families may not always agree with a teacher’s concerns regarding a child’s health or development. However, positive steps can be taken to help them understand the importance of following through with referral recommendations. ●

● ●

●

● ●

Recognize that family’s may have difficulty accepting negative or adverse comments regarding their child’s health or development; this can interfere with what they initially hear, understand, and agree with. Refrain from responding negatively or suggesting that the family is in denial. Be a supportive listener, encourage questions, and provide clarification and additional information as needed. Allow the family time to accept the information and respond at their own pace unless the situation is urgent. Offer to help in identifying appropriate community services and resources. Contact child protective services if a child’s welfare is in jeopardy due to a family’s inaction.

Often families are the first to sense that something is wrong with their child (Marotz, 2023). However, they may delay seeking professional advice, either denying that a problem exists or hoping the child will eventually outgrow it (see Teacher Checklist 2–3). Cultural differences in developmental expectations and the way children are raised may also explain why some families fail to act (Coughlan et al., 2022). For example, a toddler’s delayed walking may not be cause for concern in cultures where early walking is not encouraged. Parents may also not understand that health problems can have negative consequences on children’s development and learning potential or they may not know where to go for appropriate diagnosis and treatment (Kappi & Martel, 2021; Silverstein et al., 2021). Some families fail to see the need for routine health care when a child appears to be healthy. Others simply cannot afford preventive care. However, cost must not discourage families from obtaining needed medical attention. In the United States, every state currently offers low-cost health insurance to incomeeligible children through the national Children’s Health Insurance Program (CHIP). In addition, most communities provide a variety of free or low-cost health services for children through: ◗ ◗ ◗ ◗ ◗

Head Start Child Find screening programs Medicaid assistance Well-child clinics University-affiliated training centers and clinics

◗ ◗ ◗

Public health immunization centers Community centers Interagency coordinating councils

Contact information for these agencies can typically be found in the telephone directory, on the Internet, or through the local public health department. Teachers should familiarize themselves with community resources so they can assist families in securing appropriate services for children in need.

Stop and Check #4 Who has primary responsibility for obtaining any health care that a child may need?

Health Education

2-5

Daily health checks provide many informal opportunities for teaching children about health, safety, and nutrition. Teachers can appeal to children’s curiosity by providing information about healthy lifestyle practices, including oral hygiene, nutrition, physical activity, mental health, and sleep. For example: ◗

“Sandy, did you brush your teeth this morning? Brushing helps to keep teeth healthy and chases away the mean germs that cause cavities.”

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“Rico, what did you eat for breakfast this morning? Our bodies need good foods to stay healthy and grow just like our classroom pet hamster.” “Harrison, what should you do if a stranger asks you to come with them?”

School-age children can be engaged in discussions that are more advanced. For example: ◗ ◗ ◗

“Gabriela, what fruits and vegetables you have eaten today. What vitamins does our body get from fruits and vegetables?” “Armann, let me help you put on sunscreen before we go outdoors to play. Why is this important?” “Keiko, if someone teases or says hurtful things to you, who should you tell?”

When health education is linked to everyday situations, children are better able to comprehend its importance and application to their personal lives. They are also more likely to follow through and to implement what they have learned. Including families in children’s health education is also essential and improves the consistency of information and practices between school and the child’s home. Teachers can utilize time during daily health checks to interact with families and to raise their awareness about a variety of children’s health issues: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

new safety alerts, including toy and equipment recalls the importance of eating a healthy breakfast nutritious snack ideas ideas for increasing children’s physical activity hand washing sun protection oral hygiene vaccine updates home fire and safety drills

Families are also more likely to support a school’s health education goals when genuine efforts are made to reach out and to engage them in children’s learning experiences. Partnering with Families Promoting Children’s Oral Health Dear Families, Oral health and a bright smile are important components of children’s well-being. Teeth are essential for chewing, speech development, maintaining proper space for permanent teeth, and appearance. Decay and infection can cause discomfort and interfere with children’s ability to focus in school. Unfortunately, tooth decay continues to affect many young children today despite increased public education and improved dental treatments. Practices that you can implement at home to promote children’s oral health include: ◗ Wipe an infant’s gums with a damp washcloth after each feeding. ◗ Dampen a soft toothbrush and use it twice daily to clean an infant’s first teeth. ◗ Only offer water if your infant takes a bottle to bed. Also, stop breastfeeding once they fall

asleep. Juices, formula, and breast milk contain sugars that can lead to tooth decay when they pool around gums and teeth. ◗ Apply a pea-sized dab of toothpaste to a soft brush and encourage toddlers to begin

brushing their own teeth. Follow up their efforts by “going once around the block.” ◗ Use fluoride toothpaste and drink fluoridated water (provided in most city water supplies)

to reduce tooth decay. Your child’s dentist may prescribe fluoride drops or tablets if the local water supply does not contain adequate fluoride.

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Partnering with Families Promoting Children’s Oral Health (continued) ◗ Continue to supervise preschool children’s twice-daily tooth brushing. Discourage children

from swallowing fluoride toothpaste because it can cause white or brown spots to form on permanent teeth. ◗ Monitor school-age children to make sure they brush and floss daily. ◗ Schedule your child’s first routine dental check at around 12 months of age. Older chil-

dren should visit the dentist every six months. If you can’t afford dental care, contact local public health personnel for information about free or low-cost options in your community. Reduced-cost dental insurance is also available to eligible families in some states. ◗ Serve nutritious meals and snacks. Include fresh fruits and vegetables, dairy products,

whole-grain breads, crackers and cereals, and limit sugary foods and drinks. ◗ Offer water to children when they are thirsty. Limit their consumption of carbonated bever-

ages, fruit drinks, and sport drinks, which tend to be high in sugars.

Classroom Corner Teacher Activities I Hear with My Ears . . . (NHES PreK–2; National Health Education Standard 1.2.1, 1.2.2)

Concept: Our ears let us hear sounds.

Learning Objectives ◗ Children will learn that ears are used for hearing sounds. ◗ Children will learn that there are many different sounds in the environment.

Supplies ◗ Various musical instruments (need two of each); a divider or a barrier

Learning Activities ◗ Read and discuss one of the following books: ● ● ● ●

You Hear with Your Ears by Melvin and Gilda Berger The Ear Book by Al Perkins Hearing (The Five Senses) by Maria Ruis, J. M. Parramon, & J. J. Puig The Listening Walk by Paul Showers

◗ Explain to the children that their ears are for hearing sounds. Ask them to name some of the

sounds that they hear each day. ◗ Place the musical instruments where the children can see them and play each one so they

can become familiar with the sound each instrument makes. ◗ Next, place one of each instrument in front of the barrier/divider and one of each behind

the barrier/divider. ◗ Have one child stand behind the divider and select an instrument to play. While the child is

playing the instrument, call upon another child to come up and identify the instrument that makes the matching sound (to the one the child is playing behind the barrier). ◗ Continue until each child has had a turn, and then have the children play all the instruments

at once. ◗ Talk about why it is important to take good care of our ears so we can hear.

(continued)

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Classroom Corner Teacher Activities (continued) Assessment ◗ Children can name which body part is used for hearing. ◗ Children will name several different sounds in their environment. ◗ Children can match sounds to their source.

Summary ◗

◗

◗

◗

◗

Teachers in high-quality programs understand that children’s health is essential for optimum growth, development, and the ability to learn. ● Teachers promote children’s well-being by conducting health assessments, making referrals, maintaining safe learning environments, providing health education, collaborating with families, and serving nutritious food. Teachers’ daily observations and health checks are an essential component of a school’s health promotion efforts. ● Information obtained from these sources is useful for identifying changes in children’s health status (physical, social-emotional) and developmental progress. Daily health checks provide an efficient, effective, and cost-free method for monitoring children’s health and development. ● Checklists can be used to ensure that observations are thorough and findings are recorded accurately and in meaningful terms. ● Information regarding children’s health must be treated with strict confidentiality. Family involvement is essential for promoting children’s well-being. Children benefit when there is mutual sharing of information between teachers and families. Teachers can make recommendations, but families are ultimately responsible for following through and obtaining health care for children. One-on-one health education with children can be incorporated into daily health checks.

◖◗ Terms to Know health assessment p. 44 atypical p. 44 observation p. 44 Mongolian spots p. 46

symptoms p. 47 anecdotal information p. 47 diagnosis p. 48

◖◗ Chapter Review A. By Yourself: 1. Define each of the Terms to Know listed above. 2. Explain how children’s health status affects their development and ability to learn. 3. List the reasons why teachers should conduct daily health checks. 4. Describe how an elementary teacher might modify the health check procedure to use with schoolage children. 5. Examine your feelings about conducting daily health checks and describe them in a reflective journal entry. Do you think all beginning teachers have similar feelings? Outline several steps you can take to improve your observational skills and gain confidence in identifying children’s health problems.

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B. As a Group: 1. Describe the tools that teachers can use for gathering information about a child’s health. 2. Describe the health check routine. What common health problems/conditions should teachers look for? 3. Discuss how you might respond to a parent who objects to daily health checks conducted by her child’s teacher. 4. What benefits do daily health checks provide for children? 5. What suggestions would you have for a teacher who says they are too busy to conduct daily health checks? 6. What are some things teachers can do to get families more involved in their child’s preventive health care?

◖◗ Case Study Ava’s teacher, Liam, has been concerned about her vision. He noticed that she quickly loses interest during story time. Often, she will leave her place in the circle and move closer to see pictures in the books he is holding up. Liam has also noted that Ava typically lowers her head close to puzzles, matching manipulatives, or an art project on which she is working. Liam met with Ava’s family to discuss his concerns. Her parents were not surprised by what they were told and shared that they, too, had observed similar changes in Ava’s behavior at home. However, they were reluctant to do anything because Ava’s father had recently been laid off and they no longer had health insurance. Liam encouraged Ava’s parents to have her vision tested at the local public health department. The results of two screening tests indicated that Ava’s vision was not within normal limits. The nurse discussed the findings with Ava’s parents and helped them to arrange a follow up examination with an eye specialist at a nearby wellness clinic. 1. What behaviors caused Ava’s teacher to have concerns about her vision? 2. If Ava’s teacher suspected a vision problem, why didn’t he just go ahead and recommend that Ava get glasses? 3. What consequences might Ava have experienced if her vision disorder had not been identified and treated in a timely manner?

◖◗ Application Activities 1. Develop your own health observation checklist. With another student, role-play the daily health check procedure. Use the checklist to record your findings and discuss your reactions to the experience. What suggestions would you have for the “teacher” partner who conducted the observation? 2. Invite a public health nurse from a well-child clinic or a local pediatrician to speak to the class about preventive health care recommendations for children birth to 12 years. 3. Visit several early childhood programs in your community. Try to include a home-based, forprofit, and non-profit in your survey. Note whether health checks are conducted as children arrive. Describe the method you observed at each center. Also, briefly discuss how this information was recorded. 4. Develop a comprehensive list of state and local resources for children who have a vision or hearing impairment, speech disorder, perceptual-motor condition, autism, and learning disability. Note location, transportation requirements, fees, and if family financial assistance is available. 5. Modify the “Classroom Corner” feature activity in this chapter so a child who is severely hearing impaired could participate.

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◖◗ Stop and Check Responses #1. Some screening tools can be administered by teachers (e.g., initial vision screening, developmental evaluations) whereas others (e.g., hearing test, speech evaluation) require individuals who have specialized expertise. #2. The primary objective of daily health checks is to establish a baseline of typical behavior and appearance for each child so that any changes are easily noted. #3. Teachers should record daily health check findings for each child immediately or soon after they have completed their observations. #4. Families are ultimately responsible for protecting children’s well-being and obtaining any health care that may be needed.

◖◗ Additional Resources to Explore Canadian Paediatric Society Child Development Institute Head Start National Resource Center U.S. Department of Health & Human Services: Administration for Children & Families Tufts University: Child and Family Web Guide Zero to Three

https://www.caringforkids.cps.ca https://childdevelopmentinfo.com https://eclkc.ohs.acf.hhs.gov/child-screening-assessment https://www.acf.hhs.gov https://ase.tufts.edu/cfw/ https://www.zerotothree.org

◖◗ References Allen, K. E., & Cowdery, G. E. (2022). The exceptional child: Inclusion in early childhood education (9th ed). Boston, MA: Cengage. Coughlan, C. H., Ruzangi, J., Neale, F. K., Maldonado, B. N., Blair, M., Bottle, A., Saxena, S., & Hargreaves, D. (2022). Social and ethnic group differences in healthcare use by children age 0-14 years: A population-based cohort study in England from 2007 to 2017. Archives of Disease in Children, 107, 32–39. Denlinger, L. C., Heymann, P., Lutter, R., & Gern, J. E. (2020). Exacerbation-prone asthma. The Journal of Allergy and Clinical Immunology: In Practice, 8(2), 474–482. di Palmo, E., Filice, E., Cavallo, A., Caffarelli, C., Maltoni, G., Miniaci, A., Ricci, G., & Pession, A. (2021). Childhood obesity and respiratory diseases: Which link? Children, 8(3), 177. https://doi.org/10.3390/children8030177 Eisenhower, A., Pedraza, F. M., Sheldrick, R. C., Frenette, E., Hoch, N., Brunt, S., & Carter, A. S. (2021). Multi-stage screening in early intervention: A critical strategy for improving ASD identification and addressing disparities. Journal of Autism and Developmental Disorders, 51(3), 868–883. Kappi, A., & Martel, M. (2021). Parental barriers in seeking mental health services for attention deficit hyperactivity disorder in children: Systematic review. Journal of Attention Disorders, 26(3), 408–425. Kurian, J., Murray, D. W., Kuhn, L., & LaForett, D. R. (2022). Examining frequency and modality of parent engagement in an elementary school mental health intervention. Journal of Applied School Psychology, 38(1), 74–93. Marotz, L. (2023). Developmental profiles: Pre-birth through adolescence (9th ed). Boston, MA: Cengage. Marotz, L., & Kupzyk, S. (2018). Parenting today’s children: A developmental perspective. Boston, MA: Cengage. Nahum, A. S., Vongsachang, H., Friedman, D. S., & Collins, M. E. (2022). Parental trust in school-based health care: A systematic review. Journal of School Health, 92(1), 79–91. Silverstein, M., Scharf, K., Mayro, E. L., Hark, L. A., Snitzer, M., Anhalt, J., Pond, M., Siam, L., Tran, J., Hill-Bennett, T., Zhan, T, & Levin, A. V. (2021). Referral outcomes from a vision screening program for school-aged children. Canadian Journal of Ophthalmology, 56(1), 43–48. U.S. Department of Health and Human Services (HHS). (2020). Healthy People 2030. Retrieved from https://health .gov/healthypeople. U.S. Department of Health and Human Services (U.S. HHS) & U.S. Department of Education (U.S. DOE). (2019). Joint guidance on the application of the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to student records. Retrieved from https://www.hhs.gov/sites /default/files/2019-hipaa-ferpa-joint-guidance-508.pdf.

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chapter

3

Assessing Children’s Health Professional Standards Linked to Chapter Content

◗ ◗

◗ ◗

◗

◗

#1a, b, c, and d Child development and learning in context #2a, b, and c Family–teacher partnerships and community connections #3a, b, c, and d Child observations, documentation, and assessment #4a, b, and c Developmentally, culturally, and linguistically appropriate teaching practices #5a, b, and c Using content knowledge to build meaningful curriculum #6b and c Professionalism as an early childhood educator

Learning Objectives After studying this chapter, you should be able to:

LO 3-1 Discuss how teachers can use information in children’s health records to promote their development and well-being. LO 3-2 Identify five health screening procedures and describe the common disorders they can be used to detect. LO 3-3 Explain why it is important to follow up with families after making an initial referral.

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Teachers understand that health problems can interfere with a child’s ability to learn, and that early detection improves the success of many interventions. They also have access to a variety of screening tools for identifying children who may require further evaluation. When information is collected in an objective manner and from a combination of observations and screening procedures, it yields (1) reliable data for health promotion, (2) clues that aid in the early detection of conditions affecting children’s growth and development, and (3) an opportunity to modify learning environments to meet a child’s unique needs.

Children’s Health Records

3-1

Careful recordkeeping is not always a priority in many early childhood programs and often does not extend beyond minimal licensing requirements. Unlicensed programs are not obligated to maintain any health records. When information in children’s files is current, comprehensive, and sufficiently detailed it can be useful for promoting their developmental progress and well-being (Table 3–1). Forms and records should be designed to gather information that is consistent with a program’s goals and philosophy and protects the legal rights of the children and staff. This information serves many purposes, including: ◗ ◗ ◗ ◗ ◗ ◗ ◗

determining children’s health status identifying patterns and potential problem areas developing intervention programs evaluating the outcome of special services, such as speech therapy, occupational therapy making referrals and coordinating services monitoring a child’s progress research

Health records contain confidential information about children and their families. Information in these files should only be shared with personnel who must know something specific about a child to work effectively with them. Personal details about a child or family must never serve as topics of conversation outside of the classroom. No portion of a child’s health record should ever be released to another agency, school, health professional, or clinician until written permission has been obtained from the child’s parent or legal guardian. A release form, such as the one shown in Figure 3–1, can be used for this purpose. The nature of information and agency or person to whom it is to be transferred should be clearly stated. The form must also be dated and signed by the parent or legal guardian, and a copy retained in the child’s folder. Table 3–1 Children’s Health Records Children’s permanent health records should include: • child/family health history • current medical assessment (physical examination) • immunization records • emergency contact information • record of dental examinations • attendance data • school-related injuries • documentation of family conferences concerning the child’s health • screening results, e.g., vision, hearing, speech, developmental • medications administered while the child is at school

intervention – practices or procedures implemented to modify or change a specific behavior or condition.

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Figure 3–1 Sample information release form.

INFORMATION RELEASE FORM I understand the confidentiality of any personally identifiable information concerning my child shall be maintained in accordance with the Family Education Rights and Privacy Act (P.L.93–380), federal and state regulations, and used only for the educational benefit of my child. Personally identifiable information about my child will be released only with my written consent. With this information, I hereby grant the

_________________________________________________________________________ (Name of program, agency, or person)

permission to release the following types of information: Medical information Assessment reports Child histories Progress reports Clinical reports (Other)

_________________________ _________________________ _________________________ _________________________ _________________________ _________________________

to:_________________________________________________________________ (Name of agency or person to whom information is to be sent)

regarding _____________________________________ ______________ _____ (Child’s Name)

(Birthdate)

(Gender)

________________________________ Signature of Parent or Guardian

________________________________ Relationship of Representative

________________________________ Date

Recordkeeping is most efficient when one person is responsible for maintaining all healthrelated records. However, input from all members of the teaching team is important for determining how health problems may be affecting a child in different situations and for tracking children’s developmental progress. Health records are considered legal documents and should be retained for at least 5 years. 3-1a

Health History Questionnaire

The nature of information requested on health history questionnaires varies from program to program. Unless a standardized form is required by a licensing agency, school district, or funding agency, programs may wish to develop their own. Sample forms can often be obtained from other programs or state agencies and modified to meet a program’s specific needs. Health history questionnaires should be designed to gather basic information about: ◗ ◗ ◗

circumstances related to the child’s birth family structure, such as siblings and their ages, family members, preferred language, and legal custody issues major developmental milestones

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previous injuries, illnesses, surgeries, or hospitalizations daily routines, such as toileting, food preferences, eating patterns, and napping family concerns about the child’s development, such as behavior problems, social interactions, or speech delays any special health conditions, such as allergies, asthma, seizures, diabetes, vision or hearing disorders, and prescribed medications

Families should provide a completed health history questionnaire and copy of the child’s immunization record at the time of enrollment. Alternatively, this information may be obtained during a home visit or meeting with the program administrator. Health history information enables teachers to better understand each child’s uniqueness, including their family background, daily routines and preferences, health status, and developmental strengths and limitations. It informs teachers of children’s special needs, such as dietary restrictions, hearing loss, or mobility limitations that may require accommodations. However, caution must be exercised not to base expectations for children solely on this information. A child’s potential for learning must never be discounted until an impairment is confirmed and known to restrict performance. When goals are set too low, children may lack incentive and perform only to the level of adult expectations. In contrast, expectations that are unrealistic and beyond a child’s capabilities may cause repeated failure and loss of motivation. Health history questionnaires also provide insight into the type of medical supervision a child typically receives and the value a family places on preventive care. This information can be especially useful when making referrals and planning children’s health education experiences. 3-1b

Medical and Dental Examinations

Most states require children to complete a health assessment and update all immunizations before they attend school or an early childhood program. Some states require an annual physical examination, whereas others request it only at the time of admission. Health care providers recommend well-child checkups every 2 to 3 months for infants, every 6 months for 2- and 3-yearolds, and annually for children 4 and older. More frequent medical supervision may be necessary if children have existing health conditions or develop new ones. Information about a child and their family is updated during each wellness visit. Families are often asked to complete a brief developmental questionnaire to better help medical personnel assess all aspects of the child’s health. Immunization records are reviewed and additional vaccines are administered as indicated. The child’s heart, lungs, eyes, ears, skeletal and neurological development, and gastrointestinal function (stomach and intestines) are carefully examined. Head circumference is routinely measured on all infants and children until age 3 to be certain that the head size continues to increase at an acceptable rate. Height, weight, and blood pressure readings (after age 3) are also recorded to determine if a child’s growth is progressing satisfactorily. Growth failure, especially in height, may indicate a health disorder that requires investigation. Specialized tests, such as blood tests for anemia, sickle cell disease, or lead poisoning, may be ordered to detect or rule out these conditions. Urinalysis, tuberculin testing, vision screening, and hearing evaluaStop and Check #1 tion may also be obtained. Dental examinations are seldom required for admission purWhat steps must schools take poses, but their benefits are unquestionable. Families should be before releasing information about a child’s health, development, or encouraged to arrange routine dental checks and preventive care for performance to another program? children, including visual inspection of the teeth, cleaning, and fluoride applications, every 6 to 12 months. skeletal – pertaining to the bony framework that supports the body. neurological – pertaining to the nervous system, which consists of the nerves, brain, and spinal column.

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Screening Procedures

Screening tests are also an essential component of the comprehensive health assessment process. They support the preventive care philosophy through early detection of health conditions that could otherwise interfere with a child’s development and learning. Most screening procedures are relatively quick, inexpensive, and efficient to administer to groups of young children. Some tests can be conducted by teachers, whereas others require the services of professional clinicians. Screening tests are designed only to identify children who may have a condition that requires professional evaluation, never to diagnose or to confirm a specific impairment. Test results simply provide additional information about a child that can be used in combination with family and teacher observations, assessments of growth and development, and daily health-check findings. 3-2a

Assessing Children’s Health

▼ Height and weight measurements yield important information about children’s health.

Height and Weight

Sirtravelalot/Shutterstock.com

The first 5 years of life are an important period of rapid growth. Increases in height and weight are most dramatic during infancy, and continue at a slower, but steady, rate throughout the preschool and school-age years (Marotz, 2023). Height is the most reliable indicator of a child’s general health and nutritional status. Weight often fluctuates in response to recent illness, infection, emotional stress, or over- or under-eating and, therefore, is not considered a dependable reflection of long-term wellness. Teachers and families must understand that a child’s growth potential is ultimately governed by genetics. This is especially important to consider when working with children from different cultures and ethnic backgrounds. The Centers for Disease Control and Prevention (CDC) has updated its standard growth charts to more accurately represent the diverse child population in the United States, although they still may not be appropriate for all ethnicities (https://www .cdc.gov/growthcharts/index.htm). The World Health Organization (WHO) has also published international Child Growth Standards for children birth to 19 years (www.who.int/childgrowth /en). Their charts include developmental milestones (Windows of Achievement) based upon an extensive worldwide study of children birth to age 5. Ideally, children’s height and weight should be measured at 4- to 6-month intervals and recorded in their permanent health file. A single measurement is unlikely to identify the child who is experiencing a growth disturbance related to physical illness, a dysfunctional home, an eating disorder, or other cause. Rather, what is most important to note is if a child’s growth continues to progress satisfactorily over time. 3-2b

Body Mass Index

The body mass index (BMI) is a screening tool that provides a height-for-weight ratio. It is appropriately used with children 2 years and older to determine their risk of being underweight, normal weight, overweight, or obese. Gender-specific charts for plotting children’s BMI-for-age underweight – a BMI of less than 18.5. overweight – a BMI greater than 25. obese – a BMI over 30.

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(2–20 years) can be accessed from the CDC (www.cdc.gov/healthyweight/assessing/BMI/index .html). Children who are underweight, overweight, or obese should be referred to a health care provider for evaluation. 3-2c

Vision

During the early years, children learn primarily through their senses, particularly vision and hearing (Novak & Schwan, 2021; Shin, 2021). These systems must function properly to avoid delays in children’s learning and skill acquisition. Researchers have found that approximately 60 percent of children younger than age 6 have not had their vision tested within the past year (Child and Adolescent Health Measurement Initiative, 2022). Family income, education, insurance status, and ethnicity are factors commonly associated with a lack of testing. Vision impairments affect approximately 7 percent of children younger than 18 years (CDC, 2020). Some conditions, such as cataracts or blindness, may be present at birth. OthDid You Know... ers occur as the result of an injury or infectious illness, such as meningitis. Vision problems are also more common among children who are born prematurely or low birthweight, 1 in 4 school-age or who have other disabilities such as cerebral palsy, Down syndrome, autism, or fetal children has an alcohol syndrome (FAS) (Burstein, Zevin, & Geva, 2021; Lindly et al., 2021). undetected and untreated vision Corrective treatments are more likely to be successful when vision disorders are disorder ? detected in the early stages (Birch, Kelly, & Wang, 2021). Permanent vision loss can often be avoided by monitoring infants’ milestone achievements and observing their eyes for any notable abnormalities. A professional eye evaluation, performed by an ophthalmologist or optometrist, is recommended for all children by age 3 or at least before they enter kindergarten. Undiagnosed vision problems may result in children being inappropriately labeled as learning disabled or intellectually challenged when, in fact, they simply cannot see well enough to learn (Marotz, 2023). The following case study illustrates the point:

DGLimages/Shutterstock.com

Louie’s parents thought that he was just a clumsy child and would eventually outgrow this stage. They attributed his frequent tripping over toys or running into furniture as typical 5-year-old inattentive behavior. However, Louie’s teachers are concerned and have been observing him closely, especially during outdoor periods. They have noticed that he often fails to see a tricycle or scooter in his pathway or to catch a ball that is tossed to him. His teachers’ concerns were confirmed during a recent vision screening and follow-up appointment with an eye specialist. Louie required corrective glasses which have ▼ Teachers are often the first to notice early signs of children’s vision disorders. since made a significant improvement in his classroom behavior, social interactions, motor skills, and academic performance.

Assessment Methods Observing children carefully for specific behavioral indicators is an important first step in the early identification of vision problems (Teacher Checklist 3–1). For example, an infant’s vision can be tested informally by holding an object, such as a rattle, 10 to 12 inches away and observing the infant’s ability to focus on (fixation) and track (follow) the object as it is moved in a 180-degree arc around the child’s head. The infant’s eyes should also be observed for alignment and any uncoordinated movements as the

ophthalmologist – a physician who specializes in diseases and abnormalities of the eye. optometrist – a specialist (nonphysician) trained to examine eyes and prescribe glasses and eye exercises.

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Checklist 3–1 ✓✓✓ Teacher Early Signs of Visual Abnormalities in Infants and Toddlers Observe the infant closely for: ● ● ● ● ● ● ● ● ●

roving eye movements that are suggestive of blindness jerky or fluttering eye movements eyes that wander in opposite directions or are crossed (after age 3 months) inability to focus or follow a moving object (after age 3 months) pupil of one eye larger than the other absence of a blink reflex drooping of one or both lids cloudiness on the eyeball chronic tearing

object is brought closer to (convergence) and farther away from the face. In addition, the blink reflex (sweep hand quickly in front of the eyes; observe for blinking), and pupil response (shine a penlight, held 4 to 6 inches away, into the eye; pupil should become Did You Know... smaller) should also be checked. Infants exhibiting any abnormal responses should be infants have extremely poor vision and are referred for professional evaluation. unable to see detail, such Behavioral clues may be the first indication that a toddler or older child is experias facial features, until encing a vision disorder (Teacher Checklist 3–2). Children are seldom aware of or able 3–4 months of age? to verbalize the fact that they do not see clearly, especially if their vision has never been normal. Some vision problems, such as amblyopia, are difficult to detect because there are no visible signs or symptoms. Others become more apparent during the school years when children engage in academic work that requires greater detail and accuracy. Standardized acuity screening tests can be used to confirm a teacher’s or family’s observations. Several can be administered by teachers, school nurses, or trained volunteers (Table 3–2). It is important that children understand what the test involves and how they are expected to respond so the results are reliable. In addition to acuity screening, children should also be checked for: ◗ ◗

convergence depth perception (Titmus Fly test)

Checklist 3–2 ✓✓✓ Teacher Signs of Visual Acuity Problems in Older Children ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●

rubs eyes frequently attempts to brush away blurs is irritable with close work is inattentive to distant tasks, e.g., watching a movie, catching a ball strains to see distant objects, squints, or screws up face blinks often when reading, holds books too close or far away is inattentive with close work; loses interest after a short time closes or covers one eye to see better tilts head to one side appears cross-eyed at times reverses letters, words stumbles over objects, runs into things complains of repeated headaches or double vision exhibits poor eye–hand coordination experiences frequent sties, redness, or watery eyes

acuity – the ability to see detailed objects clearly from a specified distance.

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Table 3–2 Examples of Acuity Tests for Preschool-Age Children • • • •

Single-surround HOTV Letters Single-surround LEA Symbols Teller Acuity Cards (for preverbal or nonverbal children) PASS Test (TM)2 Preschool Assessment of Stereopsis with a Smile 2 (PASS) Test (depth perception, amblyopia, strabismus) • Random Dot E stereopsis test (depth perception, amblyopia, strabismus)

◗ ◗

binocular fusion (PASS Test [TM]2; Random Dot E) deviations in pupil position (test by holding a penlight 12 inches from the child’s face, direct light at the bridge of the nose; the light reflection should appear in the same position on both pupils; any discrepancy requires professional evaluation).

Photoscreening is useful with young children, particularly those who are preverbal, nonverbal, or have developmental delays or disabilities that make it difficult for them to complete conventional screening procedures (Neena et al., 2022; Poole et al., 2021). A special camera records a small beam of light as it reflects on the eyeball and is a useful test for the early detection of amblyopia and strabismus. Although it is an efficient and effective screening technology, the equipment is relatively expensive and requires specialized training to administer. Children who do not pass an initial vision screening should be retested within 2 to 4 weeks. Failure to pass a second screening necessitates referral to a professional eye specialist for comprehensive evaluation and diagnosis. However, results obtained from routine vision screening tests should be viewed with caution because they do not guarantee that a problem does or does not exist. Also, most routine screening procedures are not designed to detect all types of vision impairments. There will always be some over-referral of children who do not have a vision disorder, while other children may be missed. It is for this reason that teachers’ and families’ observations are extremely important. Children’s acuity can also change over time, so it is important that adults continuously monitor children’s visual performance.

▼ Early detection and treatment of vision problems improves children’s learning success.

Common Disorders Vision screening programs are designed to detect three common disorders in young children, including:

Galitsin/Shutterstock.com

◗  amblyopia ◗  strabismus ◗  myopia

Amblyopia, or “lazy eye,” affects approximately 2 to 4 percent of all children younger than 10 years and is the most common cause of childhood vision loss. Children who are born prematurely or to mothers who smoke are at higher risk for developing this and other vision disorders (Tsumi et al., 2021). Amblyopia is caused by a muscle imbalance or childhood cataracts that result in blurred, double, or reduced vision in one or both eyes. When this occurs, the child’s brain has difficulty interpreting the distorted vision and gradually responds only to images received from the stronger eye while ignoring (suppressing) those from the weaker or “lazy” eye. As a result, the area of the child’s brain responsible for vision (visual cortex) does not develop properly and sight is gradually lost in the

amblyopia – a condition of the eye commonly referred to as “lazy eye”; vision gradually becomes blurred or distorted due to unequal balance of the eye muscles. There are no observable eye abnormalities.

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Kornnphoto/Shutterstock.com

weaker eye unless treated. Amblyopia also causes a loss of depth perception, which requires comparable sight in both eyes. Early identification and treatment of amblyopia are critical for preventing permanent vision loss. However, this condition is often overlooked and treatment delayed because there are no visible signs or abnormalities. Also, children are seldom aware that anything is wrong with their vision. For these reasons, it is important that young children have routine vision screenings and comprehensive eye examinations. A significant portion of the child’s eyesight can often be restored if amblyopia is diagnosed before age 6 or 7. Even greater improvements may be achieved when this condition is detected and treated before the age of 2 or 3 years. However, research suggests that older children may regain some lost sight with intensive treatment (Sen, Singh, & Saxena, 2022). Several methods are used to treat amblyopia. A common treatment involves patching the child’s stronger (unaffected) eye for several hours each day until muscles in the weaker (affected) eye become stronger. Other treatment methods include corrective glasses, eye drops, eye exercises, video game therapy, and surgery. Teachers may be asked to administer treatments while children are in school. They must understand the importance of maintaining a child’s treatment schedule and be supportive when children resist or are embarrassed by having to wear special glasses or a patch. Added safety precautions, such as clearing obstacles from pathways and guiding children through unfamiliar spaces, may need to be taken to avoid injury during treatments. Teachers can use these opportunities to help all Stop and Check #2 children develop greater respect for, and acceptance of, individuals who Why is the early detection of have special needs. amblyopia so important? Strabismus affects approximately 3 to 5 percent of young children (AAPOS, 2021). This condition results from an observable misalignment of the eyes that is intermittent or permanent (e.g., both eyes may turn inward or be crossed, or one eye may look in a direction different from the other). Because the eyes do not work together as a unit, children experience double or blurred vision. The brain attempts to correct this problem by ignoring images received from the weaker eye. As a result, vision is gradually lost in that eye if the strabismus is not corrected. Early recognition and treatment of strabismus is essential for restoring normal vision. Today, even infants are being treated aggressively for this condition. Although uncoordinated eye movements are common in very young infants, their eyes should begin moving together as a unit by ▼ Strabismus interferes with children’s ability to see properly. 4 months of age. Traditional treatments for strabismus include surgical correction, patching of the unaffected eye, and eye exercises. Specially designed video games have also proven to be an effective treatment for older children (Boniquet-Sanchez & Sabater-Cruz, 2021; Falcone, Hunter, & Gaier, 2021). Myopia, or nearsightedness, can affect young children, but is more common in schoolage children. However, the number of children worldwide who are being diagnosed with myopia at an early age has increased significantly in recent years (Alvarez-Peregrina et al., 2021a; Liu et al., 2021). Researchers have attributed this trend to children’s increased use of digital media (e.g., video games, television, smartphones)

strabismus – a misalignment of the eyes in which they appear to be crossed or each looking in a different direction. myopia – nearsightedness; an individual has good near vision but poor distant vision.

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which strengthens near-vision development. They have also noted that children are spending less time playing outdoors which can slow or prevent myopia from developing (Cumberland et al., 2022; Wong et al., 2021). A child who is nearsighted (myopic) sees near objects clearly but has poor distant vision. This condition is especially problematic for young children because they tend to move about quickly and to engage in play that involves running, jumping, and climbing. As a result, children who have myopia may appear clumsy and often stumble over or run into objects in their pathway. Squinting is also common as children attempt to bring distant objects into better focus. Teachers can be instrumental in noting these behaviors and referring children for comprehensive screening. Mild farsightedness, or hyperopia, is common in children younger than 5 years. Their eyeballs are shorter and flatter than normal which cause images to fall behind the retina instead of on it. This condition typically corrects itself as children mature and the eyeball enlarges and changes in shape. Children who are farsighted see distant objects clearly but have difficulty focusing on near objects. Older children may struggle academically, read poorly, have a short attention span, and complain of headaches, tired eyes, or blurred vision following periods of close work (AlvarezPeregrina et al., 2021b). Because hyperopia can be difficult to detect with most routinely administered screening procedures, teacher and parent or caregiver observations may provide the best initial clues to this disorder. A child who exhibits signs of hyperopia should be referred to a professional eye specialist for evaluation. Color blindness affects a small percentage of children and is generally limited to males. Females are carriers of this hereditary defect but are rarely affected. The most common form of color blindness involves the inability to discriminate between red and green. Testing young children for color blindness is difficult and often not performed because learning is not seriously affected and there is no corrective treatment. Management When a vision problem is suspected, the child’s family should be counseled and encouraged to arrange for professional evaluation. Observation and screening results should be reviewed with the child’s family in a sensitive, non-technical, and culturally respectful manner. Referral plans, a reasonable timeframe for the next steps to be taken, and questions can also be discussed at this time. It is important for families to understand that children’s vision problems are not outgrown, nor do they typically improve without corrective treatment. Teachers can assist families in locating services and reinforce the importance of following through with treatment recommendations. Vision testing can often be arranged through pediatricians’ offices, “well-child” clinics, public health departments, professional eye doctors, and public schools. Local service organizations, such as the Lions Clubs, may assist qualified families with the costs of professional eye examinations and glasses. The early detection and treatment of children’s vision disorders remains a goal of the Healthy People 2030 initiative. Efforts to increase public awareness and to reach children in medically underserved areas are aimed at combating unnecessary and irreversible vision loss. Information about the symptoms of common visual impairments, testing procedures, and treatments is available on many profesStop and Check #3 sional organization websites, including Prevent Blindness (https://www What measures can teachers .preventblindness.org), American Academy of Ophthalmology (https:// take to help reduce children’s www.aao.org), American Academy of Pediatrics (https://www.aap risk of developing myopia? .org), and the American Association of Pediatric Ophthalmology and Strabismus (https://www.aapos.org).

hyperopia – farsightedness; a condition of the eyes in which an individual can see distant objects clearly but has poor close vision.

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Connecting to Everyday Practice

➥➥

Cultural Competence

A family’s response to screening test results and referral recommendations is often influenced by their cultural beliefs, values, and norms. Stigmas and prejudices against individuals who have a disability and their family are common in many cultures (Adugna et al., 2020). For example, some cultures believe that a child’s disability is punishment for parents who are thought to have engaged in immoral or sinful activities (Buterin, Muzur, & Glažar, 2021; Montenegro et al., 2022). In other cultures, children who require hearing aids or glasses may be perceived as being less intelligent, friendly, or successful (Qian et al., 2021). As a result, such views may cause parents to disregard screening results and not follow through with recommendations for additional evaluation or treatment. Teachers can help parents to overcome some of these barriers through the development of cultural competence. This skill set extends beyond simply being aware of or sensitive to an individual’s or family’s social, cultural, and linguistic attributes (Barrio, 2021). It involves acquiring a deeper understanding of their beliefs, values, experiences, needs, and perspectives through meaningful and continuous dialogue. It also requires that teachers practice self-awareness, acknowledge personal biases, and refrain from assumptions that all members of a particular culture hold similar views. Achievement of cultural competence is a continuous process that requires an open mind, a willingness to ask questions, and a desire to build respectful relationships with families from diverse cultural and linguistic backgrounds. Information about various racial/ethnic groups and cultural competence, especially as it relates to health care, can be found on many websites, including: ◗ CDC

https://npin.cdc.gov/pages/cultural-competence

◗ National Center for Cultural Competence ◗ EthnoMed ◗ DiversityRx

https://nccc.georgetown.edu/

https://ethnomed.org http://www.diversityrx.org/resources/culture-clues

Think About This: ◗ What steps can an individual take to identify and address personal biases? ◗ What strategies can teachers use to help a parent overcome their reluctance to follow

through with a child’s referral?

3-2d

Hearing

Each year approximately 6,000 infants in the United States are born with a profound or permanent hearing loss (CDC, 2019). An additional 12 to 15 percent of children develop mild to moderate hearing loss by age 19 years (Table 3–3). Undetected hearing loss can interfere with children’s language acquisition, grammar, social interactions, emotional development, and learning. When children do not hear properly, they may respond and behave in seemingly unacceptable ways. This can lead to incorrect labels such as developmentally delayed, cognitively challenged, or a behavior problem. The early diagnosis of hearing impairments or severe loss is, therefore, extremely critical. Assessment Methods Inappropriate responses and behaviors may be the first indication that a child is not hearing properly. Signs of hearing loss can range from obvious problems to those that are subtle and difficult to identify (Teacher Checklist 3–3). Hospitals in all states and U.S. territories currently comply with Universal Infant Hearing Screening recommendations. Twenty-eight states allow parents the right to refuse screening if cultural competence – a skill set (e.g., awareness, knowledge, attitude, communication) that enables a person to work effectively with individuals from other cultures and ethnicities.

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Table 3–3 Sources of Noise-Induced Hearing Loss

Source Decibels (dB)* Typical conversation 60 dB Washing machine 75 dB Busy city traffic 85 dB Hair dryer 90 dB Movie theater 1001 dB Personal music player 105 dB Leaf blower 115 dB Noisy toys 1151 dB Ambulance siren 125 dB Fireworks 145 dB Rock concert 1152140 dB *Measures should be taken to protect children from sounds louder than 80–85 dB to prevent hearing loss.

they object (NCSL, 2022). Trained hospital personnel test infants’ hearing shortly after birth to detect deafness so that early intervention services can be initiated. An interactive map listing state-by-state legislation, testing sites, and intervention services is available at the Did You Know... National Center for Hearing Assessment and Management (NCHAM) website (https:// that over 5 million children and adolescents www.infanthearing.org/states/). have permanent hearing An infant’s hearing development should be continuously monitored by checking loss caused by exposure behavioral responses such as eye blinking or attempts to locate sounds (e.g., stop cryto excessive noise ing, turn head, interrupt sucking) (Teacher Checklist 3–4). Older infants and toddlers levels? can be assessed by observing as they search for sounds in their environment (or emitted through speakers during formal testing procedures), as well as by the appropriateness of their responses and language development. Although these procedures can be useful for identifying some children with hearing disorders, they are not effective for detecting all forms of hearing loss. Children’s hearing should be tested by a trained specialist, such as a nurse or audiologist, at least once during the preschool and school-age years and more often if a hearing problem is suspected. Hearing tests evaluate a child’s ability to hear the normal range of tones used in everyday conversation. Checklist 3–3 ✓✓✓ Teacher Behavioral Indicators of Children’s Hearing Loss Families and teachers may observe behaviors that suggest a possible hearing loss, such as: ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●

frequent mouth breathing failure to turn toward the direction of a sound delays in acquiring language; development of inappropriate speech patterns difficulty understanding and following directions asking to have statements repeated rubbing or pulling at ears mumbling, shouting, or talking loudly reluctance to interact with others; quiet or withdrawn using gestures rather than words excelling in activities that do not depend on hearing imitating others at play responding to questions inappropriately mispronouncing many letter sounds having an unusual voice quality—one that is extremely high, low, hoarse, or monotone failing to respond to normal sounds and voices

audiologist – a specially prepared clinician who uses nonmedical techniques to diagnose hearing impairments.

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Checklist 3–4 ✓✓✓ Teacher Early Signs of Hearing Loss in Infants and Toddlers Observe the infant closely for: ● ● ● ● ● ●

absence of a startle response to loud noise failure to stop crying briefly when an adult speaks to them (3 months) failure to turn head in the direction of sound, such as a doorbell or a dog barking (4–5 months) absence of babbling or interest in imitating simple speech sounds (6–8 months) no response to adult commands, such as “no” or “come” not speaking simple words (“mama, “dada”) by age 1 year

Microgen/Shutterstock.com

Most children can complete routine hearing ▼ Hearing screenings are conducted by an audiologist or specially screenings with minimal instruction. However, trained personnel. an unfamiliar situation involving new people, instruments, and equipment, a novel task, a lack of understanding, or failure to cooperate may occasionally interfere with a child’s performance and yield unreliable test results. These factors must be taken into consideration if an initial screening is failed, and arrangements made to have the child retested later to confirm or rule out previous findings. Children who pass a second hearing test yet continue to exhibit behaviors suggestive of a hearing loss should be referred for additional evaluation. Children should be prepared for hearing screenings so they know in advance what to expect. Play activities that require children to practice listening skills and wearing headphones (e.g., disk jockey, airplane pilot, musician) will help to increase their comfort level with formal screening procedures. Teachers should also determine what response method (such as raising one hand, pressing a button, pointing to pictures, or dropping a wooden block into an empty can) children will be expected to use during the screening and practice this activity beforehand. If a special room is to be used for testing purposes, children should be given an opportunity to visit the facilities and equipment. This will help to reduce their anxiety and improve test result reliability. Common Disorders Children who are born prematurely, low-birthweight, or with any physical disability have an increased risk of experiencing hearing problems (Trudeau et al., 2021; Zhai et al., 2021). Temporary and permanent hearing loss may affect one or both ears and are commonly associated with: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

a family history of hearing problems prenatal exposure to maternal infections, such as herpes, German measles, cytomegalovirus (CMV), or toxoplasmosis prematurity, low birth weight bacterial meningitis, measles, mumps allergies frequent colds and ear infections (otitis media) birth defects, such as Down syndrome, fetal alcohol syndrome, cleft lip/cleft palate, cerebral palsy head injuries exposure to excessive or prolonged noise

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Any parent or caregiver who expresses concern about a child’s hearing should always be encouraged to seek professional advice. The most common forms of childhood hearing loss are:

Diagram of the ear.

Outer Ear

Middle Ear

Inner Ear

Conductive loss affects the volume of word tones. For example, this child can hear loud, but not soft, sounds. Conductive hearing loss occurs when sound waves are not transmitted properly from the external ear to structures in Ear Canal the middle ear (Figure 3–2). Foreign objects, Cochlea excess wax, and fluid accumulation in the child’s middle ear following an infection are Ear Drum common causes of conductive hearing loss. ◗ Sensorineural loss results when the delicate structures of the inner ear (cochlea) or the auditory nerve (which connects to the brain) have been damaged or do not function properly. A child with this type of loss can hear but is not able to understand or interpret sounds. Children who have a sensorineural loss are considered to have a permanent learning disability that requires special educational management. ◗ Mixed hearing loss refers to a disorder that involves a combination of conductive and sensorineural hearing losses. ◗ Auditory neuropathy spectrum disorder (ANSD) occurs when the auditory nerve is damaged. This condition interferes with a child’s ability to understand and interpret sound. ◗

Auditory Nerve

Management A child who experiences a sudden or gradual hearing loss should be referred to a health care provider for a medical diagnosis or to an audiologist for a comprehensive hearing evaluation. Families can arrange for this testing through the child’s physician, a speech and hearing clinic, public health department, public school, or an audiologist. Did You Know... Hearing loss can often be successfully treated if it is identified in the early stages. ears are important for Treatment methods depend upon the underlying cause and range from prescription maintaining balance ear drops and antibiotic therapy to surgery (Cetinkaya & Topsakal, 2022; Patel & and hearing even Olympia, 2022). Some children who experience permanent hearing loss benefit from when you are asleep? hearing aids, whereas others may receive cochlear implants or learn sign language. Teachers who understand how various impairments affect children’s ability to hear can take appropriate steps to improve communication and modify learning environments (Teacher Checklist 3–5). Additional information about hearing impairments, testing procedures, and resources for families can be accessed on the American Association of Speech-Language-Hearing Association website (https://www.asha.org). 3-2e

Speech and Language

Throughout the early years, children make impressive gains in the number of words they understand (receptive vocabulary) and use to express themselves (expressive vocabulary) (Table 3–4). Children’s receptive vocabulary develops earlier and is usually more extensive than their expressive vocabulary. For example, most toddlers understand and can follow simple directions long conductive loss – affects the volume of word tones heard, so that loud sounds are more likely to be heard than soft sounds. sensorineural loss – a type of hearing loss that occurs when sound impulses cannot reach the brain because of damage to the inner ear structures or auditory nerve. mixed hearing loss – a disorder that involves a combination of conductive and sensorineural hearing losses.

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Checklist 3–5 ✓✓✓ Teacher Strategies for Communicating with Children Who Are Hearing-Impaired ●

● ● ●

● ●

●

Reduce background noises, such as musical tapes, radio, motors, or fans that can interfere with a child’s limited ability to hear. Provide individualized versus group instructions. Face and stand near the child when speaking. Bend down to the child’s level; this makes it easier for the child to hear and understand what is being said. Speak slowly and clearly. Use gestures or pictures to illustrate what is being said; for example, point to the door when it is time to go outside. Demonstrate what the child is expected to do; for example, pick up a bead and thread it on a shoestring.

Table 3–4 Speech and Language Developmental Milestones

Infants Birth–4 months

• turns to locate the source of sound • begins to coo and make babbling sounds: baa, aah, ooh • imitates own voice and sounds

4–8 months

• repeats syllables in a series: ba, ba, ba • “talks” to self • responds to simple commands: no, come

8–12 months

• recognizes labels for common objects: shoe, blanket, cup • “talks” in one-word sentences to convey ideas or requests: cookie (meaning, “I want a cookie”)

Toddlers 12–24 months

• follows simple directions • knows and uses 10–30 words • points to pictures and body parts on request and asks frequently, “What’s that?,” “Why?” • enjoys being read to • understands 200–300 words • speaks in 2–3 word sentences • has speech that is 65–70 percent understandable

24–36 months

• • • • • •

refers to self as “me”: “Me do it myself.” uses language to get desired attention or object understands simple concepts when asked: “Find the small ball.” follows simple directions: “It’s time to get dressed.” understands and uses 50–300 new words has speech that is 70–80 percent understandable

Preschoolers 3–6 years

• • • • •

answers simple questions appropriately describes objects, events, and experiences in fairly detailed terms sings simple songs and recites nursery rhymes carries on detailed telephone conversations makes up and tells stories; acquires a vocabulary of approximately 10,000–14,000 words by age 6 • uses verb tenses and word order correctly

(continued)

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Table 3–4 Speech and Language Developmental Milestones (continued)

School-age 6–8 years

• • • • • •

enjoys talking and conversing with adults uses language, in place of physical aggression, to express feelings tells jokes and riddles understands complex statements and performs multistep requests finds pleasure in writing stories, letters, and e-mail messages expresses self fluently and in elaborate detail

9–12 years

• • • • • •

talks nonstop understands grammatical sequences and uses them appropriately speaks in longer, complex sentences uses and understands irony and sarcasm achieves mastery of language development becomes a thoughtful listener

Adapted from Marotz, L. R. (2023). Developmental profiles: Pre-birth through adolescence. (9th ed.). Boston, MA: Cengage Learning.

before they use words to verbalize their wants or needs. Children’s language becomes increasingly fluent and complex with maturation and practice. Although many factors influence children’s speech and language development, the ability to hear is especially important during the early years when children are learning to imitate and form sounds, words, and word patterns. Hearing disorders can jeopardize normal speech and language development and lead to long-term impairments. For this reason, a comprehensive hearing evaluation is always recommended when there are concerns about a child’s developmental progress. It is important to consider a child’s home environment when evaluating language development. Families support children’s language skills by reading aloud, engaging children in frequent conversation, and providing literacy-rich opportunities (e.g., books, singing, playing). Homes where these opportunities are lacking may limit children’s ability to develop language, acquire vocabulary, and practice communication skills. Individual family members also play a significant role in children’s language development. Words and speech patterns that children hear in their homes are learned through a process of imitation (Johnson, van Heugten, & Buckler, 2022; Serrat-Sellabona et al., 2021). For example, children who have a parent with an unusual voice inflection or speech impairment may exhibit similar qualities. A family’s cultural values and linguistic variations also exert a strong influence on bilingual children’s language usage, style, speech patterns, and vocabulary (Muhayil & Alnuzaili, 2022; Sohrabi, 2022). Assessment Methods Families are often aware of children’s speech irregularities but may not know if action needs to be taken or where to go for help. Many adults also erroneously believe that children will eventually outgrow these disorders, so they ignore any concerns. Indeed, some children have developmentally appropriate misarticulations that improve with time. For example, it is not unusual for 3-year-olds to mispronounce “r” as “w” as in “wabbit” (rabbit) or “s” as “th” as in “thong” (song); by age 4 or 5 they can correctly pronounce these letter sounds. Children who demonstrate prolonged speech irregularities should be referred for professional evaluation and hearing screening (Chow, Frey, & Naples, 2021; Wilson et al., 2022). Speech and hearing clinics are often affiliated with colleges and universities, medical centers, child

speech – the process of using words to express one’s thoughts and ideas. misarticulations – improper pronunciations of words and word sounds.

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development centers, public health departments, public schools, and Head Start programs. Certified speech and hearing specialists can also be found in telephone or online directories, or by contacting local school districts or the American Speech, Language, and Hearing Association. Efforts to conduct virtual speech evaluations have shown positive results and the potential for reaching more children, especially those who reside in underserved areas (Werfel et al., 2021). Common Disorders The term speech impairment has many different meanings to persons who work with children. For some, the term implies obvious problems, such as stuttering, lisping, or unintelligent speech patterns. For others, any deviation may be cause for concern, such as a monotone voice, nasality, improper pitch of the voice, a voice tone that is too high or too low, misarticulations, or omissions of certain letter sounds. Delayed language development or abnormal speech patterns that persist for more than a few months should be evaluated and include: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

no speech by 2 years of age stuttering substitution of word sounds rate of speech that is too fast or unusually slow monotone voice no improvement in speech development speech by age 3 that is difficult to understand inattentive behavior or ignoring others

Management Teachers play an important role in supporting families’ efforts to promote children’s speech and language development through reading and engaging in frequent conversation. They also play a critical role in identifying and referring children who have speech and language patterns that are developmentally inappropriate or that interfere with effective communication. Significant improvements can often be achieved when disorders are identified and treated in the early stages. 3-2f

Nutritional Status

The quality of children’s diets has an unquestionable effect on brain development, behavior, and health (Costello, Geiser, & Schneider, 2021; Roberts et al., 2022). However, rising costs and economic struggles have forced many families to sacrifice the nutritional value and quantity of foods they purchase and serve to children. Television advertising, fast-food consumption, and increasing reliance on prepackaged and convenience foods have contributed to a further decline in children’s nutrient intake at a time when obesity rates remain high. Clues regarding a child’s nutritional status can be noted during daily health observations. Signs such as facial pallor, dry skin, bleeding gums, lethargy, or frequent illness may reflect poor eating habits. In contrast, a healthy, well-nourished child can be expected to have: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

height appropriate for age weight appropriate for height bright, clear eyes—no puffiness, crusting, or paleness of inner lids clear skin—good color; no pallor or scaliness teeth—appropriate number for age; no cavities or mottling gums—pink and firm; not puffy, dark red, or bleeding lips—soft, moist; no cracking at corner of mouth tongue—pink; no cracks, white patches, or bright red color

pallor – paleness. lethargy – a state of inaction or indifference. mottling – marked with spots of dense white or brown discoloration.

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Assessment Methods Selecting an appropriate method for evaluating children’s nutritional status depends upon the child’s age, reason for concern, type of information desired, and available resources. Common methods include: ◗

◗

◗

◗

dietary assessment—used to determine nutrient adequacy and deficiencies in the child’s eating patterns. Food intake is recorded for a specified period (24 hours, 3 days, 1 week) (Figure 3–3). The data are analyzed with nutrient software, Reference Daily Intakes (RDIs), or MyPlate. (See Chapter 12.) anthropometric assessment—utilizes height, weight, BMI, and head circumference measurements that are compared to standardized norms. Skinfold thickness and mid-arm circumference measurements may also be taken to estimate body fat percentage. clinical assessment—involves observing a child for signs of nutrient deficiency. This method is not considered reliable due to its subjective nature. Also, physical symptoms typically do not appear until a deficiency is severe. biochemical assessment—involves laboratory testing of various body tissues and fluids (e.g., urinalysis, hemoglobin [testing for iron level]) to validate concerns related to nutrient over- or underconsumption. These tests must be ordered by a health care provider and performed by trained laboratory technicians.

Common Disorders Conditions caused by the over- or underconsumption of nutrients can have a significant effect on children’s health and development. Malnutrition, for example, occurs when children’s diets lack essential nutrients, especially protein, vitamins A and C, iron, calcium, and potassium, for prolonged periods. Misinformation, lack of nutrition knowledge, poverty, and food insufficiencies may leave children malnourished simply because they do not get enough to eat or are consuming unhealthy foods (Gol, Kheirouri, & Ali, 2022). Long-term use of medications such as steroids, antibiotics, and laxatives or lack of exposure to sunshine can interfere with nutrient absorption and leave children depleted of essential vitamins and minerals. Malnourished children often fail to reach typical growth and developmental standards and are at greater risk for behavior and learning problems, communicable illness, infection, chronic irritability, anemia, and fatigue. However, not all malnourished children are thin and emaciated. Overweight children can also be malnourished because their diets lack the proteins, vitamins, and minerals essential for healthy growth and development. Obesity also presents a serious challenge to children’s health and development. Approximately 22.4 percent of all children in the United States are considered obese or overweight for their age (State of Childhood Obesity, 2022). Researchers have reported a doubling of this number (to almost 45 percent) during the COVID-19 pandemic (Lange et al., 2021; St. Pierre et al., 2022; Woolford et al., 2021). Although the causes of childhood obesity are multiple and complex, the primary factors point to inactivity, unhealthy eating behaviors, and insufficient sleep. Because these patterns are well-established during the early years and often persist throughout adulthood, it is important that corrective measures be taken while children are young. Children who are overweight or obese are at significantly greater risk for developing life-threatening health problems including heart disease, stroke, sleep apnea, asthma, and diabetes. They also experience a higher rate of bullying, psychological problems, and academic failure (Martino et al., 2022; Uslu & Evgin, 2022). Management Obesity in young children cannot be ignored. Although prevention is always ideal, steps can be taken to help children of any age implement healthy eating, sleep, and activity behaviors (Andino et al., 2022; Forseth et al., 2022; Tamayo, Dobbs, & Pincu, 2021). For maximum skinfold – a measurement of the amount of fat under the skin; also referred to as fat-fold measurements.

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Figure 3–3 Sample questionnaire for obtaining information about a child’s eating habits. DIETARY ASSESSMENT Dear Parent: Nutrition is a very important part of our program. In order to plan appropriate nutrition-education activities and menus, we would like to know more about your child’s eating patterns. Please take the time to fill out the questionnaire carefully. CHILD’S NAME ______________________________________________ AGE __________

DATE ________________

1. How many days a week does your child eat the following meals or snacks? a morning meal ________________ a midafternoon snack ________________ a lunch or midday meal an evening snack ________________ ________________ an evening meal snack during the night ________________ ________________ a midmorning snack ________________ 2. When is your child most hungry? morning ________________ noon ________________ evening ________________ 3. What are some of your child’s favorite foods? _________________________________________________ 4. What foods does your child dislike? _________________________________________________________________________________________ 5. Is your child on a special diet? Yes ________________

No ________________

If yes, why? ______________________________________________________________________________ Describe diet ____________________________________________________________________________ Diet prescribed by whom? ________________________________________________________________ 6. Does your child eat things not usually considered food, e.g., paste, dirt, paper?___________________ If yes, what is eaten? ________________________________________________________________________ How often? ________________________________________________________________________ 7.

Is your child taking a vitamin or mineral supplement? Yes ______________

No ______________

If yes, what kind? _______________________________

8. Does your child have any dental problems that might create a problem when eating certain foods?_______________________________ 9. Does your child see a dentist regularly?________________ 10. Does your child have any diet-related health problems? Diabetes ________________ Allergies _______________________ Lactose Intolerance ___________________ Other ___________________ 11.

Is your child taking any medication for a diet-related health problem? _________________________________________________________________________________________

12. How much water does your child typically drink throughout the day? _________________________________________________________________________________________ 13. Please list any foods that should be included or avoided for cultural or religious reasons. _________________________________________________________________________________________ 14. Please list as accurately as possible what your child eats and drinks on a typical day. If yesterday was a typical day, you may use those foods and drinks. TIME

PLACE

FOOD

AMOUNT

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▼ Encouraging children’s physical activity is an effective weight management strategy.

success, weight management approaches must include the collaborative efforts of the child, family, teachers, and health care personnel, and target:

meal planning and establishing healthy eating habits ◗ strategies for increasing children’s daily activity level (for example, children can be asked to run errands, walk a pet, help with daily household chores, or ride their bike to school) ◗ acquainting children with new outside interests, hobbies, or activities, such as hiking, swimming, dancing, roller skating, yoga, soccer, or learning to ride a bike (involvement in fun activities can divert children’s attention away from food) ◗ finding ways to help children experience success and develop a positive self-image (for example, acknowledging children’s efforts, creativity, and kindness can boost self-esteem; for many children, positive adult attention replaces food as an important source of personal gratification) ◗

Long-term weight management is achieved by attending to all aspects of a child’s wellbeing—physical, emotional, spiritual, and social. It is not advisable to place children on a weight reduction plan unless they are under a doctor’s or dietitian’s close supervision. Weight reduction programs must be planned carefully to meet children’s critical nutrient needs for sustained growth and development. Adults who model healthy eating practices and an active lifestyle can also have a positive influence on children’s food preferences and weight management behaviors. Additional ideas for healthy eating and physical activities are included throughout the book and available on numerous websites, including the President’s Council on Sports, Fitness, & Stop and Check #4 Nutrition (https://health.gov/our-work/nutrition-physical-activity/presidents What role can teachers play in -council), the USDA’s MyPlate for Kids (https://www.choosemyplate.gov), reducing childhood obesity? the CDC’s Healthy Schools (https://www.cdc.gov/healthyschools), and SHAPE America (https://www.shapeamerica.org). 3-3

Referrals

A referral is made by sharing observation and screening test results with a child’s family and assisting them in identifying appropriate follow-up resources. Referrals are most successful when teachers have established cooperative and trusting partnerships with children’s families. Knowing something about their beliefs, customs, values, and community resources improves a teacher’s ability to make effective referrals. For example, mistrust of the medical profession, poverty, job conflicts, linguistic misunderstandings, religious beliefs, a lack of transportation, or limited education may affect a family’s ability and willingness to follow through with any recommendation. Meeting with the child’s family, or calling them on the telephone, is often the most effective method for making referrals: Teacher: “I have concerns about Ryan’s vision. On several occasions, I have noticed that his right eye turns inward more than the left eye and that he holds his head close to materials when he is working. Have you observed any of these behaviors at home?” Parent: “Yes, but we didn’t think it was anything to worry about. We thought he was just tired or trying to be funny.” referral – directing an individual to other sources, usually for additional evaluation or treatment.

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Teacher: “I would encourage you to have Ryan’s vision checked by an eye specialist just to be sure that everything is okay. I will give you a copy of my observations to take along. Please let me know if I can be of assistance in locating a doctor, and I look forward to learning the results of Ryan’s evaluation.”

Although a face-to-face meeting with the child’s family is always preferable, a well-written letter or e-mail may be the only way to reach some families. A copy of screening test results should also be included. This information can help medical personnel understand how the child’s vision is affecting their behavior. Teachers can also alleviate some of the family’s anxiety by offering information about local resources, such as hospitals, clinics, health departments, public and private agencies, volunteer organizations, and funding sources where services can be obtained. A follow-up contact should always be made after several days to determine if families have been successful in securing a professional evaluation. The occasion can Stop and Check #5 also be used to learn about the child’s diagnosis, treatment plan, and any instructional or environmental modifications that a teacher may need to What advantages do face-toface referrals have over other make. It is also an ideal time to acknowledge the family’s efforts in followcommunication options? ing through with recommendations and to convey the teacher’s genuine interest in the child’s well-being. Partnering with Families Children’s Eye Safety Dear Families, Each year, thousands of children sustain eye injuries as the result of hazardous conditions at home or school. Most injuries are preventable through proper supervision, careful selection of toys and equipment, and use of appropriate eye protection. You play an important role in identifying potentially dangerous situations and taking steps to protect children from unnecessary exposure or risk. It is also important that you take similar precautions to protect your own eye safety and serve as a positive role model for children. ◗ Never shake an infant! Vigorous shaking can cause serious eye damage and blindness. ◗ Make sure that children wear sunglasses whenever they play outdoors to limit exposure

to ultraviolet (UV) light. Over time, UV exposure increases the risk of developing serious eye conditions, including macular degeneration and cataracts. Purchase sunglasses that fit closely, wrap around the entire eye area, and provide UV-A and UV-B protection. ◗ Keep children indoors whenever mowing, edging the lawn, or using a snow or leaf blower.

Stones, sticks, and small debris can become dangerous projectiles. ◗ Select toys and play equipment based on your child’s age and abilities. Avoid toys with

projectile parts, such as darts, slingshots, pellet guns, and missile-launching devices. ◗ Monitor children’s access to items, such as stones, rubber bands, balls, wire coat hangers,

and fishhooks that pose a serious eye danger. ◗ Supervise children closely whenever they are using a sharp item, such as a fork, pencil,

toothpicks, wire, paperclips, scissors, or small wooden dowels. ◗ Keep children away from fireworks. Do not allow them to light fireworks or to be near any-

one while they are doing so. ◗ Lock up household cleaners, sprays, paints, paint thinners, and chemicals such as garden

fertilizers and pesticides that could injure children’s eyes. ◗ Make sure children wear appropriate protective eyewear such as goggles when working

with tools, or a helmet with a face guard when participating in sports. ◗ Don’t allow children to shine a laser pointer or aim a squirt gun or spray nozzle toward anyone’s eyes. ◗ Remind children to avoid touching their eyes with unwashed hands.

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Classroom Corner Teacher Activities My Five Senses… (NHES PreK–2; National Health Education Standard 1.2.2)

Concept: Seeing, hearing, tasting, touching, and smelling are your five senses.

Learning Objectives ◗ Children will learn to name all five senses. ◗ Children will learn which body parts are associated with each of the senses: see with eyes,

hear with ears, taste with tongue, touch with fingers and skin, and smell with nose.

Supplies ◗ Small blanket; various objects (items that children can label—plastic foods, animals, people,

and so on); small paper cups; tin foil; various scents or foods (vanilla, orange peel, ketchup, peppermint, chocolate, ranch dressing, green pepper, etc.); tape recording of children’s and teachers’ voices; feely box; various items with shapes that children can recognize (ball, pine cone, banana, block, plate, cup, and so on); salty (crackers), sweet (mandarin orange), sour (lemon), and bitter (unsweetened chocolate) items; disinfecting hand wipes; plates; forks

Learning Activities ◗ Read and discuss the following books: ● ● ● ●

Your Five Senses by Bobbi Katz The Sense of Hearing by Elaine Landau You Smell with Your Nose by Melvin Berger You Touch with Your Fingers by Melvin & Gilda Berger

◗ Each day, discuss one of the five senses and have the children participate in an activity. ◗ Seeing—Tell the children that you are going to play a game called “What’s Missing?” This is

a game that uses their sense of sight. Lay four or five objects out on the floor in front of the children and name each item. Cover the items with the towel. Remove one of the items and wrap it in the towel. Ask children to guess which item is missing. Call on children one at a time; if they name the missing item, ask them to come up and hide the next item. Continue until all children have had a turn. Vary the toys to keep children interested. ◗ Smelling—Tell the children that you are going to do an activity to learn about their sense of

smell. Make “smelling cups.” For liquid scents, put a few drops on a cotton ball and place it in the cup. Cover the cup with foil in which holes have been poked. Pass the cups around. Have children try to name the smell in each cup. After each child has had a chance to smell each cup, remove the foil so they can see if they were correct. ◗ Hearing—Make a recording of the teachers and children while they are playing. On another

day, tell the children that they will use their sense of hearing for this activity. Play the recording and see if the children can guess whose voices they are hearing on the tape. ◗ Feeling—Tell the children that this activity will involve using their sense of touch. Place vari-

ous items in a feely box. Have each child reach in and use their sense of touch to identify the object. ◗ Tasting—Tell the children you are going to have them taste different items to see if they are

sweet, sour, salty, or bitter. Talk about the taste buds on their tongue (look in a mirror) and how they help us to taste flavors in food. Next, have the children wash their hands with a wipe. Place a cracker, a mandarin orange, a small piece of lemon, and bit of unsweetened chocolate on each plate, and set a plate in front of each child. Have the children taste one item at a time and talk about the different flavors.

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Classroom Corner Teacher Activities (continued) Assessment ◗ Children will name each of the five senses. ◗ Children will name which body parts are associated with each sense.

Summary ◗

Teachers play an important role in monitoring and assessing children’s health Information about children’s physical and mental health status can be obtained from a variety of sources, including teacher observations, health records, screening procedures, daily health checks, and interactions with families. ● Assessment information is used to identify children who require professional evaluation, make referrals, and modify children’s learning environments to accommodate any special needs. Screening tools provide a relatively quick and inexpensive way to evaluate groups of children for a variety of conditions, including height/weight, BMI, vision and hearing disorders, speech and language irregularities, and nutritional status. ● The results of screening procedures are not diagnostic by themselves; they do not confirm that a child does or does not have a disorder. They should only be used to identify children who require additional evaluation. Teachers can initiate the referral process after gathering and evaluating information about a child’s health from multiple sources. ● A follow-up contact should always be made with the child’s family to learn about assessment outcomes, treatment recommendations, and any classroom modifications that may be needed. ●

◗

◗

◖◗ Terms to Know intervention p. 56 skeletal p. 58 neurological p. 58 underweight p. 59 overweight p. 59 obese p. 59 ophthalmologist p. 60 optometrist p. 60 acuity p. 61

amblyopia p. 62 strabismus p. 63 myopia p. 63 hyperopia p. 64 cultural competence p. 65 audiologist p. 66 conductive loss p. 68 sensorineural loss p. 68 mixed hearing loss p. 68

speech p. 70 misarticulations p. 70 pallor p.71 lethargy p. 71 mottling p. 71 skinfold p. 72 referral p. 74

◖◗ Chapter Review A. By Yourself: 1. Define each of the Terms to Know listed above. 2. Select the recommended screening test to use with children who exhibit the following behaviors, signs, or symptoms. Place the appropriate code letter in each space for questions 1–15. H Hearing screening V Vision screening D Developmental screening HW Height and weight Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Dt S N _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______

Dental screening Speech evaluation Nutrition evaluation 1. blinks frequently; often closes one eye when reading 2. stutters whenever tense, excited, or in a hurry to speak 3. appear listless and small for their chronological age 4. stumbles over objects in the classroom; frequently bumps into other children or play equipment 5. has overlapping and missing teeth that make speech difficult to understand 6. ignores the teacher’s requests; pushes and shouts at the other children to get their attention 7. is obese and experiences shortness of breath when running and playing 8. has trouble catching a ball, pedaling a bicycle, and cutting with scissors 9. turns head to focus on objects with one eye while the other eye appears to look in another direction 10. a toddler who has multiple cavities and refuses to chew solid foods 11. is extremely shy and withdrawn; spends most of their time playing alone and imitating other children’s actions 12. seems extremely hungry at snack time; always asks for extra servings and takes food from other children’s plates when the teacher isn’t looking 13. becomes hoarse after shouting and yelling while playing outdoors 14. arrives at school each morning with potato chips, candy, or a cupcake and soda 15. a 4½-year-old who whines and has tantrums to get their own way

B. As a Group: 1. Identify and describe the vision disorders most commonly experienced by young children. What behavioral indicators might a teacher observe? How is each disorder typically treated? 2. Discuss how teachers might use information in health records to improve learning experiences for children with special sensory needs? 3. Discuss how the learning activities outlined in the Classroom Corner feature could be modified for a child who is blind or has low vision. How might they be adapted for a child with significant hearing loss? 4. Brainstorm ideas for ways that teachers can incorporate more physical activity into classroom routines to help children achieve the recommended 60 minutes of vigorous daily activity. 5. Debate the question: Should teachers calculate children’s BMI and inform families if their child is overweight? Role-play how a teacher might share this information with an unreceptive parent and offer suggestions for improving the child’s nutrition and physical activity. Critique each other’s responses. 6. If a family asks where they can get their 2-year-old’s hearing tested, what resources in your community would you recommend?

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◖◗ Case Study A friend encouraged Mrs. Okoro to take her son to the developmental screening clinic being held this week at the community recreation center. Maduka is almost 3 years old and speaks only a few words that are understandable. He has few opportunities to play with other children of his age because he spends most days with his grandmother while his mother works at a nearby hospital. On the day of the developmental screening, team members checked Maduka’s height, weight, vision, hearing, speech, cognitive abilities, and motor skills. The team leader also read through the child history form that Mrs. Okoro completed and noted that Maduka has several food allergies, as well as frequent upper respiratory and ear infections. Maduka’s hearing test revealed a significant loss in one ear and a moderate loss in the other. 1. Is Maduka’s speech development appropriate for his age? Explain. 2. What significance might Maduka’s ear infections have to his hearing loss? How might his food allergies be contributing to the loss? 3. Should the screening team’s recommendation for Maduka include a referral to his physician? Why? 4. What behavioral signs of hearing loss might you expect Maduka to exhibit?

◖◗ Application Activities 1. Locate and read instructions for administering the single-surround HOTV letters or Teller Acuity Cards screening tests. Pair up with another student and practice testing each other. Alternatively, volunteer to conduct vision screening at a local early childhood program or shelter for homeless families. What advantages does each test offer? Disadvantages? Did you encounter any problems administering the test? How would you modify your instructions to a child based upon this experience? 2. Devise a monitoring system that can be used in a group setting to record the daily food intakes of individual children. Be sure to address the following questions: a. What nutritional information do you want to collect? In what form? b. Who will be responsible for collecting this data? c. How can this information be obtained efficiently? d. How can teachers and families use these data to improve children’s eating habits? e. What other ways might teachers use this information to promote children’s health? 3. Collect samples of child history forms from several schools and early childhood programs in your area. Review the type of information that is most often requested. Design your own form and distribute it to several families for their comments and suggestions. 4. Attend a signing class. Learn to say “hello” and “good-bye” and 10 additional words in sign language. 5. Conduct a comparison study of children’s growth at a local school or early childhood program. Measure the height and weight of 15 children, ages 3 to 6 years, and record on a standard Growth Chart (https://www.cdc.gov/growthcharts). Next, determine each child’s BMI and plot this information on the BMI-for-age charts. Which method provides the most accurate information about children’s growth? What did you learn about the children’s potential risk for becoming overweight? Learn more about the BMI measure and initiatives for preventing childhood obesity at the CDC website (https://www.cdc.gov).

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6. Spread Vaseline or butter on one lens (right or left) of an old pair of sunglasses. Compose a text message, assemble a puzzle, go for a walk, and/or prepare a meal while wearing the glasses. What condition does this activity simulate? Discuss the experience and how it affected your ability to perform various tasks. 7. Contact your local American Heart Association chapter or conduct an online search to learn about educational programs that target children’s cardiovascular health. Are the materials/ programs developmentally appropriate? How is improved cardiac health measured?

◖◗ Stop and Check Responses #1. Schools are legally obligated to obtain written parental or guardian permission before releasing any information pertaining to a child’s health or performance. #2. Early detection of amblyopia is critical for regaining sight and preventing further vision loss in the affected eye. #3. Measures to lower children’s risk of developing myopia include reducing their use of digital media and increasing time spent outdoors. #4. Teachers can help to lower children’s obesity risk by engaging them in more physical activity, providing nutritious foods, and teaching about healthy eating, sleeping, and physical activity behaviors. #5. Face-to-face referrals allow teachers to determine if parents understand the information they have received (e.g., body language, facial expressions). Parents may also feel more comfortable asking questions in-person.

◖◗ Additional Resources to Explore American Speech, Language, and Hearing Association (ASHA)

https://www.asha.org

National Association of Parents with Children in Special Education

https://www.napcse.org

National Institutes of Health

https://www.nih.gov

Optometrists Network

https://www.optometrists.org

Prevent Blindness

https://www.preventblindness.org

Action for Healthy Children

http://www.actionforhealthykids.org

◖◗ References Adugna, M. B., Nabbouh, F., Shehata, S., & Gharhari, S. (2020). Barriers and facilitators to healthcare access for children with disabilities in low and middle income sub-Saharan African countries: A scoping review. BMC Health Services Research, 20(1), 15. https://doi.org/10.1186/s12913-019-4822-6 Alvarez-Peregrina, C., Martinez-Perez, C., Villa-Collar, C., Andreu-Vázquez, C., Ruiz-Pomeda, A., & Sánchez-Tena, M. A. (2021a). Impact of COVID-19 home confinement in children’s refractive errors. International Journal of Environmental Research and Public Health,18(10), 5347. https://doi.org/10.3390/ijerph18105347 Alvarez-Peregrina, C., Villa-Collar, C., Andreu-Vázquez, C., & Sánchez-Tena, M. A. (2021b). Influence of vision on educational performance: A multivariate analysis. Sustainability, 13(8), 4187. https://doi.org/10.3390/su13084187 American Association for Pediatric Ophthalmology and Strabismus (AAPOS). (2021). Strabismus. Retrieved from https://aapos.org/glossary/strabismus. Andino, J., Park-Mroch, J., Francis, S. L., O’Shea, A. M., Engebretsen, B., Rice, S., & Laroche, H. H. (2022). A randomized controlled trial of a community-based obesity intervention utilizing motivational interviewing and community resource mobilization for low-income families: Study protocol and baseline characteristics. Contemporary Clinical Trials, 112, 106626. https://doi.org/10.1016/ Barrio, B. L. (2021). Understanding culturally responsive practices in teacher preparation: An avenue to address disproportionality in special education. Teaching Education, 32(4), 437–456.

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Birch, E. E., Kelly, K. R., & Wang, J. (2021). Recent advances in screening and treatment for amblyopia. Ophthalmology and Therapy, 10(4), 815–830. Boniquet-Sanchez, S., & Sabater-Cruz, N. (2021). Current management of amblyopia with new technologies for binocular treatment. Vision, 5(2), 31. https://doi.org/10.3390/vision5020031 Burstein, O., Zevin, Z., & Geva, R. (2021). Preterm birth and the development of visual attention during the first 2 years of life: A systematic review and meta-analysis. JAMA Network Open, 4(3), e213687. https://doi.org/10.1001 /jamanetworkopen.2021.3687 Buterin, T., Muzur, A., & Glažar, B. (2021). Saints and “Possession”: A case review bordering ethnopsychiatry and cultural diversity. Journal of Religion and Health, 60(2), 1116–1124. Centers for Disease Control and Prevention (CDC). (2019). Data and statistics about hearing loss in children. Retrieved from https://www.cdc.gov/ncbddd/hearingloss/data.html. Centers for Disease Control and Prevention (CDC). (2020). Fast facts of common eye disorders. Retrieved from https://www.cdc.gov/visionhealth/basics/ced/fastfacts.htm. Cetinkaya, E. A., & Topsakal, V. (2022). Acute otitis media. In Cingi, C., Arısoy, E. S., & Bayar, M. N. (Eds.). Pediatric ENT Infections. Springer, Cham. https://doi.org/10.1007/978-3-030-80691-0_33 Child and Adolescent Health Measurement Initiative. (2022). 2019-2020 National Survey of Children’s Health (NSCH). Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved from www.childhealthdata.org. Chow, J. C., Frey, J. R., & Naples, L. H. (2021). Associations between teacher ratings and direct assessment of elementary students’ speech and language skills. Assessment for Effective Intervention, 46(4), 310–315. Cumberland, P. M., Bountziouka, V., Hammond, C. J., Hysi, P. G., & Rahi, J. S. (2022). Temporal trends in frequency, type and severity of myopia and associations with key environmental risk factors in the UK: Findings from the UK Biobank Study. PLoS One, 17(1), e0260993. https://pubmed.ncbi.nlm.nih.gov/35045072 Falcone, M. M., Hunter, D. G., & Gaier, E. D. (2021). Emerging therapies for amblyopia. Seminars in Ophthalmology, 36(4), 282–288. Forseth, B., Hampl, S., Gillette, M. D., Foright, R. M., Gibson, M., Vandal, J., Moon, M., & Beck, A. R. (2022). Incorporating yoga into a pediatric weight management program: A pilot study. Child Obesity, 18(1), 67–71. Gol, R. M., Kheirouri, S., & Ali, M. (2022). Association of dietary diversity with growth outcomes in infants and children aged under 5 years: A systematic review. Journal of Nutrition Education and Behavior, 54(1), 65–83. Johnson, E. K., van Heugten, M., & Buckler, H. (2022). Navigating accent variation: A developmental perspective. Annual Review of Linguistics, 8(1), 365–387. Lange, S. J., Kompaniyets, L., Freedman, D. S., Krause, E. M., Porter, R., Blanck, H. M., & Goodman, A. B. (2021). Longitudinal trends in body mass index before and during the COVID-19 pandemic among persons aged 2–19 years — United States, 2018–2020. Morbidity and Mortality Weekly Report (MMWR), 70(37), 1278–1283. Lindly, O. J., Chan, J., Fenning, R. M., Farmer, J. G., Neumeyer, A. M., Wang, P., Swanson, M., Parker, R. A., & Kuhlthau, K. A. (2021). Vision care among school-aged children with autism spectrum disorder in North America: Findings from the Autism Treatment Network Registry Call-Back Study. Autism, 25(3), 840–853. Liu, J., Li, B., Sun, Y., Che, Q., & Dang, J. (2021). Adolescent vision health during the outbreak of COVID-19: Association between digital screen use and myopia progression. Frontiers in Pediatrics, 9, 662984. https://pubmed.ncbi. nlm.nih.gov/34113588/ Marotz, L. R. (2023). Developmental profiles: Pre-birth through adolescence. (9th ed.). Boston, MA: Cengage Learning. Martino, S., Agbelie, C., Mei, W., & Morelli, P. (2022). Inclusion team science improves participation of children with disabilities in pediatric obesity programs. Disability and Health Journal, 15(1), 101186. https://doi.org/10.1016/j .dhjo.2021.101186 Montenegro, M. C., Abdul-Chani, M., Valdez, D., Rosoli, A., Garrido, G., Cukier, S., Paula, C. S., Garcia, R., Rattazzi, A., & Montiel-Nava, C. (2022). Perceived stigma and barriers to accessing services: Experiences of caregivers of autistic children residing in Latin America. Research in Developmental Disabilities, 120, 104123. https://doi .org/10.1016/j.ridd.2021.104123 Muhayil, M. M., & Alnuzaili, E. S. (2022). The effect of using simulation strategy in developing English as a foreign language speaking skill. Journal of Language Research and Teaching, 13(1), 198–306. National Conference of State Legislators (NCSL). (2022). Newborn hearing screening state laws. Retrieved from https://www.ncsl.org/research/health/newborn-hearing-screening-st.ate-laws.aspx. Neena, R., Gopan, A., Nasheetha, A., & Giridhar, A. (2022). Can photoscreening effectively detect amblyogenic risk factors in children with neurodevelopmental disability? Indian Journal of Ophthalmology, 70(1), 228–232. Novak, M., & Schwan, S. (2021). Does touching real objects affect learning? Educational Psychology Review, 33, 637–665. Patel, S., & Olympia, R. P. (2022). School nurses on the front lines of healthcare: Getting aHEAD of emergent eye, ear, nose, and throat infections. National Association of School Nurses (NASN), 37(1), 25–30. Poole, K. J., Derouin, A., Yap, T. L., & Thompson, J. A. (2021). Implementation of photoscreening to improve the preschool vision screening process. The Journal for Nurse Practitioners, 17(8), 1015–1018.

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Qian, Z. J., Nuyen, B. A., Kandathil, C. K., Truong, M-T., AuD, M. S. T., Most, S. P., & Chang, K. W. (2021). Social perceptions of pediatric hearing aids. Laryngoscope, 131(7), E2387–E2392. Roberts, M., Tolar-Peterson, T., Reynolds, A., Wall, C., Reeder, N., & Mendez, G. R. (2022). The effects of nutritional interventions on the cognitive development of preschool-age children: A systematic review. Nutrients, 14(3), 532. https://doi.org/10.3390/nu14030532 Sen, S., Singh, P., & Saxena, R. (2022). Management of amblyopia in pediatric patients: Current insights. Eye, 36(1), 44–56. Serrat-Sellabona, E., Aguilar-Mediavilla, E., Sanz-Torrent, M., Andreu, L., Amadó, A., & Serra, M. (2021) Sociodemographic and pre-linguistic factors in early vocabulary acquisition. Children, 8(3), 206. https://doi.org/10.3390 /children8030206 Shin, M. (2021). Exploring multisensory experiences in infants’ learning and development in the child care. Early Child Development and Care, 191(13), 2116–2127. Sohrabi, T. (2022). To raise a bilingual or a monolingual child: Concerns of an immigrant mother. Canadian Journal of Family and Youth, 14(1), 23–37. St. Pierre, C., Guan, W., Merrill, J., & Sacheck, J. M. (2022). Urban youth perspectives on food insecurity during the COVID-19 pandemic: Evidence from the COACHES study. Nutrients, 14(3), 455. https://doi.org/10.3390 /nu14030455 State of Childhood Obesity. (2022). From crisis to opportunity: Reforming our nation’s policies to help all children grow up healthy. Retrieved from https://stateofchildhoodobesity.org/. Tamayo, M. C., Dobbs, P. D., & Pincu, Y. (2021). Family-centered interventions for treatment and prevention of childhood obesity in Hispanic families: A systematic review. Journal of Community Health, 46(3), 635–643. Trudeau, S., Anne, S., Otteson, T., Hopkins, B., Georgopoulos, R., & Wentland, C. (2021). Diagnosis and patterns of hearing loss in children with severe developmental delay. American Journal of Otolaryngology, 42(3), 102923. https://doi.org/10.1016/j.amjoto.2021.102923 Tsumi, E., Lavy, Y., Wainstock, T., Barrett, C., Imtirat, A., & Sheiner, E. (2021). Maternal smoking during pregnancy and long-term ophthalmic morbidity of the offspring. Early Human Development, 163,105489. https://10.1016/j. earlhumdev.2021.105489 Uslu, N., & Evgin, D. (2022). Bullying and coping with bullying among obese\overweight and normal weight children. Archives in Psychiatric Nursing, 36, 7–16. Werfel, K. L., Grey, B., Johnson, M., Brooks, M., Cooper, E., Reynolds, G., Deutchki, E., Vachio, M., & Lund, E. A. (2021). Transitioning speech-language assessment to a virtual environment: Lessons learned from the ELLA study. Language, Speech, and Hearing Services in Schools, 52(3), 769–775. Wilson, P., Rush, R., Charlton, J., Gilroy, V., McKean, C., & Law, J. (2022). Universal language development screening: Comparative performance of two questionnaires. BMJ Paediatric Open, 6(1), e001324. https://www.ncbi.nlm.nih. gov/pmc/articles/PMC8739429/ Wong, C. W., Tsai, A., Jonas, J. B., Ohno-Matsui, K., Chen, J., Ang, M., & Ting, D. S. W. (2021). Digital screen time during the COVID-19 pandemic: Risk for a further myopia boom? American Journal of Ophthalmology, 223, 333–337. Woolford, S. J., Sidell, M., Li, X., Else, V., Young, D. R., Resnicow, K., & Koebnick, C. (2021). Changes in body mass index among children and adolescents during COVID-19 pandemic. JAMA, 326(14), 1434–1436. Zhai, F., Fang, X., Li, Y., Chen, H., & Chen, J. (2021). Risk factors for failure in first-time hearing screening tests among high-risk neonates in neonatal intensive care unit. Audiology and Neurotology, 26(5), 338–345.

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chapter

2 4

Caring for Children with Daily Health Observations Medical Conditions Professional Standards Linked to Chapter Content

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#1a, b, c, and d Child development and learning in context #2a, b, and c Family–teacher partnerships and community connections #3a, b, c, and d Child observations, documentation, and assessment #4a and b Developmentally, culturally, and linguistically appropriate teaching practices

Learning Objectives After studying this chapter, you should be able to:

LO 4-1 Describe how IDEA serves children who have special developmental and medical needs. LO 4-2 Name and discuss the symptoms and management strategies for several common medical conditions addressed in this chapter.

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Children who have disabilities, medical conditions, and chronic diseases are often present in early childhood and school-age classrooms. This means that teachers must be able to respond to children’s educational, health, and medical needs. They also play an instrumental role in identifying children who may have undiagnosed conditions that require medical evaluation and treatment. Early identification, referral to appropriate professionals, and intervention strategies have proven successful in minimizing the negative effects that undiagnosed health conditions can have on children’s developmental progress, behavior, and ability to learn (Meinzen-Derr et al., 2022). The purpose of this chapter is to provide brief descriptions of several acute and chronic medical conditions to help prepare teachers for their role in supporting children in the classroom. 4-1

Inclusive Education: Supporting Children’s Success

The practice of including and integrating children of varying abilities and limitations together in the same classroom is commonly referred to as inclusion or inclusive education. If teachers understand that all children are uniquely different, they can individualize instruction so that it supports and builds on each child’s strengths. For example, some children may have recently immigrated and are learning a new language, others may be budding artists or innovative thinkers, and still others may present troubling behaviors or special health conditions. Fundamentally, all children are similar, despite their individual differences, and have the same basic human needs (i.e., food, shelter, love, attention, dignity, respect) that must be met. They must also have equal access to high-quality educational experiences and opportunities to succeed if they are to achieve their fullest potential. The Americans with Disabilities Act (ADA) was implemented in 1992 to prevent discrimination and to protect the constitutional rights of individuals with a disability. The law applies to early childhood programs and prevents them from denying admission to children who have developmental or health care needs. It requires programs to make reasonable facility modifications and to establish procedures that enable all children to participate fully while protecting their safety and well-being. Prior to 2004, children who had physical or cognitive disabilities were often denied access to regular educational programs. However, passage of the Individuals with Disabilities Education (Improvement) Act (IDEA) now guarantees these children the right to an appropriate education and the special services they need to be successful. IDEA regulations apply to all educational programs that receive federal funding and are administered by the U.S. Department of Education in each state. The law’s requirements strengthen the early identification process, the intervention services provided, and ensure family involvement in children’s education. It also identifies specific health conditions that make a child eligible to receive needed services (Table 4–1). Table 4–1 Disability Categories Eligible for Special Services autism deaf-blindness deafness developmental delay emotional disturbance hearing impairment intellectual disability

multiple disabilities orthopedic impairments other health impairments specific learning disabilities speech or language impairment traumatic brain injury visual impairment, including blindness

Source: Individuals with Disabilities Education (Improvement) Act of 2004, U.S. Department of Education (https://sites. ed.gov/idea/?src=pr).

inclusion – the practice of including and integrating children of all abilities in a classroom and individualizing instruction to meet each child’s unique learning needs.

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Not all children who have a chronic or acute medical condition will qualify for special education services through IDEA. A child must first undergo a comprehensive evaluation to determine if a health disorder interferes with their developmental progress and educational performance. A child who is eligible to receive special services will have an educational plan formulated according to IDEA guidelines: ◗

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Part B of IDEA provides services to children and youth ages 3 to 22 years. A multidisciplinary team creates an individualized educational plan (IEP) to meet children’s developmental and academic needs. Learning goals are established, intervention services identified, and evaluation or outcome measures are noted. Part C of IDEA serves the needs of children 0 to 3 years of age and their families. An individualized family service plan (IFSP) is prepared in which specific developmental goals, and the intervention services a child needs to help achieve them, are outlined. An individualized health service plan (IHSP) is written for children who have health care needs (e.g., food allergies, medications, medical procedures, special equipment, or transportation needs) that must be addressed during school hours. Plans include safety and emergency considerations as well as ways to collaborate with health care professionals.

Stop and Check #1 Children’s successful inclusion requires that teachers partner with a variety of community specialists to meet children’s health and educational requireA 2-year-old who has autism would qualify for ments. They must also work closely with families to ensure that children’s needs what IDEA service plan? are being met, parents’ concerns are addressed, and progress is being made. It is important that teachers remember to always use person first language when discussing children who have a disease, physical disorder, or developmental difference. For example, instead of identifying a child as asthmatic, blind, autistic, or epileptic, they should be referred to as “Melinda has asthma,” “Jalen is blind,” or “Rico has epilepsy.” When communications are framed in this manner, the child’s individuality, value, and strengths are acknowledged and attention is drawn away from existing limitations. Ideally, reference to a child’s disease or disability should be avoided all together, unless it is essential to the conversation.

Common Chronic Diseases and Medical Conditions

4-2

Some chronic diseases such as anemia and diabetes may be difficult to recognize in children because they have been present since birth. Other conditions, such as allergies, asthma, and lead poisoning, may present few early symptoms and develop slowly over time so that even the child may not be aware that anything is wrong. This means that teachers are likely to encounter children who have chronic medical disorders which have not yet been diagnosed. When teachers have concerns about the possibility of an undiagnosed condition, an ideal starting point is to consider the child’s environmental circumstances. Factors that may contribute to a child’s health condition and also serve as barriers to treatment can include: ◗ ◗

location—living in a violent or dense urban neighborhood, rural area, or being homeless family’s financial situation—may affect dietary quality, living arrangement, and access to medical and dental care

individualized educational plan (IEP) – a plan that identifies specific developmental and academic goals and intervention services for a child or youth 3 to 22 years of age who has special needs. individualized family service plan (IFSP) – a plan that outlines specific goals and intervention services for children 0 to 3 years of age who have special needs and their families. individualized health service plan (IHSP) – a plan that identifies and addresses a child’s special health care needs during school hours. person first language – a manner of addressing an individual first and then their disability; e.g., a child who has autism.

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environmental pollutants—exposure to excessive noise, rodents, or chemicals in air or water toxic stress, maltreatment, or domestic violence family unit—divorce, caregiver death, dysfunctional parenting, foster care

Teachers are not expected to be knowledgeable about the range of medical conditions and diseases that children may present in their classrooms. However, they have access to numerous resources where they can learn more about these disorders. Reliable information is available on numerous professional websites and through local libraries. Community health care providers, such as public health nurses, are often willing to answer questions and to provide expert guidance. Health consultants may be available in some communities to train and work directly with classroom teachers. School nurses in public and some private schools provide similar assistance and are often responsible for administering medications and medical procedures. Additional resources and support may also be available to teachers serving children who have an IEP, IFSP, or IHSP. The remainder of this chapter is devoted to an overview of several common acute and chronic diseases and medical conditions that teachers may encounter in their classrooms. Note that developmental and genetic disabilities have not been included here because they are topics typically addressed in-depth in special education courses and specialized textbooks. 4-2a

Allergic Diseases

Allergies are the leading cause of chronic disease among young children in the United States and may affect as many as one in every five children (AAFA, 2021). The incidence of allergic disease and the increasing number of substances to which children are reacting is raising significant concern. Although many allergic disorders can be successfully treated and controlled, it is estimated that more than 40 to 50 percent of children with symptoms remain undiagnosed (Brown & Yu, 2021; Kanchan et al., 2021). Allergic reactions range in severity from mildly annoying symptoms to those that may severely restrict a child’s activity or even result in unexpected death. Signs and Symptoms A substance capable of triggering an allergic reaction is called an allergen. An inherited error in the body’s immune system causes it to overreact to otherwise harmless environmental substances, such as dust, pollen, foods, chemicals, or medicines, that would not typically bother other persons. Allergic reactions are generally classified according to the body site where contact with the allergen occurs and where symptoms most commonly develop: ◗ ◗

◗

◗

ingestants—cause digestive upsets and respiratory problems. Common examples include foods such as milk, citrus fruits, eggs, wheat, chocolate, tree nuts, peanuts, and oral medications. inhalants—affect the respiratory system causing a runny nose, cough, wheezing, and itchy, watery eyes. Examples include pollens, molds, dust, particulate matter, animal dander, and chemicals such as perfumes and cleaning products. contactants—cause skin irritations, rashes, hives, and eczema. Common contactants include soaps, cosmetics, dyes, fibers, latex, topical medications, and some plants, such as poison ivy, poison oak, and grass. injectables—trigger respiratory, digestive, and skin disturbances. Examples of injectables include medications that are injected directly into the body and insect bites, especially those of bees, wasps, hornets, and spiders.

Children who have chronic allergies often experience irritability and malaise in addition to the discomfort that accompanies an acute reaction. To understand how allergies affect children on a day-to-day basis, consider the generalized fatigue and uneasiness that you experience at the onset of a cold or flu. Certainly, children cannot benefit fully from learning when they are not feeling well. For these reasons, the possibility of an allergic disorder should be investigated

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Chapter 4

Caring for Children with Medical Conditions

because it could be contributing to a child’s learning or behavior problems (e.g., fidgeting, disruptive behaviors, hyperactivity, fatigue, general disinterest, irritability, difficulty concentrating). Teachers can be instrumental in recognizing the early signs of children’s allergic conditions. Daily observations and anecdotal records may reveal patterns of symptoms that can be easy to overlook (Teacher Checklist 4–1). Common signs and symptoms of allergic disorders include: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

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▼ Allergies can cause a range of physical and behavioral symptoms.

frequent colds and ear infections chronic congestion, such as runny nose, cough, or throat clearing; mouth-breathing headaches frequent nosebleeds unexplained stomachaches hives, eczema, or other skin rashes wheezing or shortness of breath intermittent or permanent hearing losses reactions to foods or medications dark circles beneath the eyes mottled tongue frequent rubbing, twitching, or picking of the nose chronic redness of the throat red, itchy eyes; swollen eyelids irritability, restlessness, lack of energy or interest

Approximately 8 percent of all children have an inherited immune disorder that causes a true food allergy and is not outgrown (Chen et al., 2022). However, many children experience unpleasant reactions to specific foods that are incorrectly referred to as food allergies. This type of response is called a food intolerance or food sensitivity and does not involve the immune system; gluten and lactose intolerances are examples. Unlike

Checklist 4–1 ✓✓✓ Teacher Cold or Allergy: How to Tell? Cold

Allergy

Time of year

More likely in fall and winter

Nasal drainage Fever Cough

Begins clear; may turn color after 2–3 days Common with infection May become loose and productive

Depends on what child is allergic to—may be year round or seasonal (fall, spring) Remains clear

Itchy eyes Muscle aches Length of illness

No May be present during first 1–2 days 7–10 days

No fever Usually not productive; nasal drainage irritates the throat causing frequent throat clearing and shallow cough Typical None May last an entire season or year round

food intolerance – unpleasant reactions or sensitivities to a particular food that do not involve an immune response and are usually outgrown.

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food allergies, food intolerances are usually not life-threatening and may eventually be outgrown. Common symptoms of food allergies include: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

hives, skin rashes flushed or pale face cramps, vomiting, and diarrhea headache runny nose, watery eyes, congestion, and wheezing itching or swelling around the lips, tongue, or mouth anxiousness, restlessness shock difficulty breathing

Symptoms of an allergic reaction can develop within minutes or several hours following the ingestion of an offending food. Foods that most commonly trigger allergic reactions are listed in Table 4–2. The Food Allergen Labeling & Consumer Protection Act (2004) requires manufacturers to identify on the food label the inclusion of any of these substances in a product or exposure to any of these ingredients during a product’s preparation. Some food allergies can be severe and potentially life-threatening. For this reason, school administrators and teachers must be prepared to implement safeguards that will protect the child’s well-being (Eigenmann et al., 2021). They must work closely with the child’s family to develop a plan of action in the event of an allergic reaction. A downloadable food allergy and anaphylaxis emergency care plan is available in English and Spanish from the Food Allergy Research & Education (FARE) website (www.foodallergy.org). Extensive resource information about children’s food allergies can also be accessed from this site. A program’s emergency action plan should include telephone numbers and directives for measures to be taken in an emergency. All staff members should be familiar with the child’s plan and review it often; this step is especially important to address with new and substitute teachers. If injectable medications, such as AUVI-Q® or an EpiPen® (epinephrine auto-injector), have been ordered by the child’s physician, teachers should be trained to administer them properly. They should also know how to correctly administer inhaler treatments. Teachers must consider children’s food allergies whenever planning lessons, celebrating holidays or special occasions, or taking field trips. It is also imperative that the cook read food labels carefully and avoid cross-contamination (with other children’s food) when preparing the child’s meals. Any special food items should be labeled with the child’s name and stored away from other foods. A list of children and the foods they are allergic to should be posted inside the classroom. One teacher should be responsible for monitoring, checking, and serving all foods to children who have known allergies to prevent mistakes from occurring. Everyone (adults and children) should wash their hands carefully following a meal or snack to avoid spreading potential food allergens. Teachers can use these opportunities to help children learn about allergies, explain why these precautions are necessary, and discuss why food items must not be exchanged.

Table 4–2 Common Food Allergens

Foods that are most likely to trigger an allergic reaction include: • • • • • • •

eggs milk and milk products such as cheese and ice cream fish and shellfish peanuts tree nuts, such as almonds, cashews, and pecans wheat and wheat products soybeans

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Chapter 4

Caring for Children with Medical Conditions

89

Sharomka/Shutterstock.com

▼ Many children experience pollen allergies.

Management At present, there are no known cures for allergic conditions, only symptomatic control. In some cases, the substances to which a child is allergic may change over time. Although this gives the impression that an allergy has disappeared, it often redevelops years later or the child may become allergic to a different substance. Symptoms and complications of allergies are generally less severe and easier to control if they are identified early. Treatment is aimed at limiting a child’s exposure to troublesome allergens, and, in some cases, involves completely removing the substance(s) from their environment. For example, if a child is allergic to milk, all dairy products should be eliminated from the child’s diet. If the pet dog is a source of a child’s allergies, the dog should be kept outdoors or at least out of the child’s bedroom and frequent hand washing is practiced. In other cases, such as with dust or pollen allergies, it may be feasible to only control the amount of exposure (e.g., keeping doors and windows closed, dusting frequently, eliminating carpets and curtains). Smoking must always be avoided around children who have respiratory allergies because it is known to aggravate and intensify breathing problems (Brindisi et al., 2022). Left untreated, allergies can lead to more serious health problems, including chronic bronchitis, permanent hearing loss, sinusitis, asthma, and emphysema. Antihistamines, decongestants, bronchodilators, and anti-inflammatory nasal sprays are commonly used to treat the symptoms of respiratory allergies. Many children also receive medication through an inhaler or aerosol breathing treatments. Although medications provide effective control of symptoms, the relief is temporary. Children taking antihistamines and decongestants often experience drowsiness, difficulty concentrating, and excessive thirst and should, therefore, be supervised closely, especially during outdoor times or when activities involve greater risk. Some children Caution also experience restlessness or agitation from their medications. These side effects make it particularly difficult for children to pay Teachers should always obtain approval attention and to learn, especially if the medications are prescribed from the child’s physician and receive for an extended period. Teachers must observe these children proper training before administering aerosol carefully and discuss any concerns about the medication’s effecbreathing treatments or any other form of tiveness or side effects with the child’s family. Sometimes a differmedication therapy. ent medication with fewer side effects can be prescribed. symptomatic control – treatment that controls symptoms but does not cure the condition.

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Table 4–3 Symptoms of Anaphylaxis

Life-threatening symptoms can develop suddenly and include: • • • • • •

wheezing or difficulty breathing swelling of the lips, tongue, throat, and/or eyelids itching and hives nausea, vomiting, and/or diarrhea anxiety and restlessness blue discoloration around the mouth and nail beds

In some cases, allergy shots (desensitization therapy) are given when other treatments have been unsuccessful in controlling the child’s symptoms. Although children may experience some An ambulance should be called at once if improvement, the full effect can take 12 to 18 months to achieve. anaphylaxis occurs. Most allergic conditions are not considered to be life threatening. However, some children experience a severe allergic reaction, known as anaphylaxis, to bee stings, some medications, and certain foods (Table 4–3) (Turgay et al., 2022). This life-threatening response requires urgent medical attention because it causes the body to go into shock and the air passages to swell closed. Children who have a history of severe allergic reactions may keep emergency medication, such as AUVI-Q® or an EpiPen® at school. These auto-injecting devices administer a single dose of epinephrine when quickly pressed against the skin (usually the upper thigh) (Figure 4–1) (Waserman et al., 2022). However, it is essential that emergency Stop and Check #2 medical assistance also be summoned immediately because this medication What are the signs of a provides only temporary relief. severe allergic reaction and The emotional effect that allergies can have on the quality of children’s what immediate actions and families’ lives cannot be overlooked. Families may overprotect children or should a teacher take? subject them to frequent reminders to avoid offending allergens. Some children may also be sensitive about their appearance—frequent sneezing, runny nose, rashes, red and swollen eyes—along Figure 4–1 An EpiPen auto-injector. with feeling moody, irritable, or even depressed. In other cases, severe allergies may limit a child’s participation in physical activity. Collectively, these feelings can lead to fear, withdrawal, poor self-esteem, and other maladjustment problems if children’s allergies are not addressed in a positive manner. It is important that children not be allowed to use their allergies as a means for gaining attention or special privileges. Instead, adults can help children become more independent and self-confident in coping with their health problems. Often simple lifestyle adjustments can be made so that children can lead a more normal, healthy life. Families may also need additional support and guidance. They may benefit from parenting classes, individual counseling, and community groups that will help them to understand the child’s condition and ways to foster self-management and self-esteem. Local clinics and hospitals may also offer special classes to help families and children cope with allergic disease.

Caution

anaphylaxis – a severe allergic reaction that may cause difficulty breathing (due to swollen tongue and/or throat), severe itching, nausea and/ or vomiting, unconsciousness, and possible death. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Chapter 4

4-2b

Caring for Children with Medical Conditions

91

Asthma

Asthma is both a chronic and acute respiratory disease that affects over 7 million children and is a primary cause of school absenteeism (CDC, 2019). It is a form of allergic response most often seen in children who also have other allergic conditions. Like allergies, asthma tends to be an inherited tendency that can become progressively worse without treatment. Children who are overweight or obese, especially males, are at increased risk for developing asthma. Excess weight further compromises their breathing, health, and participation in physical activity (Chen et al., 2022). Numerous theories are being investigated to determine why the incidence of asthma is increasing at an alarming rate. Researchers are examining multiple factors, including vitamin D deficiency, infants born to mothers who experience gestational diabetes, exposure to environmental pollutants, obesity, and chronic stress (Grant, Croce, & Matsui, 2022; O’Sullivan et al., 2021). They have also found that children who were not breastfed or Did You Know... received solid foods before 6 months of age are at higher risk for developing food and that you breathe in respiratory allergies (Fleischer et al, 2021). Infants who are exposed to second-hand approximately 6 teaspoons of airborne particles (e.g., smoke or whose mothers smoked during pregnancy experience higher asthma rates formaldehyde and other organic (Peden, 2021). Researchers have also noted that children of minority backgrounds chemicals, dust, smoke, mold and those living in low-income families and neighborhoods are also at greater risk for spores, pet dander) every developing asthma (Adgent et al., 2021; Khan et al., 2021). Factors known to trigger day? acute asthma attacks include: airborne allergens, such as pollen, animal dander, dust, molds, perfumes, cleaning chemicals, paint, ozone, cockroaches ◗ foods, such as nuts, wheat, milk, eggs ◗ second-hand cigarette smoke ◗ respiratory infections, such as colds and bronchitis ◗ acute stress, anger, and fatigue ◗ extreme weather changes, such as cold, rain, or wind ◗ vigorous exercise. Figure 4–2 Swelling and excess mucus in the airways make breathing difficult during an Signs and Symptoms Acute asthma attacks are characterasthma attack. ized by episodes of wheezing, coughing, and labored breathing (especially exhalation) caused by spasms, swelling, and Airways excess mucus production in the respiratory tract (bronchial tubes) (Figure 4–2). As a result, the child may become anxious and develop a bluish discoloration around the lips and nail beds due to insufficient oxygen. Many children outgrow acute asthma attacks as the size of their air passageways increases with age. ◗

Management Asthma treatment is aimed at identifying and removing any substance(s) from the child’s environment that are known to trigger an attack. In cases where complete removal is not feasible, as with dust or pollen, steps can be taken to limit the child’s exposure. For example, it may be necessary to remove carpeting and to dust and vacuum a child’s environment daily to address an airborne allergy. Replacing furnace filters on a regular basis or installing an electrostatic air purifier will also help

Normal

Asthma

An artist’s representation of bronchial tubes, or airways in the lung, in cross section. The normal airway, left, is open. The airway affected by asthma, right, is almost completely closed off. The allergic reaction characteristic of asthma causes swelling, excess mucus production, and muscle constriction in the airways, leading to coughing, wheezing, and difficult breathing. From http://www.niaid.nih.gov

gestational diabetes – a form of diabetes that occurs only during pregnancy; associated with excess maternal weight gain, a family history of diabetes, and certain ethnicities (e.g., Latinx, Native American, African American, Asian, Pacific Islander). Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Checklist 4–2 ✓✓✓ Teacher Strategies for Managing Children’s Asthma Attacks ●

● ● ● ● ●

●

●

●

Know what substances may trigger a child’s attack; if possible, remove the child from exposure (e.g., cold air, fumes, pollen, grass). Encourage the child to remain quiet. Do not leave the child alone. Allow the child to assume a position that makes breathing easier; sitting upright is usually preferred. Administer any medications prescribed for the child. Offer small sips of room-temperature liquids (not cold). Contact the child’s family if there is no relief from medications or if the family requests to be notified in the event of an attack. Do not delay calling for emergency medical assistance if the child shows any signs of struggling to breathe, fatigue, anxiety, restlessness, blue discoloration of the nail beds or lips, or loss of consciousness. Record your observations—child’s condition prior to, during, and following an attack, factors that appeared to trigger the attack, medications administered, and when the child’s family was contacted. Stay calm; this helps to put the child at ease and makes breathing easier.

to remove offending particles from the air. Adults should avoid smoking around children and limit the use of chemicals such as cleaning supplies, paints, pesticides, and fragrances. Many “green” products have eliminated harsh chemicals that may trigger a child’s asthma symptoms. Families may choose to enroll children who have asthma in smaller-sized early childhood programs where the environment can be monitored more closely and exposure to respiratory infections may be lower. Medications, such as anti-inflammatory drugs and bronchodilators, may be prescribed and administered in the form of an inhaler or nebulizer breathing treatment to decrease swelling and open air passages. A meeting should always be arranged with the family when a child with asthma is first enrolled. This enables the teacher to better understand the child’s condition—what symptoms the child shows; what substances are likely to trigger an attack; what, when, and how medications are to be administered; and, what emergency actions are needed (Teacher Checklists 4–2 and 4-3). This information should be written down, posted where teachers can access it quickly, and reviewed frequently with the child’s family to note any changes. If weather triggers an attack, it may be advisable to keep a child indoors on days when abrupt temperature changes occur. However, children should be encouraged to participate in regular activities as much as their condition permits. If asthma attacks are caused by strenuous play, teachers should monitor children’s activity level and encourage them to rest or play quietly until

Checklist 4–3 ✓✓✓ Teacher Children with Allergies and Asthma ● ●

● ● ● ●

●

Be familiar with the symptoms of a child’s allergic reaction. Keep children’s emergency information located where it is readily accessible; make sure that others know where to find it. Post emergency numbers near a telephone. Know where emergency medications are stored and learn how to administer them. Review your program’s emergency policies and procedures. Monitor all food or other allergen sources (e.g., animals, plants, lotions, cleaning supplies, pesticides) that are brought into the classroom. Have the family review and update information about the child’s condition periodically.

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Chapter 4

the symptoms subside. Teachers should always be prepared to respond quickly if a child develops any difficulty breathing (see Chapter 9). 4-2c

Caring for Children with Medical Conditions

93

▼ Food insufficiency and unhealthy eating patterns can lead to anemia.

Anemia

Monkey Business Images/Shutterstock.com

Anemia is a common blood disorder that occurs when there are too few red blood cells available to deliver oxygen to the body’s tissues. This condition may be caused by a significant blood loss, decrease in red blood cell production, or abnormal destruction of red blood cells. Approximately 7.4 percent of children 1 to 6 years have iron-deficiency anemia (one form of anemia); this rate is 22 percent among minority child populations (Bailey et al., 2021). Iron-deficiency anemia is caused by a lack of iron and other critical nutrients the body requires to make hemoglobin for red blood cells. Food insufficiency and unhealthy dietary patterns place many young children at risk for developing this disorder. Additional causes include: ◗ ◗ ◗ ◗ ◗ ◗

deficient nutrient intake (iron, folic acid, B-12) hereditary disorders, such as sickle cell disease chronic infections, such as hepatitis and HIV some forms of cancer, such as leukemia radiation, chemotherapy, and some medications chemical exposure, such as lead poisoning

It is important to understand that anemia is not itself a disease but a symptom of some other condition that requires medical attention. Iron-deficiency anemia is a temporary condition that can be reversed by improving a child’s diet. Signs and Symptoms Excessive fatigue is a classic symptom of anemia and is caused by a lack of oxygen that cells receive. The signs of anemia may be difficult to recognize because the body often compensates for low oxygen levels in the early stages. Common signs that may be observed as anemia progresses include: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

pale skin color; blue discoloration of nail beds irritability feeling cold rapid heartbeat dizziness or headache shortness of breath decline in school performance difficulty concentrating loss of appetite swollen or sore tongue failure to grow

Not every child will experience all of these signs and may present others depending upon the underlying cause. Diagnosis requires a complete medical examination and blood tests to determine red blood cell count. For this reason, any concern about a child’s health and vitality should be evaluated by a health care professional.

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Connecting to Everyday Practice

➥➥

Supporting Children’s Medical Needs in School

It is 10 am and four children are lined up on small plastic chairs in the director’s office at the Wee Care 4 Kids Early Childhood Center. Steam hisses from clear plastic masks that the older children are holding over their noses and mouths while a teacher assists those who are still too young to manage the procedure alone. Two other children are waiting to be given their oral medication. All of these children have one thing in common—asthma. Teachers must administer the nebulizer breathing treatments and medications to these children twice each day while they are in attendance. Three other children at the center have diabetes and require that medication or an insulin injection be given at precise times. The teachers have expressed frustration with the director for enrolling these children because they “take valuable time away from other classroom duties.”

Think About This: ◗ Should teachers be responsible for administering medical procedures to children who have

special health care needs? Why or why not? ◗ What steps should teachers take to prepare themselves for this role? Who should provide

the training? ◗ What would you do if you observed a teacher administering a nebulizer treatment or medi-

cation incorrectly?

Management Treatment for anemia is determined by the cause. If the child’s diet is deficient, vitamin supplementation may be prescribed along with modifications in daily nutrient intake. If the anemia is due to chronic infection, antibiotics may be prescribed. Anemia caused by lead toxicity is often successfully treated by eliminating exposure to lead sources and correcting the child’s diet. Some children with high lead levels may require additional medication therapy. It is important that families inform teachers about their child’s condition and treatments so that adjustments can be made at school. Any special dietary requirements should be addressed during meal planning. Children may need additional opportunities to rest during the day or to participate in less physically demanding activities. Because anemia reduces children’s ability to resist infection, frequent hand washing and cleaning practices should be implemented. Teachers must also monitor children’s play more closely, as fatigue, low energy, and lack of concentration may increase their risk of unintentional injury. 4-2d

Childhood Cancers

Cancers are the leading cause of childhood deaths. Approximately 10,500 newly diagnosed cases and 1200 deaths are reported each year among children 0 to 19 years of age (National Cancer Institute, 2021). Young children (1–4 years) have the highest incidence of newly reported cases. Adolescents (15–19 years) experience the highest death rate due to leukemia, whereas children (5–9 years) have the highest death rate from brain tumors. The term childhood cancer is used inclusively in reference to a broad range of cancer types. Most often, cancers target areas of children’s bodies that are undergoing rapid growth, such as the circulatory (blood) system, brain, bones, and kidneys. Leukemia (a cancer of the blood and bone marrow) is more common among boys, particularly Hispanic populations, and accounts for approximately 30 percent of all childhood cancers. Brain and central nervous system tumors occur more often in white children (Marcotte et al., 2021). Numerous causes, including environmental chemicals, radioactivity, and some prenatal conditions continue to be

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Chapter 4

Caring for Children with Medical Conditions

investigated. Some children appear to be at higher risk for developing cancer, especially those who have HIV infections, family members who smoke, or certain genetic disorders such as Down syndrome (Marlow et al., 2021; Xu et al., 2021).

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▼ Children’s return to school following cancer treatment is an important step in their recovery process.

◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

loss of appetite, unexplained weight loss excessive fatigue that doesn’t improve with rest painful joints unusual bruising, bleeding gums, or small broken blood vessels under the skin night sweats or fever enlarged glands (in neck, armpits, or groin) frequent infections persistent headaches unexplained cough or difficult breathing lumps or masses unusual colored urine seizures

Frantab/Shutterstock.com

Signs and Symptoms Although childhood cancers are relatively rare, families should never hesitate to seek medical consultation if they have concerns. Many symptoms are unique to a specific form of cancer, while others are more general and easily mistaken for common infectious illnesses, such as the flu. Early warning signs can include:

In most cases, children who present these symptoms will not have cancer. However, medical evaluation should be sought if symptoms appear suddenly or if they persist or cause the child unusual discomfort. Early diagnosis significantly improves recovery and survival. Management Advances in diagnosis and treatment have resulted in dramatic improvements in children’s survival rates. Many children return to school after they have completed and recovered from their treatments. This transition requires careful planning and coordination between the child’s family, doctors, and school personnel. Children may be sensitive about changes in their appearance, such as surgical scars or hair loss resulting from chemotherapy and radiation. Weight loss or gain, fatigue, pain, and generalized weakness may make it difficult for children to participate fully in class activities. Extra precautions must be taken to protect children from communicable illnesses and other infectious conditions because chemotherapy and radiation therapies weaken their immune system. Children’s hearing may also be affected by radiation treatments to the head or high doses of antibiotics that have been administered to fight infection. Children’s return to school is an important step in helping them to resume a near normal lifestyle. Peer interactions provide beneficial opportunities for boosting the children’s morale and self-esteem. Teachers must work closely with families to better understand the child’s limitations and any modifications that may be needed (Martinez-Santos et al., 2021). If there are medications to be administered, proper forms and signatures must be obtained. In some cases, children may have an IEP, IFSP, or IHSP to assist with additional services and resources. It is highly likely that teachers will encounter children who have, or are recovering from, cancer as treatment success rates continue to improve. These opportunities can be used to better understand childhood cancers and, in turn, help all children learn about these conditions, accept children with differences, and discover ways to support their peers (Teacher Checklist 4–4). Initially, children may be apprehensive about a classmate whose appearance and/or ability to play may have changed. Children’s fears can be lessened by preparing them in advance and

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Checklist 4–4 ✓✓✓ Teacher Children with Cancer ●

●

●

● ●

●

Maintain close communication with the child’s family. Ask what they want other children to know about their child’s condition. Post children’s emergency contact information in a designated location where it is readily accessible to school personnel. Determine what, if any, accommodations are needed when the child returns to school, such as dietary modifications, a place to rest, or a change in seating arrangement. Review and implement sanitation and hand-washing practices. Adjust activities and expectations to acknowledge children’s limitations, e.g., short attention span, memory problems, learning difficulties, and low energy. Secure any additional resources and services children may need to be successful.

encouraging their questions. The American Cancer Society (www.cancer.org) provides extensive resource information to help families and children cope with this disease. Although the site is geared toward families, teachers will find much of the information useful. Visit the American Cancer Society’s website and search for “Returning to school after cancer treatment.” 4-2e

Diabetes

Diabetes is a chronic disease that occurs when the body is unable to produce insulin or to use it efficiently. Insulin is a hormone required for the metabolism of carbohydrates (sugars and starches) and the storage and release of glucose (blood sugar) for energy. Type 1 diabetes is a chronic, incurable, and often hereditary condition that develops in young children when their pancreas fails to produce insulin. Type 2 diabetes, often referred to as adult-onset or insulinresistant diabetes, results when an insufficient amount of insulin is produced or cells in the body are unable to use the insulin properly. Approximately 1 out of every 400 children is diagnosed with diabetes, particularly type 2. This number is nearing epidemic proportions as childhood obesity rates continue to climb (Saleh et al., 2022; Vogel et al., 2022). Obesity, inactivity, and poor dietary quality place children and adults at high risk for type 2 diabetes. At present, roughly 13.4 percent of children ages 2 to 5 years and 21 percent of children ages 6 to 17 are considered Did You Know... significantly overweight or obese (CDC, 2021b). Researchers have reported a dratoday’s children will be the first generation to have a matic increase in these numbers since the beginning of the COVID-19 pandemic shorter life expectancy (Chambers et al., 2022; Dyer, 2021). Additional risk factors associated with type than their parents due 2 diabetes include having a family history of the disease, being born to a mother to obesity and its associated health who experienced gestational diabetes, and ethnicity. Racial and ethnic minority complications? groups, particularly Native Americans, Hispanic/Latinx and African Americans, experience diabetes at a rate that is more than twice that of Caucasian populations (Serbis et al., 2021). Signs and Symptoms It is important that teachers be familiar with the signs, symptoms, and treatment of diabetes because the number of children with diabetes continues to increase. Successful management of childhood diabetes requires careful monitoring and regulation, both of which can prove challenging given children’s irregular eating habits, frequent respiratory infections, and unpredictable growth and activity levels (Gurunathan et al., 2021; Pals et al., 2021). hormone – a special chemical substance produced by endocrine glands that influences and regulates specific body functions.

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Chapter 4

◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

rapid weight loss fatigue and/or weakness nausea or vomiting frequent urination dehydration excessive thirst and/or hunger dry, itchy skin blurred vision

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▼ Children who have type 1 diabetes must follow special dietary restrictions.

Monkey Business Images/Shutterstock.com

When insulin is absent or the amount produced is insufficient, glucose continues to circulate freely in the bloodstream instead of being stored as glycogen in the liver. This causes a condition known as hyperglycemia and is responsible for the early signs associated with type 1 diabetes. If the condition is not identified and treated promptly, it can lead to serious complications including coma and death. The onset of type 1 diabetes in children is usually abrupt, and includes symptoms such as:

Caring for Children with Medical Conditions

Symptoms associated with type 2 diabetes are similar, but they tend to develop more slowly and over a longer time period. Management Teachers must be aware of each child’s individualized situation and treatment regimen—whether the child has type 1 or type 2 diabetes, what dietary restrictions are required, and what medical treatments (urine testing, insulin injections, medications) must be administered. Children who have type 1 diabetes must be given insulin (i.e., injections, pump) during the day, have their glucose levels monitored, and closely regulate their diet and activity. Insulin pumps are increasingly being used in children to replace the need for daily injections. Children with type 2 diabetes are usually able to regulate their condition through careful dietary management and/or medications that help their bodies to utilize glucose. Increasing children’s activity has proven to be effective in reducing the risk of developing type 2 diabetes as well as improving its management (Kanaley et al., 2022). Teachers must also be familiar with the signs of diabetic complications. For example, a child who receives an insulin dose that is too large or too small will exhibit different symptoms and require quite different emergency care. (See the Teacher Checklist “Signs and Symptoms of Hyperglycemia and Hypoglycemia” in Chapter 9.) Arrangements should be made to meet with the families of children who are diabetic before they attend school or an out-of-home program. They can provide information about the child’s condition and how to recognize changes in behavior and appearance that may signal an impending complication. Teachers should also learn about the child’s dietary restrictions and how to perform any required medical or emergency procedures while the child is in attendance. This information should be reviewed often with the child’s family so that it is current.

hyperglycemia – a condition characterized by an abnormally high level of sugar in the blood. dehydration – a state in which there is an excessive loss of body fluids or extremely limited fluid intake. Symptoms may include loss of skin tone, sunken eyes, and mental confusion.

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Checklist 4–5 ✓✓✓ Teacher Children with Diabetes ● ●

●

● ●

●

● ●

Meet with the family regularly to review the child’s progress and treatment procedures. Be familiar with the symptoms of hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) and know how to respond. Keep children’s emergency information where it is readily accessible; make sure others also know where to find this information. Post emergency numbers near a telephone. Know where emergency medications are stored and learn how to administer them. Also learn how to check children’s blood sugar and train additional staff members to perform these tests. Be mindful of any changes in meal schedules, length of outdoor play, or impromptu field trips that might affect the child’s insulin needs. Note signs of impending illness or infection and notify the child’s family. Review your program’s emergency policies and procedures.

Stop and Check #3 Why are so many more young children developing type 2 diabetes today?

4-2f

When teachers are familiar with a child’s condition and management plan, they can respond efficiently and effectively to any diabetic emergency (Teacher Checklist 4–5). This can be reassuring for families who may be reluctant to leave children in the care of others. Teachers are also in a unique position to help children accept and manage their diabetes and to help other children learn more about the condition (Table 4–4).

Eczema

Eczema is a chronic inflammatory skin condition. Early symptoms usually appear in infants and children younger than age 5 and affect approximately 15 percent of all children (Allergy & Asthma Network, 2022). Eczema often disappears or significantly improves between the ages of 5 and 15 years in half of the affected children. However, many children will go on to develop asthma or other allergies (Abuabara et al., 2021). Signs and Symptoms Eczema is caused by an abnormal immune system response and is commonly associated with allergies, especially to certain foods (e.g., eggs, wheat, and milk), and substances that have contact with the skin (e.g., wool, soaps, perfumes, disinfectants, animal dander). There is often a strong family history of allergy and similar skin problems. Red, irritated patches on an infant’s or toddler’s cheeks, forehead, scalp, or neck may be the first signs of eczema. Older children may develop dry, itchy, scaly areas on the knees, elbows, wrists, or back of hands. Repeated scratching may cause open, weeping areas that are prone to infection. Weather changes can trigger an eczema flare-up or cause it to worsen, especially during summer heat or in winter cold when full-length clothing is likely to be worn. Older children may be selfconscious about their appearance and reluctant to have these areas exposed and visible to others. Table 4–4 Coping Strategies for Children Who Have Diabetes

Teachers can be instrumental in helping children: • learn about their diabetes in simple terms and not to be ashamed, afraid, or embarrassed about the condition • maintain a nutritious diet and understand the critical relationship between healthy eating habits and well-being • learn to enjoy a variety of physical activities • assist with their own medical management, e.g., practice careful hand washing before glucose tests (finger sticks), cleansing the injection site, or caring for an injury • participate in opportunities that build positive self-esteem

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Management Eczema is not curable, but it can usually be controlled through preventive measures. Eliminating environmental allergens is always the preferred and first line of defense. However, in some cases the offending substance may not yet be known. In other instances, the substance, such as dust or pollen, may be difficult to eliminate so that steps can only be taken to reduce the child’s exposure. Reminding children not to scratch irritated skin, keeping their hands washed, and moisturizing their skin, especially after bathing or washing, are also beneficial measures. Avoiding exposure to extreme temperature changes can also be an effective measure for controlling eczema symptoms in some children. Keeping children cool in warm weather prevents sweating, which can increase skin irritation. Reducing room temperatures, dressing infants and children in light clothing, and wiping warm areas of their body (creases in neck, elbow, knees, and face) with cool water can improve the child’s comfort. Teachers may also be asked to administer antihistamines or topical cortisone ointments that have been prescribed. Reducing children’s exposure to stress and helping them to develop a healthy self-image are also important strategies for reducing flare-ups. 4-2g

Excessive Fatigue

Most children enjoy an abundance of energy, stamina, enthusiasm, and curiosity. This state can be temporarily disrupted by growth spurts, delayed bedtimes, major family changes, recovery from a recent illness, or participation in too many activities that deprive children of essential sleep or increase the amount of sleep needed. Some children have health conditions or prolonged sleep disturbances that can cause excessive fatigue. Children who have intellectual and developmental disabilities, including attentiondeficit/hyperactivity disorder (ADHD), autism spectrum disorder, Down syndrome, and cerebral palsy experience a high rate of sleep disturbances (Manelis-Baram et al., 2022; Shelton & Malow, 2021). Sleep deprivation has been closely linked to learning and behavior problems, health conditions (obesity, heart disease, cancer), and unintentional injury (Antza et al., 2021; Cheng et al., 2021; Hernandez-Reif & Gungordu, 2022). Researchers continue to study children’s sleep disorders because sleep is so vital to a child’s development, and well-being. Signs and Symptoms Repeated or prolonged daytime fatigue is not a normal condition for young children and should be investigated because of its potentially negative effect on growth, development, and behavior. Excessive or chronic fatigue may be an indication of other serious health problems, including: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

inadequate nutrition chronic infection, such as otitis media anemia sleep apnea allergies lead poisoning hepatitis endocrine (hormonal) disorders such as diabetes and hypothyroidism heart disorders anxiety

Management A thorough assessment of the child’s personal habits and lifestyle may reveal an explanation for the undue fatigue. A complete medical examination may be necessary to detect any existing health problems. If no specific medical cause can be identified, steps should be taken to improve the child’s general well-being and sleep habits (Table 4–5). Often these measures can also be incorporated into daily classroom routines and benefit all children. sleep apnea – temporary interruptions or stoppages in breathing during sleep. endocrine – refers to glands that produce substances called hormones that are secreted directly into the bloodstream.

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Table 4–5 Strategies for Improving Excessive Fatigue in Children • Help children form healthy dietary habits. • Encourage children to participate in moderate exercise, such as walking, swimming, playing ball, jumping rope, or riding bikes. • Provide opportunities for improved sleep, such as earlier bedtimes, short daytime naps, limited media use, or a quiet sleeping area away from noise and activity. • Arrange for alternating periods of active play and quiet times (e.g., reading a book, playing quietly with a favorite toy, listening to music). • Reduce environmental stress. • Help children build effective coping skills.

4-2h

Lead Poisoning

Lead poisoning continues to be a public health concern despite a continued decline in the numbers of affected children. Aggressive campaigns, legislation, and abatement programs have been successful in eliminating many common sources of lead contamination. However, an estimated 580,000 U.S. children between 1 and 5 years of age have blood lead levels greater than safety recommendations despite these efforts (CDC, 2022). CDC reference standards were lowered in 2021 from 5 to 3.5 micrograms per deciliter (μg/dL) to better identify children with elevated blood lead levels so they would be eligible to receive follow-up treatment (CDC, 2021a). Studies have consistently shown that no level of lead exposure is safe. Even low blood lead levels have an immediate and negative effect on children’s health, behavior, and neurocognitive and motor development as well as long-term consequences on adult productivity (Lu, Levin & Schwartz, 2022; Gibson et al., 2022). Children living in poverty, inner city areas, and near landfills and industrial areas experience a high incidence of lead poisoning, although the condition is not limited exclusively to these populations. Furthermore, these children often consume unhealthy diets (high in fat; low in calcium, iron, and vitamin C) that are thought to enhance lead absorption (Rajaee, Dubovitskiy, & Brown, 2022). Many older houses (built before 1950) still have lead water pipes or contain plumbing with lead solder which was banned in 1986. Older woodwork and furniture may have lead-based paint which was banned in the United States in 1978. Loose paint chips and paint dust released during renovations can be inhaled or ingested when children put dirty hands into their mouths. Inexpensive test kits are available from local hardware stores to determine if lead-based paint is present on surfaces.

Caution Use care when purchasing used toys and furniture at garage sales, on the Internet, or from second-hand stores, as some of these items may contain lead-based paints.

Signs and Symptoms Young children are especially vulnerable to lead poisoning. They frequently put toys and hands in their mouths, their bodies absorb lead more readily, and their developing brain and nervous systems are particularly sensitive to lead’s harmful effects. Lead accumulates in the child’s bones, brain, tissues, and kidneys with repeated exposure, and is not eliminated. Children with elevated levels of lead present a range of symptoms, including: ◗ ◗

irritability loss of appetite and nausea

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▼ Children’s nervous system (including the brain) is especially vulnerable to the effects of lead poisoning.

◗ ◗ ◗ ◗ ◗ ◗

headaches unexplained abdominal pain, muscle aches constipation listlessness learning and behavior problems, impulsivity, short attention span, aggression, intellectual disabilities sleep disorders

Children younger than 6 years of age who are at risk for lead exposure should be tested if there is any concern about the symptoms they may be exhibiting. Management Research has demonstrated that elevated levels of lead can significantly lower children’s IQ (Boyle et al., 2021; Galiciolli et al., 2022). Thus, efforts to eliminate high blood lead concentrations in children remain a priority in the Healthy People 2030 initiative. The CDC and American Academy of Pediatrics recommend that all children age 12 to 24 months be assessed for risk (e.g., location, age of housing, socioeconomic factors) to identify those who should have a blood lead level test performed (CDC, 2021). Routine screening is not recommended except for children who are enrolled in Medicaid because they are more likely to live in environments where lead exposure risk is greater. Teachers who have concerns about a child’s physical complaints, behavior, development, or learning challenges and believe there may be a risk of lead exposure should encourage families to have their child tested. Lead poisoning prevention requires that hazardous environmental sources be located and removed (Table 4–6). Early identification of children and their siblings who may also be affected by this condition is essential for halting further contamination, initiating treatment, and limiting lead’s harmful effects on development. Children should be encouraged to practice frequent hand washing and to keep hands and objects out of their mouths. Removing shoes before entering a house or classroom can also prevent the introduction of contaminated particles. Children who have significantly elevated blood lead levels may be treated with special medications along with dietary modifications that increase their iron, calcium, and vitamin C intake. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Table 4–6 Common Sources of Environmental Lead • • • • • • • • • • •

old lead-based house paint (prior to 1978), including dust from remodeling projects soil contaminated by leaded gasoline emissions and old paint chips plastic mini blinds (manufactured before 1996, not made in the United States) contaminated drinking water (from lead solder in old water pipes) imported dishware, pottery, and crystal folk remedies and medications imported toys and metallic trinkets; Mexican tamarind candies lead shot and fishing weights second-hand toys and furniture manufactured before 1978 areas around lead smelters, oil drilling, and mining operations having a parent or caregiver who works with motor vehicle batteries

Stop and Check #4 What groups of children are at highest risk for developing lead poisoning?

4-2i

There is little evidence to date suggesting that educational interventions can reverse or offer any improvement in children’s behavior or learning problems if lead has already had damaging effects. Thus, public awareness and community education continue to be the most effective measures for combating this preventable condition.

Seizure Disorders

Many children in school settings experience seizures. At present, an estimated 450,000 children under age 17 have epilepsy or a seizure disorder (Di Giovine & Catenaccio, 2021). Each year, an additional 120,000 children experience their first seizure, with more than half of these associated with high fever (febrile seizures). For some adults, the terms “seizures,” “convulsions,” or “epilepsy” create considerable apprehension and/or fear. However, prior knowledge and planning can alleviate these feelings and enable teachers to respond with skill and confidence when caring for children who experience a seizure disorder (Teacher Checklist 4–6). Checklist 4–6 ✓✓✓ Teacher Strategies for Working with Children Who Have a Seizure Disorder 1. Be aware of any children in the classroom who have a seizure disorder. Find out what the child’s seizures are like, if medication is taken to control the seizures, and whether the child is limited in any way by the disorder. 2. Know emergency response measures (see Chapter 9). Develop guidelines for staff members to follow if a child has a seizure; review the guidelines often. 3. Use the presence of a child with a seizure disorder as a learning opportunity for other children. Provide simple explanations about what seizures are; encourage children to ask questions and to express their feelings. Help children learn to accept other persons who may have special conditions. 4. Gain a better understanding of epilepsy and seizure disorders. Read books and articles, view films, and talk with health professionals and families. 5. Obtain and read the following books and pamphlets written for children. Share them with children in the classroom. • Baltaro, E. (2010). Karen’s Epilepsy. • Cooper, A. (2016). Sometimes I Get the Wiggles – Be an Epilepsy Seizure Hero! • Gosselin, K. (2002). Taking Seizure Disorders to School: A Story about Epilepsy. • Keir, G. (2020). The Abilities in Me: Epilepsy. • Rocheford, D. (2009). Mommy, I Feel Funny! A Child’s Experience with Epilepsy. • Zelenka, Y. (2008). Let’s Learn with Teddy about Epilepsy.

seizures – a temporary interruption of consciousness sometimes accompanied by convulsive movements.

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Seizures are caused by a rush of abnormal electrical impulses in the brain that trigger involuntary or uncontrollable movements in different regions of the body. The intensity and location of this activity vary with the type of seizure. For example, some seizures cause only momentary attention lapses or interruptions of thought, while others may last several minutes and cause vigorous, spasmodic contractions involving the entire body. Temporary loss of consciousness, frothing, and loss of bowel and bladder control may also accompany some seizure types. In many cases, a specific cause is never identified, although seizure disorders are more common in some families. Children who have certain developmental disabilities and genetic syndromes are at higher risk for experiencing seizures. Other conditions known to initiate seizure activity in young children include: ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

fevers that are high (101.2°F; 38.4°C) or rise rapidly (especially in infants) brain damage infections that affect the central nervous system, such as meningitis or encephalitis tumors head injuries (concussions) lead, mercury, and carbon monoxide poisoning hypoglycemia (low blood sugar) medication reactions

Signs and Symptoms Approximately 2 to 5 percent of infants and children between the ages of 6 months and 5 years’ experience febrile seizures, with most incidences occurring between 6 and 12 months of age (National Institute of Neurological Disorders and Stroke, 2021). Febrile seizures are thought to be triggered by a high fever and may cause a child to temporarily lose consciousness and experience involuntary jerking movements involving the entire body. The child’s seizures typically end once the fever subsides and, thus, are not thought to be serious or to result in any permanent damage. A classification system is currently used to describe seizures, other than febrile types. Seizures are grouped according to the area of the brain affected, the victim’s level of awareness during a seizure, and the type of movements that occur while the seizure is in progress (Sarmast, Abdullahi, & Jahan, 2020): ◗ ◗ ◗

focal onset generalized onset unknown onset

Focal onset seizures originate on one side of the brain, typically last a few seconds or as long as 2 minutes, and are the most common form that children experience. During the seizure, the child remains conscious but may appear confused and unable to respond appropriately. Other behaviors that may be noted include: ◗ ◗ ◗ ◗ ◗ ◗ ◗

staring off into space; having a blank appearance uttering a loud cry or scream momentary muscle weakness or stiffness; an extremity may become floppy, rigid, or have jerky movements that spread to other body parts brief fluttering of the eyes; lip smacking or chewing motions temporary interruption of speech or activity; unintelligible muttering undressing wandering around aimlessly and without purpose

Children may abruptly stop an activity and resume it almost as quickly once the seizure subsides. Some children experience fatigue and/or confusion for a short time afterward, but they are unlikely to recall what occurred. Teachers should report their observations to the child’s family and encourage them to consult with their health care provider unless the condition has already been diagnosed. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Generalized onset seizures involve all parts of the brain simultaneously. Some children experience an aura or sensation (e.g., specific sound, smell, taste, visual cue) immediately before the seizure begins. Consciousness is quickly lost and followed by motor involvement that ranges from eye twitching and staring off into space (absence seizures) to uncontrollable, jerky movements that affect the entire body (tonic-clonic seizures). The child may have difficulty breathing and lose bowel and bladder function during the seizure. When the seizure has ended, children may awaken briefly, appear confused, complain of a headache or dizziness, and fall asleep from exhaustion, but they will not remember the event. In some cases, medical personnel are not able to clearly determine if a seizure is focal or generalized. These seizures are referred to as unknown onset. Management Most seizures are treated and controlled with medication. It is vital that medications be taken every day, even after seizures are under control. Children may initially experience undesirable side effects to the drugs, such as drowsiness, nausea, and dizziness, but these tend to disappear with time. Children should be monitored closely by their health care provider to ensure that prescribed medications and dosages continue to be effective in controlling seizure activity and do not interfere with learning. Whenever a child experiences a seizure, families should be notified. If the nature of the seizures changes, or if they begin to recur after having been under control, families should be encouraged to consult the child’s physician. Teachers should complete a brief, written report documenting their observations during the seizure and place it into the child’s permanent health file (Teacher Checklist 4–7). This information may be useful to the child’s physician for diagnosing a seizure disorder and evaluating current medical treatments. Teachers play an important role in facilitating the inclusion of children with seizure disorders (Johnson et al., 2021). They must work closely with families to develop a seizure action plan that includes information about the nature of children’s seizures, medications, activity limitations, first aid measures to be taken (see Chapter 9), and when emergency medical personnel should be summoned. Careful attention should also be given to arranging indoor and outdoor environments so they are safe and encourage children’s full participation. It is important that children’s social and emotional needs also be addressed by encouraging their questions, providing honest answers, and nurturing confidence and self-esteem. Teachers can also use the opportunity to teach all children about seizures and to encourage healthy attitudes toward people who may experience them. A teacher’s own reactions and displays of genuine acceptance are especially important for teaching children about understanding and respecting persons with special health conditions.

Checklist 4–7 ✓✓✓ Teacher Information to Include in a Child’s Seizure Report ● ● ● ● ● ●

●

●

child’s name date and time the seizure occurred events preceding the seizure how long the seizure lasted nature and location of convulsive movements (affected body parts) child’s condition during the seizure, e.g., difficulty breathing, loss of bladder or bowel control, change in skin color (pallor, blue discoloration) child’s condition following the seizure, e.g., any injuries, complaints of headache, difficulty with speech or memory, desire to sleep name of person who observed and prepared the report

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Chapter 4

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Sickle Cell Disease

Sickle cell disease is an inherited disorder that interferes with the red blood cells’ ability to carry oxygen (Hockenberry, Wilson, & Rodgers, 2021). Approximately 1 in every 365 Black or African-American infants and 1 in every 16,300 Hispanic-American infants are born with this genetic disorder (CDC, 2020). Individuals of Mediterranean, Middle Eastern, and Latin American descent also carry the sickle cell gene. Approximately 10 percent of African Americans have the trait for sickle cell disease but do not necessarily develop the disorder; these individuals are referred to as carriers. When both parents have the sickle cell trait, some of their children may be born with the disease, while others may become carriers.

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Normal and abnormal blood cells in sickle cell disease.

Figure 4–3

Signs and Symptoms Sickle cell anemia causes a range of chronic health problems for the child. Red blood cells develop in the shape of a comma or sickle rather than their characteristic round shape (Figure 4–3). As a result, they tend to stick together and slow or obstruct blood flow, which reduces oxygen supply to the cells. Symptoms of the disease usually first appear sometime after the child’s first birthday. Clumping of deformed blood cells results in periods of acute illness called crisis. A crisis can be triggered by infection, injury, strenuous exercise, dehydration, exposure to temperature extremes (hot or cold) or, in some cases, for no known reason. Symptoms of a sickle cell crisis include fever, swelling of the hands or feet, severe abdominal and leg pain, vomiting, and ulcers (sores) on the arms and legs. Children are usually hospitalized during a crisis, but they may be free of acute symptoms between flare-ups. Children who have sickle cell disease are at high risk for experiencing a stroke, which is characterized by muscle weakness, difficulty speaking, and/or seizures (Lee et al., 2022). In addition, chronic infection and anemia may cause children to be small for their age, irritable, fatigued, and have cognitive delays. They are also more susceptible to infections, a fact that families must consider when placing young children in group care. Management At present there is no known cure for sickle cell disease. Genetic counseling can assist prospective parents who are carriers in determining their probability of having a child with this condition. Hospitals in many states are beginning to screen newborns for the disease before they are sent home. Early diagnosis and medical intervention can help lessen the frequency and severity of crises and reduce mortality. Several new drugs are being tested for use with children but not all have received final approval. Children may take daily antibiotics to reduce the risk of infections, which are a common cause of death (Reeves et al., 2021). Frequent blood transfusions have also been proven beneficial in preventing acute crises. New treatment approaches such as bone marrow and stem cell transplantation and gene therapy are also being studied (Sinha et al., 2021). Children who have sickle cell disease are living longer today as the result of improved diagnosis and treatments. Although children may appear to be perfectly normal between acute episodes, they may experience a high rate of absenteeism due to flare-ups, infections, and respiratory illnesses, which can interfere with their developmental and academic progress. Illness and pain may also disrupt children’s intake of essential dietary nutrients. Children with sickle cell disease are eligible for special education services (under IDEA) and teachers can initiate the process. When teachers understand this disease and its effects on children’s health, they can work collaboratively with families and intervention personnel to help children cope more effectively with the condition and continue to progress in school (Teacher Checklist 4–8).

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Checklist 4–8 ✓✓✓ Teacher Children with Sickle Cell Disease ● ●

●

● ● ●

● ●

●

●

Meet with the family regularly to review the child’s progress and treatment procedures. Be familiar with the symptoms of acute complications, such as fever, pain, difficulty breathing, or signs of a stroke (muscle weakness, difficulty speaking, or seizures). Keep children’s emergency information in a place where it is readily accessible; make sure that others know where to find this information. Post emergency numbers near the telephone. Collaborate with the child’s family and provide learning materials that can be used at home. Maintain strict sanitation procedures (e.g., hand washing, sanitizing of surfaces and materials) in the classroom to protect children from unnecessary infections. Monitor the child’s physical activity and provide frequent rest periods to avoid fatigue. Protect the child from temperature extremes (heat or cold); arrange for the child to stay indoors when conditions are not favorable. Encourage children to eat a nutritious diet and drink adequate fluids. (Allow them to use the restroom whenever necessary.) Review your program’s emergency policies and procedures.

Partnering with Families Children with Medical Conditions and Physical Activity Dear Families, Participation in physical activity every day has untold benefits for children and adults. It provides significant health benefits and promotes children’s motor development, problem-solving abilities, communication skills, socialization, and self-esteem. Daily activity also has positive effects on children’s mental health and serves as an ideal outlet for releasing excess energy and frustration. Vigorous activity also improves children’s appetite, sleep, weight control, and brain function by increasing blood flow and oxygen. Children’s diseases and medical conditions need not serve as barriers to participation in physical activity. In many cases, physical activity improves children’s quality of life and treatment regimens. Talk with your child’s health care provider to determine what types of physical activity are appropriate and if there are any health restrictions. And, most importantly, do fun things together with your children. ◗ Encourage children to try a variety of different activities and find those they enjoy and are

most likely to continue. Team activities provide opportunities for competition, whereas individual activities allow children to progress and experience challenge at their own pace. ◗ Be a positive role model. If you are active, children are more likely to follow your lead. ◗ Provide appropriate equipment; if necessary, modify equipment to children’s functional

abilities. ◗ Make sure play areas (especially public playgrounds) and equipment are safe for children’s

use. ◗ Monitor and supervise children’s play closely; provide clear, simple instructions for playing

safely and encourage their creativity. ◗ Know what limitations a child’s health condition may present and be prepared to respond if

an emergency should occur. ◗ Continue to advocate for safe, accessible playgrounds and public recreational facilities that

are designed for children of all abilities.

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Classroom Corner Teacher Activities Everyone Is Special (NHES PreK–2, National Health Education Standard 1.2.2)

Concept: People may be different, but everyone is special.

Learning Objectives ◗ Children will learn that people are more alike than different. ◗ Children will learn why it is important to show others respect.

Supplies ◗ Unbreakable mirror; sheets of white paper; crayons or markers; shoebox and magazine

pictures of children (different ethnicities and abilities); ball of string or yarn

Learning Activities ◗ Read and discuss any of the following books about children who have special qualities: ● ● ● ● ● ● ● ● ● ● ●

Taking Cerebral Palsy to School by M. Anderson and T. Dineen (cerebral palsy) That’s What Friends Do by K. Cave (general) Someone Special, Just Like You by Tricia Brown (general disabilities) Be Quiet, Marina! by Kristen De Bear (cerebral palsy, Down syndrome) Let’s Hear it for Almigal by W. Kupfer (hearing impairment, cochlear implant) It’s Okay to Be Different by T. Parr (general) My Friend has Down Syndrome by J. Moore-Mallinos (Down syndrome) Mommy, I Feel Funny! A Child’s Experience with Epilepsy by D. Rocheford (epilepsy) Don’t Call Me Special: A First Look at Disability by P. Thomas A Friend Like Simon by K. Gaynot (autism/ASD) Susan Laughs by Jeanne Willis (wheelchair)

◗ Ask children to help you describe the word respect. Have them suggest other words that

mean the same thing (e.g., being kind, treating a person kindly, doing things together, not making fun of a person). ◗ Have children sit in a circle. Hand the first child a ball of string or yarn; ask them to name

something special about the person sitting to their right. Have the first child hold onto the end of the yarn and pass the ball to the person they just described. Continue around the circle with each child describing something about the person sitting next to them and holding onto the string as it is passed to the next child. When everyone has had a turn, explain how the string illustrates that we are all connected by many of the same qualities and the things we need or like to do. (We are all different, but everyone is special.) ◗ As a group, make a list of things that everybody likes and needs (e.g., food, sleeping, play-

ing, having friends). ◗ Have each child look in a mirror and describe one quality that makes them special. ◗ Place magazine pictures of children in a shoebox. One at a time, have children pull a picture

out of the box and describe why they think this person would be special.

Assessment ◗ Children will name several different ways that people are the same and different. ◗ Children will explain why it is important to treat all people with respect and kindness.

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Summary ◗

◗

Many children attending school and early childhood programs experience a range of chronic diseases and medical conditions. ● Teachers are important advocates for children and play a critical role in the early detection, referral, and management of their health needs. ● The Individuals with Disabilities Education Improvement Act (IDEA) guarantees children with special needs the right to an accessible and appropriate education. ● First person language should always be used; it conveys respect and acceptance of people as individuals who may also have differing needs and abilities. Chronic diseases and medical conditions discussed in this chapter include: ● Allergies: caused by an abnormal response to substances called allergens. Symptoms can include nasal congestion, headaches, eczema, rashes, asthma, and behavioral changes. Treatment is aimed at identifying offending substances and controlling symptoms. ● Asthma: involves an allergic response and is becoming increasingly more common for unknown reasons. Management is based on avoiding triggers (e.g., smoke, chemicals, infection, pesticides) and administering medications during acute episodes. ● Anemia: occurs when there are too few red blood cells or cells lack hemoglobin and cannot carry adequate oxygen to organs and body tissues. Treatment involves identifying and treating the underlying cause: infection, unhealthy diet, disease. ● Childhood cancers: are relatively uncommon. Symptoms and treatment vary according to the type of cancer involved; leukemia is the most common form experienced by children. ● Diabetes: is caused by an inadequate amount or lack of the insulin hormone. Early symptoms include weight loss, frequent urination, fatigue, and excessive thirst. Treatment includes daily insulin injections (or pump) and careful regulation of diet and activity. ● Eczema: is an inflammatory skin condition commonly seen in children who have allergies; the condition is sometimes outgrown with age. Treatment is aimed at limiting exposure to offending substances and reducing skin irritation. ● Excessive fatigue: is not common among children, but can be caused by chronic infection, unhealthy diet, anemia, lead poisoning, and other serious conditions. Treatment is directed at eliminating the cause. ● Lead poisoning: is caused by lead ingested from contaminated objects; it continues to pose a threat to children’s health (see Table 4–6). Elevated blood lead levels can result in impaired cognitive abilities, headaches, loss of appetite, fatigue, and behavior problems. Treatment is aimed at eliminating the source, correcting dietary deficiencies, and administering medication, if needed. ● Seizure disorders: are caused by abnormal electrical activity in the brain. Symptoms depend upon the type of seizure and range from brief inattention to convulsive movements involving the entire body. Medication is usually prescribed to control seizure activity. ● Sickle cell disease: an inherited genetic disease that affects certain ethnic groups; abnormally shaped red blood cells are unable to carry adequate oxygen to cells in the body. Treatment involves avoiding infection and stress; antibiotics and blood transfusions may also be needed.

◖◗ Terms to Know inclusion p. 84 individualized educational plan (IEP) p. 85 individualized family service plan (IFSP) p. 85 individualized health service plan (IHSP) p. 85

person first language p. 85 food intolerance p. 87 symptomatic control p. 89 anaphylaxis p. 90 gestational diabetes p. 91 hormone p. 96 hyperglycemia p. 97

dehydration p. 97 sleep apnea p. 99 endocrine p. 99 seizures p. 102

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◖◗ Chapter Review A. By Yourself: 1. Explain the process involved in securing intervention services for a child who you suspect may have a significant hearing impairment. 2. Explain why some chronic health conditions may be difficult to recognize. 3. Describe the ways in which febrile, focal onset, and generalized onset seizures differ. 4. What are the early warning signs of diabetes? What resources are available in your community to help teachers improve their understanding of this condition? Where can they learn how to administer insulin injections? 5. Explain how you can determine if a child’s runny nose and lethargy are symptoms due to a cold or an allergy. B. As a Group: 1. Divide into small groups. Each group should develop a case study to illustrate one of the chronic health conditions described in this chapter. The case study should include a description of the condition—its cause, symptoms, effects on the child and family, and classroom strategies for ensuring the child’s successful inclusion. Have groups take turns reading, critiquing, and discussing each other’s case studies. 2. Develop an emergency response plan for a child who has a seizure disorder and discuss how it would be implemented in the classroom. 3. Discuss factors that may be contributing to an increased incidence of childhood allergies and asthma. 4. Explain how a child’s environment may contribute to the development and progression of chronic health conditions. 5. Discuss what teachers can do to support a child who has recently undergone cancer treatment and is ready to return to school.

◖◗ Case Study Mr. Lui arranged to take his first grade class on a field trip to a nearby nature park after they had spent several weeks learning about small mammals living in the wild. The day was warm and sunny, and the children were bubbling with excitement as they completed a short hike around the beaver ponds. As they headed back to the picnic shelter for lunch, one of the children who had run ahead let out a sudden shriek and fell to the ground. The teacher quickly ran to the child and observed that she was unconscious and her arms and legs were jerking violently. Mr. Lui sent one of the other children to get the park ranger, calmed the rest of the children down, and then used his cell phone to call 911 for emergency medical assistance. Within minutes, the seizure ended and the child regained consciousness. When the paramedics arrived, they checked the child over carefully and were satisfied that she required no additional treatment at the time. Mr. Lui contacted the child’s family and learned that her doctor had recently prescribed a new seizure medication. 1. What type of seizure was this child probably experiencing? 2. What indication did the child give of a preceding aura? 3. What signs, in addition to the jerky movements, might you expect to observe during and immediately following this type of seizure? 4. Was Mr. Lui correct in calling for emergency assistance? Would you expect his response to be different if he had known that the child was being treated for a seizure disorder?

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◖◗ Application Activities 1. Locate, read, and critique at least eight children’s books written about several of the chronic diseases and medical conditions discussed in this chapter. 2. Interview teachers in three different educational settings. Inquire about the types of childhood allergies they encounter most often and how they manage children’s health needs in the classroom. Develop a simple, 5-day snack menu for a toddler who is allergic to milk and milk products, chocolate, and eggs. 3. Locate and participate in several developmental screenings that are being conducted in your community. Evaluate the experience and identify things you thought could be improved. 4. Design a poster for classroom teachers that illustrates, step-by-step, how to use an EpiPen® or AUVI-Q® autoinjector. 5. Visit the PBS Kids website (https://pbskids.org/arthur/health/asthma) and read through the sections on childhood asthma. If you were a child, would you find the site attractive? Based on what you have learned in this chapter, is the information accurate and presented in a way that children would understand?

◖◗ Stop and Check Responses #1. A 2-year-old who has been diagnosed with an autism spectrum disorder is eligible to receive services according to the Individuals with Disabilities Education (Improvement) Act (IDEA) guidelines (Part C). Specific interventions for the child and family would be identified in an Individualized Family Service Plan (IFSP). #2. Signs of a severe allergic reaction (anaphylaxis) include difficulty breathing (due to swollen tongue, throat), swollen eye lids, severe itching, nausea/vomiting, bluish skin discoloration, and/ or unconsciousness. Teachers should call 911 immediately for emergency medical assistance. #3. The surge in type 2 diabetes in children is directly linked to the continued increase in childhood obesity. #4. Children who live in poverty, inner city neighborhoods, near landfills or industrial areas, homes with old paint (prior to 1978) or lead water pipes (prior to 1950) are at high risk for lead exposure.

◖◗ Additional Resources To Explore Asthma and Allergy Foundation of America

https://www.aafa.org

American Cancer Society

https://www.cancer.org

American Diabetes Association

https://www.diabetes.org

American Lung Association

https://www.lung.org/

Caring for Kids

https://caringforkids.cps.ca/

Centers for Disease Control and Prevention

https://www.cdc.gov

Center for Health and Health Care in Schools

https://www.healthinschools.org

Diabetes

https://www.cdc.gov/diabetes

KidsHealth

https://www.kidshealth.org

National Cancer Institute

https://www.cancer.gov/types/childhood-cancers

U.S. Department of Health and Human Services: Indian Health Service

https://www.ihs.gov

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◖◗ References Abuabara, K., Ye, M., Margolis, D. J., McCulloch, C. E., Mulick, A. R., Silverwood, R. J., Sullivan, A., Williams, H. C., & Langan, S. M. (2021). Patterns of atopic eczema disease activity from birth through midlife in 2 British birth cohorts. JAMA Dermatology, 157(10), 1191–1199. Adgent, M. A., Gevretsadik, T., Reedus, J., Graves, C., Garrison, E., Bush, N., Davis, R., LeWinn, K. Z., Tylavsky, F., & Carroll, K. N. (2021). Gestational diabetes and childhood asthma in a racially diverse US pregnancy cohort. Pediatric Allergy and Immunology, 32(6), 1190–1196. Allergy & Asthma Network. (2022). Eczema (atopic dermatitis) statistics. Retrieved from https://allergyasthmanetwork .org/what-is-eczema/eczema-statistics/. Antza, C., Kostopoulos, G., Mostafa, S., Nirantharakumar, K., & Tahrani, A. (2021). The links between sleep duration, obesity and type 2 diabetes mellitus. Journal of Endocrinology, 252(2), 125–141. Asthma and Allergy Foundation of America (AAFA). (2021). Allergy facts and figures. Retrieved from https://www .aafa.org/allergy-facts/. Bailey, A. D., Fulgoni, V., Shah, N., Patterson, A. C., Gutierrez-Orozco, F., Mathews, R. S., & Walsh, K. R. (2021). Nutrient intake adequacy from food and beverage intake of US children aged 1-6 years from NHANES 2001-2016. Nutrients, 13(3), 827. https://doi.org/10.3390/nu13030827 Boyle, J., Yeter, D., Aschner, M., & Wheeler, D. C. (2021). Estimated IQ points and lifetime earnings lost to early blood lead levels in the United States. Science of The Total Environment, 778, 146307. https://doi.org/10.1016 /j.scitotenv.2021.146307 Brindisi, G., Marazzato, M., Brunetti, F., De Castro, G., Loffredo, L., Carnevale, R., Cinicola, B., Palamara, A.T., Conte, M. P., & Zicari, A. M. (2022). Allergic rhinitis, microbiota and passive smoke in children: A pilot study. Pediatric Allergy and Immunology, 33(S27), 22–26. Brown, C., & Yu, J-D. (2021). Pediatric allergic contact dermatitis. Immunology & Allergy Clinics of North America, 41(3), 393–408. Centers for Disease Control and Prevention (CDC). (2022). Blood lead levels in children. Retrieved from https://www .cdc.gov/nceh/lead/prevention/blood-lead-levels.htm. CDC. (2021a). Child lead poisoning prevention. Retrieved from https://www.cdc.gov/nceh/lead/default.htm. CDC. (2021b). Childhood obesity facts. Retrieved from https://www.cdc.gov/obesity/data/childhood.html. CDC. (2020). Data & statistics on sickle cell disease. Retrieved from https://www.cdc.gov/ncbddd/sicklecell/data.html. CDC. (2019). Most recent national asthma data. Retrieved from https://www.cdc.gov/asthma/most_recent_national _asthma_data.htm. Chambers, M. A., Mecham, C., Arreola, E. V., & Sinha, M. (2022). Increase in the number of pediatric onset diabetes and diabetic ketoacidosis cases during the COVID-19 pandemic. Endocrine Practice, 28(5), 479–485. Chen, Q., Li, Z., Castro, A., Tang, S., Chen, J., Huang, C., Xiao, J., Liu, H., & Ding, J. (2022). Psychometric properties of disease-specific health-related quality of life (HRQoL) instruments for food allergy and food intolerance: Protocol for a COSMIN-based systematic review. BMJ, 12(1), e053534. https://bmjopen.bmj.com/content/12/1/e053534 Chen, Y-C., Su, M-W., Brumpton, B. M., & Lee, Y. L. (2022). Investigating obesity-related risk factors for childhood asthma. Pediatric Allergy and Immunology, 33(1), e13710. https://doi.org/10.1111/pai.13710 Cheng, W., Rolls, E., Gong, W., Du, J., Zhang, J., Zhang, X-Y., Li, F., & Feng, J. (2021). Sleep duration, brain structure, and psychiatric and cognitive problems in children. Molecular Psychiatry, 26(8), 3992–4003. Di Giovine, M., & Catenaccio, E. (2021). Epilepsy in children and teens: Diagnosis & treatment. Retrieved from https:// www.healthychildren.org/English/health-issues/conditions/seizures/Pages/Epilepsy-in-Children-Diagnosis-and -Treatment.aspx. Dyer, O. (2021). Obesity in US children increase at an unprecedented rate during the pandemic. BMJ, 374, 2332. https://doi.org/10.1136/bmj.n2332 Eigenmann, P. A., Ebisawa, M., Greenhawt, M., Hourihane, J., Perry, T. T., Remington, B. C., & Wood, R. A. (2021). Addressing risk management difficulties in children with food allergies. Pediatric Allergy and Immunology, 32(4), 658–666. Fleischer, D. M., Chan, E. S., Venter, C., Spergel, J. M., Agrams, E. M., Stukus, D., Groetch, M., Shaker, M., & Greenhawt, M. (2021). A consensus approach to the primary prevention of food allergy through nutrition: Guidance from the American Academy of Allergy, Asthma, and Immunology. The Journal of Allergy and Clinical Immunology: In Practice, 9(1), 22–43.e4. https://doi.org/10.1016/j.jaip.2020.11.002 Galiciolli, M. E, Lima, L. S., Costa, N., de Andrade, D. P., Irioda, A. O., & Oliveira, C. S. (2022). IQ alteration induced by lead in developed and underdeveloped/developing countries: A systematic review and a meta-analysis. Environmental Pollution, 292(Part A), 118316. https://doi.org/10.1016/j.envpol.2021.11831 Gibson, J. M., MacDonald, J. M., Fisher, M., Chen, X., Pawlick, A., & Cook, P. J. (2022). Early life lead exposure from private well water increases juvenile delinquency risk among US teens. Proceedings of the National Academy of Sciences, 119(6), 1–11. Retrieved from https://doi.org/10.1073/pnas.2110694119.

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Grant, T., Croce, E., & Matsui, E. C. (2022). Asthma and the social determinants of health. Annals of Allergy, Asthma, & Immunology, 128(1), 5–11. Gurunathan, U., Prasad, H. K., White, S., Prasanna, B., & Sangaralingam, T. (2021). Care of children with type 1 diabetes mellitus in school: An interventional study. Journal of Pediatric Endocrinology and Metabolism, 34(2), 195200. https://doi.org/10.1515/jpem-2020-0334 Hernandez-Reif, M., & Gungordu, N. (2022). Infant sleep behaviors relate to their later cognitive and language abilities and morning cortisol stress hormone levels. Infant Behavior and Development, 67, 101700. https://doi.org/10.1016/ j.infbeh.2022.101700 Hockenberry, M., Wilson, D., & Rodgers, C. (2021). Wong’s Essentials of Pediatric Nursing (11th ed.). St. Louis, MO: Mosby. Johnson, E. C., Atkinson, P., Muggeridge, A., Cross, J. H., & Reilly, C. (2021). Epilepsy in schools: Views on educational and therapeutic provision, understanding of epilepsy and seizure management. Epilepsy & Behavior, 122, 108179. https://doi.org/10.1016/j.yebeh.2021.108179 Kanaley, J. A., Colberg, S. R., Corcoran, M. H., Malin, S. K., Rodriguez, N. R., Crespo, C. J., Kirwan, J. P., & Zierath, J. R. (2022). Exercise/physical activity in individuals with type 2 diabetes: A consensus statement from the American College of Sports Medicine. Medicine and Science in Sports and Exercise, 54(2), 353–368. Kanchan, K., Clay, S., Irizar, H., Bunyavanich, S., & Mathias, R. A. (2021). Current insights into the genetics of food allergy. Journal of Allergy and Clinical Immunology, 147(1), 15–28. Khan, S., Bajwa, S., Brahmbhatt, D., Lovinsky-Desir, S., Sheffield, P. E., Stingone, J. A., & Li, S. (2021). Multi-level socioenvironmental contributors to childhood asthma in New York City: A cluster analysis. Journal of Urban Health, 98(6), 700–710. Lee, S., Lucas, S., Proudman, D., Nellesen, D., Paulose, J., & Sheehan, V. A. (2022). Burden of central nervous system complications in sickle cell disease: A systematic review and meta-analysis. Pediatric Blood & Cancer, 69(4), e29493. https://doi.org/10.1002/pbc.29493 Lu, W., Levin, R., & Schwartz, J. (2022). Lead contamination of public drinking water and academic achievements among children in Massachusetts: A panel study. BMC Public Health, 22(1), 107. https://doi.org/10.1186 /s12889-021-12474-1 Manelis-Baram, L., Meiri, G., Ilan, M., Faroy, M., Michaelovski, A., Flusser, H., Menashe, I., & Dinstein, I. (2022). Sleep disturbances and sensory sensitivities co-vary in a longitudinal manner in pre-school children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 52(2), 923–937. Marcotte, E. L., Domingues, A. M., Sample, J. M., Richardson, M. R., & Spector, L. G. (2021). Racial and ethnic disparities in pediatric cancer incidence among children and young adults in the United States by single year of age. Cancer, 127(19), 3651–3663. Marlow, E. C., Ducore, J., Kwan, M. L., Cheng, S. Y., Bowles, E. J., Greenlee, R. T., Pole, J. D., Rahm, A. K., Stout, N. K., Weinmann, S., Smith-Bindman, R., & Miglioretti, D. L. (2021). Leukemia risk in a cohort of 3.9 million children with and without Down syndrome. The Journal of Pediatrics, 234, 172–180.e3. https://doi.org/10.1016/j .jpeds.2021.03.001 Martinez-Santos, A-E., Fernandez-De-La-Iglesia, J., Sheaf, G., & Coyne, I. (2021). A systematic review of the educational experiences and needs of children with cancer returning to school. Journal of Advanced Nursing, 77(7), 2971–2994. Meinzen-Derr, J., Mekibib, A., Grove, W., Folger, A. T., & Wiley, S. (2022). Association of age of enrollment in early intervention with emergent literacy in children who are deaf or hard of hearing. Journal of Developmental Pediatrics, 43(2), 104–110(7). National Cancer Institute. (2021). Cancer in children and adolescents. Retrieved from https://www.cancer.gov/types /childhood-cancers/child-adolescent-cancers-fact-sheet. National Institute of Neurological Disorders and Stroke (NINDS). (2021). Febrile seizure fact sheet. Retrieved from https://www.ninds.nih.gov/. O’Sullivan, B. P., James, L., Majure, J. M., Bickel, S., Phan, L-T., Gonzalez, M. S., Staples, H., Tam-Williams, J., Lang, J., & Snowden, J. (2021). Obesity-related asthma in children: A role for vitamin D. Pediatric Pulmonology, 56(2), 354–361. Pals, R. A., Coyne, I., Skinner, T., & Grabowski, D. (2021). A delicate balance between control and flexibility: Experiences of care and support among pre-teenage children with type 1 diabetes and their families. Sociology of Health & Illness, 43(2), 369–391. Peden, D. B. (2021). Prenatal exposure to particulate matter air pollution: A preventable risk for childhood asthma. Journal of Allergy and Clinical Immunology, 148(3), 716–718. Rajaee, M., Dubovitskiy, E., & Brown, V. C. (2022). Evaluation of calcium-fortified municipal water as a public health intervention to mitigate lead burdens. Water Practice and Technology, 17(1), 352–365. Reeves, S. L., Freed, G. L., Madden, B., Wu, M., Miller, L., Cogan, L., Anders, D., Creary, S. E., McCormick, J., & Dombkowski, K. J. (2021). Trends in quality of care among children with sickle cell anemia. Pediatric Blood & Cancer, 69(2), e29446. https://doi.org/10.1002/pbc.29446

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Saleh, M., Kim, J. Y., March, C., Gebara, N., & Arslanian, S. (2022). Youth prediabetes and type 2 diabetes: Risk factors and prevalence of dysglycaemia. Pediatric Obesity, 17(1), e12841. https://doi.org/10.1111/ijpo.1284 Sarmast, S. T., Abdullahi, A. M., & Jahan, N. (2020). Current classification of seizures and epilepsies: Scope, limitations, and recommendations for future action. Cureus, 12(9), e10549. https://doi:10.7759/cureus.10549 Serbis, A., Giapros, V., Kotanidou, E. P., Galli-Tsinopoulou, A., & Ekaterini, S. (2021). Diagnosis, treatment, and prevention of type 2 diabetes mellitus in children and adolescents. World Journal of Diabetes, 12(4), 344–365. Shelton, A. R., & Malow, B. (2021). Neurodevelopmental disorders commonly presenting with sleep disturbances. Neurotherapeutics, 18(1), 156–169. Sinha, C. B., Bakshi, N., Ross, D., Loewenstein, G., & Krishnamurti, L. (2021). Primary caregiver decision-making in hematopoietic cell transplantation and gene therapy for sickle cell disease. Pediatric Blood & Cancer, 68(1), e28749. https://doi.org/10.1002/pbc.28749 Turgay, Y., Kulhas, C. I., Yilmaz, T. O., Civelek, E., Toyran, M., Karaatmaca, B., Kocabas, C. N., & Dibek, M. E. (2022). The etiology, clinical features, and severity of anaphylaxis in childhood by age groups. International Archives of Allergy and Immunology, 183(6), 600–610. Vogel, M., Geserick, M., Gausche, R., Beger, C., Poulain, T., Meigen, C., Körner, A., Keller, E., Kiess, W., & Pfäffle, R. (2022). Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic. International Journal of Obesity, 46(1), 144–152. Waserman, S., Shah, A., Cruikshank, H., & Avilla, E. (2022). Recognition and management of food allergy and anaphylaxis in the school and community setting. Immunology and Allergy Clinics of North America, 42(1), 91–103. Xu, K., Li, S., Whitehead, T. P., Pandey, P., Kang, A. Y., Morimoto, L. M., Kogan, S. C., Metayer, C., Wiemels, J. L., & de Smith, A. J. (2021). Epigenetic biomarkers of prenatal tobacco smoke exposure are associated with gene deletions in childhood acute lymphoblastic leukemia. Cancer Epidemiology, Biomarkers & Prevention, 30(8), 1517–1525.

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chapter

5

The Infectious Process and Environmental Control Professional Standards Linked to Chapter Content

◗ ◗

◗

#1a Child development and learning in context #2a, b, and c Family–teacher partnerships and community connections #3a, b, c, and d Child observations, documentation, and assessment

Learning Objectives After studying this chapter, you should be able to:

LO 5-1 Discuss why young children experience frequent communicable illness.

LO 5-2 Describe the components required for an illness to be communicable. LO 5-3 Identify the four stages of a communicable illness. LO 5-4 Name and discuss four control measures that teachers can use to reduce the transmission of communicable illnesses in the classroom.

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Young children, especially those under 3 years of age, are highly susceptible to communicable illness. Frequent upper respiratory infections are common, especially during a child’s first experiences in group settings.

Risk Factors

5-1

Several factors increase young children’s chances of experiencing a communicable illness. First, they tend to have fewer protective antibodies due to their limited prior exposures to infectious illnesses. Physical disabilities and chronic conditions, such as diabetes, sickle cell anemia, allergies, and asthma can further reduce children’s resistance and leave them more susceptible to communicable conditions. Second, children’s immature body structures make them more vulnerable to many communicable illnesses. For example, short distances between child’s ears, nose, and throat make it easy for organisms to enter and infect these areas. Third, group settings, such as home- and center-based early childhood programs and elementary school classrooms are ideal environments for the rapid spread of illness (Endo et al., 2021; White, Murray, & Chakravarty, 2022). Children in these settings spend their days in close proximity to one another and come in frequent contact with items such as toys and furniture that others have touched. However, children can also be exposed to communicable illnesses in other crowded Stop and Check #1 settings, such as grocery stores, shopping centers, churches, libraries, and restaurants. Additionally, many of children’s habits, such as sucking on fingers, mouthing Why are young children toys, carelessness with bodily secretions (runny noses, drool, urine, stool), and an especially susceptible to abundance of physical contact also encourages the rapid spread of communicable communicable illnesses that are transmitted via illnesses. For these reasons, every attempt must be made to establish and impleairborne droplets? ment policies, practices, and learning experiences to protect young children from unnecessary exposure.

Communicable Illness

5-2

Communicable illnesses are infectious conditions that can be transmitted or spread from a person, animal, or intermediary source to an individual. Three factors, all of which must be present at approximately the same time, are required for this process to occur (Figure 5–1): a pathogen a susceptible host a method of transmission

First, a pathogen or microorganism, such as a bacteria, virus, fungus, or parasite, must be present and available for transmission. These invisible germs are specific for each disease and are commonly located in discharges from the respiratory (nose, throat, lungs) and intestinal tracts of infected persons. They can also be found in the blood, urine, and discharges from the eyes and skin. Most pathogens require a

Figure 5–1 Communicable illness model.

Host

Pathogen

Method of Transmission

antibodies – special substances produced by the body that help to protect against disease. pathogen – a microorganism capable of producing illness or infection.

Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Samuel Borges Photography/Shutterstock.com; National Institute of Allergy and Infectious Diseases; Kornnphoto/Shutterstock.com

◗ ◗ ◗

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living host (e.g., human, animal, insect) for their survival, except for the organism that causes tetanus; it can survive in soil and dust for years. Second, there must be a susceptible host or person who is vulnerable to the disease-causing organism. Most communicable illnesses that children experience enter through the respiratory tract, the digestive tract, or a break in the skin or mucous linings. The entry route is specific for each infectious disease. Not every child who is exposed to a particular virus, bacteria, or other pathogen will become infected. Conditions must be favorable to allow an infectious organism to avoid the body’s defense systems, multiply, and establish itself. Children who are well rested, adequately nourished, immunized, and healthy are generally less susceptible to infectious organisms. Some children will have immunity because they experienced a prior case of the same illness. However, the length of this protection varies with the illness and can range from several days to a lifetime. For example, a child who has had chickenpox will have permanent immunity against a recurrence, whereas immunity following a cold may last only a few days. Children who are carriers or who experience a mild case of some communicable diseases may develop immunity without knowing that they have been infected. Third, a method for transmitting the infectious agent from the original source to a new host is necessary to complete the communicable process. Infectious agents are most commonly spread via airborne transmission in school settings. Disease-causing pathogens are carried on tiny droplets of moisture that are expelled during coughs, sneezes, or while talking (Figure 5–2). Influenza, colds, meningitis, tuberculosis, and chickenpox are examples of infectious illnesses spread in this manner. Fecal–oral transmission is the second-most common route by which infectious illnesses are spread in group settings, particularly when infants and toddlers in diapers are present. Teachers who fail to wash their hands properly after changing diapers or assisting children with toileting needs are often responsible for spreading disease-causing germs, especially if they also handle food. For this reason, it is advisable to assign diaper changing and food preparation responsibilities to different individuals. Children’s hands should always be washed after diaper changes or after using the bathroom because their hands often end up in their mouths. Appropriate handwashing procedures should be taught and monitored closely to be sure children are washing correctly. Pinworms, hepatitis A, Salmonella, and giardiasis are examples of illnesses transmitted by fecal–oral contamination.

Airborne

Fecal-oral

Direct

Indirect

Kornnphoto/Shutterstock.com; Venus Angel/ Shutterstock.com; Ana Blazic Pavlovic/Shutterstock. com; U.S. Department of Health & Human Services

Figure 5–2 How infectious illnesses are commonly spread.

susceptible host – an individual who is capable of being infected by a pathogen. respiratory tract – the nose, throat, trachea, and lungs. immunized – a state of becoming resistant to a specific disease through the introduction of living or dead microorganisms, which stimulate the body to produce protective antibodies. airborne transmission – the process by which germs are expelled into the air through coughs and sneezes and transmitted to another individual via tiny moisture droplets. fecal–oral transmission – the process in which germs are transferred to the mouth via hands contaminated with fecal material.

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Chapter 5

The Infectious Process and Environmental Control

A third common method of transmission involves direct contact with body fluids, such as blood or mucus, or by touching an infected area on another person’s body. The infectious organisms are transferred directly from the original source of infection to a new host. Ringworm, athlete’s foot, impetigo, hepatitis B, and conjunctivitis (pinkeye) are a few of the conditions spread in this manner. Communicable illnesses can also be transmitted through indirect contact. This method involves the transfer of infectious organisms from an infected individual to an intermediate object, such as water, milk, dust, food, toys, towels, eating utensils, animals, insects, or surfaces and finally to the susceptible host. It is also possible to infect oneself with certain bacteria and viruses, such as those causing colds and influenza, simply by touching the moist linings of the eyes, nose, or mouth with contaminated hands. Several communicable illnesses, including conjunctivitis (pinkeye), cytomegalovirus (CMV), impetigo, scabies, athlete’s foot, and head lice can be transmitted through indirect and direct contact. Eliminating any one of these three factors (pathogen, host, or method of transmission) will disrupt the spread of a communicable illness. This is an important concept for families and teachers to understand when trying to control communicable illness, especially in group settings. It can also be beneficial for reducing the number of illnesses that teachers may experience or carry home to their families.

117

▼ Communicable illnesses can be spread when children mouth toys and objects that other children have used.

Stages of Illness

5-3

Communicable illnesses generally develop in fairly predictable stages: ◗ ◗ ◗ ◗

incubation prodromal acute convalescence

Did You Know... it is common for children to experience 5–8 colds per year?

The length of each stage is often different for a specific illness. In some cases, the stages may overlap and be difficult to identify when one begins and another ends. The incubation stage includes the time between exposure to a pathogen Stop and Check #2 and the appearance of the first signs or symptoms of illness. During this period, the infectious organisms enter the body and multiply rapidly to establish themWhat three factors are selves and overpower the body’s defense systems. The length of the incubation necessary for an infectious stage is described in terms of hours or days and varies for each communidisease to be transmissible from one person to cable disease. For example, the incubation period for chickenpox ranges from another? 2 to 3 weeks following exposure, whereas for the common cold it is thought to be only 12 to 72 hours. Many infectious illnesses are already communicable

direct contact – coming in direct or immediate contact with infectious material. indirect contact – contact with infectious material that is transmitted via surfaces, animals, or insects. incubation – the interval of time between exposure to infection and the appearance of the first signs or symptoms of illness.

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near the end of this stage. Children are often contagious before any specific symptoms appear, which can make some communicable illnesses difficult to control despite teachers’ careful observations. The prodromal stage begins when an infant or young child experiences the first nonspecific signs of illness and ends with the appearance of symptoms characteristic of a particular communicable disease. This stage may last from several hours to several days. However, not all communicable diseases have a prodromal stage. Early symptoms commonly associated with the prodromal stage may include headache, unexplained fatigue, low-grade fever, a slight sore throat, and a general feeling of restlessness or irritability. Many complaints are so vague that they can easily go unnoticed. However, because children are highly contagious during this stage, teachers and parents must understand that these subtle changes may signal an impending illness. During the acute stage there is no doubt that an infant or child is sick and highly contagious. The onset of this stage is marked by the appearance of Stop and Check #3 symptoms characteristic of the illness and ends as the child begins to recover. A child who wakes up with Early symptoms, such as fever, sore throat, cough, runny nose, rash, or enlarged a fever and red, blistered lymph glands are common to many infectious diseases during the acute stage. bumps (chickenpox) on These symptoms often develop in a characteristic pattern that can be useful for their body is in what stage identifying the communicable illness involved. of the communicable The convalescent or recovery stage generally follows automatically unless illness? complications develop. During this stage, symptoms gradually disappear and children begin to feel better.

Control Measures

5-4

Teachers have an obligation and responsibility to help protect young children from communicable illnesses. Although many illnesses are simply an inconvenience, others can cause serious complications. Because classrooms are ideal settings for the rapid spread of many infectious conditions, control measures must be practiced diligently to limit their spread. 5-4a

Observations

Teachers’ daily health observations are an effective tool for identifying children in the early stages of a communicable illness. Removing children who are ill from classrooms eliminates a primary source of infection. However, it is important to remember that many illnesses are communicable before the characteristic symptoms appear, so not all spread can be avoided. For this reason, it is important to continuously note changes in children’s appearance and behavior patterns. This process is made easier by the fact that young children often look and behave differently when they are not feeling well. Their actions, facial expressions, skin color, sleep habits, appetite, and comments provide valuable warnings of impending illness. Additional signs may include: ◗ ◗ ◗ ◗ ◗ ◗

unusually pale or flushed skin red or sore throat uncontrollable coughing enlarged lymph glands nausea, vomiting, or diarrhea rash, spots, or open lesions

contagious – capable of being transmitted or passed from one person to another. prodromal – the appearance of the first nonspecific signs of infection; this stage ends when the symptoms characteristic of a particular communicable illness begin to appear. acute – the stage of an illness or disease during which an individual is definitely sick and exhibits symptoms characteristic of a specific illness or disease. convalescent – the stage of recovery from an illness or disease. lymph glands – specialized groupings of tissue that produce and store white blood cells for protection against infection and illness. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Chapter 5

◗ ◗ ◗ ◗

The Infectious Process and Environmental Control

watery or red eyes headache or dizziness chills, fever, or achiness fatigue or loss of appetite

119

▼ Changes in children’s appearance and behavior may be an early indication of an impending illness.

The appearance of these signs and symptoms does not always warrant concern in all children. For example, a teacher who knows that Tony’s allergies often cause a red throat and cough in the fall, or that Shadra’s recent irritability is probably related to her mother’s hospitalization, would not be alarmed by these observations. Teachers must be able to distinguish between children with potentially infectious illnesses and those with health problems that are explainable and not necessarily contagious. Knowing that some illnesses are more prevalent during certain times of the year or that a current outbreak exists in the community can also be useful for identifying children who may be infectious. 5-4b

Policies

Written exclusion and inclusion policies offer another important method for controlling infectious illnesses in group settings (AAP, APHA, NRC, 2020, 2022). Policies should be consistent with state regulations and in place before a program enrolls children. They should be reviewed frequently so that staff members are familiar with the guidelines and more likely to enforce them consistently. General health and exclusion policies should also be described in a program’s family handbook. Informing families in advance about what to expect if their child does become ill allows them time to make alternative arrangements. Exclusion and inclusion policies should establish clear guidelines for when children who are ill should be kept home, when they will be sent home due to illness, and when they are considered well enough to return (Figure 5–3). Opinions differ on how restrictive exclusion policies should be. Some experts believe that children with mild illnesses can remain in group care, while others feel that children who Figure 5–3

Sample exclusion policy. EXCLUSION POLICY

Control of communicable illness among the children is a prime concern. Policies and guidelines related to outbreaks of communicable illness in this center have been developed with the help of the health department and local pediatricians. To protect the entire group of children, as well as your own child, we ask that families assist us by keeping children who are ill at home if they have experienced any of the following symptoms within the past 24 hours: fever over 100°F (37.8°C) orally or 99°F (37.2°C) axillary (under the arm) signs of a newly developing cold or uncontrollable coughing diarrhea, vomiting, or an upset stomach unusual or unexplained loss of appetite, fatigue, irritability, or headache any discharge or drainage from eyes, nose, ears, or open sores Children who become ill with any of these symptoms will be sent home. We appreciate your cooperation with this policy. If you have any questions about whether or not your child is well enough to attend school or group care that day, please call before bringing your child.

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Figure 5–4

Sample letter notifying families of their child’s exposure. Date_____________________

Dear Parent: There is a possibility that your child has been exposed to impetigo. Please observe your child’s skin closely for the next 2–10 days and look for: itchy rash that may develop blisters moist sores that are more likely to appear around the face, ears, nose, or arms sores that increase in size or spread to other parts of the body Impetigo is highly contagious and requires careful hand washing to prevent it from infecting others. Please contact your child’s health care provider for advice about treating the condition. Children may return to school after receiving medical care and all sores have healed over. If you have any questions, please call before bringing your child to school. We appreciate your cooperation in helping us to protect children’s well-being.

exhibit symptoms should be sent home. Because many early signs of communicable illnesses are nonspecific, teachers and families may have difficulty distinguishing between conditions that warrant exclusion and medical attention and those that do not. Consequently, programs may decide to set exclusion policies that are fairly restrictive unless they are prepared to care for sick children. It is also important for programs to adopt policies about notifying families when children are exposed to communicable illnesses. This measure enables parents to watch for early symptoms and to keep sick children home (Figure 5–4). Immunization requirements, as well as actions the program will take if children are not in compliance, should also be addressed in a program’s policies. Local public health authorities can provide information and guidance to programs when they are formulating new policies or are confronted with a communicable health problem about which they are unsure. Guidelines for Teacher Illness Teachers work in conditions that can be physically and emotionally challenging. In addition, they are exposed to many infectious illnesses through their daily contact with children. They often experience an increased frequency of illness—especially during the initial months of employment—that is similar to what young children experience when they initially enroll in a new program or school (Swigonski et al., 2021). However, over time, teachers gradually build up resistance to many of these illnesses. They can also take steps to minimize their risk by obtaining a preemployment health assessment and tuberculin test, updating immunizations, following a healthy lifestyle, and practicing frequent hand washing. Teachers who are pregnant may want to temporarily reconsider working around young children because some communicable illnesses, such as cytomegalovirus and German measles, can affect the fetus, especially during the early months. When teachers are ill and trying to decide whether they should go to work, they must follow the same exclusion and inclusion guidelines that apply to sick children. Adults who do not feel well will not be able to meet the rigorous demands necessary for working with young children and face an increased risk of sustaining an injury. It is important for programs to maintain a list of substitute teachers so that staff members do not feel pressured to work when they are ill. Administration of Medication The administration of medicine to young children is a responsibility that must always be taken seriously (see Teacher Checklist 5–1). Policies and procedures for administering prescription and nonprescription medications, including ointments and creams; Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Chapter 5

The Infectious Process and Environmental Control

121

Checklist 5–1 ✓✓✓ Teacher Administering Medications to Children 1. Always wash your hands before handling medications and after administering them. 2. Be honest when giving children medication! Do not use force or attempt to trick children into believing that medicines are candy. Instead, use the opportunity to help children understand the relationship between taking a medication and recovering from an illness or infection. Also, acknowledge the fact that the taste of medicine may be disagreeable, or a treatment may be somewhat unpleasant; offer a small sip of juice or cracker to eliminate an unpleasant taste or read a favorite story as a reward for their cooperation. 3. Designate one individual to accept medication from families and administer it to children; this could be the director or the head teacher. This step reduces the opportunity for errors, such as omitting a dose or giving a dose twice. 4. When medication is accepted from a family, it should be in the original container and labeled with the child’s name, the drug name, and the time and dose to be administered. A medication authorization form should be completed by the child’s parent or legal guardian.

Caution NEVER give medicine from a container that has been prescribed for another individual. 5. Store all medicines in a locked cabinet. If it is necessary to refrigerate a medication, place it in a locked box and store it on a top shelf in the refrigerator. 6. When administering medication to a child, concentrate and do not talk with anyone until you are finished. 7. Compare the label information with the medication authorization form. Make sure you have the correct medication, dose, child, time, and route of administration. Read the label on the bottle or container three times: ● when removing it from the locked cabinet ● before pouring it from the container ● after pouring it from the container 8. Note when the last dose was given. Administer medication on time and give only the amount prescribed. (Carefully note the difference between tsp (teaspoon) and tbsp (tablespoon) to prevent giving an overdose. 9. Make sure you have the correct child! If the child is old enough to talk, ask “What is your name?” and have the child state their name. 10. Record and maintain a permanent record of each dose of medicine that is administered (Figure 5–5). Include the: ● date, time, and dose of medication given ● name of teacher administering the medication ● any unusual physical or behavioral changes noted after the medication was administered 11. Inform the child’s family of the dosage(s) and time medication was given, as well as any unusual reactions that may have occurred. 12. NOTE: Adults should never take any medication in front of children.

eye, ear, and nose drops; cough syrups; pain or fever-reducing medications; inhalers; and nebulizer breathing treatments should be developed in accordance with state licensing or school district regulations to safeguard children as well as teaching staff. These policies and procedures should be in writing, familiar to all staff members, filed in an accessible location, and distributed to every family (Figure 5–5). When children are enrolled in part-day programs, families may be able to alter medication schedules and administer prescribed doses at times when children are at home. However, this may not be an option for children who attend full-day school or early childhood programs. In these cases, families will need to make prior arrangements with the child’s teachers or school nurse to have prescribed medications administered at the appropriate times. Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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Figure 5–5

Sample medication recording form.

MEDICATION ADMINISTRATION FORM Child’s name _______________________________ Date of birth _____________________ Prescription number __________________________________________________________ Date of prescription __________________________________________________________ Doctor prescribing medicine ____________________________________________________ Medication being given for _____________________________________________________ Time medication is to be given by staff ____________________________________________ Time medication last given by parent (guardian) ____________________________________ Amount to be given at each time (dosage) _________________________________________

...................................................................................... I, ___________________________________ give my permission for the staff to administer the above prescription medication (according to the above guidelines) to _________________ _______________________________________ . I understand that the staff cannot be held (child’s name)

responsible for allergic reactions or other complications resulting from administration of the above medication when given according to the directions.

Parent/guardian name (print) ___________________ Signature ___________________________________ Date ______________________________________

...................................................................................... Staff Record Staff member accepting medication and signing this form (print) ________________________ Is medication in its original container? ____________________________________________ Is original label intact? _________________________________________________________ Is there written permission from the doctor attached (or the original prescription)? __________ Signature of accepting staff ___________________________________

...................................................................................... Administration Record

DATE

TIME

AMOUNT GIVEN

STAFF ADMINISTERING

INITIALS

Medications should never be given to children without their family’s written consent and written instructions from a licensed physician. The label on a prescription drug is considered an acceptable physician’s directive. In the case of nonprescription medicines, families should obtain written instructions from the physician stating the child’s name, the medication to be given, Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Chapter 5

5-4c

Immunization

123

▼ Immunizations protect children from many preventable childhood diseases.

Monkey Business Images/Shutterstock.com

the reason for giving the medication, the dose, how often it is to be administered, potential reactions, and any special precautions that may be necessary. There are risks associated with giving children over-the-counter medications that have not been authorized by a physician. It is the physician’s professional and legal responsibility to determine which medication and exact dosage is appropriate for an individual child. Teachers can protect themselves from potential liability by refusing to give medications without a doctor’s order.

The Infectious Process and Environmental Control

Immunization offers permanent protection against fourteen preventable childhood diseases, including diphtheria, tetanus, whooping cough (pertussis), polio, measles, mumps, rubella, Haemophilus influenzae, meningitis, hepatitis, pneumonia, and chickenpox. However, outbreaks of some diseases continue to occur because not all children are fully immunized according to recommendations. Large-scale national, state, and local initiatives increased the number of children who had received all age-appropriate immunizations to approximately 90 percent prior to the COVID-19 pandemic (Hill et al., 2021). However, immunization rates fell to approximately 65–67 percent during the pandemic, with black and Hispanic children receiving the fewest immunizations (DeSilva et al., 2022). Efforts to assure that all children are fully immunized remains a Healthy People 2030 priority (U.S. DHHS, 2022). Why are some families so seemingly hesitant about having their children immunized? Perhaps they do not realize that some communicable illnesses are still life-threatening and continue to place children who are not protected at risk. Recent outbreaks of mumps, measles, tuberculosis, and whooping cough, for example, have clearly demonstrated this potential (Dimala et al., 2021). Some families falsely believe that antibiotics are available to cure all infectious illness, so they are willing to take a chance. Others have expressed concern about vaccine safety and the number of immunizations that children must receive (Ellithorpe, Adams, & Aladé, 2022). Pharmaceutical companies continue to make strides in combining some vaccines to help reduce this number. Manufacturers have also eliminated questionable substances, such as thimerosal, from vaccines to improve their safety (Löffler, 2021). Scientists and health advocates have repeatedly shown that the benefits of immunization far outweigh the safety and disease risks. Most states require children’s immunizations to be complete and current when they enter school or enroll in early childhood programs. In states where immunization laws are lax, teachers must insist that every child be fully immunized unless families are exempt for religious or medical reasons (National Conference of State Legislatures, 2022). Teachers should also be diligent about keeping their own immunizations up to date. Vaccines work by triggering the body’s immune system to produce protective substances, called antibodies, against a specific disease. This process is similar to what occurs when a person becomes ill with certain infectious diseases. Infants are born with a limited supply Did You Know... of antibodies, acquired from their mothers, which protects them against some commuchildren miss approximately nicable illnesses. However, this maternal protection is only temporary and, therefore, 22 million days due to a the immunization process must be initiated early in an infant’s life. The immunizacold and 38 million days tion schedule jointly recommended by the Centers for Disease Control and Protection because of influenza (CDC), the American Academy of Pediatrics (AAP), and the American Academy of each school year? Family Physicians (AAFP) appears in Figure 5–6. Similar recommendations are available for Canadians and children in other countries (Government of Canada, 2021). Copyright 2024 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

1st dose

Pneumococcal conjugate (PCV13) 4th dose -----u

dose -----u

Range of recommended ages for all children

¢

Range of recommended ages for certain high-risk groups

¢

2nd dose

2nd dose

or

¢

Recommended vaccination can begin in this age group

17–18 yrs

See Notes

1st dose

See Notes

2nd dose

Annual vaccination 1 dose only

Annual vaccination 1 dose only

16 yrs

Recommended vaccination based on shared clinical decision-making

¢

No recommendation/ not applicable

Seropositive in endemic areas only (See Notes)

Source: Centers for Disease Control and Prevention. (2022). https://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-schedule.pdf

¢

Dengue (DEN4CYD; 9-16 yrs)

Pneumococcal polysaccharide (PPSV23)

Meningococcal B (MenB-4C, MenBFHbp)

Meningococcal (MenACWY-D ≥9 mos, MenACWY-CRM ≥2 mos, MenACWY-TT ≥2years)

See Notes

4th dose

See Notes

2-dose series, See Notes

t-----1st dose-----u

st

t----- 1

Annual vaccination 1 or 2 doses

3rd dose ----------------------------u

t-----

5th dose

7–10 yrs 11–12 yrs 13–15 yrs

Human papillomavirus (HPV)

¢

4th dose ------u

3rd or 4th dose,u See Notes--

t--

t-----

4–6 yrs

Annual vaccination 1 or 2 doses

18 mos 19–23 mos 2–3 yrs

dose ----------------------------u

15 mos

1 dose

See Notes

See Notes

t----------------------------

3rd dose

2nd dose See Notes

3rd dose

rd

12 mos

Tetanus, diphtheria, acellular pertussis (Tdap ≥7 yrs)

Hepatitis A (HepA)

Varicella (VAR)

Measles, mumps, rubella (MMR)

Influenza (LAIV4)

or

Influenza (IIV4)

Range of recommended ages for catch-up vaccination

1st dose

Haemophilus influenzae type b (Hib)

2nd dose

9 mos

t---------------------------- 3

6 mos

2nd dose See Notes

4 mos

Unit 1

Inactivated poliovirus (IPV 70 y

Males

600 700 700 700 700 700

15 25

300 400

1–3 y 4–8 y

Children

40* 50*

400* 500*

Vitamin A Vitamin C Vitamin D Vitamin E Vitamin K Thiamin Riboflavin Niacin Vitamin B6 Folate (mg/d)a (mg/d) (mg/d)bc (mg/d)d (mg/d) (mg/d) (mg/d) (mg/d)e (mg/d) (mg/d)f

0 to 6 mo 6 to 12 mo

Infants

Life Stage Group

Food and Nutrition Board, Institute of Medicine, National Academies

Table 12–2 Dietary Reference Intakes: RDA and AI for Vitamins and Elements

Chapter 12 Nutrition Guidelines

329

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Unit 3

Foods and Nutrients: Basic Concepts

Figure 12–1 Physical activity recommendations for young children. The American Academy of Pediatrics (AAP), National Association for Sport & Physical Education (NASPE), and Canadian Academy of Sport Medicine (CASM) encourage children of all ages to engage in physical activity daily: – infants should have “tummy time” and ample opportunities to explore their environment during awake periods. They should not be confined to a stroller or carrier for longer than 60 minutes a day. – toddlers should accumulate at least 30 minutes of structured, vigorous physical activity and at least 60 minutes or more of unstructured active play throughout the day. – preschoolers should participate in at least 60 minutes of vigorous physical activity and several hours of unstructured moderate activity or free-play daily. – school-age children should participate in at least 60 minutes of vigorous physical activity daily. Muscle-strengthening and bone-strengthening activities should be included as part of their regular activity at least 3 days a week.

at least every 5 years. This document reflects the Advisory Committee’s efforts to establish recommendations based upon the latest scientific evidence regarding nutrition’s role in health maintenance and disease prevention. The 2020–2025 edition is available online (https:// www.dietaryguidelines.gov/). Did You Know... The Dietary Guidelines for Americans serve as the basis for nearly all nutrition salt occurs naturally in information in the United States (USDA & U.S. HHS, 2020). While the DRIs focus many foods, but added salt in restaurant, fast food, and on specific nutrients and age groups, the Dietary Guidelines assume a broader processed foods accounts for approach. They provide information about healthy eating patterns and physical nearly 80 percent of a person’s activity and their role in weight management and disease prevention for persons total daily intake? 2 years of age and older (Figure 12–1). Four primary health-promoting guidelines, along with key recommendations, are highlighted in the 2020–2025 Dietary Guidelines (Table 12–3). Canada has developed similar guidelines in a document entitled, Canada’s Dietary Guidelines (2019). The recommendations are intended to promote healthier eating habits among diverse multicultural audiences based upon the most recent research findings (Health Canada, 2019). The principles in this document are similar to those described in the U.S. Dietary Guidelines and encourage individuals to achieve good health by choosing nutritious foods (e.g., proteins, fruits/vegetables, whole grains, water) and limiting those that are high Table 12–3 Dietary Guidelines for Americans 2020–2025: Key Guidelines and Recommendations

Guidelines • Follow a healthy dietary pattern at every life stage. • Customize and enjoy nutrient-dense food and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations. • Focus on meeting food group needs with nutrient-dense foods and beverages, and stay within calorie limits. • Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages.

Recommendations • Limit added sugars* to less than 10% of calories per day for ages 2 and older and to avoid added sugars for infants and toddlers. • Limit saturated fat to less than 10% of calories per day starting at age 2. • Limit sodium intake to less than 2,300 mg per day (or even less if younger than 14). • Limit alcoholic beverages* (if consumed) to 2 drinks or less a day for men and 1 drink or less a day for women. Source: U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services (U.S. HHS). (2020). 2020−2025 Dietary Guidelines for Americans (9th ed.).

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in sodium, sugar, fats, and calories. A companion document, Canada’s Food Guide: Physical Activity and Healthy Eating, emphasizes the importance of making sound food choices and maintaining an active lifestyle. Similar dietary recommendations have been adopted by other countries worldwide. Schools and early childhood programs have an obligation and opportunity to promote children’s healthy eating and physical activity behaviors in a continued effort to address childhood obesity. Scientists have established a direct link between excessive weight gain and sedentary lifestyles with the development of many adult chronic disStop and Check #2 eases (e.g., cancer, heart disease, stroke, diabetes) which pose a serious public Why are individuals health concern (Handakas et al., 2022; Moxley, Webber-Ritchey, & Hayman, encouraged to include a 2022). Schools must assume an active role in combating these problems by wide variety of foods in adhering to Dietary Guideline recommendations when serving food to chiltheir diet? dren and by providing more health education and physical activity opportunities throughout the day.

12-3

MyPlate

12-3a

Vegetables

United States Department of Agriculture

The MyPlate model provides a graphic representation of the Dietary Guidelines for Americans (Figure 12–2). It translates important dietary recommendations into a pictorial illustration that is concise and easy for the public to navigate, understand, and implement. Did You Know... It conveys a strong preventive message and emphasizes the importance of balancing studies have shown that eating a diet rich in a variety caloric intake with physical activity, consuming a greater variety of foods from each of fruits and vegetables can food group, and limiting foods high in added sugars, fats, and calories. MyPlate also reduce a person’s risk of encourages consumers to incorporate more low-fat dairy products into their diet, and developing some cancers? to fill half of their plate with fruits and vegetables, one-fourth with whole grains, and the remaining fourth with a lean protein food. The MyPlate website (https://www.myplate.gov) also offers comprehensive information in 22 languages about Figure 12–2 The MyPlate model provides extensive food groups and appropriate portion sizes (click on “Life nutrition and physical activity information and Stages”), nutrients and their health contributions, and meal online tools in a clear and easy-to-use manner. preparation suggestions for individuals and families. The site provides consumers with access to extensive resource information about calories, weight management, physical Dairy activities, healthy eating suggestions (e.g., vegetarian, culFruits tural cuisine, food safety, recipes, sample menus), and tips Grains for eating in restaurants. The MyPlate app can be downloaded to a smart phone and includes a QR code that can be used for shopping. The app is designed to help consumers Vegetables Protein locate budget-friendly foods and SNAP EBT opportunities in their area. The MyPlate “Shop Simple” feature works in the same way on a phone, tablet, or computer. Lesson and activity plans, graphics, and quizzes are also available for teachers to download and use in their classrooms (click on ChooseMyPlate.gov “Professionals” link).

The vegetable group is composed of food items in an array of colors and flavors. Vegetables contribute notable amounts of minerals, vitamins, and fiber to a person’s diet and are low in fat and calories (Table 12–4). The vegetable group is organized into five subgroups based on their

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Table 12–4 Good to Excellent Vitamin A Sources cantaloupe carrots pumpkin sweet potatoes spinach

winter squash greens apricots watermelon* broccoli

*May cause allergic reactions.

nutrient strengths: dark green; starchy; red and orange; beans and peas; and others. Daily food selections should include dark green vegetables such as broccoli and leafy greens, which are rich in vitamins A and C, as well as orange-red foods such as sweet potatoes, squash, tomatoes, and carrots, which are rich in vitamin A (Table 12–4). Adults are encouraged to consume 2½ to 3 cups of vegetables daily (based on a 2,000-calorie intake), children 2 to 3 years old require 1 cup, and 4- to 8-year-olds should have 1½ cups. Dietary fiber continues to receive significant attention for its health-promoting benefits. Yet, it is deficient in many children’s (and adults’) diet due to the inclusion of highly processed foods and lack of fruits and vegetables (Bailey et al., 2021; Seiverling et al., 2022). Thus, increasing children’s acceptance of a variety of different fruits and vegetables is an important issue to address (see Chapter 17). However, including too much fiber in a child’s diet can interfere with the absorption of essential vitamins and minerals. A practical recommendation for fiber intake for children over 2 years of age is the “age plus 5” rule. For example, JoJo, age 3 years, would require 8 grams of fiber per day (3 1 5); Aileene, age 4 years, should consume 9 grams (4 1 5). A sampling of food sources and their fiber contribution is presented in Table 12–5. 12-3b

Fruits

The fruit group is also a major contributor of vitamins, especially vitamins A and C, potassium, folate (folic acid), and dietary fiber. Choosing a variety of fruits that are of different colors improves a child’s nutrient intake. Children are generally more receptive to eating fruit because it tastes sweet. Fruit can be prepared and served in many ways to increase its appeal to children Table 12–5 Dietary Fiber in Common Foods

Food

Amount

Fiber (gram)

Cheerios®

1/2 cup

1.5

Raisin bran

1/2 cup

2.5

oatmeal

1/4 cup

1.9

macaroni, enriched

1/2 cup

1.3

bread, whole wheat

1/2 slice

0.9

bread, white

1/2 slice

0.6

graham crackers

1 square

0.5

orange sections

1/2 cup

2.2

banana, sliced

1/2 cup

1.9

apple with skin

1/2 cup

1.3

acorn squash

1/4 cup

2.3

green peas

1/4 cup

2.2

corn, frozen

1/4 cup

1.0

pinto beans

1/2 cup

5.5

black beans

1/2 cup

7.5

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Table 12–6 Good to Excellent Vitamin C Sources orange*

tomatoes*

orange juice*

grapefruit*

strawberries*

mustard greens

cauliflower

spinach

broccoli

cabbage

sweet peppers, red or green

tangerine*

*May cause allergic reactions.

(e.g., frozen, in smoothies, in muffins, with a nutritious yogurt dip, cut into different shapes). Adults are encouraged to consume the equivalent of 2 cups of fruit daily, whereas children 2 to 3 years old should have 1 cup, and 4- to 8-year-olds require 1 to 1½ cups. At least one vitamin C-rich and one vitamin A-rich selection should be included in a child’s diet every day (Tables 12–4 and 12–6). 12-3c

Grains

Foods such as breads, breakfast cereals, pastas, and a variety of whole grains make up the grains group. Items from this group provide complex carbohydrates, B vitamins, minerals, and dietary fiber and are known to decrease the risk of developing chronic diseases, such as diabetes, heart disease, and hypertension. The grains group is divided into two subcategories: whole grains and refined grains. Recommendations suggest that at least half of the grains an individual consumes each day should be whole grain. Whole-grain products retain their original nutrients and are an ideal source of dietary fiber. Some grains are refined to improve their texture and shelf-life but the process removes important vitamins and minerals. Manufacturers are required to restore some of the lost nutrients so they are equivalent to the original whole grain. Breads and cereals are examples of foods that must be fortified or enriched with iron, calcium, thiamin, riboflavin, and niacin. Most grain products today are also fortified with folacin (folic acid), which reduces the incidence of spina bifida, cleft lip, and cleft palate birth defects (Martinez et al., 2021). Researchers have also reported a significant reduction in autism spectrum disorders associated with prenatal folic acid intake and supplementation (Liu et al., 2022). A typical serving from the grain group consists of one slice of bread, 1 Stop and Check #3 cup of dry, ready-to-eat cereal, or 1/2 cup (1 ounce) of cooked rice, cereal, What nutrient benefits do or pasta. A child’s serving size is approximately one-half that of an adult whole grains provide? portion. Adults should consume the equivalent of 6 ounces of grains daily, whereas children 2 to 3 years require 3 ounces, and 4- to 8-year-olds should have 5 ounces. 12-3d

Protein Foods

The protein foods group consists of meats (e.g., beef, veal, pork, poultry, lamb, wild game), seafood, eggs, beans, peas and lentils, nuts and seeds (nut butters), and soy products (e.g., tofu, tempeh, edamame). Food items in this group play an important role in promoting children’s growth. They provide critical nutrients, including protein, B vitamins, iron, zinc, and magnesium. Foods from this group should be selected carefully to avoid those high in calories, fat, and cholesterol. Consumers are encouraged to include more plant-based protein sources (e.g., beans, lentils, peas, protein – class of nutrients used primarily for structural and regulatory functions.

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nuts and seeds, soy products) in their diet to lower saturated fat and cholesterol intake (Ormiston, Rosander, & Taub, 2022). Information to help individuals make healthier food choices is offered on the MyPlate website. The recommended daily intake from the protein foods group, as with the other groups, varies according to age, gender, and level of physical activity. Children 2 to 3 years old require approximately 2 ounces of protein equivalents daily; children 4 to 8 years old should receive 4 ounces; adults should consume between 5 and 6 1/2 ounces. The following foods contain protein that is approximately equivalent to 1 ounce of meat, poultry, or fish: 1 egg 1/4 cup cooked dried peas or beans 2 tablespoons peanut butter 1/2 ounce nuts or seeds 1/4 cup tofu 2 tablespoons hummus 12-3e

Dairy

The dairy group includes milk and milk-based products that retain their calcium content, such as home-made pudding, frozen yogurt, ice cream; hard cheeses such as Swiss and cheddar; soft cheeses such as ricotta and cottage cheese; yogurt; and calcium-fortified soy milk. This group is a major supplier of the mineral calcium, which is essential for healthy bone development and tooth formation. Dairy products that provide little or no calcium include butter, cream, and cream cheese and are not considered part of the dairy group. Food examples that provide the amount of calcium equivalent to one cup of milk include: 1 1/2 ounces cheddar, mozzarella, 1 cup pudding or frozen yogurt 1 1/2 cups ice cream 1/2 cup ricotta cheese

2 cups cottage cheese 1 cup plain yogurt (8 ounces) 1 cup calcium-enriched soy milk

The dairy group is a primary source of dietary calcium, potassium, and vitamin D, but also a poor source of iron and vitamins A and C. Children 2 to 3 years old should consume 2 cups of milk daily or the equivalent from this group; 4- to 8-year-olds require 2 1/2 cups; and, adults should ideally consume the equivalent of 3 cups. Servings may be divided into 1/2cup portions in consideration of children’s smaller appetites and stomach capacity. The number of servings reflects new recommendations for increased calcium and vitamin D intakes. Whenever possible, low-fat items should be selected because foods in the dairy group tend to be high in fat and cholesterol. However, children should not be given low-fat milk and dairy products prior to the age of 2. Infants and toddlers require the critical fats and fat-calories present in whole milk and milk products to meet their high energy needs and to support healthy nervous system development (Franklyn et al., 2022; Jiang et al., 2022). Many new plant-based milk substitutes are being introduced to the market. Although most are significantly lower in saturated fats and cholesterol than cows’ milk, they typically lack adequate protein, calcium, and vitamins D and B12 (Craig, Mangels, & Brothers, 2022) (Table 12–7). Even when products are fortified, the amount of these critical nutrients often remains insufficient to meet the growing child’s requirements (Collard & McCormick, 2021). As a result, milk alternatives, with the exception of fortified soy milks, are not recommended for infants younger than 12 months. They can be given to toddlers and older children as long as parents provide fortified products or supplements and include other foods that make up for insufficient nutrients. Consumers are urged to read product labels carefully. calcium – mineral nutrient; a major component of bones and teeth.

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Table 12–7 Approximate Nutrient Contributions of Plant-based Milk Alternatives

Fat 2% Milk

4.69 g

Saturated Fat 2.7 g

Added Sugar 0.0 g

Protein 8.2 g

Vitamin D

Calcium

2.7 mcg

260 mg

Almond

2.5 g

0.0 g

0.0 g

1.0 g

5.0 mcg

350 mg

Cashew

2.0 g

0.0 g

0.0 g