Many Factors Limit Play in Child Care

Why do kids get little physical activity in child care and preschool? Researchers asked providers and got a long list of answers. Centers often lack play equipment because of cost or space problems. What they have may be safe but boring. And child care providers feel more pressure to stress ABCs than active play. Researchers found this out through focus groups that included 49 child care providers. They said state licensing rules limit the play equipment they can offer. And kids often lose interest in equipment that meets safety standards. Providers said parents also worry about injuries and don't push for more physical activity. But they do push for more academic work. The journal Pediatrics published the study. HealthDay News and Reuters Health news service wrote about it January 4.

What Is the Doctor's Reaction?

We are turning our preschoolers into couch potatoes.

Three-quarters of the kids aged 3 through 5 are in child care. Studies have shown that for the vast majority of their time in child care they are not physically active. In fact, only 2% to 3% of that time is spent in vigorous activity.

Researchers from Cincinnati Children's Hospital wanted to find out why. So they put together focus groups of various child care providers, and asked them why the kids weren't more active. Here's what they found out:

• For some, the issue was financial. They didn't have much space for play outside or inside. They also couldn't afford outside play equipment (or at least the kinds that really encouraged activity).

• Even when there was enough space and money, concern for injury was a big factor. Providers have to follow licensing rules. The rules restrict the equipment allowed for play by preschoolers. Beyond that, providers said they often stopped kids from active play for fear of injury. Often they did this at the request of parents.

• Child care providers felt a lot of pressure to get as much academics into the day as possible. Parents were much more interested in what their child learned that day than how much they played.

These are all understandable concerns. But daily physical activity is really important for kids. That's why the American Academy of Pediatrics recommends at least an hour of it every day.

With one-third of U.S. kids overweight or obese, physical activity is crucial. When kids sit around, they are far more likely to be overweight.

And it's in childhood that we develop lifelong habits. If children don't learn to enjoy physical activity when they are young, it's harder to get them to move when they are older. More and more studies show that overweight kids grow into overweight adults. Too little activity is a big part of the reason.

But play isn't just important for weight. Play is important for learning. It's a big part of how kids learn what we call "executive function," the organizing principles of behavior. Executive function has to do with the ability to concentrate, take turns, problem-solve, negotiate and wait for things that you want. Kids try this stuff out and practice it during play. If they play less, they are more likely to have behavioral problems. It can affect them in the classroom as well.

What Changes Can I Make Now?

If you are picking a preschool or child care setting, choose one with lots of chances for play — especially active play. Look for access to big outdoor places and equipment that encourages kids to really get moving.

Of course, you want your child to learn. But at preschool age, much of how they learn is play. So find a place with lots of books on the bookshelf. But also look for dress-up gear and finger paints and blocks and a pretend kitchen and other things that encourage creativity and fun.

Policy makers should pay attention to the findings of this study. So should school personnel and everyone involved in early childhood education. They need to help make active play (and other kinds of play) a bigger part of every child's day.

What Can I Expect Looking to the Future?

As I've said in many news reviews related to childhood obesity, if we don't start making real changes, we can expect an increase in the number of obese kids. This will lead to an increase in the number of obese adults, with all the terrible health, emotional and financial consequences that brings.

And if we don't give kids more chances to play, we are going to see more children — and later, more adults — with poor executive function and all the behavioral and learning problems that brings.

This can't be what we want for our children and our future. It's time to do something. Our children are depending on us.

Medical content reviewed by the Faculty of Harvard Medical School. Copyright © 2012 by Harvard University. Illustrations copyright © 2000-2012 Harvard University and © 2000-2012 The StayWell Company. All rights reserved. Used with permission of StayWell. Use of content is subject to Terms of Use and Medical Disclaimer.