See Also Acronyms/Abbreviations

Abrasion - An injury (such as a scrape) that occurs when the top layer of skin is removed, with little blood loss.

Acute - Adjective describing an illness that has a sudden onset and is of short duration.

Acrocyanosis - Blueness or pallor of the extremities usually associated with pain and numbness and caused by vasomotor disturbances.

Adaptive equipment - Equipment (such as eye glasses, hearing aids, wheelchairs, crutches, prostheses, oxygen tanks) that helps children with special health care needs adapt to and function within their surroundings. See also Appendix X.

Aflatoxin - A naturally occurring mycotoxin (fungus). This toxic metabolite occurs in soil, decaying vegetation, hay, and grains undergoing microbiological deterioration. Favorable conditions include high moisture content and high temperature.

Age-appropriate physical activity - See Physical activity

Age-appropriate solid foods - Also known as complementary foods, foods introduced at the correct age to infants. Examples are iron-fortified infant cereals and pureed meats for infants.

AIDS - See Human Immunodeficiency Virus (HIV).

Air Quality Index (AQI) - A tool used by EPA and other agencies to describe how clean the air is and whether or not the public should be concerned for their health. The AQI is focused on health effects that can happen within a few hours or days after breathing polluted air.

Allergens - A substance (food, pollen, pets, mold, medication, etc.) that causes an allergic reaction.

Ambient measurements - Measurements that help assess the amount of air pollutants, noise, or lighting within a specific area.

Anaphylaxis - An allergic reaction to a specific substance (food, pollen, pets, mold, medication, etc.) that causes dangerous and possibly fatal complications, including the swelling and closure of the airway that can lead to an inability to breathe.

Anemia - Having too little hemoglobin (hemoglobin carries oxygen from the lungs throughout the body). The terms anemia, iron deficiency, and iron deficiency anemia often are used interchangeably but are equivalent.

Antibiotic prophylaxis - Medicine that is prescribed to prevent infections in infants and children in situations associated with an increased risk of serious infection with a specific disease.

Antibody - A protein substance produced by the body's immune defense system in response to something foreign. Antibodies help protect against infections.

Antiseptic - Antimicrobial substances that are applied to the skin or surfaces to reduce the number of microbial flora. Examples include alcohols, chlorhexidine, chlorine, hexachlorophene, iodine, chloroxylenol (PCMX), quaternary ammonium compounds, and triclosan.

Antigen - Any substance that is foreign to the body. An antigen is capable of causing a response from the immune system.

Antisiphon ballcock - An automatic valve in the toilet tank, the opening and closing of which is controlled by a spherical float at the end of a lever. The antisiphon ballcock does not allow dirty water to be admixed with clean water.

Asbestos - A mineral fiber that can pollute air or water and cause cancer or asbestosis when inhaled.

Friable asbestos - Any material containing more than one-percent asbestos, and that can be crumbled or reduced to powder by hand pressure. (May include previously non-friable material, which becomes broken or damaged by mechanical force.)

Asphyxial crib death - Death attributed to an item within the crib that caused deprivation of oxygen or obstruction to normal breathing of an infant.

Asphyxiation - Death or unconsciousness due to inadequate oxygenation, the presence of noxious agents, or other obstructions to normal breathing.

Aspiration - The inhalation of food, liquid, or a foreign body into a person's airway which results in choking/respiratory distress.

Assessment - An in-depth appraisal conducted to determine the status of an individual, diagnose a condition, or evalutate the performance of a program or individual or the importance or value of a procedure.

Asymptomatic - Without symptoms.

Autism spectrum disorders - A group of developmental disabilities associated with problems in the brain. Children with ASDs have trouble in three core areas of their development: language difficulties, especially no apparent desire to communicate, social interaction, restricted interests and behaviors that are repeated over and over again.

Autonomous behavior - Behavior that is independent, free, and self-directing.

Axillary - Pertaining to the area under the arm (armpit).

Background screenings - The process of checking the history of adults before they are allowed to care for children.

Bacteria - Plural of bacterium. Organisms that may be responsible for localized or generalized diseases and can survive in and out of the body. They are much larger than viruses and can usually be treated effectively with antibiotics.

Balusters - Vertical stair railings that support a horizontal handrail.

Bleach solution - A chemical used to sanitize or disinfect environmental serfaces. See also Disinfect and Sanitize.

Bloodborne pathogens - Infectious microorganisms present in blood that can cause disease in humans.

BMI - See Body Mass Index (BMI).

Body fluids - Urine, feces, saliva, blood, nasal discharge, eye discharge, and injury or tissue discharge.

Body Mass Index (BMI) - Measurement of weight in kilograms divided by height in meters squared. Overweight and obesity can be defined by the BMI for age measurement.

Bottle propping - Bottle-feeding an infant by leaning the bottle against the infant's mouth and leaving the infant alone rather than holding the bottle by hand.

Botulism - A severe illness of the nervous system. Four distinct, naturally occurring forms of human botulism exist: infant, foodborne, wound, and adult intestinal colonization.

BPA (BISPHENOL A) - An organic compound used to manufacture polycarbonate plastics. This type of plastic is used to make some types of beverage containers, compact disks, plastic dinnerware, impact-resistant safety equipment, automobile parts, and toys.

Bronchitis - A bacterial or viral infection that leads to swelling of the tubes (bronchioles) leading to the lungs.

Cadmium - An extremely toxic metal commonly found in industrial workplaces, particularly where any ore is being processed or smelted.

Campylobacter - A bacterium that causes diarrhea.

Campylobacteriosis - A diarrheal infection caused by the Campylobacter bacterium.

Capture velocity - Airflow that will collect the pollutant (such as dust or fumes) that you want removed.

Cardiopulmonary resuscitation (CPR) - Emergency measures performed by a person on another person whose breathing or heart activity has stopped. Measures include closed chest cardiac compressions in a regular sequence.

Care coordinator - An individual assigned to work with the child's family or alternative caretaker to assist in coordinating services, either internally within an agency directly providing services or with other service providers for the child and family. This term is also used by some agencies or caregivers in place of, or in association with, the term case manager.

Care plan - A document that provides specific health care information, including any medications, procedures, precautions, or adaptations to diet or environment that may be needed to care for a child with chronic medical conditions or special health care needs. Care Plans also describe signs and symptoms of impending illness and outline the response needed to those signs and symptoms. A Care Plan is completed by a health care professional and should be updated on a regular basis.

Caregiver/Teacher - The primary staff member(s) who work directly with the children in the center and in small and large family child care homes.

Carrier - A person or animal who carries within his/her body a specific disease causing organism, who has no symptoms of disease, and who can spread the disease to others.

Case manager - See Care coordinator

Catheterization - The process of inserting a hollow tube into an organ of the body, either for an investigative purpose or to give some form of treatment (such as to remove urine from the bladder of a child with neurologic disease).

CCA (chromated copper arsenate) - A chemical wood preservative containing chromium, copper, and arsenic. CCA is used in pressure treated wood to protect wood from rotting due to insects and microbial agents.

Ceftriaxone - An antibiotic often prescribed for those exposed to an infection caused by Haemophilus influenzae type b (Hib) or Neisseria meningitidis (meningococcus).

Celiac disease - A digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. Gluten is found mainly in foods but may also be found in everyday products such as medicines, vitamins, and lip balms.

Center - A facility that provides care and education of any number of infants, toddlers, and preshool- or school-aged children in a nonresidential setting, or thirteen or more children in any setting if the facility is open on a regular basis.

Certification (as it relates to a form of licensing) - Designation as having met the requirements to operate or practice in a specific sector.

Certified playground safety inspector (CPSI) - Individuals who have attained a measured level of competency to inspect playgrounds for safety hazards and to ensure compliance with national standards set by ASTM International (ASTM) and the U.S. Consumer Product Safety Commission (CPSC).

Child abuse and neglect - Any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm. See also Appendix M for definitions of types of abuse and neglect.

Child and Adult Care Food Program (CACFP) - The U.S. Department of Agriculture's sponsored program whose child care component provides nutritious meals to children enrolled in centers and family child care homes throughout the country.

Child care health consultant (CCHC) - A licensed health professional with education and experience in child and community health and early care and education, preferably specialized training in child care health consultation.

Child Development Associate (CDA) - A credential awarded to those who have completed a list of requirements, including 120 hours of training, set forth by the Council for Professional Recognition.

Child:staff ratio - The maximum number of children permitted per teacher/caregiver. See also Group size.

Children with special health care needs - Children who have or are at increased risk for chronic physical, developmental, behavioral, or emotional conditions who require health and related services of a type or amount beyond that required by children generally.

Children's Health Insurance Program (CHIP) - A program that provides free or low-cost health coverage for children up to age nineteen. CHIP covers U.S. citizens and eligible immigrants.

Chronic - Describing a disease or illness of long duration or frequent recurrence, often having a slow progressive course of indefinite duration.

Ciprofloxacin - An antibiotic often prescribed for those exposed to an infection caused by Haemophilus influenzae type b (Hib) or Neisseria meningitidis (meningococcus).

Clean - To remove dirt and debris by scrubbing and washing with a detergent solution and rinsing with water. The friction of cleaning removes most germs and exposes any remaining germs to the effects of a sanitizer or disinfectant used later.

CMV - See Cytomegalovirus

Communicable disease - See Infectious disease.

Complementary foods - Solid foods that are age-appropriate for infants such as iron-fortified infant cereals and pureed meats.

Compliance - The act of carrying out a recommendation, policy, regulation, or procedure.

Congenital - Existing from the time of birth.

Conjunctivitis - Also known as "Pink eye," inflammation (redness and swelling) of thin tissue covering the white part of the eye and the inside of the eyelids.

Contact dermatitis - A skin inflammation that results when the skin comes in direct contact with substances that can cause an allergic or inflammatory reaction.

Contamination - The presence of infectious microorganisms in or on the body, on environmental surfaces, on articles of clothing, or in food or water.

Contraindication - Something (as a symptom or condition) that makes a particular treatment or procedure inadvisable.

Contractual relationship - A relationship based on a signed and written contract between parents/guardians and caregivers/teachers that documents child care agreements involving policies and procedures and educational programming goals.

Corporal punishment - Physical harm inflicted on the body (such as spanking).

CPR - See Cardiopulmonary resuscitation.

Croup - A respiratory infection, caused by various viruses, that results in the swelling of the voice box (larynx) and the area below the voice box (subglottis) that can cause difficult breathing, hoarse voice, and a cough sounding like a seal's bark.

Cryptosporidium - A parasite that causes cryptosporidiosis, a diarrheal illness.

"Cue" feeding - Feeding an infant based on their "cues" such as opening the mouth, making suckling sounds and moving the hands at random, as well as discontinuing feedinsg by observing cues that they are full.

Cytomegalovirus (CMV) - A viral infection common to children. In most cases, CMV causes no symptoms. When symptoms are experienced, they typically consist of fever, swollen glands, and fatigue. CMV can infect a pregnant woman who is not immune and damage the fetus, leading to mental retardation, hearing loss, and other nervous system problems in the unborn child.

Daily health check - Assessment of a child's health each day through observation of the child, talking with the parent/guardian, and if applicable, with the child.

Decibel (db) - The unit of measure of the loudness of sounds; one decibel is the lowest intensity of sound at which a given note can be heard. The decibel level is the number of decibels of noise perceived or measured in a given place.

DEET (N,N-Diethyl-meta-toluamide) - An ingredient in many insect repellents.

Delegation of medication administration - Delegation is a tool that may be used by the health professional to allow unlicensed assistive personnel to administer medication under the supervision of the health professional's guidance and assessment of the unique needs of the individual and the suitability of delegation of specific tasks.

Demand feeding - The feeding of infants whenever they indicate that they need to be fed, rather than feeding according to a clock schedule. See also "Cue" feeding.

Dental caries - A disease process that leads to holes in the teeth (commonly called dental cavities).

Dental Home - The ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care delivered in a comprehensive, continuously accessible, coordinated and family-centered way.

Dental sealants - Clear protective coatings that cover tooth surfaces and prevent bacteria and food particles from settling into the pits and grooves. Dental sealants are usually applied after a child reaches the age of six when the first permanent molars come in. Dental sealants last for four to five years and can be reapplied when they wear off.

Dermatitis - An inflammation of the skin.

Developmental screening - The use of standardized tools to identify a child at risk of a developmental delay or disorder.

Diabetes - A disorder that affects the way the body uses or converts food for energy and growth. Type 1 diabetes is a disease in which the immune system destroys the cells in the pancreas that make insulin. Children with type 1 diabetes need to take insulin injections to live. Type 2 diabetes is a condition in which the pancreas produces insulin, but the body cannot use it, often because of obesity; this is known as insulin resistance.

Diarrhea - An illness in which an individual develops more watery and more frequent stools than is typical for that person.

Disease surveillance - Close observation for the occurrence of a disease or infection. Surveillance is performed to discover a disease problem early, to understand a disease problem better, and to evaluate the methods used to control the disease.

Disinfect - To destroy or inactivate most germs on any inanimate object, but not bacterial spores. See Appendix J: Selecting an Appropriate Sanitizer or Disinfectant.

Drop-in care facility - Program where children are cared for over short periods of time on a one-time, intermittent, unscheduled and/or occasional basis. It is often operated in connection with a business (e.g., health club, hotel, shopping center, or recreation centers).

Dyslipidemia - A condition marked by abnormal concentrations of lipids or lipoproteins in the blood, consisting of one or a combination of high LDL, low HDL, and high triglycerides.

E. coli - See Shiga toxin-producing E. coli (STEC).

Early childhood education consultant (ECEC) - Education professionals within the early childhood community who are trained in literacy, child development, curriculum development, instruction, and coaching.

Egress - A place or means of going out. An exit.

Electret test device - Equipment used to measure the short-term and long-term concentrations of radon in the air.

Emergency/Disaster plan - An action plan that lets affected individuals know what to do in particular disaster situations and how to be prepared in advance. See Standard for specific components.

Emergency medical services (EMS) - A system of care for victims of sudden and serious injury or illness.

Emergency response plan - Procedures used to call for emergency medical assistance, to reach parents/guardians or emergency contacts, to arrange for transfer to medical assistance, and to render first aid to the injured person. See also Emergency/Disaster plan.

Emphysema - A lung disease that causes breathing-related problems by destroying the air sacs in the lungs (alveoli).

Encephalitis - Inflammation (redness and swelling) of the brain, which can be caused by a number of viruses, including mumps, measles, and varicella.

Endotracheal suctioning - The mechanical aspiration and removal of mucous from a person's airway through a tracheostomy (an artificial opening in the trachea).

Enteric - Describes the location of infections affecting the intestines (often with diarrhea) or the liver.

Enterovirus - A common virus infection spread by fecal-oral and respiratory routes. A common enterovirus infection in young children is "hand-foot-and-mouth disease" in which fever and blister-like eruptions in the mouth and/or a rash (usually on the palms and soles) may occur.

Environmental audit - Evaluation of a location site and buildings to determine if healthy and safe for humans to occupy. Assessments include: Potential air, soil, and water contamination on facility sites and outdoor play spaces; potential toxic or hazardous materials in building construction; and potential safety hazards in the community surrounding the site.

Epidemic - Affecting or tending to affect an atypically large number of individuals within a population, community, or region at the same time.

Epidemiology - The scientific study of the occurrence and distribution of diseases.

EpiPen - A registered trade name for an automatic epinephrine injector. Epinephrine is administered in response to some allergic reactions.

EPSDT - Abbreviation for Medicaid's Early Periodic Screening and Diagnostic Treatment program, which provides health assessments and follow up services to income-eligible children.

Ergot - A toxic fungus found as a parasite on grains of rye and other grains. Consumption of food contaminated with ergots may cause vomiting, diarrhea and may lead to gangrene in serious cases.

Erythromycin - An antibiotic medication used to treat many upper respiratory illnesses. It is often prescribed for people exposed to pertussis.

Evaluation - Impressions and recommendations formed after a careful appraisal and study.

Exclusion - Denying admission of a child or staff member to a facility (e.g., child or staff who is ill).

Excretion - A process whereby the body rids itself of waste material, such as feces and urine.

Expulsion - Expulsion is the permanent removal of the child from the child care facility.

Facilitated play - Appropriate play experiences which are set-up by, but do not involve interaction from the caregiver/teacher, that facilitate development in all domains and promote autonomy, competency and a sense of joy in discovery and learning.

Facility - The buildings, the grounds, the equipment, and the people involved in providing child care of any type.

Facility for children who are mildly ill - A facility providing care of one or more children who are mildly ill, children who are temporarily excluded from care in their regular child care setting;

  1. Integrated or small group care for children who are mildly ill: A facility that has been approved by the licensing agency to care for well children and to include up to six children who are mildly ill;
  2. Special facility for children who are mildly ill: A facility that cares only for children who are mildly ill, or a facility that cares for more than six children who are mildly ill at a time.

Failure to Thrive - Failure of a child to develop physically.

Family child care - The setting where early care and education is provided in the home of the caregiver/teacher.

Small family child care provides care and education for one to six children, including the caregiver's/teacher's own children. Family members or other helpers may be involved in assisting the caregiver/teacher, but often, there is only one caregiver/teacher present at any one time.

Large family child care provides care and education for seven to twelve children, including the caregiver/teacher's own children. One or more qualified adult assistants are present to meet child:staff ratio requirements.

Febrile - The condition of having an abnormally high body temperature (fever).

Fecal coliform - Bacteria in stool that normally inhabit the gastrointestinal tract and are used as indicators of fecal pollution. They denote the presence of intestinal pathogens in water or food.

Fever - An elevation of body temperature considered meaningfully elevated above normal. Temperature above 101°F (38.3°C) for infants and children older than 2 months and above 100.4°F (38.0°C) for any infant younger than 2 months.

Fifth disease - A common viral infection with rash occurring one to three weeks after infection, also known as Parvovirus B19.

First aid - See Pediatric first aid

Foodborne illness/disease - An illness or disease transmitted through food products.

Foot-candles - The amount of illumination produced by a standard candle at a distance of one foot.

Formaldehyde - A colorless, flammable gas at room temperature that has a pungent, distinct odor and may cause a burning sensation to the eyes, nose, and lungs at high concentrations.

Free play - See Unstructured physical activity.

Friable asbestos - See Asbestos

Functional outcomes - Health status measures that go beyond traditional physiological assessments. By incorporating a multidimensional definition of health that encompasses physical, psychological and social aspects, functional outcome measures can capture the broader impact of disease and treatment on life from a child's (or parent's/guardian's) own perspective. Such tools enable children and parents/guardians to offer input on their quality of life and their capacity to function in normal social roles.

Fungi - Plural of fungus. Plantlike organisms, such as yeasts, molds, mildews, and mushrooms, which get their nutrition from other living organisms or from dead organic matter.

Galactosemia - A condition in which the body is unable to use (metabolize) the simple sugar galactose.

G-MAX - The measure of the maximum acceleration (shock) produced by an impact.

Gastric tube feeding - The administration of nourishment through a tube that has been surgically inserted directly into the stomach.

Gastrointestinal (GI) tract - The human digestive tract that breaks down and absorbs food. Organs that make up the GI tract) are the mouth, esophagus, stomach, small intestine, large intestine, rectum, and anus.

Germ - Small particles (viruses) or organisms (bacteria, fungi, or parasites) that may cause infections. Some germs are harmless.

Gestational - Occurring during or related to pregnancy.

Giardia intestinalis - A parasite that causes giardiasis, an intestinal infection commonly referred to as "Giardia."

Glomerulonephritis - A type of kidney disease in which the part of the kidneys that helps filter waste and fluids from the blood is damaged.

Gross motor skills - Large movements involving the arms, legs, feet, or the entire body (such as crawling, running, and jumping).

Ground-fault circuit-interrupter (GFCI) - A piece of equipment in an electrical line that offers protection against electrocution if the line comes into contact with water.

Group A Streptococcus (GAS) - A bacterium commonly found in the throat and on the skin that can cause a range of infections, from relatively mild sore throats "strep throat" and skin infections (e.g., "scarlet fever") to life-threatening disease.

Group size - The number of children assigned to a caregiver/teacher or team of caregivers/teachers occupying an individual classroom or well defined space within a larger room. See also Child:staff ratio.

Haemophilus influenzae type b (Hib) - A group of bacterial infections that can infect ears, eyes, sinuses, epiglottis (i.e., the flap that covers the windpipe), skin, lungs, blood, joints, and coverings of the brain (meningitis). Hib should not be confused with "the flu" which is a disease caused by a virus. Hib infection is a vaccine preventable disease.

HAV - An abbreviation for hepatitis A virus. See also Hepatitis.

HBV - An abbreviation for hepatitis B virus. See also Hepatitis.

HCV - An abbreviation for hepatitis C virus. See also Hepatitis.

Head Injury Criterion (HIC) - An empirical measure of impact severity based on published research describing the relationship between the magnitude and duration of impact accelerations and the risk of head trauma.

Health advocate - A staff person in an early care and education setting responsible for policies and day-to-day issues related to health, development, and safety of individual children, children as a group, staff, and parents/guardians. The health advocate does not fill the same role as the child care health consultant. See also Child care health consultant.

Health care professional - Someone who practices medicine with or without supervision, and who is licensed by an established licensing body The most common types of health care professionals include physicians, nurse practitioners, nurses, and physician assistants.

Health consultant - See Child Care Health Consultant

Health history - A compilation of health information about an individual.

Health plan - See Care Plan.

Health supervision - Routine screening tests, immunizations, and chronic or acute illness monitoring. For children younger than twenty-four months of age, health supervision includes documentation and plotting of charts on standard sex-specific length, weight, weight for length, and head circumference and assessing diet and activity. For children twenty-four months of age and older, sex-specific height and weight graphs should be plotted by the primary care provider in addition to body mass index (BMI).

Hepatitis - Inflammation of the liver caused by viral infection. There are six types of infectious hepatitis: type A; type B; nonA, nonB; type C; and type D.

Herpes simplex virus - A viral organism that causes a recurrent disease which is marked by blister-like sores on mucous membranes (such as the mouth, lips, or genitals) that weep clear fluid and slowly crust over.

Herpetic gingivostomatitis - Inflammation of the mouth and lips caused by the herpes simplex virus.

Hib - See Haemophilus influenzae type b.

HIPPA - Health Insurance Portability and Accountability Act - Federal act that provides protections for personal health information held by covered entities and gives patients an array of rights with respect to that information.

HIV - See Human Immunodeficiency Virus (HIV).

HPV (human papillomaviruses) - Viruses that cause a number of skin and mucous membrane infections; the most common infection is the skin wart.

Human Immunodeficiency Virus (HIV) - A virus that affects the body in a variety of ways. In the most severe infections, the virus progressively destroys the body's immune system, causing a condition called acquired immune deficiency syndrome, or AIDS.

HVAC - Abbreviation for heating, ventilation, and air-conditioning.

Hygiene - Protective measures taken by individuals to promote health and limit the spread of infectious diseases.

Hypercholesterolemia - Having elevated cholesterol levels. High levels of cholesterol increase the risk for cardiovascular disease and stroke.

IEP - See Individualized Education Program.

IFSP - See Individualized Family Service Plan.

Immune globulin (Gamma globulin, immunoglobulin)- An antibody preparation made from human plasma. It provides temporary protection against diseases.

Immunity - The body's ability to fight a particular infection.

Immunizations - Vaccines that are given to children and adults to help them develop protection (antibodies) against specific infections. Vaccines may contain an inactivated or killed agent or a weakened live organism.

Immunocompromised - The state of not having normal body defenses (immune responses) against diseases caused by microorganisms.

Immunosuppression - Inhibition of the body's natural immune response, used especially to describe the action of drugs that allow the surgical transplantation of a foreign organ or tissue by inhibiting its biological rejection.

Impervious - Adjective describing a smooth surface that does not become wet or retain particles.

Impetigo - A common skin infection caused by streptococcal infection or staphylococcal bacteria.

Incubation period - Time between exposure to an infectious microorganism and beginning of symptoms.

Individualized Education Program (IEP) - A written document, derived from Part B of IDEA 2004 (Individuals with Disabilities Education Improvement Act), that is designed to meet a child's individual educational program needs. The main purposes for an IEP are to set reasonable learning goals and to state the services that the school district will provide for a child with special educational needs. Every child who is qualified for special educational services provided by the school is required to have an IEP.

Individualized Family Service Plan (IFSP) - A written document, derived from Part C of IDEA 2004 (Individuals with Disabilities Education Improvement Act), that is formulated in collaboration with the family to meet the needs of a child with a developmental disability or delay, to assist the family in its care for a child's educational, therapeutic, and health needs, and to deal with the family's needs to the extent to which the family wishes assistance.

Infant - A child between the time of birth and the age of ambulation (usually the ages from birth through twelve months).

Infant walkers - Equipment consisting of a wheeled base supporting a rigid frame that holds a fabric seat with leg openings and usually a plastic feeding/play tray. Also known as baby walkers.

Infectious disease - A disease caused by a microorganism (bacterium, virus, fungus, or parasite) that can be transmitted from person to person via infected body fluids or respiratory spray, with or without an intermediary agent (such as a louse, mosquito) or environmental object (such as a table surface). Many infectious diseases are reportable to the local health authority.

Infested - Common usage of this term refers to parasites (such as lice or scabies) living on the outside of the body.

Influenza ("flu") - An acute viral infection of the respiratory tract. Symptoms usually include fever, chills, headache, muscle aches, dry cough, and sore throat. Influenza should not be confused withHaemophilus influenzae infection caused by bacteria, or with "stomach flu," which is usually an infection caused by a different type of virus.

Ingestion - The act of taking material (whether food or other substances) into the body through the mouth.

Injury, unintentional - Physical damage to a human being resulting from an unintentional event (one not done by design) involving a transfer of energy (physical, chemical, or heat energy).

Integrated pest management (IPM) - An approach to eliminating the root causes of pest problems, providing safe and effective control of insects, weeds, rodents, and other pests while minimizing risks to human health and the environment.

Intradermal - Relating to areas between the layers of the skin (as in intradermal injections).

Isolation - The physical separation of a person who is ill from other persons in order to prevent or lessen contact between other persons and the body fluids of the person who is ill.

Jaundice - Yellowish discoloration of the whites of the eyes, skin, and mucous membranes caused by deposition of bile salts in these tissues.

Kinesiology - The study of the principles of mechanics and anatomy in relation to human movement.

Laceration - A cut, which can be jagged or smooth and may be superficial or deep, large or small.

Large family child care home - See Family child care.

Lead - A highly toxic metal. Common sources of lead exposure are lead-based paint in older homes, contaminated soil, household dust, drinking water, lead crystal, and lead-glazed pottery.

Lead agency - An individual state's choice for the agency that will receive and allocate the federal and state funding for children with special educational needs. The federal funding is allocated to individual states in accordance with the Individuals with Disabilities Educational Act (IDEA).

Lecithin - Any of several waxy lipids which are widely distributed in animals and plants, and have emulsifying, wetting, and antioxidant properties.

Lethargy - Unusual sleepiness or low activity level.

Lice - Parasites that live on the surface of the human body (in head, body, or pubic hair).

Light emitting diode (LED) - Small light sources that become illuminated by the movement of electrons through a semiconductor material.

Listeriosis - Diseases caused by the Listeria bacterium. Can cause meningitis, blood infections, heart problems, and abscesses, and can cause a pregnant woman to miscarry.

Longitudinal study - A research study in which patients are followed andMethicillin-resistant Staphylococcus aureus examined over a period of time.

Lyme disease - An infection caused by a type of bacteria known as spirochetes, that is transmitted when particular ticks attach to a person's skin and feed on that person's blood.

Lymphadenitis - An acute infection of one or more lymph nodes.

Lymphoma - A general term for a group of cancers that originate in the lymph system. The two primary types of lymphoma are Hodgkin lymphoma, which spreads in an orderly manner from one group of lymph nodes to another; and non-Hodgkin lymphoma, which spreads through the lymphatic system in a non-orderly manner.

Mandatory reporters - Individuals required by their state laws to report concerns of child abuse and neglect.

Mantoux intradermal skin test - A test to assess the likelihood of infection with tuberculosis.

Measles (red measles, rubeola, hard measles, 8 to 10 day measles) - A serious viral illness characterized by a red rash, high fever, light sensitive eyes, cough, and cold symptoms.

Medicaid - A program which provides medical assistance for individuals and families with low incomes and resources. The program became law in 1965 as a jointly funded cooperative venture between the Federal and State governments to assist states in the provision of adequate medical care to eligible needy persons.

Medical home - Primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective. The child health care professional works in partnership with the family and patient to ensure that all the medical and non-medical needs of the patient are met.

Medications - Any substance that is intended to diagnose, cure, treat, or prevent disease or is intended to affect the structure or function of the body of humans or other animals.

Meningitis - A swelling or inflammation of the tissue covering the spinal cord and brain. Meningitis is usually caused by a bacterial or viral infection.

Meningococcal disease - Pneumonia, arthritis, meningitis, or blood infection caused by the bacterium Neisseria meningitides.

Mercury - A naturally occurring metal which has several forms. Exposure to high levels of metallic, inorganic, or organic mercury can permanently damage the brain, kidneys, and developing fetus.

Methemoglobinemia - Also known as blue baby syndrome, is a blood disorder caused when nitrite interacts with the hemoglobin in red blood cells and is characterized by the inability of the blood to carry sufficient oxygen to the body's cells and tissues. Although methemoglobinemia is rare among adults, it may affect infants, when nitrate-contaminated well water is used to prepare formula and other infant foods.

Methicillin-resistant Staphylococcus aureus (MRSA) - A potentially dangerous type of staph bacteria that is resistant to certain antibiotics and may cause skin and other infections.

Methionine - A sulfur containing essential amino acid that is important in many body functions.

MMR - Abbreviation for the vaccine against measles, mumps, and rubella.

MMRV - Abbreviation for the vaccine against measles, mumps, rubella, and varicella.

Mold - Fungi that are found virtually everywhere, indoors and outdoors. Mold can cause or worsen certain illnesses (e.g., some allergic and occupation-related diseases and infections in health care settings).

Molluscum contagiosum - A common skin disease that is caused by a virus. Molluscum infection causes small white, pink, or flesh-colored bumps or growths with a dimple or pit in the center.

Morbidity - The incidence of a disease within a population.

Motor skills - Coordinated muscle movements involved in movement, object control, and postural control perceived as occurring after a stage (or stages) involving birth reflexes, with the idea that fundamental motor skills must be mastered before development of more sport-specific skills.

MRSA - See Methicillin-resistant Staphylococcus aureus.

Mucous membranes - Membranes that line body passages and cavities which communicate directly or indirectly with the exterior (as the alimentary, respiratory, and genitourinary tracts), that functions in protection, support, nutrient absorption, and secretion of mucus, enzymes, and salts.

Mumps - A viral infection with symptoms of fever, headache, and swelling and tenderness of the salivary glands, causing the cheeks to swell.

Nasogastric tube feeding - The administration of nourishment using a plastic tube that stretches from the nose to the stomach.

Necrotizing enterocolitis - A condition when the lining of the intestinal wall dies and the tissue falls off. This disorder usually develops in an infant that is already ill or premature, and most often develops while the infant is still in the hospital.

Neisseria meningitidis (meningococcus) - A bacterium that can cause meningitis, blood infections, pneumonia, and arthritis.

NOAA Weather Radio All Hazards (NWR) - A nationwide network of radio stations broadcasting continuous weather information directly from the nearest National Weather Service office. NWR broadcasts official Weather Service warnings, watches, forecasts and other hazard information twenty-four hours a day, seven days a week.

Non-prescription medications - Drugs that are available without a prescription, also known as "over-the-counter" (OTC) medications.

Non-transient, non-community water supply - A non-community water system in a location that serves the same non-resident users daily. Schools, colleges, hospitals, and factories with their own water supplies are examples.

Norovirus - Virus that causes an illness in humans called gastroenteritis. Noroviruses are very contagious. They usually are found in contaminated food or drinks, but they also can live on surfaces or be spread through contact with an infected person.

Nutritionist/Registered Dietitian - A professional with current registration with the Commission on Dietetic Registration of the American Dietetic Association or eligibility for registration with a Bachelor's and Master's degree in nutrition; a Master's degree from an approved program in public health nutrition may be substituted for registration with the Commission on Dietetic Registration. Current state licensure or certification as a nutritionist or dietitian is acceptable. See also Appendix C.

Obesity - An excess percentage of body weight (Body Mass Index equal or greater than 95%) due to fat that puts people at risk for many health problems. In children older than two years of age, obesity is assessed by a measure called the Body Mass Index (BMI).

Occupational therapy - Treatment based on the utilization of occupational activities of a typical child (such as play, feeding, toileting, and dressing). Child specific exercises are developed in order to encourage a child with mental or physical disabilities to contribute to their own recovery and development.

Organisms - Living things. Often used as a general term for germs (such as bacteria, viruses, fungi, or parasites) that can cause disease.

Otitis media - Inflammation or infection of the middle part of the ear. Ear infections are commonly caused by Streptococcus pneumoniae or Haemophilus influenzae.

Outbreak - A sudden rise in the incidence of a disease.

Outdoor learning environment - The physical outdoor space used during the planned program of daily activities. It encompasses the objects (natural and manufactured) within the space, the specific play and learning settings, and the interactions that occur between the caregivers/teachers and children.

Over-the-counter medication (OTC) - Medicine that can be bought without a prescription.

Overweight - Children and adolescents with a Body Mass Index (BMI) equal to or over the 85th percentile for age but less than the 95th percentile for age are considered overweight.

Oxygen saturation - A relative measure of the amount of oxygen that is dissolved or carried in a given medium.

Paradichlorobenzene - A white crystalline compound C6H4Cl2 made by chlorinating benzene and used chiefly as a moth repellent and deodorizer (also called PDB).

Parasite - An organism that lives on or in another living organism (such as ticks, lice, mites, etc.).

Parent/Guardian - The child's natural or adoptive mother or father, guardian, or other legally responsible person.

Pasteurized - The partial sterilization of a food substance and especially a liquid (as milk) at a temperature and for a period of exposure that destroys objectionable organisms without major chemical alteration of the substance.

Pediatric first aid - The immediate care given to a suddenly ill or injured child until a medical professional or a parent or legal guardian assumes responsibility for the medical condition from becoming worse and does not take the place of proper medical treatment.

Pentachlorophenol - A manufactured chemical which is a restricted use pesticide and is used industrially as a wood preservative for utility poles, railroad ties, and wharf pilings. Exposure to high levels of pentachlorophenol can have negative effects on the body.

Perishable foods - Foods (such as fruit, vegetables, meat, milk and dairy, and eggs) that are liable to spoil or decay.

Pertussis - A highly contagious bacterial respiratory infection, which begins with cold-like symptoms and cough and becomes progressively more severe, so that the person may experience vomiting, sweating, and exhaustion with the cough, also known as whooping cough.

Pesticides - A chemical used to kill pests, particularly insects.

Phenylketonuria (PKU) - A genetic disorder in which the body can't process part of a protein called phenylalanine (Phe).

Phthalates - A group of chemicals used to make plastics more flexible and harder to break, also known as plasticizers. They are used in products, such as vinyl, adhesives, detergents, oils, plastics, and personal-care products.

Physical activity - Any bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above a basal level. Physical activity generally refers to the subset of activity that enhances health.

Age-appropriate physical activity - Physical movement that is suitable for a specific age.

Moderate physical activity - Levels that are at intensities faster than a slow walk, but still allow children to talk easily. It increases your heart rate and breathing rate. You may sweat, but you are still able to carry on a conversation; you can talk, but you probably can't sing.

Structured physical activity - Caregiver/teacher-led, developmentally appropriate, and fun physical movement. Structured activity should include: a) Daily planned physical activity that supports age-appropriate motor skill development (the activity should be engaging and involve all children with minimal or no waiting); and b) Daily, fun physical activity that is vigorous (gets children "breathless" or breathing deeper and faster than during typical activities) for short bouts of time.

Unstructured physical activity - Physical movement that is child-led free play. Unstructured activity should include: a) Activities that respect and encourage children's individual abilities and interests; and b) Caregiver/teacher engagement with children, support for extending play, and gentle prompts and encouragement by caregivers/teachers, when appropriate, to stay physically active.

Vigorous-intensity physical activity - Rhythmic, repetitive physical movement that uses large muscle groups, causing a child to breathe rapidly and only enabling them to speak in short phrases. Typically children's heart rates are substantially increased and they are likely to be sweating.

Physical therapy - The use of physical agents and methods (such as massage, therapeutic exercises, hydrotherapy, electrotherapy) to assist a child with physical or mental disabilities to optimize their individual physical development or to restore their normal body function after illness or injury.

Pica - A pattern of eating non-food materials (e.g., dirt or paper).

Picaridin - An EPA registered synthetic ingredient formulated for use in insect repellents.

Picocuries - A measure of concentration of radiation per liter of air.

Plagiocephaly - Refers to a head that is abnormally shaped from a variety of causes.

Pneumonia - An acute or chronic disease marked by inflammation of the lungs and caused by viruses, bacteria, or other microorganisms and sometimes by physical and chemical irritants.

Poison Center - Service that provides poison expertise treatment advice by phone. All poison centers can be reached by calling the same telephone number: 1-800-222-1222. Poison centers are staffed by pharmacists, physicians, nurses, and poison information providers who are toxicology specialists.

Polybrominated diphenyl ether (PBDE) - Flame-retardant chemicals that are added to plastics and foam products to make them difficult to burn.

Polymer panels - A glass-like panel that is made of polymers and which serves to protect or add design elements to a living/play area.

Pooling - A practice in larger child care settings where children of various ages are brought together as they arrive at the beginning of the day or depart at the end of the day to consolidate the number of staff needed to meet child:staff ratios.

Postural drainage - Body positioning resulting in the gradual flow of mucous secretions from the edges of both lungs into the airway so secretions can be removed from the lungs by coughing.

Potable - Suitable for drinking.

Prenatal - Existing or occurring before birth (as in prenatal medical care).

Preschooler - A child from achievement of self-care routines (such as toilet learning/training) and the age of entry into a regular school; usually three to five years of age (thirty-six to fifty-nine months of age).

Prescription medications - Medications that can only be prescribed by a licensed practitioner (such as a physician or nurse practitioner).

Primary care provider - A person who by education, training, certification, or licensure is qualified to and is engaged in providing health care. A primary care provider coordinates the care of a child with the child's specialist and therapists.

Professional development - A continuum of learning and support opportunities designed to prepare individuals for work with and on behalf of young children and their families, as well as opportunities that provide ongoing experiences to enhance this work. These opportunities lead to improvements in the knowledge, skills, practices, and dispositions of early childhood professionals. Professional development programs encompass both education and training programs:

Education programs help learners to "have a deep foundation of factual knowledge, understand facts and ideas in the context of a conceptual framework, and organize knowledge in ways that facilitate retrieval and application." Education programs are broad based: They include learning experiences specific to a primary area of inquiry (e.g., child development, early childhood education, or related fields including elementary education and early childhood special education), as well as subjects of general knowledge (e.g., mathematics, history, grammar). Education programs typically lead to an associate's, baccalaureate, or graduate degree or other credit-based certification. These programs provide the foundations for a lifetime of professional practice, expanded upon through experience and ongoing professional development. Education programs also may include continuing education programs that lead to the award of continuing education units (CEUs), but not college credits.

Training programs are specific to an area of inquiry and set of skills related to an area of inquiry (e.g., a workshop series on positive discipline for preschoolers). Completion of training participation can lead to assessment for award of the Child Development Associate (CDA) Credential or another type of credential, CEUs, clock hours, or certification.

Projectile - A fired, thrown, or otherwise propelled object.

Prone - Lying face-down.

Prosthetic devices - An artificial body replacement adapted to reproduce the form and, as much as possible, the function of the missing part.

Protective barrier - Type of containment or deflector system that surrounds and obstructs primarily vehicle passage into a play area, such as bollards and posts. Barriers must pass impact tests for the highest speed limit allowed and posted on the street, road or parking lot adjacent to the outdoor play area.

Pseudomonas aeruginosa - A type of organism that is commonly a contaminant of skin sores but that occasionally causes infection in other parts of the body and is usually hospital-acquired.

Psychosocial - Involving aspects of social and psychological behavior (as in a child's psychosocial development).

Purulent - Containing pus, a thick white or yellow fluid.

Purulent conjunctivitis - Also known as "Pink eye," a white or yellow eye discharge, often with matted eyelids after sleep, and including eye pain or redness of the eyelids or skin surrounding the eye. This type of conjunctivitis is more often caused by a bacterial infection, which may require antibiotic treatment.

PVC (polyvinyl chloride) - Chemical, made up of many chains of vinyl chloride, used to make a variety of plastic products including pipes, wire and cable coatings, and packaging materials. PVC is made up. Vinyl chloride is a known carcinogen.

Quality rating and improvement system (QRIS) - A systemic approach to assess, improve, and communicate the level of quality in early and school-age care and education programs. Similar to rating systems for restaurants and hotels, QRIS award quality ratings to early and school-age care and education programs that meet a set of defined program standards.

Radon - A radioactive gaseous element formed by the disintegration of radium that occurs naturally in the soil. Radon is considered to be a health hazard that may lead to lung cancer.

Reflux - An abnormal backward flow of stomach contents into the esophagus.

Registration - Permission from a state that is required to operate a child care facility. Some states use this term to describe their regulatory process instead of the word licensing.

Rescue breathing - The process of breathing air into the lungs of a person who has stopped breathing. This process is also called artificial respiration.

Respiratory syncytial virus (RSV) - A virus that causes colds, bronchitis, and pneumonia.

Respiratory tract - The nose, ears, sinuses, throat, and lungs.

Return demonstration - An individual demonstrating what (procedure, technique, etc.) they just learned.

Rheumatic fever - A severe infectious disease often occurring after a strep infection. Rheumatic fever is characterized by fever and painful inflammation of the joints and may result in permanent damage to the valves of the heart.

Rhinorrhea - Excessive mucous secretion from the nose.

Rhinovirus - A virus that causes the common cold.

Rifampin - An antibiotic often prescribed for those exposed to an infection caused by Haemophilus influenzae type b (Hib) or Neisseria meningitidis (meningococcus), or given to treat an infection caused by tuberculosis.

Ringworm - A fungal infection that may affect the body, feet or scalp.

Roseola - A viral infection causing rash in infants and children that primarily occurs between six and twenty-four months of age.

Rotavirus - A virus that causes diarrhea and vomiting.

Rubella - A mild viral illness usually lasting three days, with symptoms of red rash, lowgrade fever, swollen glands, and sometimes achy joints also known as German measles, three-day measles, or light measles.

Safety data sheet (SDS) - Information regarding the proper procedures for handling, storing, and disposing of chemical substances. Federal law dictates that employers must provide information to their employees about hazardous materials and chemicals that employees may be exposed to in the workplace. The vehicle for that information is the SDS.

Safety vacuum release system (SVRS) - A system or device capable of providing vacuum release at a suction outlet (as in a swimming pool) caused by a high vacuum occurrence due to a suction outlet blockage. SVRS devices must allow for the vacuum release with or without the suction outlet cover(s) in place, and shall operate in such a way as to not defeat or disengage other layers of protection installed to protect against suction entrapment.

Salmonella - A type of bacteria that causes food poisoning (salmonellosis) with symptoms of vomiting, diarrhea, and abdominal pain.

Salmonella paratyphi - The bacterium responsible for paratyphoid fever. This Salmonella serotype has three forms: A, B, and C.

Salmonella typhi - The bacterium responsible for causing the life-threatening illness typhoid fever.

Salmonellosis - A diarrheal infection caused by Salmonella bacteria.

Sanitize - To reduce germs on inanimate surfaces to levels considered safe by public health codes or regulations. See Appendix J: Selecting an Appropriate Sanitizer or Disinfectant.

Scabies - An infestation of the skin by small insects called mites.

Scarlet fever - A fine red rash that makes the skin feel like sandpaper caused by a streptococcal infection.

School-age child - For the purposes of early care and education settings, a child at the entry into regular school, including kindergarten through sixth grade.

School-age child care facility - A facility offering activities to school-age children before and after school, during vacations, and non-school days set aside for such activities as caregivers'/teachers' in-service programs.

Screen time - Time spent watching TV, videotapes, or DVDs; playing video or computer games; and surfing the internet.

Screening - Examination of a population group or individual to detect the existence of a particular disease (such as diabetes or tuberculosis). See also Developmental screening.

Secondary infection - When a person is infected by an organism that had originated from the illness of another person. The first person infected has the primary infection, and any persons infected from the originally infected person is said to have contracted a secondary infection.

Secondhand emission (from electronic cigarettes) - Exhaled vapors into the air.

Secondhand smoke - Exhaled smoke from smokers into the air.

Secretion - Wet material, such as saliva, that is produced by a cell or a gland and that has a specific purpose in the body.

Sedentary activity - Non-moving activity like reading, playing a board game, or drawing.

Seizure - A sudden attack or convulsion due to involuntary, uncontrolled burst of electrical activity in the brain that can result in a wide variety of clinical manifestations, including muscle twitches, staring, tongue biting, loss of consciousness, and total body shaking.

Sensory table - A piece of equipment consisting of a liner set inside of a frame; water and sand are popular fillers, but almost anything can be used.

Sepsis - An infection that involves the presence of pathogenic organisms or their toxins in the blood or body tissues.

Serotype - A group of intimately related microorganisms distinguished by a common set of antigens. For example, Salmonella has many serotypes including typhimurium and enteritidis.

Serum - The clear liquid that separates in the clotting of blood.

Sexual orientation - A person's sexual identity in relation to the gender to which they are attracted. This includes heterosexuality (attraction to the opposite sex), homosexuality (attraction to the same sex), and bisexuality (attraction to either sex).

Shelter-in-place - The process of staying where one is located and taking shelter, rather than trying to evacuate.

Shiga toxin-producing E. coli (STEC) - Bacterial intestinal tract infection that causes diarrhea.

Shigella - A type of bacterium that causes bacillary dysentery or shigellosis, a diarrheal infection.

Shigellosis - A diarrheal infection caused by the Shigella bacterium.

SIDS - See Sudden Infant Death Syndrome (SIDS).

Small family child care home - See Family child care.

Special facility for children who are ill - See Facility for children who are mildly ill.

SSRI (selective serotonin reuptake inhibitors) - A type of medication used to treat depression, anxiety disorders, and some personality disorders.

Stackable cribs - Cribs that are built in a manner that there are two or three cribs above each other that do not touch the ground floor.

Staff - All personnel employed at the facility, including directors, caregivers/teachers, and personnel who do not provide direct care to the children (such as cooks, drivers, and housekeeping personnel).

Standard precautions - Use of barriers (e.g. gloves) to handle potential exposure to blood, including blood-containing body fluids and tissue discharges, and other potentially infectious fluids and the process to clean and disinfect contaminated surfaces.

Standing orders - Orders written in advance by a health care provider that describes the procedure to be followed in defined circumstances.

Staphylococcus - A common bacterium found on the skin that may cause skin infections or boils.

Streptococcal pharyngitis (strep throat) - A disease caused by Streptococcus bacterium.

Streptococcus - A common bacterium that can cause sore throat, upper respiratory illnesses, pneumonia, skin rashes, skin infections, arthritis, heart disease (rheumatic fever), and kidney disease (glomerulonephritis).

Structured physical activity - See Physical activity.

Substitute staff - Caregivers/teachers hired for a temporary time frame (one day or for an extended period of time), who work under direct supervision of a trained, permanent caregiver/teacher.

Suction - The removal of respiratory secretions or mucous of a child to aid in breathing.

Sudden Infant Death Syndrome (SIDS) - The sudden death of an infant under one year of age, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.

Supine - Lying on the back or with the face upward.

Swaddling - The act of wrapping an infant tightly in a blanket.

Systemic - Pertaining to a whole body rather than to one of its parts.

TB - See Tuberculosis.

Tdap - Abbreviation for the immunization against tetanus, diphtheria, and pertussis.

Thermal injury - Bodily injury due to burns.

Thirdhand Smoke - Residual smoke and chemicals on the smoker's clothes and hair or on surfaces where smoking occurs.

Thrush - A yeast infection predominately produced by the Candida albicans organisms causing mouth infections in young infants.

Toddler - A child between ambulation to accomplishment of self-care routines such as use of the toilet, usually thirteen through thirty-five months of age.

Touch supervision - Within an arm's reach or able to touch the child at all times. This concept has derived from the supervision of children during water play.

Toxoplasmosis - A parasitic disease usually causing no symptoms. When symptoms do occur, swollen glands, fatigue, malaise, muscle pain, fluctuating low fever, rash, headache, and sore throat are reported most commonly. Toxoplasmosis can infect and damage an unborn child while producing mild or no symptoms in the mother.

Transmission - The passing of an infectious organism or germ from person to person.

Tremolite - A mineral that can occur in fibrous form (an asbestos).

Tributyltin oxide - A volatile organic compound, used as a wood preservative.

Tricolosan - A chemical with antibacterial properties; used in consumer products such as detergents, soaps, skin cleansers, deodorants, lotions, creams, toothpastes, and dishwashing liquids.

Tricyclic antidepressants - Any of a group of antidepressant drugs (as imipramine, amitriptyline, desipramine, and nortriptyline).

Tuberculosis (TB) - A disease caused by an infection with the bacteria Mycobacterium tuberculosis that usually involves the lungs but could affect other parts of the body.

Tummy time - The time an infant spends on his stomach (tummy) throughout the day. Tummy time is only for when the infant is awake, alert and being watched.

Ulcerative colitis - A disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon.

Under-immunized - A person who has not received the recommended number or types of vaccines for his/her age according to the current national and local immunization schedules.

Unitary surface material - A cushioned surface material (such as rubber mats or a combination of rubberlike materials held in place by a binder) for placement under and around playground equipment that forms an uninterrupted shock absorbing surface.

Universal precautions - See Standard precautions

Vacuum breaker - A device put on a pipe containing liquid (such as drinking water) to prevent the liquid from being sucked backward within the pipe.

Varicella-zoster - An illness with rash and fever caused by the varicella-zoster virus, also known as chickenpox.

Vector-borne diseases - A disease in which the pathogenic microorganism is transmitted from an infected individual to another individual by an arthropod (e.g., insect) or other agent, sometimes with other animals serving as intermediary hosts.

Vegan - Individual who does not eat meat, poultry, fish, eggs, or dairy products; the individual only eats plant foods.

Vegetaria - An individual who does not eat meat, poultry, or fish. Variations of vegetarians include: Lacto-ovo-vegetarians who consume eggs, dairy products, and plant foods and lacto-vegetarians who eat dairy products and plant foods but not eggs.

Ventilation - Method of controlling the environment with air flow.

Venlafaxine - A medication in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs).

Viandas - Root vegetables common in some diets.

Vigorous - intensity physical activity - See Physical activity.

Virus - A microscopic organism, smaller than a bacterium, which may cause disease. Viruses can grow or reproduce only in living cells.

Volatile organic compound (VOC) - Emitted gases from certain solids or liquids. VOCs include a variety of chemicals. Many types of household products contain VOCs, including paints, paint strippers, adhesives, cleaners, pesticides, building materials, and office equipment.

Volunteer - An individual who is not paid and gives their time to work at an early care and education program.

Water play activities - Activities that involve the use of water such as swimming, wading, sprinklers, and water play tables.

West Nile virus (WNV) - An infectious disease due to a virus spread by infected mosquitos.

Zika - A mosquito-borne viral disease that usually causes mild illness but may damage the unborn child of a pregnant woman who is infected.