Caring for Our Children (CFOC)

Chapter 2: Program Activities for Healthy Development

2.1 Program of Developmental Activities

2.1.1 General Program Activities Health, Nutrition, Physical Activity, and Safety Awareness

Content in the STANDARD was modified on 5/30/2018

Early care and education programs should create and implement written program plans addressing the physical, oral, mental, nutritional, and social and emotional health, physical activity, and safety aspects of each formally structured activity documented in the written curriculum. These plans should include daily opportunities to learn health habits that prevent infection and significant injuries and health habits that support healthful eating, nutrition education, physical activity, and sleep. Awareness of healthy and safe behaviors, including good nutrition, physical activity, and sleep habits, should be an integral part of the overall program.


Young children learn better through experiencing an activity and observing behavior than through didactic methods (1). There may be a reciprocal relationship between learning and play so that play experiences are closely related to learning (2). Children can accept and follow rules, routines, and guidelines about health and safety when their personal experience helps them to understand why these rules were created. National guidelines for children birth to age 5 years encourage their engagement in daily physical activity that promotes movement, motor skills, and the foundations of health-related fitness (3). Physical activity is important to overall health and to overweight and obesity prevention (4). Healthy sleep habits (e.g., a bedtime routine, an adequate amount of sleep) (5,6) helps children get the amount of uninterrupted sleep their brains and bodies need, which is associated with lower rates of overweight and obesity later in life (7-11).

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS Coordinated Child Care Health Program Model Active Opportunities for Physical Activity Scheduled Rest Periods and Sleep Arrangements Socialization During Meals Nutrition Learning Experiences for Children Nutrition Education for Parents/Guardians Supply of Food and Water for Disasters
Appendix S: Physical Activity: How Much Is Needed?
  1. Stirrup J, Evans J, Davies B. Learning one’s place and position through play: social class and educational opportunity in early years education. Int J Early Years Educ. 2017;1–18

  2. Weisberg D, Hirsh-Pasek K, Golinkoff R, Kittredge A, Klahr D. Guided play: principles and practices. Curr Dir Psychol Sci. 2016;25(3):177–182

  3. Roth K, Kriemler S, Lehmacher W, Ruf KC, Graf C, Hebestreit H. Effects of a physical activity intervention in preschool children. Med Sci Sports Exerc. 2015;47(12):2542–2551

  4. US Department of Health and Human Services, US Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th ed. Washington, DC: US Government Printing Office; 2015. Published December 2015. Accessed November 14, 2017

  5. Sivertsen B, Harvey AG, Reichborn-Kjennerud T, Torgersen L, Ystrom E, Hysing M. Later emotional and behavioral problems associated with sleep problems in toddlers: a longitudinal study. JAMA Pediatr. 2015;169(6):575–582

  6. Kelly Y, Kelly J, Sacker A. Time for bed: associations with cognitive performance in 7-year-old children: a longitudinal population-based study. J Epidemiol Community Health. 2013;67(11):926–931

  7. Institute of Medicine. Early Childhood Obesity Prevention Policies: Goals, Recommendations, and Potential Actions. Washington, DC: Institute of Medicine; 2011. Published June 2011. Accessed November 14, 2017

  8. Fatima Y, Doi SA, Mamun AA. Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis. Obes Rev. 2015;16(2):137–149

  9. Li L, Zhang S, Huang Y, Chen K. Sleep duration and obesity in children: a systematic review and meta-analysis of prospective cohort studies. J Paediatr Child Health. 2017;53(4):378–385

  10. Anderson SE, Andridge R, Whitaker RC. Bedtime in preschool-aged children and risk for adolescent obesity. J Pediatr. 2016;176:17–22

  11. Lumeng JC, Somashekar D, Appugliese D, Kaciroti N, Corwyn RF, Bradley RH. Shorter sleep duration is associated with increased risk for being overweight at ages 9 to 12 years. Pediatrics. 2007;120(5):1020–1029


Content in the STANDARD was modified on 5/30/2018