HBEC4103

Safety, Health and Nutrition

in Early Childhood Education

Copyright © Open University Malaysia (OUM)

 HBEC4103
SAFETY, HEALTH AND
NUTRITION IN EARLY
CHILDHOOD
EDUCATION
Wynand Diergaardt

Copyright © Open University Malaysia (OUM)

Project Directors: Prof Dr Widad Othman
Dr Aliza Ali
Open University Malaysia

Module Writer: Wynand Diergaardt

Namibian College of Open Learning

Moderator: Dr Azhar Md Adnan

Enhancer: Dr Rosinah Mahmood

Open University Malaysia

Developed by: Centre for Instructional Design and Technology

Open University Malaysia

First Edition, December 2013

Second Edition, April 2020 (MREP)
Copyright © Open University Malaysia (OUM), April 2020, HBEC4103
All rights reserved. No part of this work may be reproduced in any form or by any means without
the written permission of the President, Open University Malaysia (OUM).

Copyright © Open University Malaysia (OUM)

Table of Contents
Course Guide ixăxiv

Topic 1 A Holistic Approach to Early Childhood Education

Environments 1
1.1 Definitions of Terms 2
1.1.1 Holistic 2
1.1.2 Safety 2
1.1.3 Nutrition 3
1.1.4 Health 3
1.2 A Holistic Approach to Safety, Nutrition and Health 4
1.2.1 Six Aspects of the Holistic Approach 4
1.2.2 Importance of the Holistic Approach 6
1.3 Interrelationship between Safety, Nutrition and Health 8
Summary 10
Key Terms 10
References 10

Topic 2 Creating a Safe Environment 12

2.1 Indoor Safety 12
2.2 Outdoor Safety 17
2.3 Emergency Response Procedures 19
2.4 Accidents and Prevention of Injuries 22
Summary 25
Key Terms 26
References 26

Topic 3 Prevention of Illness 27

3.1 Illness Prevention Methods 27
3.1.1 Hand Washing 29
3.1.2 Diapering 30
3.1.3 Toileting 30
3.1.4 Food Preparation 31
3.2 Infection Control 32
3.3 Germs and Infections 34
Summary 36
Key Terms 37
References 37

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iv  TABLE OF CONTENTS

Topic 4 Health of the Young Child 38

4.1 Promoting ChildrenÊs Health and Well-being 39
4.1.1 Parents 39
4.1.2 Schools 40
4.1.3 Community 42
4.2 Health Assessment 43
4.2.1 Principles of Ongoing Assessment 43
4.2.2 Types of Screening 44
4.3 Recording ChildrenÊs Health Status 47
4.3.1 Health History 47
4.3.2 Health Record 47
4.4 Ongoing Observation of Children 48
Summary 50
Key Terms 51
References 51

Topic 5 Illness in Children 53

5.1 Environmental Conditions Affecting ChildrenÊs Health 54
5.2 Communicable Illness 56
5.3 Caring for Sick Babies and Children 57
5.3.1 When to Keep Children at Home 57
5.3.2 Taking Care of Children at School 58
Summary 59
Key Terms 60
References 60

Topic 6 Promoting Good Nutrition 62

6.1 Defining and Identifying Good Nutrition 63
6.1.1 Good Nutrition 63
6.1.2 Identifying Good Nutrition 66
6.2 Logistics of Good Nutrition 67
6.3 Plan and Design a Good Diet 69
6.4 Protection and Sanitation of Food 71
6.5 Food Technology 73
Summary 74
Key Terms 75
References 76

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 TABLE OF CONTENTS  v

Topic 7 Providing Food for Infants 77

7.1 Infant Feeding 78
7.1.1 When an Infant is Not Receiving Breast Milk 78
7.1.2 When an Infant is Receiving Breast Milk 79
7.2 Feeding the Autonomous Toddler 80
7.2.1 Food as an Issue of Control 80
7.2.2 Feeding the Toddler 81
7.2.3 Keep Offering New Types of Food 82
7.2.4 How Well is the Toddler Growing? 82
7.2.5 How Can Meal Times be Pleasant? 83
7.3 Food for the Preschooler 84
7.3.1 Feeding Behaviours of Toddlers and Preschoolers 85
7.3.2 Types of Food and Eating Habits of Preschoolers 86
Summary 87
Key Terms 88
References 88

Topic 8 Menu Planning and Food Safety 89

8.1 Health Problems Related to Eating Habits 90
8.1.1 Factors Associated with Unhealthy Eating Habits 90
8.1.2 Developing Healthy Eating Habits 94
8.2 Food Safety and Hygiene 96
8.3 Menu Planning for Early Childhood Environment 97
8.3.1 Why Meal Plan? 98
8.3.2 Meal Planning Methods 98
8.3.3 Meal Planning ă Tips and Sample 99
Summary 100
Key Terms 101
References 101

Topic 9 Current Issues: Helping the Abused and Neglected Child 103
9.1 Preventative Measures 104
9.1.1 Prevent Accusations 106
9.2 Intervention in Child Abuse and Neglect Situation 108
9.2.1 Building a Relationship with the Family 109
9.2.2 Developing Case and Safety Plans 109
9.2.3 Establishing Clear and Concrete Goals 109
9.2.4 Targeting Outcomes 110
9.2.5 Tracking Family Progress 111
9.2.6 Analysing and Evaluating Family Progress 112

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9.3 Reporting Incidents of Abuse and Neglect 113

9.3.1 Protective Measures for Child Maltreatment 114
9.4 Activities to Help the Abused Child 115
9.4.1 Help the Child Develop Positive Self-esteem 115
9.4.2 Help the Child to Trust 115
9.4.3 Help the Child to Identify and Express Emotions 116
9.4.4 Help the Child to Learn to Communicate 116
9.4.5 Help the Child to Identify and Solve Problem 117
Situations
9.4.6 Help the Child to Catch Up Developmentally 117
9.4.7 Help the Child to Develop a Safety Plan 117
9.4.8 Link Families to Community Support 118
Summary 118
Key Terms 119
References 120

Topic 10 Educating Parents on Safety, Health and Nutrition 121

10.1 Educate Parents on Safety, Health and Nutrition 122
10.1.1 Health Education for Parents 122
10.1.2 Nutrition Education for Parents 123
10.1.3 Safety Education for Parents 126
10.2 Techniques for Sharing Information with Parents 127
10.2.1 Communication 127
10.2.2 Volunteer Opportunities 128
10.2.3 Committees and Advisory Boards 129
10.2.4 Resources for Families 130
10.3 Utilising Community Resources 131
10.3.1 Sharing Strategies and Resources to Strengthen 131
Concrete Support
Summary 133
Key Terms 134
References 135

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COURSE GUIDE

Copyright © Open University Malaysia (OUM)

Copyright © Open University Malaysia (OUM)
 COURSE GUIDE  ix

COURSE GUIDE DESCRIPTION

You must read this Course Guide carefully from the beginning to the end. It tells
you briefly what the course is about and how you can work your way through
the course material. It also suggests the amount of time you are likely to spend in
order to complete the course successfully. Please keep on referring to the Course
Guide as you go through the course material, as it will help you to clarify
important study components or points that you might miss or overlook.

INTRODUCTION
HBEC4103 Safety, Health and Nutrition in Early Childhood Education is one of
the courses offered at Open University Malaysia (OUM). This course is worth
three credit hours and should be covered over 8 to 15 weeks.

COURSE AUDIENCE
This course is offered to all learners taking the Bachelor of Early Childhood
Education with Honours programme. This module aims to provide knowledge of
their roles in promoting childrenÊs safety, health and nutrition as well as helping
young children to establish good habits, attitudes and lifelong responsibility for
optimising personal well-being.

As an open and distance learner, you should be able to learn independently and
optimise the learning modes and environment available to you. Before you begin
this course, please ensure that you have the right course materials, understand
the course requirements and know how the course is conducted.

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x  COURSE GUIDE

STUDY SCHEDULE
It is a standard OUM practice that learners accumulate 40 study hours for every
credit hour. As such, for a three-credit hour course, you are expected to spend
120 study hours. Table 1 gives an estimation of how the 120 study hours can be
accumulated.

Table 1: Estimation of Time Accumulation of Study Hours

Study
Study Activities
Hours
Briefly go through the course content and participate in initial discussions 3
Study the module 60
Attend 3 to 5 tutorial sessions 10
Online participation 12
Revision 15
Assignment(s), test(s) and examination(s) 20
TOTAL STUDY HOURS ACCUMULATED 120

COURSE LEARNING OUTCOMES

By the end of this course, you should be able to:

1. Describe the interrelationship between safety, health and nutrition in the

early childhood context;

2. Apply knowledge of nutrition and safety in the context of early childhood

education;

3. Discuss the components of a safe environment and ways to implement

health goals; and

4. Design a quality curriculum for early childhood education in the areas of

safety, health and nutrition.

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 COURSE GUIDE  xi

COURSE SYNOPSIS
This course is divided into 10 topics. The synopsis of each topic is listed as
follows:

Topic 1 begins with definitions of health, safety and nutrition. It discusses the
holistic approach to safety, health and nutrition in quality early childhood
education environments, and the interrelationship between health, safety and
nutrition.

Topic 2 examines ways to create a safe environment for early childhood

education. It discusses guidelines and policies for a safe environment, accident
and injury prevention, and indoor and outdoor safety.

Topic 3 focuses on the prevention of illness in child care and education settings.
Illness prevention and infection control can be done through better hand
washing, diapering, toileting and food preparation practices.

Topic 4 discusses ways to promote young childrenÊs health and well-being, and
the use of health assessment tools, and childrenÊs health records.

Topic 5 discusses illness in young children, conditions affecting their health,

communicable illness, and how to care for sick babies and young children.

Topic 6 talks about promoting good nutrition in the early childhood setting, basic
concepts of food and nutrients, and providing good nutrition in early childhood
education environments.

Topic 7 discusses feeding issues involving infants, toddlers and pre-schoolers ă

infant feeding, feeding the autonomous toddler, and food for the preschooler.

Topic 8 examines health problems related to eating habits, food safety and
hygiene, and menu planning for the early childhood education environment.

Topic 9 addresses current issues in early childhood education ă children with

disabilities or other special needs, child abuse and neglect, child maltreatment,
and nutritional disorders in children.

Topic 10 focuses on encouraging safety, health and nutrition practices at home,

educating parents on health, safety and nutrition issues, techniques for sharing
health, safety and nutrition information, and utilising community resources.

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xii  COURSE GUIDE

TEXT ARRANGEMENT GUIDE

Before you go through this module, it is important that you note the text
arrangement. Understanding the text arrangement will help you to organise your
study of this course in a more objective and effective way. Generally, the text
arrangement for each topic is as follows:

Learning Outcomes: This section refers to what you should achieve after you
have completely covered a topic. As you go through each topic, you should
frequently refer to these learning outcomes. By doing this, you can continuously
gauge your understanding of the topic.

Self-Check: This component of the module is inserted at strategic locations

throughout the module. It may be inserted after one subtopic or a few subtopics.
It usually comes in the form of a question. When you come across this
component, try to reflect on what you have already learnt thus far. By attempting
to answer the question, you should be able to gauge how well you have
understood the subtopic(s). Most of the time, the answers to the questions can be
found directly from the module itself.

Activity: Like Self-Check, the Activity component is also placed at various

locations or junctures throughout the module. This component may require you
to solve questions, explore short case studies, or conduct an observation or
research. It may even require you to evaluate a given scenario. When you come
across an Activity, you should try to reflect on what you have gathered from the
module and apply it to real situations. You should, at the same time, engage
yourself in higher order thinking where you might be required to analyse,
synthesise and evaluate instead of only having to recall and define.

Summary: You will find this component at the end of each topic. This component
helps you to recap the whole topic. By going through the summary, you should
be able to gauge your knowledge retention level. Should you find points in the
summary that you do not fully understand, it would be a good idea for you to
revisit the details in the module.

Key Terms: This component can be found at the end of each topic. You should go
through this component to remind yourself of important terms or jargon used
throughout the module. Should you find terms here that you are not able to
explain, you should look for the terms in the module.

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 COURSE GUIDE  xiii

References: The References section is where a list of relevant and useful

textbooks, journals, articles, electronic contents or sources can be found. The list
can appear in a few locations such as in the Course Guide (at the References
section), at the end of every topic or at the back of the module. You are
encouraged to read or refer to the suggested sources to obtain the additional
information needed and to enhance your overall understanding of the course.

PRIOR KNOWLEDGE
There is no prior knowledge required.

ASSESSMENT METHOD
Please refer to myINSPIRE.

REFERENCES
Bruce, T., & Meggitt, C. (2002). Child care and education. London, United
Kingdom: Hodder Education.

Endres, J., Rockwell, R., & Mense, C. G. (2003). Food, nutrition, and the young
child. New York, NY: Pearson.

Hewes, D. W., Leatherman, J. M., & Leatherman, J. (2004). An administratorÊs

guidebook to early care and education programs. New York, NY: Pearson.

Marotz, L., Cross, M., & Rush, J. M. (2008). Health, safety and nutrition for the
young child. New York, NY: Cengage Learning.

Motricardi, J., McLarty, J., & McLarty, J. (2007). Health, safety, and nutrition
activities A to Z. New York, NY: Cengage Learning.

Robertson, C. (2010). Safety, nutrition and health in early education. New York,
NY: Cengage Learning (Pearson).

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xiv  COURSE GUIDE

TAN SRI DR ABDULLAH SANUSI (TSDAS)

DIGITAL LIBRARY
The TSDAS Digital Library has a wide range of print and online resources for
the use of its learners. This comprehensive digital library, which is accessible
through the OUM portal, provides access to more than 30 online databases
comprising e-journals, e-theses, e-books and more. Examples of databases
available are EBSCOhost, ProQuest, SpringerLink, Books247, InfoSci Books,
Emerald Management Plus and Ebrary Electronic Books. As an OUM learner,
you are encouraged to make full use of the resources available through this
library.

Copyright © Open University Malaysia (OUM)

Topic   A Holistic
Approach to
1 Early
Childhood
Education
Environments
LEARNING OUTCOMES
By the end of this topic, you should be able to:
1. Define the terms „holistic, „safety‰, „health‰ and „nutrition‰ in early
childhood education environments;
2. Explain the holistic approach to early childhood education
environments; and
3. Describe the interrelationship between safety, nutrition and health.

 INTRODUCTION
Have you ever come across the term, „holistic approach‰? You probably have but
do you know what it means? In this topic, we will first look at the terminologies
related to early childhood education environments, and then examine the holistic
approach to these environments.

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2  TOPIC 1 A HOLISTIC APPROACH TO EARLY CHILDHOOD EDUCATION
ENVIRONMENTS

1.1 DEFINITIONS OF TERMS

In the study of safety, nutrition and health in early childhood education, there are
a few terms that we ought to know. The following will explore the definitions of
these terms further.

1.1.1 Holistic
Holistic means a whole rather than a part of something. For example, when we
look at a childÊs development, we look at his or her development in a holistic way
ă encompassing all aspects such as body, mind and soul. The online Oxford
LearnerÊs Dictionaries define „holistic‰ as follows: „Considering a whole thing or
being to be more than a collection of parts.‰ In early childhood education, it is of
utmost importance to look at the components together and not as separate parts.
These three components ă safety, nutrition and health ă form the whole.

1.1.2 Safety
Safety has been coined as „a state in which hazards and conditions leading to
physical, psychological or material harm are controlled in order to preserve the
health and well-being of individuals and the community‰ (Maurice, Lavoie,
Laflamme, Svanström, Romer & Anderson, 2001). Thus, this state is not only linked
to the absence of intentional or unintentional injuries but also being sheltered from
danger. For example, children should be safe when they are in an early childhood
education centre. Secondly, they should be free from the occurrence of risk or
injury. Accidents can happen, so we should adhere to all safety rules and
regulations. The least we can do is to make sure that safety procedures are in place
and practised on a daily basis. All safety features for children will be addressed in
Topic 2, which discusses the need to provide indoor and outdoor safety.

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 TOPIC 1 A HOLISTIC APPROACH TO EARLY CHILDHOOD EDUCATION  3
ENVIRONMENTS

1.1.3 Nutrition
Nutrition is important for growth, metabolism and repair. According to Marotz
(2008), nutrition is the study of food and how it is consumed by the body. The body
needs energy and materials for it to grow and regulate all body processes. Having
knowledge of what to eat is beneficial for us, especially knowledge of the adequate
amount of nutrients that are needed for the body to function normally. Our body
needs a variety of food to get all the nutrients. There is no single food that contains
all the nutrients to support life. Remember, this is only an introductory part to
nutrition. You will learn more about nutrition in Topics 3 and 4.

1.1.4 Health
How important is nutrition and fitness? According to Mayo Clinic (2013), nutrition
and fitness are the cornerstones of childrenÊs health. Can you see the relationship
between both components, and why it is important to have a holistic approach to
safety, nutrition and health in early childhood education settings? Nutrition and
fitness are certainly a good combination. With this knowledge, you can give a child
a head start.

SELF-CHECK 1.1

1. In your own words, write a short definition for each of these terms:
holistic, safety, health and nutrition.

2. Why is it important to adopt a holistic approach? Discuss with your

coursemates.

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4  TOPIC 1 A HOLISTIC APPROACH TO EARLY CHILDHOOD EDUCATION
ENVIRONMENTS

1.2 A HOLISTIC APPROACH TO SAFETY,

NUTRITION AND HEALTH
In this subtopic, we will examine the holistic approach to safety, nutrition and
health, starting with the six aspects of the holistic approach. We will then discuss
the importance of the holistic approach in early childhood education.

1.2.1 Six Aspects of the Holistic Approach

The Early Head Start National Resource Centre (2004) states that health is the
prerequisite to school readiness and social competence because it provides the
foundation from which children can grow, develop and learn. When children are
sick, hungry and tired, in an unsafe environment or under emotional stress, they
will not be able to learn properly and as a result, their learning process and growth
will be affected. If we follow a holistic approach, children will have a better chance
of growing and reaching their full potential. Figure 1.1 shows the different aspects
of the holistic approach.

Figure 1.1: Different aspects of the holistic approach

Source: Google Images

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 TOPIC 1 A HOLISTIC APPROACH TO EARLY CHILDHOOD EDUCATION  5
ENVIRONMENTS

A healthy and safe child will be a happy child and will perform well in all areas of
development, be it physical, social, environmental, emotional, spiritual or
intellectual. These different aspects interact to support or obstruct good health.
What it means is that if one of these areas is impaired or affected, the other aspects
will be affected as well. For example, if a child is affected physically, the other
aspects will also be affected.

The World Health OrganizationÊs constitution (WHO: 2019) states that health is
complete physical, mental and social well-being and not merely the absence of
disease or infirmity. The constitution also stresses that the enjoyment of the highest
attainable standard of health is one of the fundamental rights of every human
being without distinction of race, religion, political belief, economic or social
condition. Thus, the constitution encourages us to pay more attention to all aspects
of individual development and the environment to promote health and well-being.

The following are the various scopes of health for infants, toddlers and their
families (Early Head Start National Resource Centre, 2004):

(a) Physical Health

(i) Absence of illness or injury;

(ii) Regularly scheduled and administered immunisations and well-baby

care, including oral health;

(iii) Well-maintained nutrition and hygiene; and

(iv) Opportunities for exercise and physical fitness.

(b) Emotional Health

(i) The ability to cope with stress;

(ii) The experience of, and ability to express, a range of emotions; and

(iii) The ability to engage in meaningful play or work.

(c) Social Health

(i) A sense of belonging or community;

(ii) The ability to have an effect on the world in work or play; and

(iii) The ability to sustain intimate relationships.

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6  TOPIC 1 A HOLISTIC APPROACH TO EARLY CHILDHOOD EDUCATION
ENVIRONMENTS

(d) Cognitive Health

The ability to concentrate, remember, and solve problems.

(d) Environmental Health

The experience of living, working, and playing in areas that are clean, safe
and pleasant.

(e) Spiritual Health

The freedom to worship.

SELF-CHECK 1.2

1. Briefly explain the holistic approach to safety, nutrition and health.

2. Name the different aspects of the holistic approach.

1.2.2 Importance of the Holistic Approach

Robertson (2015) is of the view that it can no longer be assumed that all of the
safety, nutritional and health needs of children are met at home by parents. Now,
let us look at the statistics and points provided by Robertson:

(a) More than 13 million children younger than six years old have mothers in
the workforce.

(b) There are more than 50 per cent of children younger than five years old
receiving early childhood education.

(c) More than 50 per cent of infants are in an early childhood education
environment on a regular basis.

(d) By the age of six, more of 82 per cent of children in the United States have
received supplemental early childhood education.

(e) More children over the age of five participate in after-school care.

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 TOPIC 1 A HOLISTIC APPROACH TO EARLY CHILDHOOD EDUCATION  7
ENVIRONMENTS

(f) A new trend is growing where there is round-the-clock childcare available

for parents who work the second and third shifts.

(g) Non-parental teachers must help parents meet the health, safety and
nutritional needs of the children in their care.

(h) Teachers, family, childcare providers, nannies and other non-parental

caregivers spend their days working with children to provide intellectual
stimulation, social and emotional support, and physical care.

(i) Good physical care is of primary importance to support the health, safety
and nutritional well-being of children.

(j) Children who are unhealthy or whose physical well-being is at risk may have
difficulty performing cognitive tasks and relating to others in terms of social
and emotional development.

(k) Cognitive, social and emotional deficits as well as physical difficulties may
result in poor health.

(l) Health should be defined in terms of a personÊs physical, mental, social and
emotional well-being.

All the above points raised by Robertson (2010) give us food for thought. These
factors are interrelated and a holistic approach should be considered for a childÊs
development, health and well-being. As practitioners, you have the responsibility
of ensuring that you include all these areas. Why? With good health, unnecessary
risks such as illness are prevented. Furthermore, neglecting good health practices,
living in an unsafe environment or providing poor nutrition may contribute to
failure in protecting children (Robertson, 2010). Your job will be to create an
atmosphere where a child can grow holistically and all areas are catered for.

Robertson (2010) has also provided some suggestions on the holistic approach to
safety, nutrition and health in early childhood education:

(a) Early childhood educators must have the knowledge, training and skills to
support the development of the whole child;

(b) Quality early childhood education should involve families to reduce the
magnitude of the effects of problems that children may encounter, such as
poverty and violence, to achieve their whole potential;

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8  TOPIC 1 A HOLISTIC APPROACH TO EARLY CHILDHOOD EDUCATION
ENVIRONMENTS

(c) A holistic approach is required to address the needs of children who are at
risk of severe health problems and school failure;

(d) Nutrition can affect childrenÊs well-being in both short and long terms. Thus,
we need to facilitate good nutritional habits;

(e) Excellence of early childhood education is directly related to compliance

with a high standard of care. Early childhood teachers with more
professional training provide more nurturing and responsive care;

(f) Early childhood education programmes can be seen as second homes, and
teachers face the task of creating safe environments in these challenging
times; and

(g) Teachers need the knowledge to promote childrenÊs health and nutrition,
establish and sustain mutual relationships with families, and use community
resources to help children and families.

1.3 INTERRELATIONSHIP BETWEEN SAFETY,

NUTRITION AND HEALTH
In this subtopic, we will learn about the interrelationship between safety, nutrition
and health in early childhood education. According to Encarta Dictionary,
interrelationship means, „to have a relationship in which each person or thing
depends on or is affected by the others, or to cause persons or things to have such
a relationship‰. In the interrelationship between safety, nutrition and health, these
three components depend on or are affected by each other.

We have looked at the definitions of safety, nutrition and health in Subtopic 1.1.
Now, let us look at the interrelationship between these three components:

(a) Good nutrition has an impact on health in terms of boosting immunity to

protect the body from disease or illness.

(b) Good nutrition also reduces the incidence of illness, which in turn can lead
to an increase in body weight and height.

(c) Nutrition and health influence the growth and development of children in
the physical, mental and social aspects, as well as psychology.

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 TOPIC 1 A HOLISTIC APPROACH TO EARLY CHILDHOOD EDUCATION  9
ENVIRONMENTS

Figure 1.2 is a graphical representation of the interrelationship between safety,

nutrition and health.

Figure 1.2: Interrelationship between safety, nutrition and health

Such interrelationship, as seen in Figure 1.2, is important for healthy growth and
safety. For example, our body needs good nutrition to prevent accidents. If you
start your day without having breakfast, it can result in low blood sugar, which
can in turn lead to a decrease in alertness. Accidents can happen when your
reaction time is slow. In another example, being overweight can cause a person to
feel tired easily, which can decrease his or her will to exercise. Thus, you need to
take in good nutrients for the body to grow and for all body functions to run
efficiently. Good nutrition intake leads to more energy and you will then find
strength to exercise. This in turn ensures good reaction time and alertness to avoid
accidents.

SELF-CHECK 1.3

1. Explain the interrelationship between safety, nutrition and health.

2. Give one example of the interrelationship between safety, nutrition

and health.

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10  TOPIC 1 A HOLISTIC APPROACH TO EARLY CHILDHOOD EDUCATION
ENVIRONMENTS

 Holistic means a whole rather than a part of something. In early childhood

education, safety, nutrition and health need to be approached in a holistic
manner. These components are defined as follows:

ă Safety: Free from risk or occurrence of injury, meaning a state of being safe;

ă Nutrition: The study of food and how it is necessary for the body to
function; and

ă Health: A state of physical and mental well-being.

 Taking a holistic approach will help to ensure quality in early childhood

education environments. To get the best out of children, we should ensure their
safety, nutrition and health.

 Knowledge of nutrition is essential, especially what to eat and the correct

portions, to ensure the body functions well. Leading a healthy lifestyle is of
utmost importance.

Health Nutrition
Holistic Safety
Interrelated

Boschee, M. A., & Jacobs, J. M. (1998). Ingredients for quality child care. Retrieved
from http://www.nncc.org/choose.quality.care/ingredients.html

Bullard, J. (2011). Safety in early childhood environments. Retrieved from

http://www.education.com/reference/article/safety-early-childhood-
environments/

Early Head Start National Resource Center. (2004). A holistic approach to health
and safety. Technical Assistance Paper No. 7.

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 TOPIC 1 A HOLISTIC APPROACH TO EARLY CHILDHOOD EDUCATION  11
ENVIRONMENTS

Marotz, L. (2008). Health, safety and nutrition for the young child. Clifton Park,
New York, NY: Cengage Learning.

Maurice, P., Lavoie, M., Laflamme, L., Svanström, L., Romer, C., & Anderson, R.
(2001). Safety and safety promotion: definitions for operational developments.
Injury Control and Safety Promotion, (4), 237ă240.

Mayo Clinic. (2013). ChildrenÊs health. Retrieved from

http://www.mayoclinic.com/health/childrens-health/MY00383

Oxford LearnerÊs Dictionaries. (2020) Retrieved from

https://www.oxfordlearnersdictionaries.com/definition/english/holistic?
q=holistic

Robertson, C. (2015). Safety, nutrition and health in early education. Boston, MA:
Cengage.

World Health Organization. (2019). Constitution: Retrieved from:

https://www.who.int/about/who-we-are/constitution

Copyright © Open University Malaysia (OUM)

Topic  Creating a Safe
Environment
2
LEARNING OUTCOMES
By the end of this topic, you should be able to:
1. Discuss indoor and outdoor safety;
2. Demonstrate emergency response procedures; and
3. Describe accidents and prevention of injuries.

 INTRODUCTION
There are numerous proverbs and quotes about safety such as „better a thousand
times careful than once dead‰ and „safety first is safety always‰. In early childhood
education, safety is one of the essential aspects which need to be taken seriously.
Nelson Mandela emphasised the importance of childcare when he said, „There can
be no keener revelation of a societyÊs soul than the way in which it treats its
children.‰ We need to ensure the safety of our children and see to it that emergency
procedures are in place. In this topic, we will discuss indoor and outdoor safety,
emergency response procedures and injury prevention.

2.1 INDOOR SAFETY

We will now look at safety requirements which should be put in place in buildings
to ensure childrenÊs indoor safety, especially in a learning environment. We need
to examine policy guidelines ă the policies clearly describe the guidelines that early
childhood education centres need to comply with. By following these specified
guidelines, injuries can be prevented, thus protecting children from harm.

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 TOPIC 2 CREATING A SAFE ENVIRONMENT  13

Buildings are areas where children spend time, grow and develop. There are
certain requirements for buildings, specifically for features such as doors,
windows, bathrooms, stairways, floors and emergency exits. These requirements
not only apply to our own homes but also establishments such as preschools. Now,
let us look at the features in a preschool building where safety requirements must
be met.

(a) Doors and Windows

There should be one central entrance point at a preschool for control and
safety purposes. It is important for staff to know who enters the building
through the entrance door. For safety reasons, it is recommended that all
other doors into the preschool compound be locked. Rooms should have
enough windows for good ventilation and natural light. It is recommended
that child-height windows be used for safety reasons, especially to avoid
situations where children climb onto chairs or objects to look outside.

Marotz (2008) suggested these other safety considerations include

(i) Install safety cameras and monitor the surroundings at all times;

(ii) Install keypad buzzers on exit doors, especially the front door;

(iii) Use lightweight doors as interior doors, with a panel of safety glass at
the height of young children to see through;

(iv) Use door stoppers and U-shaped safety sponges for extra safety
precautions;

(v) Use shatterproof glass windows to reduce injury in case they break;

(vi) Install burglar bars on windows to protect children or to prevent them

from falling out; and

(vii) Install windows with safety hinges.

(b) Safety Features of a Room

Rooms should be safe for children to grow and learn in. A roomÊs size will
depend on the number of children in the room. Marotz (2008) indicates that
a room should be at least 40 to 45 square feet. If converted to square metres,
the size will be 4.18 square metres per child. The rooms should have
functionality, ample space to move about and, most importantly, safety. It is
also important to make provisions for children with disabilities such as those
who use wheelchairs. If a room will have large play structures or special
equipment for children with disabilities, it should be bigger.

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14  TOPIC 2 CREATING A SAFE ENVIRONMENT

Other safety considerations suggested by Marotz (2008) are as follows:

(i) Provide ample space to accommodate different activities (such as quiet

versus noisy areas), bearing in mind that the movement area per child
in a room should be at least 4.18 square metres;

(ii) Separate infants and toddlers from older children to avoid injuries; and

(iii) Lock the exit room to ensure childrenÊs safety.

(c) Bathroom Safety

A preschool should cater to the needs of all children. Remember, they are
small, so the facilities should be appropriate for their height and size. Safety
features should be put in place to prevent accidents.

The safety requirements for bathrooms are as follows (Robertson, 2002):

(i) Install child-size toilets, sinks, soap dispensers and towel racks;

(ii) Make sure that there are a toilet and a sink for every 10 to 12 children;

(iii) Provide a footstool or wooden block for children to reach, if there are
only adult-size toilets available;

(iv) Make provisions for children with disabilities;

(v) Install a separate bathroom for staff members;

(vi) Install hand-washing facilities close to toilets to encourage hand

washing;

(vii) Maintain temperature of hot water between 40.5C and 48.8C to

avoid accidental burns;

(viii) Place fixtures such as mirrors, light switches and towel dispensers
within easy reach of children; and

(ix) Use light colours for easy detection of dirt for cleaning purposes.

(d) Floor Safety

Floors in preschools should ideally be covered with tiles, plastic or vinyl so
that they are easy to clean. These floors can be slippery so part of their surface
area should be covered with non-stick rugs. You should make provisions for
both soft surface and hard surface areas where activities like painting can be
done.

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 TOPIC 2 CREATING A SAFE ENVIRONMENT  15

The safety requirements for preschool flooring are summarised as follows

(Robertson, 2002):

(i) Cover the floors with tiles, plastic or vinyl for easy cleaning;

(ii) Cover parts of the floor with non-slip rugs;

(iii) Use tiled areas for messy play and work; and

(iv) Use rugs in areas where children sit on the floor and participate in
activities.

(e) Furniture, Lighting and Ventilation

Ensure that all furniture is child size and things are within reach. In a shared
setting, it is important to provide children with a space of their own. Hence,
they should be given their own storage space, such as a shelf or cabinet.

With regard to lighting, use lights which will brighten the space indoors
without creating too much glare, such as fluorescent lights.

There should be ample ventilation, so windows should be constructed low

for air to flow freely, and fitted with safety glass and burglar bars to prevent
accidents.

(f) Fire Safety

Children should be taught early on what to do in the event of a fire. The best
way is to contact the local fire department and get the firemen to do a
demonstration.

Other safety precautions are as follows (Robertson, 2002):

(i) Invite fire department officials to the school and request advice on floor
plans and the best escape route;

(iii) Install smoke and carbon monoxide detectors in each room;

(iv) Have a fire extinguisher available and make sure it is in a good working
condition;

(v) Familiarise staff with emergency exits;

(vi) Conduct regular fire drills with staff and children;

(vii) Remove extension cords from classes, as they can be obstacles in an

emergency; and

(viii) Cover electrical outlets with caps and make sure they are not removed.

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16  TOPIC 2 CREATING A SAFE ENVIRONMENT

(g) Electrical Safety

Electrical outlets such as plugs can cause accidents, especially around
children. Thus, electrical safety measures should be in place to protect
children from harm or injury. Table 2.1 presents a few rules for electrical
safety.

Table 2.1: Electrical Safety Rules

Electric Safety Rule Diagram

 Do not plug too many equipment into one outlet
or extension cord.
 Remove unnecessary cords and appliances.

 Plug one appliance into one electrical outlet.

 Fix safety caps on all unused electrical outlets.

Source: Alliant Energy Kids (2013)

There are a few more electrical safety rules that need to be followed, such as
keeping water away from electrical equipment. At the early childhood stage,
children may not yet comprehend the consequences of any electrical misuse, so
adults should always handle electrical equipment.

Copyright © Open University Malaysia (OUM)

 TOPIC 2 CREATING A SAFE ENVIRONMENT  17

SELF-CHECK 2.1

1. List the requirements for the following to ensure childrenÊs safety:

rooms, doors, windows and flooring.

2. Discuss bathroom safety features and requirements for lights and

ventilation in an early childhood environment.

2.2 OUTDOOR SAFETY

In this subtopic, we will learn about safety requirements for playgrounds and
preschool equipment. A playground can be a dangerous place, especially if there
are no safety rules and procedures in place. Let us now look at some of the safety
requirements.

(a) Playground Layout (Fencing, Space, Plants, Sandboxes, Water and Sanded
Areas)
A layout is a plan drawn on paper. A playground layout shows how the play
area is arranged. Among the considerations for the playground are as follows
(Marotz, 2008):

(i) Fence the area with two exit gates. These gates should be locked at all
times to prevent children from wandering off by themselves. There
should be no sharp wire or picket-type fencing around children.

(ii) Arrange the playground in such a way that children are visible from all
directions at all times.

(iii) Allocate a large open area that is ideal for running and tossing balls,
and make provisions for children with disabilities, such as those who
are wheelchair-bound, to help them move around.

(iv) Allocate large areas for riding, especially when the weather does not
permit.

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18  TOPIC 2 CREATING A SAFE ENVIRONMENT

(v) Grow flower gardens to encourage gardening. You may ask your local
nursery which plants are not poisonous to grow in the garden.

(vi) Use an alternative measure, such as putting up large colourful shades,

if there are no trees for shading.

(vii) Buy the correct sand for sandboxes from local garden centres
or building contractors. Other play sand may contain obstacles or
asbestos which are dangerous for children.

(viii) Cover sandboxes tightly to keep out animals and insects. If not, they
should be raked first and inspected for any dangerous object, insect,
spider or stone.

(ix) Take extra precautions at the swimming pool and other water areas. A
teacher should be on duty while these areas are being used, and should
know how to perform cardiopulmonary resuscitation (CPR). The
number of children present in these areas at any one time should be
limited. The areas should be fenced and their gates locked at all times.
The pools should be covered when not in use.

(x) Disinfect pools regularly to avoid the spread of diseases.

(b) Preschool Equipment

There are approximately 200,000 cases treated in emergency rooms each year
due to play equipment accidents and thus, careful attention should be given
to equipment selection, placement and maintenance, as follows (Marotz,
2008):

(i) Install equipment according to the age level of the preschool group;

(ii) Anchor large pieces of equipment and portable structures for climbing.
Poles should be 12 to 18 inches below the ground;

(iii) Make sure that preschool equipment is not taller than 6 feet and spaced
at least 9 feet apart. The distance should be increased to 15 feet if swings
are installed;

(iv) Make sure that if tyres are used for swings, there are no holes in them
to prevent water from collecting because that could be a breeding area
for mosquitoes; and

(v) Make sure that openings in the play area, such as in guardrails, are less
than 3.5 inches or more than 9 inches.

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 TOPIC 2 CREATING A SAFE ENVIRONMENT  19

SELF-CHECK 2.2

List the safety features and requirements for playgrounds.

ACTIVITY 2.1

Explain briefly the maintenance of playground equipment. Share your

answer with your coursemates in myINSPIRE online forum.

2.3 EMERGENCY RESPONSE PROCEDURES

Robertson (2002) states that screening of the environment for potential risks such
as choking, poisoning, insect stings, snake bites, fire outbreaks and general injuries
should be done in an organised manner. Should an emergency arise, it is important
to call the emergency response team immediately and take certain measures.

Table 2.2 presents different types of hazards and their respective emergency
response procedures.

Table 2.2: Types of Hazards and Emergency Response Procedures

Emergency Hazard Procedure

Choking  Give back blows.
 Perform abdominal thrusts.
 Give CPR when necessary.
Poisoning  Control nausea and vomiting.
 Prevent dehydration by giving the child clear fluids to drink.
 Call the doctor.
General injuries For general bruises:
 Put ice on the area depending on the severity.
 If blood is visible, clean the area first before putting on any
non-adhesive cloth or bandage.
Insect stings If the child is not allergic to stings:
 Remove the stinger.
 Control the swelling by putting ice on it.
 Treat the symptoms by giving painkillers.

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20  TOPIC 2 CREATING A SAFE ENVIRONMENT

Snake bites If you know the snake is not venomous, treat its bite as a
puncture wound. Do the following:
 Note the appearance of the snake.
 Protect the child.
 Please do not cut the bite and try to suck out the venom. Do
not apply ice or water. Do not give the child caffeinated
drinks.
Burns  Stop the burns immediately.
 Remove all clothing, jewellery and belts.
 If more serious, such as first-degree burns call 999.
ă Cool down under cold running water or compresses.
ă Protect the burn area by covering it with non-adhesive
bandage or cloth.
ă Treat the pain.
ă See the doctor immediately.
Nosebleeds  Stop the bleeding by letting the child sit up straight and
slightly forward. Pinch the nose just below the bone against
the face. Apply pressure for five minutes and repeat if
bleeding continues.
 Call healthcare services if bleeding does not stop after
10 minutes.

Source: WebMD (2013)

For more information on how to respond to emergency hazards, you may visit this
website: http://www.webmd.com/first-aid/default.htm

ACTIVITY 2.2

1. Based on what you have learnt, design a safe environment for

preschoolers.

2. In a group, make a list of emergency response procedures and

discuss their significance.

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 TOPIC 2 CREATING A SAFE ENVIRONMENT  21

Let us continue our discussion on emergency procedures in an early childhood

education environment. To ensure childrenÊs safety, an early childhood education
centre should have the following:

(a) An emergency response plan;

(b) A checklist for the centreÊs safety;

(c) Inside and outside the centreÊs site plan; and

(d) Child release guidelines.

Every preschool must have emergency procedures in place. Holding regular fire
drills is a good example of a precautionary measure. An emergency may arise due
to a fire, tornado, severe storm or earthquake, so each preschool should be
prepared for it, particularly in the following aspects:

(a) Having an emergency plan and emergency procedure;

(b) Allocating a gathering place where parents can sign children out for pick-up;

(c) Making sure the fire alarm is in working condition; and

(d) Making sure emergency numbers are visible to all staff members. It is
recommended that one teacher be responsible for calling the response team.

Figure 2.1 illustrates the steps to be taken in the face of an emergency.

Figure 2.1: Action steps in an emergency

ACTIVITY 2.3

Design a poster to illustrate the steps you will take to evacuate children
if a fire breaks out in your preschool.

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22  TOPIC 2 CREATING A SAFE ENVIRONMENT

2.4 ACCIDENTS AND PREVENTION OF

INJURIES
What is an accident? We can say it is an unexpected and undesirable event,
especially if it results in damage or harm. Whether the setting is a family day care
home, a preschool, a group day care home, other community settings or parentsÊ
home, there should be precautionary measures against accidents. The principles
and practices of injury prevention serve as a basis for ensuring childrenÊs safety
(BC Health Planning, 2003). Thus, how can we implement injury prevention? We
cannot stop accidents from happening but we can at least minimise damage or
harm through injury prevention.

The following are some findings on injury cases involving young children
(BC Health Planning, 2003):

(a) The vast majority of injuries are predictable and preventable;

(b) Most injuries to young children result from burns, poisoning and choking or
suffocation;

(c) Most injuries to young children occur in the late afternoon or early evening
when they are tired;

(d) Injuries in early childhood education settings occur more frequently at

arrival and departure times than at other times of the day; and

(e) Children are more likely to suffer injuries when they are unfamiliar with a
setting.

One thing we need to remember is that when children learn, explore and develop
new skills, they will face certain challenges and, in some cases, risks. For that
reason, it is our responsibility to provide the safest environment possible for them.

According to BC Health Planning (2003), planning for childrenÊs safety is the most
effective tool for preventing injuries. Among the suggestions given include:

(a) Active and positive supervision;

(b) Safe space arrangement;

(c) Developmentally appropriate programmes and activities; and

(d) Preventive policies and procedures.

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 TOPIC 2 CREATING A SAFE ENVIRONMENT  23

Thus, the steps for preventing injuries can be drawn up as follows:

(a) Make sure that the arrangement of space (such as furniture and play area) in
all preschool settings is safe;

(b) Conduct supervision at all times (draw up a supervision timetable especially

for playgrounds);

(c) Plan the timetable of programmes and activities; and

(d) Implement policies and procedures.

To understand the circumstances surrounding an injury and to help prevent future

injuries, we can refer to the injury triad proposed by Marotz (2008), as presented
in Figure 2.2:

Figure 2.2: Injury triad

Marotz (2008) further states that every accident has a cause. Accidents normally
occur when a risk is taken or a hazard is presented in the environment. The only
way to avoid unintentional injuries is to understand causal factors and to
anticipate what can happen. Marotz further indicates that when an accident has
occurred, we can ask the following questions about the resulting injury:

(a) What type of injury is that?

(b) How did the injury happen?

(c) Why did the injury occur?

(d) Where did the injury occur?

(e) When did the injury occur?

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24  TOPIC 2 CREATING A SAFE ENVIRONMENT

By using the triad as a tool, we can answer all these questions. Marotz (2008)
categorises the how, why, where and when of an injury into three parts which
include accessory, behaviour and condition. Let us refer to Table 2.3 for
descriptions of the injury triad:

Table 2.3: Descriptions of the Injury Triad

Accessory (How an Injury Behaviour (Why an Injury Condition (Where and

Occurred) Occurred) When an Injury Occurred)
 Physical and By Child Where
environmental hazards  Developmental level  Place
 Lack of devices  Level of comprehension  Indoors or outdoors
about cause and effect
 Lack of physical ability When
 Lack of fear  Time of day
 Inattention  Tired, hungry, in a
hurry, etc.
 Emotion
 Stress
 Imitation

By Adult
 Inattention or no
supervision
 Lack of knowledge or
understanding
 Lack of communication
 Lack of safety
precautions
 Emotion
 Stress

Based on the injury triad, we can gather more information about the occurrence of
an injury. For example, we can assess how an injury occurred. Was it due to
physical and environmental hazards or lack of devices? Or, was it due to lack
of physical ability, inattentiveness or lack of safety precautions? Having an
understanding of the circumstances involved enables better injury prevention in
the future.

Thus, creating a safe environment for early childhood education encompasses

implementing indoor and outdoor safety, emergency response procedures and
injury prevention.

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 TOPIC 2 CREATING A SAFE ENVIRONMENT  25

SELF-CHECK 2.3

1. How do accidents occur?

2. How can accidents be prevented?

3. Draw an injury triad.

 To ensure childrenÊs indoor safety, safety requirements should be put in place

in buildings, specifically for features such as doors, windows, bathrooms,
stairways, floors and emergency exits.

 Safety requirements for playgrounds and preschool equipment should also be

met to ensure childrenÊs outdoor safety. A playground can be a dangerous
place, especially if there are no safety rules and procedures in place.

 Careful attention should be given to the selection, placement and maintenance

of preschool equipment.

 Every preschool must have emergency response procedures in place. To

ensure childrenÊs safety, a preschool or early childhood centre should have the
following:

ă An emergency response plan;

ă A checklist for centre safety;

ă Inside and outside centre site plan; and

ă Child release guidelines.

 An accident is an unexpected and undesirable event, especially one resulting

in damage or harm. To understand the circumstances surrounding an injury
and to help prevent future injuries, we can draw up an injury triad of
accessory, behaviour and condition, as proposed by Marotz (2008).

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26  TOPIC 2 CREATING A SAFE ENVIRONMENT

Accidents Injury triad

Emergency Prevention of injuries
Injuries Safety

Alliant Energy Kids. (2013). Top 10 rules for electric safety. Retrieved from
http://www.alliantenergykids.com/PlayingItSafe/ElectricSafety/000552

BC Health Planning. (2003). Preventing injury in child care settings. Retrieved

from
http://www.health.gov.bc.ca/library/publications/year/2003/oip003.pdf

Marotz, L. (2008). Health, safety and nutrition for the young child. New York, NY:
Cengage Learning.

Robertson, C. (2002). Safety, nutrition and health in early education. New York,
NY: Cengage Learning.

WebMD. (2019). First aid and emergencies. Retrieved from

http://www.webmd.com/first-aid/default.htm

Copyright © Open University Malaysia (OUM)

Topic   Prevention of
Illness
3
LEARNING OUTCOMES
By the end of this topic, you should be able to:
1. Discuss the prevention of illness in early childhood education; and
2. Explain infection control and prevention.

 INTRODUCTION
Thomas Fuller, an English churchman and historian, once said, „He who cures a
disease may be the skilfullest, but he who prevents it is the safest physician.‰ Can
illness be prevented? To a great extent, it can. However, there are instances where
illness is inevitable. Thus, the prevention of disease today is one of the most critical
factors in promoting wellness. In this topic, we will discuss the prevention of
illness and infection control in early childhood education.

3.1 ILLNESS PREVENTION METHODS

Each childcare facility should have a set of policies on illness prevention. These
written policies should be explained to the staff as well as parents and displayed
clearly at the childcare centre.

Why is it important to have all these policies in place? These policies help parents
to make informed decisions when their children are ill, and ensure that the centre
has preventative mechanisms in place.

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28  TOPIC 3 PREVENTION OF ILLNESS

Let us first go through the findings on early childcare and illness provided by the
California Childcare Health Programme (2006):

(a) Illness occurs more frequently in young children in early childhood

education (ECE) settings than in young children who stay at home.

(b) Cases of illness can be reduced and managed, but not eliminated completely,
through preventative health policies and practices and thorough staff
training.

(c) Hand washing is an essential practice in the reduction of transmission of

illness.

(d) Children with mild symptoms of common illness can participate in ECE
programmes, provided they feel well enough and do not require more care
than the ECE professional can give.

(e) Age-related immunisations must be kept up-to-date by ECE programmes.

The Occupational Safety and Health Administration mandates policies,
practices and training by employers to prevent employee exposure to disease
spread through the blood.

(f) The administration of medication to young children in ECE settings requires

specific safeguards, policies, practices and training.

(g) Clear communication about policies related to illness prevention and

management ensures that ECE providers and families collaborate effectively
to minimise the spread of illness.

To prevent the spread of illness, the following steps should be taken by ECE
providers:

(a) Request for the childÊs medical history, and set up a record.

(b) Update the immunisation record of the child and make sure he or she is
immunised against all preventable diseases. Among these diseases are:

(i) Diphtheria;

(ii) Whooping cough (pertussis);

(iii) Measles;

(iv) Rubella;

(v) Tetanus;

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 TOPIC 3 PREVENTION OF ILLNESS  29

(vi) Polio;

(vii) Mumps; and

(viii) Meningitis (caused by Haemophilus influenza type B).

Immunisation against these diseases is of the utmost importance as they are easily
transmitted amongst children in a childcare setting. Table 3.1 shows a sample of
an immunisation schedule.

Table 3.1: Sample Immunisation Schedule

Age
2 mo 4 mo 6 mo 12 mo 18 mo 4ă6 yrs
Vaccine
Diphtheria x x x x x
Acellular pertussis x x x x x
Tetanus x x x x x
Inactivated polio vaccine x x x x x
Measles x x x
Mumps x x x
Rubella x x x
Haemophilus influenza Type B x x x x

Source: BC Health Planning (2003)

Next, we will discuss how to prevent the spread of diseases through practices
such as hand washing, diapering and toileting, as well as through proper food
preparation.

3.1.1 Hand Washing

Proper hand washing by staff and children in ECE settings is essential (BC Health
Planning, 2003). It is the basic method of preventing illness in ECE. Good hand
washing practices include the following:

(a) Washing your hands after diapering and toileting a child and before
handling food;

(c) Making sure that the children wash their hands after toileting and handling
animals as well as before eating; and

(d) Displaying hand washing rules at sinks to encourage hand washing.

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30  TOPIC 3 PREVENTION OF ILLNESS

What is the proper way to wash your hands? The steps are as follows.

(a) Use warm water to break down the dirt and oil on your skin;

(b) Wash hands with soap and rinse well with warm running water;

(c) Use liquid soap in a dispenser rather than a bar of soap, as liquid soap is
more sanitary;

(d) Use paper towels to dry your hands instead of towels. Use the same paper
towels to turn off the tap; and

(e) Use a lotion for hands to avoid dry skin since hand washing is done on a
regular basis.

Next, we will look at diapering practices.

3.1.2 Diapering
The diapering and changing area should be cleaned and disinfected with bleach
sanitising solution after every diaper change (BC Health Planning, 2003). It is
therefore important to make sure that the diaper changing area is near to a source
of warm running water with a deep sink. The diaper changing area should also be
away from the food preparation area and it should never be used for preparing
food.

The following are requirements for the diaper changing area:

(a) The counter surface should be made of smooth, non-porous material

(formica, hard plastic, stainless steel or washable pad covered with smooth
vinyl). It should be free from cracks and easy to clean;

(c) Use a disinfectant solution in a spray bottle and then air-dry the surface; and

(d) Label the disinfectant bottle and store it away from children.

3.1.3 Toileting
The toilet area should receive special attention. BC Health Planning (2003)
recommends a few guides in this area, as follows:

(a) The toilet should have a hand washing area;

(b) Ensure step stools and toilet adapters are available for children to flush
toilets;

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 TOPIC 3 PREVENTION OF ILLNESS  31

(c) Empty potty chairs immediately after use; and

(d) Clean toilets and potty chairs with disinfectant solution (preferably during
nap times and at the end of the day or when urine or faeces are present).

3.1.4 Food Preparation

Food preparation practices play an equally important role in preventing illness.
These practices must not be neglected in the early childhood education
environment. So, what are some of the food preparation practices that we should
adopt? BC Health Planning (2003) has the following recommendations:

(a) Wash your hands before handling food, after going to the toilet and after
changing a diaper.

(b) Store perishable foods (such as dairy products, meat, poultry and eggs) in a
refrigerator at or below 4C.

(c) Serve cooked food immediately or keep it above 60C.

(d) Make sure that food which comes from animal sources (such as poultry, eggs
and meat) are cooked thoroughly.

(e) Thaw meat in a refrigerator.

(f) Wash and sanitise all utensils, cutting boards and counters. This is to prevent
raw food from contaminating ready-to-eat foods. Also, make sure all contact
areas such as surfaces and furniture (table tops, high chairs and small chairs)
are wiped clean and sanitised after use. Use a sanitising solution in a spray
bottle and wipe it with a disposable paper towel. This way, we can minimise
the spread of infection.

(g) Keep hot foods hot and cold foods cold.

(h) Keep food preparation, serving and storage areas clean, dry and separate
from playing, toileting and diapering areas.

(i) Make sure that food contact surfaces are free from cracks and chips. This is
important because germs can spread easily on such surfaces.

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32  TOPIC 3 PREVENTION OF ILLNESS

SELF-CHECK 3.1

1. What are some of the illness prevention measures in an early

childhood education environment?

2. List some vaccine-preventable diseases.

3.2 INFECTION CONTROL

Infection control is concerned with preventing the spread of infections. The best
way to control infection is to practise good hygiene. Infection can be spread
through hands, as shown in Figure 3.1.

Figure 3.1: The spread of infection through hands

Source: Commonwealth of Australia (2012)

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 TOPIC 3 PREVENTION OF ILLNESS  33

Precautions also need to be taken in handling blood and bodily fluids.

Transmission of blood and bodily fluids can lead to the spread of Hepatitis B,
Hepatitis C and HIV. When handling blood, it is important to take note of the
following (BC Health Planning, 2003):

(a) Avoid getting blood on your skin. If this happens, wash it off immediately
with soap and water.

(b) Cover cuts, especially on your hands.

(c) Make use of absorbent material to stop bleeding.

(d) Always wear disposable latex or vinyl gloves, especially if coming into
contact with blood or open cuts. Wash your hands with soap and water when
the gloves are removed.

(e) Clean all surfaces afterwards with disposable paper towels. Wash the area
with a soapy detergent, rinse and then apply a sanitising solution to allow
the area to dry.

(f) Wash blood-stained laundry separately in hot, soapy water.

(g) Seal all blood-stained materials in plastic bags and discard them in covered
garbage containers.

To control HIV infections, we need to be aware of how HIV is transmitted. It is not

transmitted through everyday contact like touching, hugging and kissing; sharing
food, cutlery, toys and toilet seats; or through urine and stools. Instead, it is
transmitted from one person to another via semen, vaginal secretions, breast milk,
blood and bodily fluids which contain blood. Transmission of HIV can only be
possible in the presence of three conditions:

(a) The blood must be fresh;

(b) There must be a sufficient quantity of blood; and

(c) There must be a route of entry into the bloodstream of the uninfected person.

For example, HIV infections can be spread through bites. A HIV-infected child can
transmit the disease to another child via biting if he has fresh blood in his mouth
and breaks the skin of the uninfected child.

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34  TOPIC 3 PREVENTION OF ILLNESS

Other steps to prevent infection in ECE include:

(a) Developing your own childcare policy which deals with illness;

(b) Explaining the policy to staff and parents;

(c) Giving the policy to staff and parents and displaying it clearly at the child
care centre;

(d) Building a trusting relationship with parents;

(e) Requesting for records of childrenÊs family physician and medical history;
and

(f) Requesting for the immunisation records of children and making sure they
have been immunised against all vaccine-preventable diseases.

SELF-CHECK 3.2

1. Explain infection control in early childhood care.

2. List the steps to be taken in handling blood.

3. State the three conditions necessary for HIV transmission.

3.3 GERMS AND INFECTIONS

What causes infection? Microscopic living things (germs) are always around us.
Some of these germs can cause diseases in people, animals or plants. The four
major types of germs are:

(a) Bacteria
Bacteria are almost everywhere, on and in the human body as well. Some
bacteria are good for us. They live in our intestines, help us use the nutrients
in food and make waste from the leftovers. Bacteria which are bad for us
infect the body and cause diseases. Some examples include sore throat,
pertussis (whooping cough) and meningococcal disease.

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 TOPIC 3 PREVENTION OF ILLNESS  35

(b) Viruses
Viruses grow and reproduce inside other living cells, which are called host
cells. They cannot live very long outside their host cells. When a virus enters
our body, it can multiply and cause illness. Among the diseases caused by
viruses are common cold, gastroenteritis, chickenpox (varicella), measles and
influenza (flu).

(c) Fungi
Fungi is a group of organisms such as yeasts, moulds and mushrooms. These
organisms live in damp, warm places. Not all fungi are harmful such as
bakerÊs yeast and edible mushrooms. Among those that are harmful and can
cause diseases include ringworm (tinea corporis), athleteÊs foot (tinea pedis)
and thrush (candida).

(d) Protozoa
Protozoa are microscopic living things that thrive on moisture and
spread diseases through water. Some can cause intestinal infections like
diarrhoea, nausea and stomach upsets. These infections can spread through
contaminated water.

How do infections spread? The three steps in the chain of infection are as
follows:

(i) The germ has a source;

(ii) The germ spreads from the source; and

(iii) The germ infects another person.

Young children come into close contact with each other in an early childhood
education centre through cuddling, playing, etc. They like putting objects into their
mouths and do not always cover their mouths when they cough or sneeze. Germs
can survive on surfaces. When children touch the contaminated surfaces and then
put their hands into their mouths, they become infected.

According to Commonwealth of Australia (2012), we can stop infection from

spreading or break the chain of infection through:

(a) Effective hand hygiene;

(b) Exclusion of children, educators and other staff from ECE activities when
they fall ill; and

(c) Immunisation.

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36  TOPIC 3 PREVENTION OF ILLNESS

Other strategies to prevent infection include:

(a) Cough and sneeze etiquette;

(b) Appropriate use of gloves; and

(c) Effective environmental cleaning.

SELF-CHECK 3.3

1. Name four major types of germs and describe the diseases or

infections they can cause.

2. Describe the three steps in the chain of infection.

 To prevent the spread of diseases in early childhood education, it is important

that each facility has a policy to deal with illness. This policy should be
explained to staff and parents. It should also be displayed clearly in the centre.

 Cases of illness can be reduced and managed, but not eliminated completely,
through preventative health policies and practices and thorough staff training.

 Hand washing is an essential practice in the prevention of illness. Hands

should be washed after diapering and toileting a child and before handling
food. Hand washing routines should be displayed clearly in the centre.

 The records of a childÊs family physician and medical history should be

submitted to the centre.

 The child should be immunised against vaccine-preventable diseases and all

immunisation records should also be submitted to the centre.

 Precautions should be taken in handling blood and bodily fluids.

 The four major types of germs are bacteria, viruses, fungi and protozoa.

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 TOPIC 3 PREVENTION OF ILLNESS  37

Bacteria Immunisation
Disease spreading Infection control
Fungi Prevention of illness
Germs Sanitation
Hand washing Virus

BC Health Planning. (2003). Preventing illness in child care settings. Retrieved

from:
http://www.health.gov.bc.ca/library/publications/year/2003/com018.pdf

California Childcare Health Program. (2006). Preventing and managing illness in

ECE Programs. Retrieved from
http://www.ucsfchildcarehealth.org/pdfs/Curricula/Instuctors_Guide/C
CHA_IG_9_IllnessPrev_v3.pdf

Commonwealth of Australia. (2012). Staying healthy: Preventing infectious

diseases in early childhood education and care services (5th ed.). Retrieved
from
http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/ch55
_staying_healthy_childcare_5th_edition_0.pdf

Marotz, L. (2008). Health, safety and nutrition for the young child. New York, NY:
Cengage Learning.

Copyright © Open University Malaysia (OUM)

Topic  Health of the
Young Child
4
LEARNING OUTCOMES
By the end of this topic, you should be able to:
1. Explain ways to promote childrenÊs health through their parents,
school and community;
2. Discuss how health assessment can be carried out;
3. Describe the recording of childrenÊs health status; and
4. Explain how ongoing observation of children can be done.

 INTRODUCTION
The early years of a child are a period when he or she goes through a series of rapid
growth and development. To ensure the overall development of the young child,
it is essential that we promote good health and well-being in the early childhood
education environment. In this topic, we will discuss how to promote childrenÊs
health, conduct health assessment, and record the health status of children.

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 TOPIC 4 HEALTH OF THE YOUNG CHILD  39

4.1 PROMOTING CHILDREN’S HEALTH AND

WELL-BEING
Promoting the health of children is not the responsibility of one person only.
It involves effective multi-agency collaboration between social workers, health
professionals and carers. Let us start by looking at the people who play important
roles in promoting the health and well-being of young children. They are:

(a) Parents;

(b) Schools; and

(c) Community.

4.1.1 Parents
It is the parentsÊ responsibility to keep records of their childrenÊs health history
and give the information to the childrenÊs school. Such records are vital for the
childrenÊs welfare as they provide information on any health needs that should be
considered and other important details such as where they live (placement), where
they go to school (education) and where they are going to live in the long term
(permanence).

Figure 4.1 shows a sample checklist of items that a parent should submit to
the school. It should be emphasised that all information must be treated as
confidential by the school.

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40  TOPIC 4 HEALTH OF THE YOUNG CHILD

Figure 4.1: Checklist for health assessment

Source: Robertson (2010)

4.1.2 Schools
Schools play a critical role in improving the dietary behaviour and physical activity
of children and adolescents. This is because schools can:

(a) Create environments that encourage healthy eating;

(b) Implement policies and practices that support healthy eating and regular
physical activity; and

(c) Provide opportunities for pupils to learn about and practise a healthy
lifestyle.

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 TOPIC 4 HEALTH OF THE YOUNG CHILD  41

Andrews (2011) suggested that the following five steps be implemented in schools
to promote a healthy lifestyle:

Step 1
Schools should offer nutrition education to help children develop a healthy eating
pattern. These nutrition and health classes should focus on:

(a) Types of healthy foods and why;

(b) What foods to eat in moderation and why; and

(c) The impact of healthy foods on our body.

Step 2
Schools should offer healthy meal options for kids. They should also reduce or
eliminate meal options that are unhealthy such as chips, burgers and ice cream
in favour of fruits, vegetables, whole grains and lean protein. If schools offer
unhealthy options, more children will opt for those types of food.

Step 3
School vending machines should be stacked with healthy snack items such as
whole grain granola bars, baked pita chips, crackers with peanut butter and
all-natural fruit snacks. Try to avoid displaying items like soda pop, chips and
candy bars.

Step 4
Schools should introduce breakfast programmes that serve healthy breakfasts a
few times a month. The reason for having such an initiative is to educate children
on the importance of breakfast. A healthy breakfast can be in the form of:

(a) Whole grain pancakes or oatmeal with eggs; or

(b) Grab-and-go snack items such as granola bars, yoghurt and fresh fruits.

Step 5
Schools should seek parentsÊ involvement through a parent-teacher committee to:

(a) Educate parents on the importance of healthy eating habits;

(b) Discuss how to instil healthy lifestyle habits in children; and

(c) Encourage parents to act as role models for their children in terms of making
healthy lifestyle choices.

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42  TOPIC 4 HEALTH OF THE YOUNG CHILD

4.1.3 Community
The community has a role to play in promoting the health and well-being
of children. Telethon Institute for Child Health Research (n.d.) has proposed the
following steps:

(a) Organise cooking classes where community members can share their
knowledge of healthy cooking and eating;

(b) Grow an edible garden and encourage others in the whole community to get
involved;

(c) Share healthy grocery lists;

(d) Talk to stores about stocking and promoting healthy foods;

(e) Provide information about how to eat well on a budget;

(f) Organise breakfast and lunch clubs for children;

(g) Organise community dinners where everyone shares food, cooks and eats
together; and

(h) Urge people to keep food diaries to monitor what they eat.

Other ideas of how the community can promote childrenÊs health are as follows
(US Department of Health & Human Services, 2010):

(a) Form walking groups ă Choose a time to meet and walk through the town or
community;

(b) Organise fitness classes ă Find a space and someone to run it. Use an exercise
video or engage an instructor; and

(c) Get people together ă Play football, basketball or any other sport.

SELF-CHECK 4.1

1. Describe how parents, the school and the community can play a
role in promoting the health of children.

2. List five steps that can be implemented in schools to promote a

healthy lifestyle.

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 TOPIC 4 HEALTH OF THE YOUNG CHILD  43

4.2 HEALTH ASSESSMENT

Health assessment is used to measure the status of a personÊs health. The following
are what we need to know when considering a health assessment (DelCarmen-
Wiggins and Carter, 2004):

(a) Purpose of assessment;

(b) Source of data;

(c) Types of quantifiable data; and

(d) Standardisation and psychometric properties.

Health assessment is conducted for a number of reasons such as diagnosis,

screening and early intervention. Knowing why you want to do an assessment is
essential in selecting the correct assessment tools.

The sources of data, especially for developmental tests, are:

(a) Direct assessment;

(b) Incidental observation; and

(c) Caregiver report.

The assessment of a child is an ongoing process. Let us now look at some principles
of ongoing assessment.

4.2.1 Principles of Ongoing Assessment

The key principles for conducting assessments on young children are as follows
(US Department of Health & Human Services, 2010):

(a) Parents and other primary caregivers are integral to the process;

(b) Information is most accurate when gained from multiple sources and
contexts;

(c) Assessments are recurrent processes;

(d) Tasks and settings should be relevant and familiar to the child;

(e) Assessment identifies current competencies and upcoming developmental

markers;

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44  TOPIC 4 HEALTH OF THE YOUNG CHILD

(f) Assessors should be knowledgeable and effectively trained;

(g) Tools used for assessment should be standardised, reliable and valid;

(h) Assessment should attend to the childÊs functional capacities, not isolated
skills; and

(i) Assessment should be culturally and linguistically appropriate.

4.2.2 Types of Screening

The goal of screening and assessing is to gain the most accurate portrait of a childÊs
development and capacities. The types of screening are:

(a) Vision Screening

Having poor vision will hinder a childÊs learning ability. Thus, vision
problems should be treated at the early stages to prevent any learning
problems. Schoolchildren should be screened for myopia (short-sightedness)
every year. How is it done? The children will be required to read off a chart
from a pre-determined distance as shown in Figure 4.2.

Figure 4.2: Vision screening

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 TOPIC 4 HEALTH OF THE YOUNG CHILD  45

(b) 3D Vision Screening

This test is carried out to find out whether a child has normal three-
dimensional (3D) vision. Special patterned plates are shown to him. If the
child is unable to pick out the right images, he may be suffering from a squint
or other eye conditions. Referral is recommended in such a case.

(c) Hearing Screening

Hearing problems can affect a childÊs learning ability. Hence, if it is detected
that a child has hearing problems, he must be treated. How is a hearing
screening done?

(i) The child will be asked to put on earphones and have his hearing tested
with an audiometer (see Figure 4.3).

Figure 4.3: Hearing screening

(ii) The child will be asked to indicate on a chart when he hears a sound in
each ear.

(iii) If the child cannot hear all or some of the sounds, he should be referred
for further assessment.

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46  TOPIC 4 HEALTH OF THE YOUNG CHILD

(d) Spinal Screening

A test called AdamÊs Forward Bend Test is used to screen for abnormal spinal
curve (see Figure 4.4). This test is normally done by schools which continue
to screen for scoliosis among children. Children will be asked to bend
forward so that a doctor or nurse can look for any bulge in the rib cage on
one side. Although this can be detected, it cannot determine the type or
severity. However, if a hump is detected in a childÊs spinal cord, the child
will be referred for further evaluation.

Figure 4.4: AdamÊs Forward Bend Test

Now that we have gone through the various types of screening, we will
discuss two more assessment tools ă growth and development assessment
and medical check-up.

(a) Growth and Development Assessment

In the growth and development assessment, the height and weight of a child
will be checked to see if he is growing well. Once the weight and height are
checked, growth charts are used to compare his height and weight with
those of other children of the same age. The child will be referred for further
assessment if his growth rate is not within the normal range.

(b) Medical Check-up

To check whether the child is healthy, the medical check-up should include
tests that can detect:

(i) Heart defects;

(ii) Slow growth;

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 TOPIC 4 HEALTH OF THE YOUNG CHILD  47

(iii) Squint (and other eye conditions); and

(iv) Other developmental problems.

It is the responsibility of the parents to inform the school of any health problems
that the child might have so that his condition can be reviewed or referred for
assessment.

SELF-CHECK 4.2

1. Explain the different types of screening.

2. State the principles of ongoing assessment.

4.3 RECORDING CHILDREN’S HEALTH STATUS

As stated earlier, assessment is an ongoing process. Thus, it is vital that parents
and teachers know childrenÊs health history, keep a copy of their medical records,
as well as constantly observe the childrenÊs development and behaviour.

4.3.1 Health History

A childÊs health history is a record of the childÊs past health status (for example,
allergies, chronic illnesses and injuries). The record includes:

(a) Family medical history (for example, a child who has family members with
diabetes may also be at risk for diabetes);

(b) The childÊs current health status; and

(c) Socioeconomic status.

4.3.2 Health Record

Schools should keep a health record of each child. A record is used to:

(a) Determine the health status of the child;

(b) Identify any health problem;

(c) Propose an early intervention programme;

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48  TOPIC 4 HEALTH OF THE YOUNG CHILD

(d) Refer the child to paediatricians; and

(e) Supervise the childÊs development.

The health record must be updated from time to time. For example, according to
Bettercare Learning Programmes (2019), it is necessary to measure childrenÊs
weight and height every six months thereafter to the age of five years, and compare
the measurement against the growth chart to determine their nutrition level.
However, it is often measured routinely at every visit to a clinic or hospital.

A health record should have the following information:

(a) Personal details of the child and his parents;

(b) Birth rank;

(c) Anthropometric details such as height, weight and head diameter;

(d) Medical record;

(e) Immunisation record;

(f) Dental record;

(g) Speech assessment;

(h) Eye and hearing test; and

(i) Developmental evaluation.

4.4 ONGOING OBSERVATION OF CHILDREN

Observation can be used as a method of screening to detect health problems in
children. It is the caregiversÊ responsibility for ongoing observation of children and
recording of data (Robertson, 2010). Observation helps to give a complete picture
of the childÊs temperament, personality, behavioural characteristics and ability.
If developmental or health problems are detected through observation and
screening, the child should be referred for further assessment. Among the
advantages of observation are that it:

(a) Is simple to conduct;

(b) Can be conducted informally on many children at the same time;

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 TOPIC 4 HEALTH OF THE YOUNG CHILD  49

(c) Is a brief process; and

(d) Does not require any medical equipment.

Observation should be noted and kept as a record, such as in the form of

observation checklists, plotting information on a chart and actual writing.
Robertson (2010) suggests that the observer use precise words in stating the
condition of a child. The writing should be a summary and correct words should
be used for accuracy and better understanding.

Table 4.1 shows the types of health assessment records through observation.

Table 4.1: Types of Health Assessment Records through Observation

Type of
Definition Best Used For Limitation
Record
Anecdotal Brief narrative account that Daily open-ended Relies on memory
describes health conditions observation of observer; can be
and behaviours out of context
Running Detailed narrative account in More Time consuming;
Record the sequence of health status comprehensive and caregiver must
conditions and behaviours keeps better track have time apart
over time from children to
record
Checklist A list of specific health status Daily scan Does not describe
records, communicable specific traits and
diseases, etc; monthly, behaviours
quarterly, and yearly growth
and development
observations
Time Records frequency of health Good for over time, Does not describe
Sampling status condition or takes less time; condition or
behavioural occurrences objective and behaviour
controlled
Event Waits for health condition or Recurring problem; Misses details of
Sampling behaviour to occur, then objective and condition or
records specific behaviour defined ahead of behaviour
time

Source: Robertson (2010)

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50  TOPIC 4 HEALTH OF THE YOUNG CHILD

SELF-CHECK 4.3

1. Explain the importance of health history, records and observation

for a childÊs health assessment.

2. Where can the health history of a child be found?

3. State the advantages of observation.

ACTIVITY 4.1

Based on the information obtained from observing a child, design your

own health assessment recording sheet and include the types of record
you regard as important.

 It is the responsibility of parents, school and community to promote the health

and well-being of children.

 Direct assessment, incidental observation and caregiver reports are important

sources of data about a childÊs health status.

 There are a few types of screening, such as vision, 3D vision, hearing and spinal
screenings.

 A childÊs health history includes family medical history, past and present
health status, and socioeconomic status.

 Observation has some advantages such as that it is simple to conduct, can be

done informally on many children at the same time, is a brief process, and does
not require any medical equipment.

 Observation should be noted and kept as a record, such as in the form of

observation checklists, plotting information on a chart and actual writing.

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 TOPIC 4 HEALTH OF THE YOUNG CHILD  51

AdamÊs Forward Bend Test Recording of data

Health history Records
Hearing screening Spinal screening
Observation Vision screening

Andrews, J. (2011). How schools can help promote healthy eating. Retrieved from
http://www.livestrong.com/article/387740-how-schools-can-help-
promote-healthy-eating/

Bettercare Learning Programmes. (2019). Child health care: Growth and

development. Retrieved from: https://bettercare.co.za/learn/child-
healthcare/text/03.html#objectives.

Centers for Disease Control and Prevention. (2013). Nutrition, physical activity, &
obesity: School health guidelines to promote healthy eating and physical
activity. Retrieved from
http://www.cdc.gov/healthyyouth/npao/strategies.htm

DelCarmen-Wiggins, R., & Carter, A. (Eds.). (2004). Handbook of infant, toddler,

and preschool mental health assessment. New York, NY: Oxford University
Press.

Department for Education, UK. (2012). Promoting health and wellbeing. Retrieved
from
http://www.education.gov.uk/childrenandyoungpeople/families/childre
nincare/a0065777/promoting-health-and-wellbeing

Health Promotion Board. (2012). Health screening for primary school. Retrieved
from http://www.hpb.gov.sg/HOPPortal/health-article/632

Robertson, C. (2010). Safety, health and nutrition in early education. Belmont, CA:
Cengage Learning.

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52  TOPIC 4 HEALTH OF THE YOUNG CHILD

Telethon Institute for Child Health Research. (n.d.). Nutrition & being active:
Supporting and promoting healthy lifestyles in your community. Retrieved
from
http://aboriginal.childhealthresearch.org.au/media/57063/5_nutrit_life_fi
nal.pdf

US Department of Health & Human Services. (2010). Infant/toddler development,

screening, and assessment. Retrieved from
http://www.zerotothree.org/public-policy/state-community-
policy/nitcci/multidisciplinary-consultant-module-2.pdf

Copyright © Open University Malaysia (OUM)

Topic   Illness in
Children
5
LEARNING OUTCOMES
By the end of this topic, you should be able to:
1. Explain environmental conditions which affect childrenÊs health;
2. Define communicable illness;
3. Discuss the prevention of illness; and
4. Explain how to care for sick babies and children.

 INTRODUCTION
The saying goes that when it comes to a serious illness, the obedient child has four
times a better chance of recovery than the spoilt and undisciplined child. Illness in
children is inevitable but by adhering to certain rules and practices, some of these
illnesses can be prevented. In this topic, we will discuss the conditions affecting
childrenÊs health, communicable illnesses, prevention of illness and lastly, how to
care for sick babies and children.

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54  TOPIC 5 ILLNESS IN CHILDREN

5.1 ENVIRONMENTAL CONDITIONS

AFFECTING CHILDREN’S HEALTH
As a child grows, his health and physical development should be at the top of any
parentÊs priority list (Morgan, 2013). It is the parentsÊ responsibility to ensure a safe
and healthy environment for their child to grow. According to Surbhi (2012),
the health status of a person is „the outcome of a continual adjustment and
readjustment between the internal and external environment.‰ There are three
components of the external environment that have an impact on the childrenÊs
health and well-being: physical, biological and psychosocial environment. Let us
look at each of these environmental components:

(a) Physical Environment

The physical environment encompasses all non-living things such as
housing, water, air, soil, climate, heat, light and noise. We are in constant
interaction with all these elements. These elements can be a threat in the
following instances: unsafe water, soil pollution and poor housing.

(b) Biological Environment

The biological environment encompasses all living things such as germs,
animals and plants. These living things are constantly working for their
survival, and in the process, some of them act as disease-producing agents,
reservoirs of infections and vectors of diseases.

(c) Psychosocial Environment

The psychosocial environment encompasses social and psychological factors
and conditions such as cultural values, customs, habits, religions, education,
occupation, standard of living and community life. We are exposed to the
social environment through the media, literature and the arts, etc. Crime,
violence, drug abuse and other forms of deviant behaviour are due to
psychosocial stress. These conditions have a direct influence on the health of
children.

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 TOPIC 5 ILLNESS IN CHILDREN  55

What can we do to ensure the healthy growth of children? Recommendations for

childrenÊs proper nutrition and rest are as follows (Morgan, 2013):

(a) Nutrition
Nutrition plays a vital role in the health and development of children.
Without proper nutrition, children might be afflicted by conditions such as
high blood pressure and obesity. What should children consume? They
should:

(i) Eat whole foods regularly;

(ii) Increase their consumption of fruits and vegetables;

(iii) Eat moderate amounts of fats and carbohydrates; and

(iv) Limit sodas and sweetened juice beverages.

(b) Rest
Sleep is important for children. Lack of rest or sleep can affect a
childÊs neurological development, social development and learning ability.
Children who get the right amount of sleep develop better and are more
relaxed, happy and well-behaved (see Figure 5.1).

Figure 5.1: Children are relaxed and happy after having proper rest

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56  TOPIC 5 ILLNESS IN CHILDREN

SELF-CHECK 5.1

1. Explain the conditions which affect childrenÊs health.

2. Explain why nutrition is important and list the food that children
should eat.

5.2 COMMUNICABLE ILLNESS

According to Edemekong and Huang (2018), communicable diseases are illnesses
caused by viruses or bacteria that people spread from one person to another
through contact with contaminated surfaces, bodily fluids, blood products, insect
bites or the air. It is also called contagious disease.

The occurrence of communicable diseases is particularly high in childcare centres

and lower primary schools. This is because small children are less likely to adhere
to personal hygiene standards, with teachers and/or caregivers constantly aware
of those coughing or sneezing with an open mouth or not washing their hands
after coming into contact with disease symptoms.

The following are some of the most common communicable diseases found in
most schools or childcare centres:

(a) Conjunctivitis

(b) Pertussis (whooping cough);

(c) Tuberculosis;

(d) Common cold;

(e) Hand, foot and mouth disease;

(f) Influenza (flu);

(g) Hepatitis;

(h) Head lice (ticks); and

(d) Foodborne or waterborne illnesses.

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 TOPIC 5 ILLNESS IN CHILDREN  57

Hillendale Health explains, „When a person becomes sick with a communicable

disease, it means a germ has invaded the body‰. How do you get rid of these
germs? You need to wash your hands regularly ă with soap and water.

We have discussed germs and infections in Topic 3. Here, we will recall what we
have learnt about germs. These are tiny organisms (living things) that may cause
diseases, and are the reason behind symptoms such as runny nose, cough, sore
throat or fever. Germs can only be seen through a microscope and are therefore,
microbes. Microbes are the smallest form of life on Earth. Where do we find
microbes? They can be found anywhere such as in the air, water, plants, animals
and humans. There are four major types of germs: bacteria, viruses, fungi and
protozoa.

SELF-CHECK 5.2

1. Define communicable illness.

2. List examples of communicable illness.

3. Explain what germs are.

5.3 CARING FOR SICK BABIES AND CHILDREN

If a child has a mild illness such as a fever lower than 38C, runny nose and slight
cough, it is best to leave the child at the health care centre. We will now look at
when children should be kept at home and secondly, how to care for them when
they are at school.

5.3.1 When to Keep Children at Home

Click and Karkos (2010) suggest that children be kept at home when they show the
following conditions or until a doctor indicates that they can go back to school:

(a) Very high temperature and other signs of illness;

(b) Symptoms of severe illness such as coughing, irritability, crying and

wheezing;

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58  TOPIC 5 ILLNESS IN CHILDREN

(c) Vomiting;

(d) Uncontrollable diarrhoea;

(e) Severe rash with fever and change in behaviour;

(f) Mouth sores accompanied by drooling;

(g) Conjunctivitis (pink eye);

(h) Tuberculosis;

(i) Scabies, head lice or other infections;

(j) Chicken pox, until sores are dry and crusted;

(k) Mumps, nine days after onset of gland swelling;

(l) Hepatitis A virus;

(m) Rubella, six days after onset of rash; and

(n) Measles, six days after onset of rash.

The teacher or caregiver should be trained to recognise the symptoms and when
to act. If it is in the beginning of the school day, the child should be sent home. If
it is only evident later in the day, it is best to keep the child in a separate section of
the school which is set aside to take care of children until it is possible for the
parents to pick up the child. It is important to have medical services available for
the child.

5.3.2 Taking Care of Children at School

Some centres or schools allow sick children to stay in school in either a separate or
regular class. It all depends on the severity of their illness. If a child is placed in a
separate class, a trained childcare worker should be stationed there. Parents
should inform the school about the evening and morning symptoms displayed by
the child. The staff should keep a record of the childÊs condition throughout the
day to give this information to the parents at pick-up time. Younger children
should be taken care of based on the childcare policy at the school or centre. The
following are a few suggestions on how a teacher should take care of a child
(California Childcare Health Program, 2006):

(a) Check that the child receiving the medication is the same as the child whose
name is listed on the medication;

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 TOPIC 5 ILLNESS IN CHILDREN  59

(b) Read the label and follow the prescription instructions related to measured
dose, frequency and other circumstances related to administration (such as
in relation to meals);

(c) Administer the medication according to the prescribed method and dosage;

(d) Observe and report any side effects from medications; and

(e) Document the administration of each dose by recording the time and amount
given.

If the procedures are followed and medication is given to the child, the parents
will also be at ease. If the illness is not severe, the child can be allowed to attend
regular classes.

SELF-CHECK 5.3

1. List some health conditions which require a child to be kept at

home.

2. Explain how to take care of a sick child at a childcare centre or

school. What should a teacher do when caring for the child?

 The health and physical development of a child should be the top priority of a
parent. External environmental components such as physical, biological and
psychosocial environments are important for a childÊs growth. It is also
important that parents administer the nutritional intake of the child and that
the child gets proper rest.

 Communicable illness is a disease that is transmitted through direct contact

with an infected individual or indirectly through a vector. A person is infected
when germs invade his body.

 These illness preventative methods should be taken into consideration: hand

washing, immunisation and policy development and implementation.

 Children should be kept at home when they show symptoms such as high
fever, vomiting, diarrhoea and other symptoms of infection. Centres should
have trained staff who can take care of children and administer medicine.

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60  TOPIC 5 ILLNESS IN CHILDREN

Bacteria Immune system

Communicable illness Nutritional intake
Disease Physical development
Germs Protozoa
Illness prevention

Brodey, D. (2013). 5 simple ways to prevent illness. Retrieved from:

http://www.parenting.com/article/5-simple-ways-to-prevent-
illness?page=0,1

California Childcare Health Program. (2006). Preventing and managing illness in

ECE programs. Retrieved from
http://www.ucsfchildcarehealth.org/pdfs/Curricula/CCHA/9_CCHA_Ill
nessPrev_0506.pdf

Click, P. A., & Karkos, K. A. (2010). Administration of programs for young children
(8th ed.). Belmont, CA: Wadsworth.

Edemekong, P. F., & Huang, B. (2018). Epidemiology, Prevention Communicable

Diseases. In StatPearls [Internet]. StatPearls Publishing.

Hillendale Health. (n.d.). Communicable disease. Retrieved from:

http://hes.ucfsd.org/gclaypo/commdise/commdise.html

Morgan, L. (2013). Factors that affect the health & physical development of
children. Retrieved from:
http://www.ehow.com/list_6387013_factors-health-physical-
development-children.html

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 TOPIC 5 ILLNESS IN CHILDREN  61

Rothenberg, M. B. (1988). The healthy child. Working Mother. Retrieved from:

http://books.google.com.na/books?id=TmEEAAAAMBAJ&pg=PA92&dq
=taking+care+of+sick+children+at+schools&hl=en&sa=X&ei=U7NGUd-
MPIewhAe234GYBw&ved=0CC8Q6AEwAA#v=onepage&q=taking%20car
e%20of%20sick%20children%20at%20schools&f=false

Surbhi (2012). How does the environment affect our health? Retrieved from:
http://www.preservearticles.com/201105156669/how-the-environment-
affects-health.html

Copyright © Open University Malaysia (OUM)

Topic  Promoting
Good Nutrition
6
LEARNING OUTCOMES
By the end of this topic, you should be able to:
1. Identify good nutrition;
2. Discuss the logistics of good nutrition;
3. Design a good diet;
4. Implement the protection of food and sanitation; and
5. Define food technology.

 INTRODUCTION
„Let food be thy medicine and medicine be thy food,‰ said Hippocrates. This is a
strong statement made by the ancient Greek physician about the importance of
food. What do you think it means?

In this topic, you are going to learn about promoting good nutrition to children.
Well, to promote something means you will have to understand it first. So, in this
topic, you are going to learn about eating healthy food and keeping to a healthy
diet. Just as the famous proverb reminds us that „an apple a day keeps the doctor
away,‰ eating the right food will enable us to stay healthy and keep us from
becoming sick.

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 TOPIC 6 PROMOTING GOOD NUTRITION  63

6.1 DEFINING AND IDENTIFYING GOOD

NUTRITION
Let us define the following concepts first: nutrition, nutrients, diet and a balanced
diet. Nutrition is the study of and how food is used by the body (Marotz, 2008). It
covers aspects of digestion, absorption, transportation, usage, interaction, keeping
and disposal of nutrients. The relationship between nutrients and health is also
covered.

Nutrients are substances contained in food that could be used by the body to
produce energy and growth as well as look after health and regulate bodily
processes.

Diet is all kinds of food that we eat, either solid or liquid.

A balanced diet comprises a mixture of the main varieties of nutrients (protein,

carbohydrates, fats, minerals and vitamins).

Next, we will define good nutrition and then look at how to identify it.

6.1.1 Good Nutrition

What do you think is the correct definition of good nutrition? Remember that we
said nutrition is the process by which living organisms obtain food and use it for
growth, metabolism and repair. To explain this, we will look at the stages of
nutrition.

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64  TOPIC 6 PROMOTING GOOD NUTRITION

Figure 6.1 shows the six stages of nutrition.

Figure 6.1: Six stages of nutrition

As explained by dieticians, a good nutritional diet will have a combination of four

main groups, especially for children. In this subtopic, we will look only at these
four main groups. Next, we will discuss the value of these food groups.

Eating a variety of foods from the four main food groups is what health experts
recommend. Table 6.1 highlights these food groups:

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 TOPIC 6 PROMOTING GOOD NUTRITION  65

Table 6.1: Four Main Food Groups

Source: Google images

http://www.weightlossresources.co.uk/children/nutrition_calorie_needs.htm

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66  TOPIC 6 PROMOTING GOOD NUTRITION

When we look at the different food groups, we can see that we would have a
balanced diet if we eat at least a few items from the food groups. Diet will be
discussed later. To sum up, good nutrition means getting all the calories that you
need for enough energy and all the right nutrients for proper and healthy growth.
Next, we will look at how to identify good nutrition.

6.1.2 Identifying Good Nutrition

Do you think it is possible to identify good nutrition? Will it be possible to do it by
only looking at the food or is it the knowledge that you have gained that will make
it possible? Let us find out how you can identify good nutrition. To identify good
nutrition, you basically have to look at the four main food groups. The only way
to get children to be interested and willing to eat healthy is by creating an
environment where they can make their own choices.

The four groups as shown in Table 6.1 will be your guide, but let us look a bit
further and see how we can identify good nutrition.

We can consider variety, balance and moderation as good nutrition, according to

the National Food Service Management Institute at the University of Mississippi
in the United States. Let us look at variety, balance and moderation as key aspects
in identifying good nutrition.

(a) Variety
A variety of foods, including vegetables, fruits, grain and protein, is essential
to make sure we get the full range of nutrients for good health.

(b) Balance
The right balance of calories, protein, fat, carbohydrates, vitamins and
minerals provides energy and the variety of nutrients which growing
children need.

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 TOPIC 6 PROMOTING GOOD NUTRITION  67

(c) Moderation
Foods that are high in fat, sugar or salt, and lack important nutrients need to
be limited.

(i) Children younger than two years old need calories and fat to support
rapid growth.

(ii) Children over the age of two can be served low-fat milk.

(iii) By age five, children should get no more than 30 per cent of their daily
calories from fat.

Serve tasty, fresh vegetables and fruits as snacks. Choose bright-coloured foods
since they are often the highest in nutrients such as vitamins A and C. If you follow
the three key aspects above, you will certainly be able to identify good nutrition.

SELF-CHECK 6.1

1. Define nutrition.

2. Name the factors that you will consider in identifying good

nutrition.

6.2 LOGISTICS OF GOOD NUTRITION

Have you ever heard of logistics of good nutrition? For a better understanding, let
us look at the term „logistics‰ first. Learn Lean Logistics (2012) defines it as follows:

„Logistics refers to the process of ensuring the right items are in the right place
at the right time.‰

So, logistics of good nutrition is a way of ensuring that all good nutrition is at the
right place at the right time for children. How do we do that?

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68  TOPIC 6 PROMOTING GOOD NUTRITION

Let us look at Table 6.2. It highlights the food groups and what you gain by eating
them. Bad or negative food groups are added.

Table 6.2: Food Groups and Their Benefits for Our Body

Source: http://www.teachingideas.co.uk/themes/keepinghealthy/index.htm

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 TOPIC 6 PROMOTING GOOD NUTRITION  69

The next step is to use the information in Table 6.2 to design a healthy diet for
preschoolers. The logistics part will be to make sure the food is prepared and
delivered to the preschoolers. This is only possible if you have a prepared diet.

SELF-CHECK 6.2

Name the four main food groups and explain how these affect our body.

ACTIVITY 6.1

What is logistics of good nutrition and how will you ensure good
nutrition is provided?

6.3 PLAN AND DESIGN A GOOD DIET

Do you know how to plan and design a good diet? With the information that we
have shared so far, you will be able to do so. We will use Table 6.1 as a guide in
planning and designing a good and healthy diet.

A healthy diet should include food from all food groups. Remember to make sure
there is always variety in the food and that each dayÊs meals are different from
those of the previous day.

Scottish Executive (2006) suggests the following tips in designing a diet for
preschoolers:

(a) Colour ă Use at least two colours such as grains, meat and poultry.

(b) Texture ă Such as breads, pasta, meats and also fresh fruits and vegetables.

(c) Flavours ă Use different flavours such as breads, fruits, vegetables and
cheeses.

(d) Shapes ă Use different shapes to cut food such as strips, circles or
triangles.

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70  TOPIC 6 PROMOTING GOOD NUTRITION

When planning a menu for a good diet, variety, balance and moderation should
be taken into consideration. Let us look at a sample menu for one day from Martin
and Oackley (2008) as shown in Table 6.3.

Table 6.3: Sample Menu for a Healthy Diet

Breakfast Lunch/Supper Snack

Oatmeal Chicken nuggets Rice cake
Blueberries Green beans Apple juice
Milk Orange Slices
Bread & butter

Source: http://stepbystepcc.com/menu.html

Now, use the information and food table (see Table 6.4) to plan and design a diet
plan for preschoolers.

Table 6.4: Food Groups

Source:
http://www.teachingideas.co.uk/themes/keepinghealthy/_files/foodgroups.pdf

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 TOPIC 6 PROMOTING GOOD NUTRITION  71

If you look at the main food groups, you can see why it is important to have
a balanced diet. According to the National Network for Child Care (2013), our
bodies need protein to help with growth and repairing the body. Carbohydrates
such as bread, pasta, cereal and chips are for energy. We need vitamins and
minerals to keep our body and cells healthy. The body needs fibre for digestion
and to keep our intestines healthy. The last food group, that is fats, also has its
benefits, because the body needs energy and it helps to build up our body.

Let us design a healthy diet. After we have completed our sample diet by using all
the food groups, I want you to design your own healthy diet.

ACTIVITY 6.2

Design a healthy diet by using the information given in Table 6.4

and discuss it in the myINSPIRE online forum. Were there cultural
differences in the food items selected?

6.4 PROTECTION AND SANITATION OF FOOD

Protection and sanitation of food is a priority and essential for every early
childhood programme, according to Martin and Oackley (2008). Sanitation
regulations should be followed for the following purposes:

(a) Storing;

(b) Transporting;

(c) Preparing; and

(d) Serving.

Other day-to-day regulations should be followed such as regular hand washing

as well as the correct temperature for storing food. The question is, why is it so
important to protect food?

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72  TOPIC 6 PROMOTING GOOD NUTRITION

Food need to be protected against food-borne diseases. Hence, it is advised to have

a food safety and sanitation policy. It will ensure that a preschool adheres to the
rules and regulations. The following are safety and sanitation procedures which
should be followed by caregivers and schools:

(a) Practise Good Personal Hygiene

(i) Wear clean clothes.

(ii) Wash hands regularly.

(iii) Wear a hairnet at all times.

(b) Receive and Store Food Properly

(i) Storage facilities should be clean and available.

(ii) Make sure food is not spoilt already when you receive it.

(c) Handle Food in a Safe and Sanitary Manner

(i) Ensure a surface is clean before preparing food on it (hands must also
be clean).

(ii) Separate foods.

(iii) Make sure food is cooked in the right temperature.

(iv) Store cooked food in a cool place if it is not used immediately after
preparation.

If these guidelines are not followed, food-borne diseases can develop and spread.
An example is salmonella or food poisoning. What is that, you might ask? It is any
disease or illness caused by eating contaminated food or drink.

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 TOPIC 6 PROMOTING GOOD NUTRITION  73

SELF-CHECK 6.3

1. Explain the terms „food protection‰ and „sanitation‰.

2. Name three aspects that need to be considered according to the

food and safety policy.

6.5 FOOD TECHNOLOGY

What is food technology? Traditionally, we know that food comes from the
ground. Fruit is from trees, fish is from the sea and meat is from animals. Food
technology, however, is something new. It is the application of science and
engineering to the refining, manufacturing and handling of foods (The Free
Dictionary, 2019).

This brings us a bit closer to the true meaning of food technology. In short, we
can say that raw food such as meat, fish, vegetables, fruits and all other food from
the food groups are refined, manufactured and handled. Let us see how food
technology developed.

In 1810, Nicolas Appert developed the canning process. It was a form of

preservation at the time and although it was not called canning then, the technique
had a major impact on the preservation of food.

In 1864, Louis Pasteur conducted research on the spoilage of wine, vinegar, alcohol
and beer and also on the souring of milk. He developed pasteurisation, which
is the process of heating milk and milk products to destroy food spoilage and
disease-producing organisms. This was the beginning of food technology.

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74  TOPIC 6 PROMOTING GOOD NUTRITION

The following list in Table 6.5 gives us an idea of how food technology developed.

Table 6.5: Development of Food Technology

Product Description
Instantised Milk D. D. Peebles developed the first instant milk powder. This
Powder has become the basis for a variety of new products that are
rehydratable in cold water or milk.
Freeze-drying The first application of freeze drying of coffee was a breakthrough
development. Wikipedia states that it was most likely in the
pharmaceutical industry where a successful large-scale industrial
application of the process was developed.
High-temperature These processes are characterised by rapid heating and cooling,
Short Time holding for a short time at a relatively high temperature and
Processing filling it into sterile containers.
Decaffeination of Around 1900, decaffeinated coffee and tea were first developed
Coffee and Tea on a commercial basis in Europe. The process worked as follows:
green coffee beans were treated with steam or water to around
20% moisture. This heating and adding of water caused the
caffeine to separate from the beans and rise to the surface.
Solvents were then used to remove the caffeine from the beans.
Process Today, the production of food is becoming more efficient with
optimisation oil-saving techniques. The production methods and methodology
are becoming more and more sophisticated.

SELF-CHECK 6.4

1. Define food technology.

2. Name and explain one example of food technology.

 In this topic, we looked at the definitions of nutrition, nutrients and diet. We

zoomed in on what is considered a balanced diet. The body needs good
nutrition for digestion, absorption, transportation, usage, interaction, keeping
and disposal of nutrients. The stages of nutrition include ingestion, digestion,
absorption, transport, assimilation and excretion. These stages are important
for a healthy lifestyle.

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 TOPIC 6 PROMOTING GOOD NUTRITION  75

 Food intake should be balanced, so it is good to be able to identify good

nutrition.

 A healthy lifestyle means having a diet which contains the main food groups
which are:

ă Bread, cereals, potatoes, rice and pasta;

ă Fruit and vegetables;

ă Milk and dairy foods;

ă Meat, fish, eggs and pulses; and

ă Fat.

 Variety, balance and moderation are considered good nutrition. In a preschool

setting, it is of utmost importance that food items are in the right place at the
right time. This is called logistics of good nutrition.

 When planning a good and healthy diet for preschoolers, consider the
following:

ă Colour;

ă Texture;

ă Flavours; and

ă Shapes.

 Once these are taken care of, sanitation and protection of food should be a
priority.

Balance Moderation
Diet Nutrients
Food group Nutrition
Food technology Sanitation
Logistics Variety

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76  TOPIC 6 PROMOTING GOOD NUTRITION

Martin, J., & Oakley, C. (2008). Managing child nutrition programmes. Leadership
for excellence (2nd ed.). Boston, MA: Jones and Bartlett Publishers, Inc.

Peterson, S. (2009). Eat smart. Play Hard. San Luis Obispo: A nutrition and fitness
pilot program for young children and their adult buddies.

Scottish Executive, S. (2006). Nutritional guidance for early years: Food choices for
children aged 1ă5 years in early education and childcare settings. Edinburgh,
United Kingdom: Scottish Executive.

The Free Dictionary. (2019). Food technology. Retrieved from:

https://encyclopedia.thefreedictionary.com/food+technology

Copyright © Open University Malaysia (OUM)

Topic   Providing Food
for Infants
7
LEARNING OUTCOMES
By the end of this topic, you should be able to:
1. Explain how to feed infants;
2. Demonstrate how to feed an autonomous toddler; and
3. Discuss the type of food that is suitable for a preschooler.

 INTRODUCTION
Providing food for infants, toddlers and preschoolers can be a challenge if you
are doing it for the first time. When do we start giving infants solid food and
what type of food is appropriate for infants, toddlers and preschoolers? Whose
responsibility is it to provide food for infants and preschoolers? UNICEF has
repeatedly called on governments to ensure basic services for children and this
includes providing food where the need arises. In this topic, we will explain how
to feed infants, demonstrate how to feed autonomous toddlers and discuss the
types of food that are suitable for preschoolers.

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78  TOPIC 7 PROVIDING FOOD FOR INFANTS

7.1 INFANT FEEDING

Do you know how old is an infant? A young child aged between 0 and 12 months
is called an infant. Lippencoth, Williams and Wilkins (2002) state that infancy is a
time of unparalleled growth and development. They also pose the question ă What
do you need to teach parents of infants? According to them, it is everything. New
parents and teachers or caregivers need to know:

(a) How to hold an infant;

(b) How to bathe, dress and put a diaper on the infant;

(c) How to feed the infant; and

(d) What to expect as the infant develops during the first year.

The National Health and Medical Research Council (NHMRC, 2013) has the
following recommendations:

(a) Encourage, support and promote exclusive breastfeeding to around

6 months of age.

(b) Continue breastfeeding while introducing appropriate solid foods until

12 months of age and beyond, for as long as the mother and child desire.

(c) While breastfeeding is recommended for the first 6 to 12 months and beyond,
any breastfeeding is beneficial to the infant and mother.

This will work if the child stays with the mother but what about feeding at the
preschool or day care centre?

7.1.1 When an Infant is Not Receiving Breast Milk

If an infant is not breastfed or is partially breastfed, commercial infant formulas
should be used as an alternative to breast milk until 12 months of age (NHMRC,
2013). It is important to prepare and store feeds correctly.

(a) At around the age of 6 months, infants are physiologically and

developmentally ready for new foods, textures and modes of feeding, and
they need more nutrients than can be provided by breast milk or formula
alone.

(b) By 12 months of age, a variety of nutritious foods should be given from the
five food groups.

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 TOPIC 7 PROVIDING FOOD FOR INFANTS  79

(c) Solid foods should provide an increasing proportion of the energy intake
after 12 months of age.

(d) Offering a variety of nutritious foods is likely to help meet the need for most
nutrients and provide a basis for healthy eating habits.

(e) All foods given to infants should be nutritious and fed in a safe way.

(f) Foods which are provided to an infant must be free of pathogens and of
suitable quantity, size and texture.

(g) Infants should be supervised during feeding.

(h) Propping the bottle against an infantÊs mouth and leaving the infant to feed
from the bottle without supervision should be avoided. The infant might fall
asleep with the bottleÊs teat still attached to the mouth, increasing the risk of
choking, ear infection and dental caries.

7.1.2 When an Infant is Receiving Breast Milk

Breast milk is the ideal food for babies. Burgess and Glasauer (2004) suggest that a
babyÊs body be turned towards the mother, with the chin touching the motherÊs
breast, the mouth wide open and both lips turned outwards. In this position, more
areola will be above than below the babyÊs mouth. The baby will then be able to
take the milk in slow deep sucks and swallowing can be heard. Figure 7.1 shows
how a baby should be held when breastfeeding takes place.

Figure 7.1: Suckling in the correct position

Source: Burgess & Glasauer (2004)

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80  TOPIC 7 PROVIDING FOOD FOR INFANTS

ACTIVITY 7.1

1. Explain in your own words how to feed an infant who is not

receiving breast milk.

2. Demonstrate your understanding by explaining how an infant who

is receiving breast milk should be held.

7.2 FEEDING THE AUTONOMOUS TODDLER

What is an autonomous toddler? This is a toddler who is old enough to have the
freedom to eat what he or she likes to eat. This can be a challenge if the parent or
school is not prepared. There are questions such as what can we feed such a young
child or how can I encourage him/her to eat the right foods?

Autonomy refers to a childÊs quest from ages one to two to develop a sense of self
and self-rule (Robertson, 2011). The transition from infancy to toddlerhood is seen
in the eating behaviour (Robertson, 2011). Why do you think this is the case?
Seeing that it is something that happens frequently, it is here that a child starts
showing independence and need for autonomy. The child wants to take control
of things that relate to him/her. By now, you should know good nutrition is
important for growth, playing and learning. For a teacher of a preschooler, it is a
challenge to make sure the child has a nutritious diet to establish good food habits.
Furthermore, it is important to establish good eating behaviours and an
understanding of the development in a child which affects the toddlerÊs actions.
Let us look at food as an issue of control as explained by Robertson (2011) in the
following subtopic.

7.2.1 Food as an Issue of Control

It is the responsibility of adults to ensure healthy eating habits. What they
normally do if a child is not eating right is to beg or bribe the child to do so. Is this
right? According to Robertson (2011), this practice is the start of the battle for
control between the well-meaning adults and the independence-seeking toddler.
When adults fall into the trap, it will affect the toddlerÊs eating habits. Table 7.1
shows common patterns of the toddlerÊs eating actions.

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 TOPIC 7 PROVIDING FOOD FOR INFANTS  81

Table 7.1: Common Patterns of the ToddlerÊs Eating Actions

1. Child wants and needs to be independent: child wants to control his own eating.
2. Child learns to say „no‰ even to favourite food.
3. Appetite is sporadic as growth slows.
4. Child learns by doing ă wants to feed self.
5. Child has food likes and dislikes. Child may develop food jags for favourite foods.
6. Child is gaining more control over large motor skills and can lift food to his/her
mouth. Because large muscle control is still developing, the child will sometimes
drop or spill food.
7. Child is gaining more control over fine motor skills and is able to use a spoon.
8. Child is learning to manipulate objects and likes to touch and play with food.
9. Child may be teething and have more difficulty chewing: he/she will spit out or
remove food from mouth.
10. Child wants to master the job of eating and be successful, even if it means hiding
food under a plate or in a pocket to show that he or she is done.
11. Child is learning to be a social creature and may entertain others with food antics.

Source: Robertson (2011)

7.2.2 Feeding the Toddler

During the toddler period, the child will continue to develop his or her sense of
autonomy and this can be a difficult time for the parents as well as the caregiver at
the preschool (Satter, 2013). A toddler may refuse to eat certain foods or get stuck
on specific food. It is important to note that this is only a phase and even a way of
asserting themselves. The fact is that toddlers can refuse certain foods as long as
they do not refuse all foods from the same food group.

The following are guidelines for caregivers and parents (Satter, 2013):

(a) Make sure three meals with planned snacks in between are offered each day.

(b) Remember that the serving size for a toddler is smaller than an adult portion.

(c) A childÊs serving size is approximately ó of an adultÊs portion size.

(d) A childÊs appetite can vary ă some days they will not eat much at all and
other days they will want seconds.

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7.2.3 Keep Offering New Types of Food

Why do you think it is important to offer new types of food to toddlers? Satter
(2013) explains that many children learn to like a food after it has been offered
many times. For that reason, caregivers and parents should offer food often and
show their joy in eating foods. Satter (2013) also suggests the following guidelines:

(a) Show the child the food tastes good without over-emphasising it;

(b) Keep your opinion to yourself about food you do not like;

(c) Serve the same food in different forms;

(d) Offer the new food first, followed by familiar food that the child already
likes; and

(e) Offer toddlers the same food that the rest of the family is having.

7.2.4 How Well is the Toddler Growing?

Make sure the toddlerÊs growth chart is kept up to date. This will give you a precise
idea of how the toddler is growing. It is important to monitor the toddlerÊs growth
for two reasons:

(a) If the Toddler is Not Growing Enough

(i) Check with the parents and doctor to see if the toddler needs to eat
more.

(ii) Children have a very small stomach. They often need to eat five to six
small meals a day to get the amount of food they need to grow.

(b) If You Feel the Toddler is Overweight

(i) Check with the parents and doctor first to see if the child has become
overweight.

(ii) Restricting calories is not a good action. Instead, give the toddler a
chance to grow into the weight as he or she gets taller.

(iii) Provide healthy food choices and help him or her spend more time
being physically active.

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The following guidelines are healthy eating habits for parents and centres (Satter,
2013):

(a) Parents should stock their home with breads, cereals, fruits, vegetables,
low-fat milk products (for children over two years old) and lean meats. Do
not overdo snack foods like sweets, chips and ice-cream;

(b) Serve meals and snacks about the same time every day at home and at
centres;

(c) Make a house rule: eat only at the dining table (parents);

(d) Reward children with love and attention, never with food;

(e) Talk to your children about feelings and how to solve problems, other than
using food as a way to escape from them;

(f) Make fun activities a part of the things you do together as a family; and

(g) Limit the amount of TV that your family and you watch to about two hours
a day.

7.2.5 How Can Meal Times be Pleasant?

For the autonomous toddler, it is important to make meal times pleasant. Do you
know why? During meal times, toddlers can be taught positive eating behaviour.
The centre can do the following as suggested by Satter (2013):

(a) Turn off the TV during meal times;

(b) Focus on each other and interact with different children;

(c) Set a good example by eating calmly and taking pleasure in the meal
moment;

(d) Decide which foods to offer to toddlers and have a specific schedule for meal
times; and

(e) Give toddlers the opportunity to decide which foods to eat and how much to
eat.

It is very important to remember that meal times are a great opportunity for
interaction between toddlers and caregivers. It is, therefore, important to provide
structure and limits for toddlers and give them an opportunity to make decisions
with regard to healthy eating.

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SELF-CHECK 7.1

1. Demonstrate how to feed the autonomous toddler.

2. How can you make meal times pleasant for the toddler?

7.3 FOOD FOR THE PRESCHOOLER

Let us start from toddlers and move gradually to preschoolers, as this will give
you a better understanding of the type of food that is suitable for preschoolers.
Brown (2011) states that between 12 and 18 months, toddlers are able to move their
tongue from side to side and learn to chew food with rotary, rather than just up
and down, movements. They are now ready to handle chopped or soft table food.

At about 12 months, children have a refined pincher grasp which enables them to
pick up small objects, such as cooked peas and carrots, and put them into their
mouths. They can even pick up a spoon and eat. At about 18 to 24 months, toddlers
are able to use their tongue and clean their lips and have well-developed rotary
chewing movements. At this stage, toddlers can handle:

(a) Meats;

(b) Raw fruits and vegetables; and

(c) Multiple food textures.

Now, toddlers develop a strong need for self-independence and would like to do
everything themselves. As they are trying to practise their newfound skills, they
become easily distracted. Although their skills improve in using the spoon, they
prefer to eat with their hands. This self-feeding is messy but it is part of the childÊs
developmental process.

A useful hint to parents and caregivers is to keep distractions such as television

away during meal times and to allow toddlers to practise their self-feeding
skills and experience new food and textures. Supervision during this period is
important to avoid choking. Make sure toddlers are seated on a high chair during
meals and snacks with the family. Do not allow them to run around. Avoid hard
food that can cause choking such as hard candy, popcorn, nuts, whole grapes and
hot dogs.

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7.3.1 Feeding Behaviours of Toddlers and

Preschoolers
Brown (2011) suggests rituals for feeding to prevent food jags from developing.
Do you know what is a food jag? A food jag is when a child will eat only one food
item, meal after meal. The aim of parents and caregivers is to develop good eating
habits for the toddler/preschooler. The child can develop the following behaviours:
(a) Demonstrating likes and dislikes;
(b) Refusing particular food for long periods; and
(c) Refusing food depending on temperament.

What can parents and caregivers do? They can serve new types of food along
with familiar food. The important point is to serve new food when a toddler/
preschooler is hungry. If family members and other toddlers/preschoolers eat the
same food, it will trigger the childÊs curiosity. Toddlers/preschoolers will do the
obvious thing and start imitating the eating behaviours of others because they
are great imitators. Now, let us look at the types of food to serve preschoolers.
Remember, we listed different food groups in the previous topics.

Look at Table 7.2 for the types of food suitable for the preschooler.

Table 7.2: Types of Food for the Preschooler

Food Type What You Get Servings

Bread, cereal, rice, pasta Receives carbohydrates for energy 5ă9 servings
and noodles B vitamins (calcium, iron, fibre)
Vegetables and legumes Vitamins, mineral, carbohydrates, 4ă5 servings
fibre
Fruit Vitamins, mineral, carbohydrates, 2ă3 servings
fibre
Milk, yoghurt and cheese Calcium, protein, vitamins 2ă4 servings
group
Meat, poultry, fish, beans, Protein, iron, vitamins, minerals Half ă 2 servings
eggs, nuts and legumes
Fats and oils Can be found in foods like poultry Enough intake when
and meat you eat meat and
poultry

Source: Kids Health at

http://www.cyh.com/HealthTopics/HealthTopicDetailsKids.aspx

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86  TOPIC 7 PROVIDING FOOD FOR INFANTS

7.3.2 Types of Food and Eating Habits of

Preschoolers
A guide by Busy Bodies (2007) suggests the following actions:

(a) Offer new types of foods to the child along with familiar foods. Start with
small portions. It can take 12 to 15 times before a child accepts new food.

(b) Serve a variety of food and set an example. Preschoolers will follow the
example.

(c) Start a vegetable garden and get children involved in planting and taking
care of it.

(d) Serve vegetables with dips and sauces and make eating vegetables fun. Ask
them to name the different colours and serve each one of them.

(e) Let children explore different types of food by tasting, touching and smelling
them. Encourage them to do so and make the experience fun.

(f) Prepare smoothies for preschoolers as they need two cups of milk each day
for healthy bones and teeth.

(g) Prepare pizzas and let children get involved in selecting toppings (one out of
each food group).

(h) Cut meat into small pieces and add to soups, stews or tomato sauce. Also
offer different types of protein food such as eggs, cheese, fish, tofu, cooked
dried beans, peas or lentils.

(i) Offer fruit salads instead of juice, because the child needs enough fibre
intake. Cut fruits in slices and offer them to the children.

(j) Offer snacks between meals, but make sure they include at least two of the
food groups. Examples are:

(i) Cereal and milk;

(ii) Milk blended with fruit;

(iii) Cheese sticks with apple slices;

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 TOPIC 7 PROVIDING FOOD FOR INFANTS  87

(iv) Slices of bread;

(v) Pizza slice and juice or milk; and

(vi) Carrot or muffin with juice or milk.

(k) Keep portion sizes small and increase gradually as children grow.

(l) Make sure preschoolers get enough nutrition, higher fat foods such as peanut
butter and cheese to meet their energy needs.

(m) Encourage reading about food types and show examples.

(n) Take meals at the table, switch off the television and put away all distractions
such as toys. Let children focus on their food and eating.

ACTIVITY 7.2
1. Name the different food types with an example of each food group.

2. List food types for the preschooler.

 An infant is a child aged between 0 and 12 months. The best feeding for an
infant is breastfeeding. Breastfeeding should continue at least until six months
because it is beneficial for the infant and mother. Good commercial formulas
should be used if an infant cannot be breastfed until at least 12 months. Infants
are ready at six months for new foods, textures and modes of feeding.

 Autonomous means acting independently or having the freedom to do so. The

toddler wants to take control of things that relate to him/her and in this case,
eating. Make sure the toddler is offered three meals a day. Serve the correct
portions and give the toddler options to decide what and how much to eat.
Keep offering new foods to encourage the toddler to eat.

 Food for the preschooler ă serve new food with familiar foods. Provide food
from each of the food groups. Also make sure that a variety of food is served.
Another important hint is to make meal times pleasant.

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88  TOPIC 7 PROVIDING FOOD FOR INFANTS

Autonomous toddler Infant feeding

Autonomy Preschooler
Food groups Toddler

Brown, J. E. (2016). Nutrition through the life cycle. Belmont, CA: Cengage
Learning.

Burgess, A., & Glasauer, P. (2004). The family nutrition guide. Feeding Babies
Aged 0ă6 Months. Retrieved from
http://www.fao.org/docrep/007/y5740e/y5740e09.htm

Kids Health. (2012). Retrieved from:

http://www.cyh.com/HealthTopics/HealthTopicDetailsKids.aspx?p=335
&np=284&id=1443#top

Lippencoth, Williams, & Wilkins. (2002). Illustrated manual of nursing practice,

Philadelphia, PN: Wolters Kluwer.

National Health and Medical Research Council. (NHMRC: 2013). Infant feeding
guidelines: Summary. Canberra, Australia: National Health and Medical
Research Council.

Netting, M. J., Campbell, D. E., Koplin, J. J., Beck, K. M., McWilliam, V., Dharmage,
S. C., ... & Loh, R. K. (2017). An Australian consensus on infant feeding
guidelines to prevent food allergy: outcomes from the Australian Infant
Feeding Summit. The Journal of Allergy and Clinical Immunology: In
Practice, 5(6), 1617ă1624.

Robertson, C. (2011). Safety, nutrition, and health in early education. New York,
NY: Cengage Learning Pearson.

Satter, E. (2011). Department of Community Health. Retrieved from:

http://www.michigan.gov/mdch/0,4612,7-132-2942_4910_4918-12543--
,00.html

Copyright © Open University Malaysia (OUM)

Topic   Menu Planning
and Food
8 Safety
LEARNING OUTCOMES
By the end of this topic, you should be able to:
1. Explain health problems due to bad eating habits;
2. Discuss food safety and hygiene; and
3. Plan a menu for an early childhood environment.

 INTRODUCTION
Planning a menu can be a challenge, but with the correct information you
can do it. Jean-Anthelme Brilatt-Savarin in The Physiology of Taste (2009) says,
„An intelligently planned feast is like a summing up of the whole world, where
each part is represented by its envoys.‰

Many questions come to mind such as what to include, how to make it interesting
and enjoyable for children. Do you know how to plan a healthy menu? In this
topic, we will explain health problems due to bad eating habits, discuss food safety
and hygiene and plan a menu for an early childhood environment.

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8.1 HEALTH PROBLEMS RELATED TO EATING

HABITS
Do you know that if you do not eat correctly and consume properly balanced
meals, you are hurting your health? Therefore, we need to make sure that what
you are eating is healthy. A healthy eating behaviour helps children in their
physical and psychological development (Gonzalez, 2010). The benefits for
children are that they will have energy and their bones and muscles will be well
developed. The opposite is also true if a child does not have a healthy diet, because
it can have a serious effect on a childÊs health. Let us look at some problems that
can occur if you do not eat healthily, according to Gonzalez (2010).

8.1.1 Factors Associated with Unhealthy Eating

Habits
In this subtopic, we will learn about several factors associated with unhealthy
eating habits. Unhealthy eating habits could have a physical or emotional
influence. The following are some factors associated with unhealthy eating habits.

(a) Overweight and Obesity

Practising healthy eating habits could help prevent and control these
problems.

(b) Malnutrition
Gonzalez (2010) states that not all problems are related to excessive food
intake. If a child does not get proper intake of a variety of food, for example,
fruits, vegetables, protein, fat and carbohydrates, it can lead to malnutrition.
This in turn can result in nutrient deficiency. What do you think is nutrient
deficiency? It occurs when a personÊs nutrient intake consistently falls
below the recommended requirement. This could have an impact on a
childÊs physical development and academic performance.

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(c) Emotional Health

Children who are overweight or obese are often teased and bullied. What do
you think will happen to them? They might have low self-esteem, become
depressed and lose interest in school. If a child is depressed, he or she might
lose interest in activities, sleep more or cry more than usual. It can also affect
the childÊs performance in school.

(d) Chronic Diseases

Low nutrition intake can lead to diseases, for example, Type 2 diabetes and
cardiovascular disease. How can this risk be lowered? Start with a diet that
is rich in fruits and vegetables. These are rich in fibre content which will
reduce the risk of cardiovascular disease and diabetes. A regular intake of
fruits and vegetables also helps in managing the weight of a child.

Other diseases that are related to unhealthy eating habits are:

(i) Malnutrition;

(ii) Kwashiorkor;

(iii) Night blindness and scurvy;

(iv) Anaemia and rickets;

(v) Obesity;

(vi) Diabetes and hypertension;

(vii) Anorexia nervosa; and

(viii) Bulimia nervosa.

It is important for us to have a balanced and healthy diet which covers all classes
of food. These classes of food include carbohydrate, protein, vitamin, fibre, water,
mineral and fat in the right amounts every day. Why is this important? Consuming
a diet with balanced nutrient intake is not only important to prevent and manage
chronic diseases, but also essential for children and adolescents to ensure their
healthy development (Lim, 2018). Table 8.1 gives a short explanation and some
examples of health problems related to nutrition and eating habits:

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Table 8.1: Eating Disorders Related to an Unhealthy Diet

Health Problems/Eating Disorders Description

Malnutrition Malnutrition is due to an unhealthy diet with
one or more groups of food missing or in
wrong quantities.

Kwashiorkor Caused by a severe lack of protein in the diet.

The signs of kwashiorkor are potbelly, dry
skin, loss of muscle tissue and low body
weight.

Scurvy Night blindness and scurvy are some

diseases related to malnutrition due to
vitamin deficiency.

Rickets Rickets and anaemia are caused by lack of

minerals and vitamins.

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Obesity Obesity occurs when a person eats

excessively until his food intake is more than
the daily energy requirements of his body.

Hypertension Hypertension and diabetes occur due to bad

eating habits such as excessive consumption
of food with high cholesterol as well as sweet
and salty food. This can lead to heart
diseases.

Anorexia and bulimia nervosa Anorexia nervosa refers to an eating disorder

characterised by self-starvation due to an
irrational fear of gaining weight.

Meanwhile, bulimia nervosa refers to an

eating disorder characterised by episodes of
binge eating (taking in a lot of food quickly)
followed by compensatory behaviour, most
commonly vomiting or purging.

Source: http://anjungsainssmkss.wordpress.com/2012/04/24/health-problems-related-
to-nutrition/

These are examples of unhealthy eating habits. What can be done to reduce them?
We will look at ways to develop healthy eating habits in the following subtopic.

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8.1.2 Developing Healthy Eating Habits

Healthy eating can stabilise childrenÊs energy, sharpen their minds and even
control their moods, according to Paul and Robinson (2010). They state that by
encouraging healthy eating habits in children, parents and caregivers can make a
huge impact on their lifelong relationship with food and give them the best
opportunity to grow into healthy and confident adults. Set the example and show
children that you are eating healthy. You should also remember that children
normally develop a natural preference for the food they enjoy the most. Paul and
Robinson (2010) further state that it is a challenge for children to make healthy
choices when it comes to choosing food that they should eat.

Paul and Robinson (2012) suggest the following tips for parents. These tips should
be shared with parents when a child is enrolled at a child care centre:

(a) Top Tips to Promote Healthy Childhood Eating

It is not always easy to encourage your children to eat a balanced diet. Here
are few tips to help them develop healthy habits at a young age.

(i) Have Regular Family Meals

Knowing dinner is served at approximately the same time every night
and that the entire family will be sitting down together is comforting
and enhances appetite.

(ii) Cook More Meals at Home

Eating home-cooked meals is healthier for the whole family and sets a
great example for children about the importance of food.

(iii) Get Children Involved

Children enjoy helping adults to shop for groceries, selecting what goes
in their lunch box and preparing dinner. It is also a chance for you to
teach them about the nutritional values of different foods, and for older
children to learn how to read food labels.

(iv) Make a Variety of Healthy Snacks Available Instead of Empty Calorie

Snacks
Keep plenty of fruits, vegetables, whole grain snacks and healthy
beverages (water, milk, pure fruit juice) around. Make the food easily
accessible so that children become used to reaching for healthy snacks
instead of empty calorie snacks like soda, chips and cookies.

(v) Limit Portion Sizes

Do not insist that your child cleans his or her plate and never use food
as a reward or bribe.
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(b) How Can I Get My Picky Child to Enjoy a Wider Variety of Food?
Remember in Topic 7 we discussed the autonomous toddler and how to
feed such a child? The picky eater is the same as the autonomous toddler.
Paul and Robinson (2010) said that picky eaters go through a normal
developmental stage, exerting control over their environment and expressing
concern about trusting the unfamiliar. They have various demands but, like
the autonomous toddler, we should repeatedly give them certain types of
food until they get used to them. Paul and Robinson (2010) compare this to
advertising consumer goods to adults. Numerous advertisements need to be
repeated to convince the adults to buy something.

Paul and Robinson (2010) suggest that we should try the following instead
of just insisting that a child should eat a new food:

(i) Offer a new food only when the child is hungry and rested;

(ii) Present only one new food at a time;

(iii) Make it fun ă present the food as a game, a play-filled experience. Or

cut the food into unusual shapes;

(iv) Serve new foods with favourite foods to increase acceptance;

(v) Eat the new food yourself, as children love to imitate;

(vi) Have your children help to prepare the food. Often, they will be more
willing to try something when they have helped to make it;

(vii) Limit beverages. Picky eaters often fill up on plain drinking water
instead; and

(viii) Limit snacks to two per day.

Well, let us pause for a while and do the next self-check to assess your
understanding of the part we have completed so far.

SELF-CHECK 8.1
1. Name and explain what type of health problems can occur in
relation to eating habits.

2. How can healthy eating habits be developed?

3. Give some tips to promote healthy eating.

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8.2 FOOD SAFETY AND HYGIENE

Protection and sanitation of food is a priority and essential for every early
childhood education programme (Martin & Oackley, 2008). Sanitation regulations
should be followed for:

(a) Storing;

(b) Transporting;

(c) Preparing; and

(d) Serving.

Other day-to-day regulations should be followed such as regular hand washing

and using the correct temperature for storing food. The question is, why is it so
important to protect food?

It is advised to have a food safety and sanitation policy. This will ensure that a
preschool adheres to the rules and regulations. The following safety and sanitation
procedures are adapted from the site https://childcare.extension.org/food-
safety-guidelines-for-child-care-programs/ titled Food Safety Guidelines for
Child Care Programs(August, 2019).

(a) Practise Good Personal Hygiene

(i) Wear clean clothes;

(ii) Wash hands regularly; and

(iii) Wear a hairnet at all times.

(b) Receive and Store Food Properly

(i) Storage facilities should be clean and available; and

(ii) Make sure food is not spoilt already when you receive it.

(c) Handle Food in a Safe and Sanitary Manner

(i) Ensure the surface is clean before food is prepared (hands are also
clean);

(ii) Separate the food;

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 TOPIC 8 MENU PLANNING AND FOOD SAFETY  97

(iii) Make sure food is cooked at the right temperature; and

(iv) Store cooked food in a cool place if it is not eaten immediately after it
has been prepared.

If these guidelines are not followed, food-borne diseases can develop and spread.
One example is salmonella or food poisoning.

SELF-CHECK 8.2
1. Explain the terms „food protection‰ and „sanitation‰.

2. Name three aspects that need to be considered, according to the

food and safety policy.

8.3 MENU PLANNING FOR EARLY

CHILDHOOD ENVIRONMENT
Do you know how to plan a menu for yourself? What will you include in the
menu? This will be your first question ă What to include? The guide, Healthy
Meals and Food for Healthy Kids (2012), suggests that meal planning is the best
way to ensure your family is eating nutritious quality food. We need to plan what
to include in a daily meal to ensure children eat healthy and grow properly.

Table 8.2 shows you a sample menu for a week, which can be used for a home or
centre. It is important to make purposeful decisions about the food you bring into
your home or centre and serve to your family or the children at the centre.

Table 8.2: Menu for Early Childhood Education

Day Breakfast Lunch Snack

Monday Pumpkin bread Leftover Easter Eggs Yoghurt pops
Orange juice Tropical fruit salad
Tuesday Almond butter Chicken rice Sandwiches
Strawberry toast Porridge Veggie sticks
Wednesday Oatmeal Chicken salad wrap Banana cakes
Thursday Banana pancake Chicken soup and rice Sandwiches
Friday Cereal Spaghetti Fruits

We will discuss aspects such as why plan a meal, meal planning methods and
simplifying meal planning.

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8.3.1 Why Meal Plan?

The reasons for meal planning are as the following (Healthy Meals and Food for
Healthy Kids, 2012):

(a) To Make Sure that Everyone Whom You Cook for is Getting Nutritious
Meals that Taste Good
For parents, it is obvious that they have to make sure their children get
enough nutrition so that they can grow into healthy, strong and disease-free
adults. At the preschool centre, we should adopt the same approach for the
children in our care. What do we want to achieve? We certainly want them
to develop healthy eating habits along the way so that they will make good
food choices on their own someday. The only way we can ensure that is by
providing healthy balanced meals.

(b) Planning Helps to Decrease the Amount of Money We Spend on Food

For a centre, we need to be extra careful about what we spend to ensure that
we have enough food for the month. Planning ensures that we know exactly
what we are going to make for meals, and we do not end up buying extra
ingredients that we will not use. Also, making seasonal recipes reduces costs
because we are buying things at a better price when they are in season.

(c) Planning Saves You Time, Effort and Stress

Knowing what we are going to make ahead of time allows us to prepare by
having the ingredients on hand, letting food thaw if needed and saving our
time.

Next, we will look at meal planning methods. These methods will help you plan
for a week, two weeks or a month.

8.3.2 Meal Planning Methods

There are a lot of different methods of meal planning. The following meal plan
methods are suggested by Healthy Meals and Food for Healthy Kids (2012):

(a) Weekly Method

(i) Begin by taking an inventory of ingredients you already have on hand.
(ii) Choose meals for each day of the week and make a shopping list that
reflects the ingredients needed to make these meals.
(iii) The next week, go through the same routine, plan out your shopping
for what you plan to make that week, and so on.

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 TOPIC 8 MENU PLANNING AND FOOD SAFETY  99

(b) Two-week Method

(i) Begin by taking an inventory of the staples in your pantry and freezer
food that you have at the centre. Do a large shopping trip at the
beginning of the month.

(ii) For the first week of the month, plan meals for that week and make a
shopping list that coincides with the meals you planned and what you
already have.

(iii) When you go to the store, buy what is on your list, but also look for
deals. If something is on sale, stock up to use that item later in the
month.

(iv) To plan your second week of the month, there is no shopping required.
Carefully plan meals with the supply of food that has been purchased
and plan your weekly meals around that food only.

(c) Monthly Method

(i) Choose 30 to 40 of your favourite recipes that you can rotate through.
You can add in a new recipe or make something twice if your family
really loves it, but generally you stick to your tried and true 30 recipes.

(ii) Take a brief inventory of staples and basic ingredients before you go
grocery shopping.

(iii) Start the month with a large shopping trip, buying anything that will
not go bad and perishable at least for one to two weeks. After that, just
refer to your meal plan and shop weekly for needed items.

8.3.3 Meal Planning – Tips and Sample

In this subtopic, we will talk about meal planning that is important for preschool
children. There are two common tips on meal planning that we will share with you
further in this subtopic. This subtopic also includes a sample daily menu for
preschool children which consists of all the nutrients that they need.

Meal Planning Tips

(a) Plan your meals accordingly. You will save money this way and also get the
most flavour from your food.

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100  TOPIC 8 MENU PLANNING AND FOOD SAFETY

(b) Make meals that can work together. Try to plan your meals so that you can
use leftover parts of one meal to supplement another meal.

These guidelines can be used together with information from previous topics. It is
important to include the main food groups in your daily menu. Look at the sample
daily menu shown in Table 8.3.

Table 8.3: Daily Menu

Breakfast Snack Lunch Snack

 1⁄2 cup milk  1⁄2 cup milk  1⁄2 cup milk  1 teaspoon
 1⁄2 cup cereal  1⁄2 cup fruits  1 sandwich ă peanut butter
such as melon, 2 slices whole with 1 slice
 4ă6 oz. or 1⁄2 whole wheat
cup banana or banana or wheat bread
berries with 1ă2 oz. of bread or
local fruits 5 crackers or
 1⁄2 cup yoghurt meat and
cheese, veggie string cheese or
and dressing (if slice fruits
needed) or
peanut butter
and jelly
 1⁄4 cup dark-
yellow or dark-
green vegetable

ACTIVITY 8.1

1. Based on what you have learnt, plan a menu for a day and another
for a week.

2. Share these menus with your coursemates and use them to draw
up a menu for a preschool.

 Health problems related to eating habits occur when we do not eat correctly
and have a proper balanced meal. It can affect our health.

 Children benefit when they eat a balanced meal because they will have energy
as well as healthy bones and muscles.

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 TOPIC 8 MENU PLANNING AND FOOD SAFETY  101

 Problems that can occur due to unhealthy eating habits are overweight and
obesity, malnutrition, kwashiorkor, night blindness, scurvy, anaemia and
rickets, diabetes and hypertension, anorexia and bulimia nervosa.

 Protection and sanitation of food is a priority and essential for every early
childhood programme. Sanitation regulations should be followed such as
storing, transporting, preparing and serving.

 Menu planning is important, even if it is only for yourself. There are three
reasons for planning a meal. Firstly to make sure everyone that you cook for is
getting nutritious meals that taste good. Secondly it helps to decrease the
amount of money we spend on food. Thirdly, planning saves time and effort,
and reduces stress.

Chronic diseases Healthy diet

Eating disorders Malnutrition
Eating habits Menu planning
Health problems Overweight/obesity

American Academy of Pediatrics. (2013). Retrieved from

http://www.healthychildren.org/English/ages-
stages/preschool/nutrition-fitness/pages/Sample-One-Day-Menu-for-a-
Preschooler

Brillat-Savarin, J. A. (2009). The physiology of taste: Or meditations on on

transcendental gastronomy. New York, NY: Random House.

Food Safety Guidelines for Child Care Programs. (15 August 2019). Retrieved from
http://www.scdhec.gov/health/mch/childcare/knowing.htm

Gonzalez, C. (2010). What health problems in children does eating healthy

prevent? Retrieved from http://www.livestrong.com/article/284311-what-
health-problems-in-children-does-eating-healthy-prevent/

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102  TOPIC 8 MENU PLANNING AND FOOD SAFETY

Healthy Meal Plans For Kids. (2012). Retrieved from

http://www.superhealthykids.com/healthy-meal-plans.php

Health Problems Related to Nutrition and Eating Habits. (2012). Retrieved from
http://anjungsainssmkss.wordpress.com/2012/04/24/health-problems-
related-to-nutrition/

Lim, S. (2018). Eating a Balanced Diet: A Healthy Life through a Balanced Diet in
the Age of Longevity. Journal of obesity & metabolic syndrome, 27(1), 39.

Martin, J., & Oakley, C. (2008). Managing child nutrition programmes: Leadership
for excellence (2nd ed.). Boston, MA: Jones and Bartlett Publishers, Inc.

Paul, M. W., & Robinson, L. (2012). Nutrition for children and teens, helping your
kids eat healthier. Retrieved from
http://www.helpguide.org/life/healthy_eating_children_teens.htm

Copyright © Open University Malaysia (OUM)

Topic   Current Issues:
Helping the
9 Abused and
Neglected
Child
LEARNING OUTCOMES
By the end of this topic, you should be able to:
1. Explain preventative measures to help an abused and neglected
child;
2. Explain the concept of intervention;
3. Explain reporting as a technique for helping the child; and
4. List down activities that can be used to help the child.

 INTRODUCTION
Desiderius Erasmus said, „Prevention is better than cure‰. Who is this man? He
was a Dutch Renaissance humanist, Catholic priest, social critic, teacher and
theologian. Erasmus was a classical scholar who wrote in a pure Latin style. In life,
however, it is not always possible to prevent something bad from happening but
if we can, we should. If abuse or neglect occurs, we should act or have activities
and techniques to help the abused and neglected child. In this topic, we will
explain preventative measures and intervention. We will discuss reporting
techniques and finally, list and explain activities to help the abused and neglected
child.

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104  TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD

9.1 PREVENTATIVE MEASURES

How can teachers offer preventative measures? Teachers can be screened for a
history of child maltreatment by the authority. After the screening, the employer
can make sure that the prospective employee conforms to licensing regulations. A
further suggestion would be to interview a person if there is any doubt. Safety of
children in care cannot be compromised. New employees should go through a
probationary period to be observed carefully, especially how they handle and
relate to children. What if they do not meet the standards of behaviour? This is
where your policy should be in place to terminate the employment of that person.

Another preventative measure is a proper teacher-child ratio. The following ratio

is taken from the United StatesÊ National Association for the Education of Young
Children (NAEYC) accreditation as suggested by Robertson (2010). You can use
these ratios as a guideline if your state does not have them.

(a) 1 teacher for 6ă8 infants;

(b) 1 teacher for 8ă12 toddlers;

(c) 1 teacher for 14ă20 preschoolers;

(d) 1 teacher for 16ă20 kindergartners; and

(e) 1 teacher for 20 primary school children.

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 TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD  105

Figure 9.1 shows sample interview questions to screen for potential of abuse by
teachers.

Figure 9.1: Sample interview questions to screen for abuse potential

Source: Robertson (2010)

Pre-service orientation and in-service training should also be given to teachers

about child maltreatment. The training should include:

(a) The definition of child maltreatment;

(b) The identification of signs of maltreatment;

(c) How to document and report child maltreatment;

(d) Understanding common behaviour signs and symptoms of child

maltreatment;

(e) Restrooms should have an open door policy so that the door remains open
to avoid privacy;

(f) Supervision should be provided at all times;

(g) The policy should discourage maltreatment, such as to avoid using physical
punishment; and

(h) Emotional maltreatment should be discouraged, especially the belittling of a

child.

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106  TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD

9.1.1 Prevent Accusations

Parents should be informed when they sign up their children at the centre that
there is a policy in place that covers child maltreatment (Robertson, 2010). All
maltreatment cases should be reported to avoid false accusations. All steps should
also be communicated to parents to prevent maltreatment from occurring in the
care situation. It is important to make sure parents understand the philosophy of
discipline, guidance and childcare as well as the policy about suspected childcare
abuse (Robertson, 2010).

The following measures are important to avoid accusations:

(a) Routine quick health checks on a daily basis;

(b) Observation for bruises, scratches or any other injury;

(c) If unexpected injuries or bruises are observed, the teacher should ask the
parents about it;

(d) A report of the bruise and explanation for it should be made and added to
the childÊs file (time, date, nature of injury);

(e) Documentation is the teacherÊs best defence;

(f) Daily discussions with parents are important;

(g) Visitors to childcare centres should sign in and out;

(h) Parents should indicate clearly who is allowed to pick up their child or
children at a centre; and

(i) Parents should be informed if a new substitute or volunteer is present for the
day or whether the child will be in their care.

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 TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD  107

Figure 9.2 shows a sample of an injury incident report.

Figure 9.2: A sample injury incident report

Source: Robertson (2010)

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108  TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD

ACTIVITY 9.1

Design your own incident report. Share it with your coursemates in the
myINSPIRE online forum.

SELF-CHECK 9.1
Pre-service and in-service training are needed for teachers and
caregivers. What aspects should be included in the training?

9.2 INTERVENTION IN CHILD ABUSE AND

NEGLECT SITUATION
Do you know what intervention is or how to intervene? According to DePanfils
(2006), intervention means to involve oneself in a situation so as to alter or hinder
an action or development.

The following key steps are necessary in the intervention process:

(a) Building a relationship with the family;

(b) Developing case and safety plans;

(c) Establishing clear and concrete goals;

(d) Targeting outcomes;

(e) Tracking family progress; and

(f) Analysing and evaluating family progress.

Let us discuss each intervention strategy separately.

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 TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD  109

9.2.1 Building a Relationship with the Family

When there is a good relationship with the family, trust can be established. This is
important because if a family believes their feelings and concerns are heard,
respected and considered, they are more likely to engage in planning and taking
the right steps to change behaviours and conditions which could lead to neglect. It
is important that case workers are prepared for the emotionally draining effect this
process can have on all parties involved.

9.2.2 Developing Case and Safety Plans

Interventions should be structured in such a way as to increase protective factors
or to decrease risk factors identified in the family assessment process. Case
workers should remember that flexibility is critical in designing case plans to leave
room for the familyÊs changing needs and resources. The following are purposes
of case planning (DePanfils, 2006):

(a) Identify strategies with the family that address the effects of neglect;

(b) Provide a clear and specific guidelines for changing behaviours and
conditions that influence risk; and

(c) Establish a benchmark to measure progress for achieving outcomes.

9.2.3 Establishing Clear and Concrete Goals

Family members should be involved in developing plans to maximise the chances
of improving family functioning and reducing the risk of neglect. All goals should
be concrete, measurable and achievable with continuous positive feedback to
ensure that the desired outcome is reached. The goals should also indicate positive
behaviours or conditions that will result from the change and not concentrate only
on reducing negative behaviours.

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110  TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD

The next step after goals have been identified is to break them down into small,
incremental tasks. Why tasks, you may ask. These tasks describe exactly what
the children, family and case worker will do and identify timeframes for
accomplishing each task. The important part here is that families should
understand exactly what is expected of them and what they can expect from the
case worker and other service providers, if there are any.

9.2.4 Targeting Outcomes

All outcomes should be targeted so that both the risks and effects of neglect are
reduced due to changes in the behaviours or conditions that contributed to it. The
outcomes should also address issues related to:

(a) The child (changes in behaviour, development, mental health, physical

health, peer relationships and education ă sample desired outcome would be
improved controlled behaviour such as managing anger or developmental
appropriateness and adjustment in areas of functioning);

(b) The parents and caregivers (mental and health functioning, problem-solving
ability, impulse control, substance abuse treatment and parenting skills ă
sample desired outcome would be improved child management skills such
as establishing and consistently following through with rules and limits for
children);

(c) The family system (issues such as roles and boundaries, communication
patterns and level of social support received ă the sample desired outcome
would be enhanced family maintenance and safety); and

(d) The environment (factors such as social isolation, housing issues or

neighbourhood safety ă the sample desired outcome would be utilising social
support).

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 TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD  111

9.2.5 Tracking Family Progress

Monitoring of family progress should begin early in the implementation phase and
continue throughout the entire life of the case. Why is this important? This is
important in order to monitor whether the targeted outcomes have been achieved.
The following steps can be followed:

(a) Review the Case Plan

All outcomes, goals and tasks should be written down to determine progress
towards reducing risk and treating the effects of maltreatment.

(b) Collect and Organise Information on Family Progress

Each contact with the child and family should focus on assessing the progress
being made to achieve established outcomes and reassess safety.

(c) Collect Information from All Service Providers

All referrals to specific service providers should clearly specify the number,
frequency and methods of reports expected. The case worker should ensure
the submission of reports and request meetings with service providers.

(d) Engage the Child and Family in Reviewing Progress

Use the plan as a framework for communication. The family should be asked
about their perceptions and progress.

(e) Measure Family Progress

The change should be measured during the evaluation of the family progress
on two levels. First, reassess the most critical factors. Secondly, evaluate
the extent to which specific outcomes have been accomplished by the case
worker and service provider.

(f) Document Family Progress

A thorough documentation is crucial to measure family progress. Why?
It is to measure family progress between initial assessment and the current
evaluation.

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112  TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD

9.2.6 Analysing and Evaluating Family Progress

The case worker should analyse progress to determine it and to make decisions on
further actions. The evaluation should address the following issues:

(a) Is the child safe?

(b) What changes have occurred in the factors contributing to the risk of neglect?

(c) What progress has been made towards achieving the case goals and
outcomes?

(d) How effective has the service been in achieving the case goals and outcomes?
The following specific questions should be considered:

(i) Have services been provided in a timely manner?

(ii) Has the family participated in services as scheduled?

(iii) Has the service provider developed rapport with the family?

(iv) Is there a need to alter the plan of service based on changes in the
family?

(e) What is the current level of risk in the family?

(f) Have the risk factors been reduced sufficiently to ensure protection of their
children and meet their developmental needs to close the case?

Now that we have discussed the key steps in intervention, I hope that by now you
understand the significance of intervention. It is also important to note that a
teacher should be able to identify when children or their parents are under stress,
as suggested by Robertson (2010). There should also be a good communicative
relationship between the teacher and the parents. Table 9.1 describes actions and
further steps that will be taken by teachers as their intervention strategies.

Copyright © Open University Malaysia (OUM)

 TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD  113

Table 9.1: Intervention Strategies

Teacher Action Further Step

Observe parents and child  Talking to parents may  Can inform parents that
over a period. relieve stress. there is outside help.
 Provide information  Children older than
regarding the stages of three can be taught
child development and preventative strategies
effective ways to and concepts (abuse,
discipline children. body parts and types of
touching).

SELF-CHECK 9.2
1. Define intervention in your own words.

2. List the key steps in the intervention process.

3. From the key steps that you have listed, choose any three and
discuss them shortly.

9.3 REPORTING INCIDENTS OF ABUSE AND

NEGLECT
Who should report maltreatment? If it is the teacher, then the reporting process
should be clear. The following can be seen as basic reporting steps:

(a) Making a phone call or written report:

(i) ChildÊs name;

(ii) Address;

(iii) Age; and

(iv) TeacherÊs name and address.

(b) Anonymity will be provided for the teacher.

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114  TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD

Maltreatment might not be reported due to reluctance on the teacherÊs part

(Robertson, 2010). This reluctance could be due to:

(a) The teacherÊs personal background;

(b) Lack of support from supervisory personnel;

(c) Family issues;

(d) The teacher may feel that parents will retaliate or pull their child from the
school; and

(e) The teacher may fear losing his or her job.

9.3.1 Protective Measures for Child Maltreatment

Protective measures such as recognition of maltreatment, documentation and
reporting provide teachers with the tools needed to protect children from
maltreatment. The teacher should be able to recognise the physical and
behavioural indicators of physical abuse, emotional abuse, sexual abuse and
neglect. The teacher should understand the procedures for documentation and
reporting maltreatment and know the practices and strategies that will offer care
to a maltreated child.

SELF-CHECK 9.3

1. Explain in short what information is needed in reporting a case of

abuse or neglect.

2. What factors could contribute to reluctance on a teacherÊs part in

reporting maltreatment?

Copyright © Open University Malaysia (OUM)

 TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD  115

9.4 ACTIVITIES TO HELP THE ABUSED CHILD

Adults can help children to feel good about themselves. This is really important
for children who have been victims of abuse and/or family violence.

The following subtopics discuss how we can help an abused child, as suggested
by Rimer and Prager (1998).

9.4.1 Help the Child Develop Positive Self-esteem

How can we help a child develop positive self-esteem? Abused children often have
poor self-esteem. Staff/caregivers can help to build a childÊs self-esteem by:

(a) Planning activities where success is built in (these activities should be based
on the childÊs age and development, and realistic expectations should be set);

(b) Giving positive reinforcement for accomplishments and desired behaviour;

(c) Displaying the childÊs accomplishments; and

(d) Reinforcing through discussion and activities that both women and men are
valued, respected and should never be controlled through violence.

9.4.2 Help the Child to Trust

Trust is important in any relationship and for an abused child, it should be given
attention. An abused child often feels betrayed and does not trust that the world
is safe. Staff/caregivers can help the child to develop trust again by:

(a) Establishing limits, routines, consistency and predictability;

(b) Showing love, affection and also respect for the child, who may need more
time before feeling comfortable with being touched;

(c) Allowing the child to be angry without fear of punishment; and

(d) Spending one-on-one time so that the child feels cared for and listened to.

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116  TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD

9.4.3 Help the Child to Identify and Express Emotions

Staff/caregivers can help a child who has been abused to show and understand
feelings that may have been hidden or punished in the past by:

(a) Naming emotions;

(b) Planning sensory and dramatic play activities;

(c) Providing books and other play materials that help the child to learn about
feelings;

(d) Showing the child healthy ways to express anger and solve problems without
hurting himself or others;

(e) Accepting a childÊs need to talk about fears, sadness and loss experienced
because of abuse; and

(f) Helping the child to gain control over the environment, since many children
who have experienced abuse and family violence had little or no control in
their environment.

9.4.4 Help the Child to Learn to Communicate

Children who have been abused may not have had opportunities for conversation
and sharing in a positive parenting relationship. Staff/caregivers can help the
child who has been abused to learn communication skills by:

(a) Speaking to the child calmly;

(b) Using a firm but kind tone when asking the child to do things or when
expressing disapproval;

(c) Giving the child the message that it is okay to ask questions and say how he
feels;

(d) Spending time talking and listening; and

(e) Planning activities that encourage language and listening skills.

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 TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD  117

9.4.5 Help the Child to Identify and Solve Problem

Situations
Many children who have been abused have learnt that problems are solved by
using violence. Staff/caregivers can help a child to learn positive ways to solve
problems by:

(a) Teaching the child that he has choices and how to pick the best choice;

(b) Using positive methods to guide the childÊs behaviour;

(c) Planning activities that require problem-solving; and

(d) Solving any conflicts that happen through non-violent methods and by role-
modelling calm and non-aggressive ways of dealing with anger.

9.4.6 Help the Child to Catch Up Developmentally

As a result of abuse, many children do not develop at a normal rate.
Staff/caregivers can help a child with developmental skills by:

(a) Planning activities that help the child to practise motor and language skills;

(b) Supporting positive relationships between the child and his friends; and

(c) Helping the child with schoolwork, with the advice from appropriate
professionals.

9.4.7 Help the Child to Develop a Safety Plan

A child who is in a situation where there is violence or fear of violence can be
encouraged to:

(a) Learn how to dial the emergency toll number (i.e. practise memorising the
phone number with the child; teach the child to leave the phone off the hook
until police arrive);

(b) Choose a neighbour he can go to for help; and

(c) Plan how to keep safe during a violent scene, for example, identify a safe spot
to hide, and do not try to stop a fight.

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118  TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD

9.4.8 Link Families to Community Support

Victims of abuse and violence need support to cope with stress and build healthy
relationships. Staff/caregivers can help by:

(a) Directing families to local community agencies which work with children
and families (e.g. shelters, legal aid, help lines, parenting groups); and

(b) Watching how children in their care are developing and reporting any
suspicions of abuse.

These activities should be used to help abused and neglected children. Let us
assess your progress and understanding through the last activity.

ACTIVITY 9.2

1. One of the activities to help the abused child is to help him or her
develop positive self-esteem. Name a few ways this can be done.

2. How will you help a child to build trust?

3. Explain how you can help a child to learn to communicate.

 Preventative measures should be in place at early childhood centres. One

measure is to screen prospective employees to ensure that they conform to
licensing regulations. Another preventative measure is a proper teacher-child
ratio.

 In-service orientation should be given to teachers on child maltreatment.

 Another preventative measure is high visibility.

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 TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD  119

 Intervention is to involve oneself in a situation to alter or hinder an action or

development. Steps in intervention can include relationship building, safety
plans, clear and concrete goals, and tracking family outcomes.

 Measures such as recognition of maltreatment, documentation and reporting

give teachers the tools needed to protect children from maltreatment. The
teacher should be able to recognise physical and behavioural indicators of
physical abuse, emotional abuse, sexual abuse and neglect ă all these should
be reported.

 Activities to help the abused and neglected child include helping the child to:

ă Develop a positive self-esteem;

ă Trust;

ă Identify and express emotions;

ă Learn to communicate;

ă Identify and solve problem situations;

ă Catch up developmentally; and

ă Develop a safety plan.

Child abused Prevention

Express emotions Reporting
Intervention Safety plan
Maltreatment Teacher-child ratio
Positive self-esteem Trust

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120  TOPIC 9 CURRENT ISSUES: HELPING THE ABUSED AND NEGLECTED CHILD

DePanfils, D. (2006). Child Neglect: A Guide for Prevention, Assessment, and

Intervention. Retrieved from
https://www.childwelfare.gov/pubs/usermanuals/neglect/neglect.pdf

Rimer, & Prager. (1998.) Adapted from Reaching Out: Working Together to
Identify and Respond to Child Victims of Abuse. Child Abuse Prevention
and Intervention. Helping the child who has been abused. Retrieved from:
http://www.boostforkids.org/Portals/1/Info%20Sheets/English/Info%20
Sheet%2011%20-%20Helping%20Children.pdf

Robertson, C. (2002). Safety, nutrition and health in early education. New York,
NY: Cengage Learning (Pearson).

Copyright © Open University Malaysia (OUM)

Topic   Educating
Parents on
10 Safety, Health
and Nutrition
LEARNING OUTCOMES
By the end of this topic, you should be able to:
1. Educate parents regarding safety, health and nutrition issues;

2. Apply techniques for sharing safety, health and nutrition

information; and

3. Explain how to utilise community resources.

 INTRODUCTION
Can we really educate parents about safety, health and nutrition? Yes, we can.
From a teacherÊs perspective, parents can be educated because they do not have
all the answers when it comes to the education of children and specifically
safety, health and nutrition. In this last topic, we will discuss educating parents
with regard to safety, health and nutrition. Secondly, we will discuss how to use
different techniques in sharing information with parents. The last part will deal
with utilising community resources.

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122  TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION

10.1 EDUCATE PARENTS ON SAFETY, HEALTH

AND NUTRITION
A healthy body often leads to positive effects on attitude, self-confidence, interest
and energy levels (Endres, Rockwell & Mense, 2003). Do you know how we can
achieve this in a family setting? A healthy lifestyle, which should include a
nutritious diet and regular physical activity, is essential. If this package is
complete, we can be sure that children will be able to perform their best. The family
plays a crucial role in ensuring that children form early habits about good nutrition
and daily exercise. In discussing about educating parents on health, nutrition and
safety, we will discuss each one separately.

10.1.1 Health Education for Parents

How do we educate parents on health? Is it not their responsibility to make sure
their child is getting and adopting a healthy lifestyle? I would say yes, but there is
more to it. Parents do not have all the answers.

Health promotion for families is important, according to a guide by Edelman,

Mandle and Kudzma (2013). They suggest using the help of a health promotion
nurse, who could assist the family in adopting behaviours that will promote better
emotional and physical health in children and later in adulthood. They used the
old saying, „An ounce of prevention is worth a pound of cure.‰ According to them,
if it is acted upon, it can be very effective in promoting an individualÊs health.

Health is largely a subjective judgement and each personÊs perception of health is

related to the following (Edelman et al., 2013):

(a) Physical and mental capabilities;

(b) Self-concept;

(c) Relationships with others and the environment; and

(d) Personal goals and values.

The nurse uses every opportunity to convey confidence in parentsÊ health

perception and health management pattern to improve their ability to implement
behaviours that promote health. Do you know why the nurse is using every
opportunity? When parents learn and adopt behaviours that improve their own
health, they will ensure that the needs of their children are met as well. It is a fact
that parental modelling increases the chances of good health practices throughout
a childÊs life.

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 TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION  123

Furthermore, if a nurse works with parents, the aim is to:

(a) Assist them in identifying health needs; and

(b) Develop problem-solving skills by using the familyÊs own resources.

How will the nurse be able to meet these goals? The nurse can identify the familyÊs
perception of good or bad health practices. This can be achieved by parentsÊ
participation in health promotion activities. The following factors play an
important role in the health perception of parents:

(a) Age;

(b) Gender;

(c) Educational level;

(d) Cultural orientation;

(e) Financial status; and

(f) Occupation.

The task of the nurse is also to support parents by strengthening their parental
confidence and self-esteem, providing information on meeting their childÊs needs,
and by reinforcing their health perception and management (Edelman et al., 2013).

10.1.2 Nutrition Education for Parents

When health is promoted, the most important aspect is the nutritional status
of the child. Child nutritional requirements are based on what is considered
necessary to:

(a) Support life;

(b) Provide for growth; and

(c) Maintain health.

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124  TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION

Let us look at a few aspects or facts that parents need to know about good
nutrition. First on the list is essential nutrients (Edelman et al., 2013).

(a) Essential Nutrients

Look at Figure 10.1 for essential nutrients.

Figure 10.1: A list of essential nutrients

Source: Edelman, Mandle & Kudzma (2013)

Parents should be made aware of these essential nutrients to ensure a healthy

child. How do we make parents aware of these essential nutrients?

(b) Nutritional Policy

Robertson (2012) suggests that nutritional policies be created for the early
childhood education environment. These policies should cover nutritional
guidelines and basic nutrition. The policies should also help teachers to
engage with families, follow standards and use education to help children
learn about the importance of good nutrition. These guidelines should be
given to parents since young children eat most of their meals at home. This
is another way of transferring nutritional information to parents. Get them
involved and let them make sure the childrenÊs needs are met.

(c) MyPlate Food System

By choosing Malaysian dietary guidelines dietary for children and
adolescents (Ministry of Health Malaysia, 2014) or MyPlate, parents can be
sensitised about nutritional standards (Robertson, 2012). The plate has been
designed to:

(i) Help people meet nutritional standards;

(ii) Make better food choices; and

(iii) Cut down excesses.

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 TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION  125

It should be noted that MyPlate is not designed for children but can be easily
adapted for them because of its ease of use. Before we go into further discussions,
let us look at Figure 10.2 which shows MyPlate.

Figure 10.2: Malaysian healthly plate

If you look at the entire MyPlate, the emphasis is on the consumption of:

(a) Fruits;

(b) Vegetables;

(c) Whole grains;

(d) Lean proteins; and

(e) Fat-free or low-dairy products.

Furthermore, parents can be encouraged to use the new system of determining

how to eat in a healthy manner:

(a) Balancing Calories

(i) Enjoy your food but eat less; and

(ii) Avoid oversized portions.

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126  TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION

(b) Foods to Increase

(i) Make half of your plate fruits and vegetables;

(ii) Make at least half of your grains whole grains; and

(iii) Switch to fat-free or whole milk.

(c) Foods to Reduce

(i) Compare sodium in foods like soup, bread and frozen meals ă choose
food with lower numbers; and

(ii) Drink water instead of sugary drinks.

If we can encourage parents to adopt this lifestyle, we are moving in the right
direction with regard to encouraging children to live a healthy lifestyle. Let us look
at safety education for parents next.

10.1.3 Safety Education for Parents

ChildrenÊs growth and development are continuous and influenced by their
environment. Their environment is not only the school, but mostly the home.
According to Marotz (2008), the growth of a child is enhanced through:

(a) Nurturing and responsive caregiving;

(b) Good nutrition;

(c) Homes and schools which are clean and safe;

(d) Access to appropriate dental and health care; and

(e) Communities that are free of drugs and violence.

For intellectual and psychological development, the following are essential:

(a) Opportunities for learning;

(b) Experiencing new challenges; and

(c) Positive social interaction.

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 TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION  127

By looking at all these aspects, we, including parents, should pay special attention
to a childÊs environment. Why? It is to create physical, cognitive and psychological
conditions that have positive effects on childrenÊs growth and development
(Marotz, 2008).

Let us pause for a while to assess your understanding of the part on educating
parents on health, nutrition and safety.

SELF-CHECK 10.1
1. According to Edelman et al. (2013), what is a personÊs perception of
health related to?

2. List the essential nutrients needed in any diet.

3. What is the aim of the MyPlate Food System?

10.2 TECHNIQUES FOR SHARING

INFORMATION WITH PARENTS
Do you know any techniques for sharing information with parents? The guide,
Child Care Aware (2013), states that families are a key element in all childcare
programmes. These programmes stress the importance of a positive relationship
with the family of each child in your care and this positive relationship should be
encouraged. The programmes also suggest that family involvement can include
regular communication, volunteering, serving as advocates for young childrenÊs
issues, serving on the programmesÊ parent board or advisory group, and getting
involved in the community. The list mentioned from these programmes will be
discussed separately.

10.2.1 Communication
Communication can also be sharing information with parents in different
ways. What do we share with parents? We share information with parents by
communicating with them. Parents should have access to your programmes
when their child is in your care. Child Care Aware (2013) suggests these ideas
to communicate well with parents:

(a) Encourage them to read your parentsÊ handbook so that they know your
policies.

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128  TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION

(b) Offer to have regular discussions with them so that you can discuss their
childrenÊs progress (see Figure 10.3).

Figure 10.3: A teacher discussing with a parent regarding

her childÊs progress in school.

(c) Provide information through a bulletin board, newsletter or website so that

they know what to expect.

(d) Prepare a brief „My Day‰ each day for them which describes what their child
experienced.

(e) Encourage them to share information about important events in their family.

(f) Ask them how they celebrate birthdays and holidays.

Remember, it is important that these ideas be communicated in good time with

parents. Next, we will look at volunteer opportunities.

10.2.2 Volunteer Opportunities

Instead of doing everything, you can get parents to get involve on voluntary basis
to assist at the centre. Many parents are eager to help in activities that involve their
children.

The following are examples of activities that parents to become involved in:

(a) Assist in a classroom activity regularly e.g. reading to children, cooking and
gardening;

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 TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION  129

(b) Be a driver or chaperone for field trips;

(c) Help with improvement projects like gardening;

(d) Plan special occasions (festivals, teacher recognition events, clean up days
and cultural events); and

(e) Visit the classroom to share specific information about special skills or family
traditions.

Remember that not all parents are trained caregivers or teachers. It is therefore
important that you provide your volunteers with training and supervision. Why
do you think this is important? You are still responsible for the safety and well-
being of all children in your care. Parents are there just to assist. They require clear
expectations about their duties, time commitment, budget and resources.

Again, you have to remember that if the volunteers work directly with children,
they need a complete background check for safety reasons. You also need to give
them information about appropriate and inappropriate discipline and techniques
for interacting with children. Next, let us look at committees and advisory boards.

10.2.3 Committees and Advisory Boards

Make sure that you stipulate clearly in the policy about committees and advisory
boards. This is another method of getting parents involved. Why? Parents bring
added value and voice to committees and advisory boards. The Child Care Aware
(2013) guide suggests the following ideas for committees and advisory boards:

(a) They can participate in parent committees in your programme;

(b) They can share their professional and personal knowledge in areas
appropriate to your programme (business, marketing, legal matters,
fundraising);

(c) They can participate in community initiatives or organisations as a

representative of your programme; and

(d) They can advocate for your programme to funders and politicians.

Finally, let us look at some resources for families.

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130  TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION

10.2.4 Resources for Families

What do you regard as resources for families? Child Care Aware (2013) states that
the information you share with families about their children and your programme
are the resources. The following are examples of communication with families
according to the Child Care Aware (2013) guide:

(a) Day-to-day information on childrenÊs activities and development;

(b) Regular conferences on childrenÊs progress;

(c) Events to showcase childrenÊs work;

(d) Newsletters and websites about activities, goals and fun ideas to try at home;

(e) Family education packets (information about sudden infant death syndrome,
communicable diseases, age-appropriate activities, why children bite and
how to discourage it, etc.);

(f) Information about parenting classes in the community; and

(g) Information about community events and resources.

These are just a few examples of resources that can be used to share information
with parents on health, nutrition and safety.

SELF-CHECK 10.2
1. List some ideas on how to communicate well with parents.

2. List techniques for sharing information with parents.

3. What type of activities can be regarded as volunteer activities for

parents?

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 TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION  131

10.3 UTILISING COMMUNITY RESOURCES

What are community resources? The guide, Child Welfare Information Gateway
(2013), explains that there are many factors beyond the parent-child relationship
that affect parentsÊ ability to care for their children. What do parents need to
support their children? They need basic resources such as:

(a) Food;

(b) Clothing;

(c) Housing;

(d) Transportation; and

(e) Access to essential services.

Some families may also need support connecting to social services such as alcohol
and drug treatment, domestic violence counselling and public benefits (Child
Welfare Information Gateway, 2013).

It is not always possible for families to provide for their children. The guide, Child
Welfare Information Gateway (2013), states clearly that providing or connecting
families to concrete support that families need is important and one way to help
families cope with stress and prevent situations where maltreatment could occur.
Let us look at some strategies for sharing resources and strengthening support.

10.3.1 Sharing Strategies and Resources to

Strengthen Concrete Support
As caregivers, we should share information and link parents to the right support.
Why do you think this is necessary? The guide, Child Welfare Information
Gateway (2013), explains that parents may not always know about community
resources that can help meet their basic needs or how to access essential services.
Can you still list the basic needs? If you are not sure, please go one page back and
refresh your memory. However, there are two barriers which prevent parents from
utilising community resources:

(a) Language barriers; and

(b) Cultural barriers.

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132  TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION

These barriers can make it difficult for some parents to identify services and make
the necessary contacts.

What can we do to help? We can provide information and connections to concrete

support. Make sure you include contact information such as a personÊs name. You
can also help parents make the initial calls or appointments, depending on what
they say they need (Child Welfare Information Gateway, 2013).

It is not always possible for a community to have all the services needed. If a
service is not available in your community, you can work with parents or
community leaders to help establish them. In that way, parents can become
powerful advocates for a particular cause, such as:

(a) Low-cost after-school programmes; or

(b) Safe transportation for teenagers (forming groups and creating services can
be possible options).

You as a caregiver can be very instrumental and your expertise may be most
helpful in the following ways:

(a) Linking Families with Services

Table 10.1 provides examples of parentsÊ situations and the solutions.

Table 10.1: Examples of ParentsÊ Situations and Solutions to Them

Example Your Role as Caregiver

Parents may not be aware of services You can let them know about all
that could help. available resources, so that they may
select what is most appropriate for
their needs.
Parents are more likely to use culturally If you can link them with a service
appropriate services. provider who speaks their language or
comes from a similar background,
parents may feel more comfortable and
experience greater benefit.
Parents with many needs may A „systems of care‰ approach may be
be overwhelmed by the different most useful, in which different helping
requirements for accessing various systems work together to support the
services. family.

Source: Child Welfare Information Gateway (2013)

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 TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION  133

(b) Building Community Services

(i) Linking parents with community leaders and others to organise

support, advocacy and consulting groups gives parents the
opportunity to use their experience to help others.

(ii) Parents who go public with their need or cause usually find that they
are not alone. The fact that a parent is willing to publicise a need or
cause may mobilise the community.

(iii) Parents who are new to advocacy may need help connecting with the
media, businesses, funding and other parts of the community to have
their needs heard and to identify solutions (Child Welfare Information
Gateway, 2013).

SELF-CHECK 10.3
1. What are community resources?

2. Explain in short what are the basic resources that parents need to
support their children.

3. How can parents be linked with services? Explain.

 In educating parents on health, nutrition and safety, it is important to note

that a healthy body often leads to positive effects on attitude, self-confidence,
interest and energy levels.

 Health education for parents can be made easier through the help of a health
nurse. A nurse could assist the family in changing behaviours to produce better
emotional and physical health in their children.

 A health promotion nurse works with parents with the aim of:

ă Assisting them in identifying health needs;

ă Developing problem-solving skills by using the familyÊs own resources;

and

ă Providing nutrition education for parents-child nutritional requirements

are based on what is considered necessary to support life, provide for
growth and maintain health.
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134  TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION

 The essential nutrients are: water, proteins, fats, carbohydrates, vitamins and
minerals.

 The MyPlate Food System was designed to:

ă Help people meet nutritional standards;

ă Make better food choices; and

ă Cut down excesses.

 Safety education for parents ă The safety and growth of a child is enhanced
through:

ă Nurturing and responsive caregiving;

ă Good nutrition;

ă Homes and schools that are clean and safe;

ă Access to appropriate dental and health care; and

ă Communities that are free of drugs and violence.

 Communication can involve sharing information with parents in different

ways. Get them to volunteer at the centre and become involved in committees
and advisory boards.

 Community resources can help families meet their basic needs or teach them
how to access essential services. However, there can be language or cultural
barriers.

Essential nutrients Nutritious diet

Healthy lifestyle Resources for families
Information sharing

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 TOPIC 10 EDUCATING PARENTS ON SAFETY, HEALTH AND NUTRITION  135

Child Care Aware. (2013). A program of child care aware of America, U.S.
Department of Health & Human Services.
Retrieved from: http://childcareaware.org/child-care-providers/program-
planning/family-involvement

Child Welfare Information Gateway. (2013). Protecting children, strengthening

families, U.S. Department of Health & Human Services. Retrieve from
https://www.childwelfare.gov/preventing/preventionmonth/factors.cfm

Edelman, C. L., Mandle, C. L., & Kudzma, E. C. (2014). Health promotion

throughout the life span (8th ed.). Canada, Ontario: Elsevier.

Endres, J., Rockwell, R., & Mense, C. G. (2003). Food, nutrition, and the young
child. New York, NY: Pearson.

Marotz, L. (2008). Health, safety and nutrition for the young child. New York, NY:
Cengage Learning.

Ministry of Health Malaysia. (2014). Malaysian dietary: Guidelines dietary for

children and adolescents. Kuala Lumpur, Malaysia: Nutrition Division.

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