Physical & Motor Development
Physical Health & Well-Being
Core Finding: PM-PHL-C02

The reading of infant’s cues such as crying can be addressed in parent education. Effective intervention programmes are the key to good physical health and well-being for both child and caregiver.

EFFECTIVE INTERVENTION PROGRAMMES IS THE KEY TO GOOD PHYSICAL HEALTH AND WELL-BEING FOR BOTH CHILD AND CAREGIVER

Crying can be very stressful for parents and caregivers. Studies have shown that crying, one of the self-regulation issues, was associated with negative behavioural outcomes in early and middle childhood.

However, it is uncertain whether these problems predict
dysregulated behaviour

Dysregulation - Also known as emotional dysregulation, refers to a poor ability to manage emotional responses or to keep them within an acceptable range of typical emotional reactions. This can refer to a wide range of emotions including sadness, anger, irritability, and frustration.

across childhood.

Researchers addressed this gap in the literature using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Regulatory problems at 6, 15-18 and 24-30 months and childhood dysregulated behaviour were assessed at 4, 7, 8 and 9.5 years. The analysis indicated that the predictability of childhood dysregulated behaviour was stable over time. Findings suggest that regulatory problems in infants and toddlers predict dysregulated behaviour across childhoods. Interventions for early regulatory problems could help prevent the development of chronic, dysregulated behaviour.

Another common concern is biting, a typical, frequent developmental phenomenon in toddlers, much like temper tantrums and separation anxiety. Biting injuries in early childhood settings are common.

Researchers estimate that one out of 10 toddlers is prone to biting.
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  1. Wien, C. A. (2004). From policing to participation: Overturning the rules and creating amiable classrooms. Beyond the Journal. Retrieved from: www.journal.naeyc.org/btj/200401/wien.asp.
35 to 51 per cent of all injuries in childcare centres are due to biting incidents.
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  1. Strauman, R. K., Lie, L., & Kempf, B. J. (1993). Creating a safe environment for children in day care. Journal of School Health, 63, 254–57.
Teachers often observe that biting occurs more frequently when children experience stress, such as changes in their environment or a lack of adult attention.
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  1. Claffey, A. E., Kucharski, L. J., & R. R. Gratz. (1994). Managing the biting child. Early Child Development and Care, 99, 93-101.

Biting may occur when children are at a significant stage of development, such as learning to walk and falling more often, or learning to talk and feeling frustrated in their attempts to communicate. When children learn and transition from one feeding level to the next, they tend to bite more often. For example, infants are ready for pureed and solid food when they start biting during breastfeeding. Biting other children can become a form of active stimulation during certain time interval or activity.

Recognising the link between behaviour and senses provides insights into how to address biting and children's sensory and developmental needs. It is recommended that toddlers be offered food with various textures and be provided with appropriate objects to chew to prevent biting related to sensory needs.

There are various foods that provide sensory stimulation (sucking, munching, crunching, chewing) and specific food types depending on the growth stages and the children's feeding skill level.

Well-being is linked to children's need to form positive relationships with parents and other caregivers during daily routines such as diapering. Tuning in to the uniqueness of a child's individuality during diapering by responding with sensitivity, encouragement in an unhurried manner sends a powerful message to the children about their bodily functions.

Crucially, the key message that the caregiver sends is that they enjoy being with the child, forming trust and attachment between them.

A researcher paper highlights how diapering can foster high-quality caregiver-child interactions and its associations with child well-being and involvement. The author explores how missed opportunities during diapering can be transformed from a rushed routine into an opportunity to enhance child well-being and involvement. When infants and toddlers have opportunities to investigate and explore the things that interest them and practise and refine emerging skills and understanding, new skills, abilities, and understandings emerge, including increasing autonomy and responsibility for their own actions.

Infants and toddlers learn through play and active exploration of their environment, as well as through interactions with the significant adults in their lives. The quality of babies' early learning experiences at home and in other care settings has a lasting impact on their preparedness for lifelong learning and success.

Play activities from birth to 3 months old that can be beneficial for cognitive growth include observing the babies track caregivers as they move around the room.

Additionally, giving babies opportunities to shift gaze between two objects so that they can focus their attention and vision on objects they find interesting.

Besides play and interactions, consistent caregiving routines should be emphasised to meet the needs of the baby. Despite the importance of early learning at home, surprisingly few parents report engaging in daily reading or singing with their babies, interactions that are closely related to children's language development.
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  1. Keating, K. (2019). Examining the Well-Being of America’s Babies. Zero to Three, 39(5), 58–64.

These low rates of language interaction, particularly for reading, suggest that many parents and other caregivers may not understand that children begin acquiring language skills from birth and that they are not too young to enjoy books with those who nurture them.

Parents and caregivers who are not aware of children's development may turn to screen time to engage the baby instead. Researchers examined the sociodemographic and behavioural predictors of total and device-specific screen viewing time (SVT) in a Singaporean cohort.

At ages 2 and 3 years, SVT of 910 children was reported by their parents. Interviewer-administered questionnaires assessed SVT on weekdays and weekends for television, computer, and hand-held devices. Multivariable linear mixed-effect models were used to examine total and device-specific SVT associations at ages 2 and 3 with predictors, including children's sex, ethnicity, birth order, family income, and parental age, education, BMI, and television viewing time.

Results showed that at age 2, children's total SVT averaged one to five hours per day. At age 3, hand-held device SVT was twenty minutes higher, while no increases were observed for other devices. Compared to Chinese children, Malay and Indian children spent 1 hour and 32 minutes watching screens, respectively. Other predictors of longer SVT were younger maternal age, lower maternal education, and longer parental television time.

Higher screen viewing time (SVT) in childhood has been associated with adverse health outcomes. In a 2019 study, researchers found that greater screen-viewing at age 2-3 years was associated with later childhood obesity at 3-5 years in boys, but not in girls.

Gender-specific analyses showed significant associations with both BMI and sum of skinfold thicknesses in boys, but not in girls. There were increases in average BMI per hour increase in daily total, television, and handheld-devices screen-viewing among boys. The corresponding increases in the mean sum of skinfold thicknesses were also observed. These findings may have important public health implications considering the increasing use of screen devices and cardiometabolic risk in young children.

Through reading aloud and play, positive parenting has a positive effect on the socioemotional competencies in toddlers. Researchers analysed socio-emotional outcomes from 14 to 36 months children in three groups made of Video Interaction Project, Building Blocks and the control group.

The randomised controlled trial study was to determine the effects of paediatric primary care abstract interventions on the socio-emotional development of toddlers from low-income, primarily immigrant households.

Mother-newborn dyads were enrolled postpartum in an urban public hospital. In Video Interaction Project, dyads met with an interventionist on days of well-child visits. The interventionist facilitated interactions in play and shared reading by providing learning materials and reviewing videotaped parent-child interactions. In Building Blocks, parents were mailed parenting pamphlets and learning materials. Researchers found that children in the Video Interaction Project group scored higher on imitation/play and attention, and lower on separation distress, hyperactivity, and externalising problems.

Children in the Building Blocks intervention group made greater gains in imitation/play compared with control. This study adds to the burgeoning evidence of the effectiveness of a range of interventions directed at families of very young children to increase their efficacy in parenting.

Interventions could help prevent the development of chronic, highly dysregulated behaviour. Supporting parents and caregivers on the importance of quality caregiving is essential for positive effects in the overall development of infants and toddlers.

Researchers report effects from a randomised trial of a high-quality centre-based early intervention on infants and toddlers in two communities in northern Colombia.

Just eight months into the programme, results indicate large positive effects on language, cognitive development and overall development. A pair of researchers also found that their intervention programme, Parents Interacting With Infants (PIWI), has helped parents increase their parental capacity to understand their child's cues and preferences and the importance of relationships and play in supporting their child's development.
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  1. Nenide, L., & Sontoski, S. (2014). Breaking the Cycle: Supporting Parent–Child Relationships Through the “Parents Interacting with Infants” Intervention. Zero to Three, 34(6), 31–36.
PIWI is designed to support parents in developing their capacity to create positive, sensitive and engaging interactions with their infants and toddlers.
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  1. Nenide, L., & Sontoski, S. (2014). Breaking the Cycle: Supporting Parent–Child Relationships Through the “Parents Interacting with Infants” Intervention. Zero to Three, 34(6), 31–36.