Source: The following summary is wholly based on the article by Betsy Thigpen (Western Kentucky University) called, Outdoor Play: Combating Sedentary Lifestyles which was published in the ZERO TO THREE publication September 2007. Any additions to the original article by Thigpen are noted with an asterisk.

The Trend Toward Less Active Children Results in Health Consequences

In the U.S., play has become less valued, with a focus instead on cognitive and preliteracy skills. Even during the infant and toddler years, cognitive and preliteracy skills are stressed over physical development. This lack of physical activity directly relates to unhealthy sedentary lifestyles (*see this updated source, for example: https://medlineplus.gov/healthrisksofaninactivelifestyle.html). Despite the benefits children receive when they move and play, they are often limited or denied physical activity in home and child care environments. Adults frequently caution children to move less; for example, telling them to sit quietly without making movement, to slow their fast pace, and not to run. Child care programs that do not keep children active often also offer few chances for children to play outdoors. And, after a long day at work, parents may also have little opportunity to play with their children.

Many factors are responsible for the retreat from earlier times when more children participated in unstructured play outdoors to more and more children spending time indoors. Two such factors include parent’s safety concerns, and children’s increasing involvement in structured activities. Some people are now concerned about the negative social and emotional effects that occur in children when they spend less time playing and interacting with peers and others outdoors.

Spending time indoors with little open space for physical activity results in more sedentary children. And in turn, these children then face the consequences of being overweight or obese as well as other concerning health issues. Making the problem of inactivity even worse are poor practices that include and overuse contraptions that restrain children for long periods of time such as: infant seats, swings, bouncy chairs, *walkers, etc. For example, rather than allowing toddlers to use their muscles to walk and run, caregivers may transport children ‘on a walk’ in a wagon or buggy.

Making the Case for Going Outside

Spending time in the great outdoors allows children to explore and learn about the natural world. As they spend time outdoors, very young children can exercise their sense of smell, hear new sounds, see the natural world, and touch new and interesting textures. Children are more likely to play more energetically when outdoors, thus fortifying their muscles, hearts, and lungs.

Opportunities for Physical Activity in Child Care Are Often Lacking

Millions of children in the U.S. spend more than 35 hours weekly in child care, much of that time spent inactive * see, for example, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3258280/. However, given this large amount of time that children spend in child care centers, these centers can realize the great opportunity they have to address sedentary behaviors. Child care centers can present children with opportunities to improve health outcomes. 

SHAPE America (Society of Health and Physical Educators, formerly National Association for Sport and Physical Education) provide guidelines for children from birth to five:

SHAPE America Guidelines for Infants

1: Infants should interact with caregivers in daily physical activities that are dedicated to exploring movement and the environment.

2: Caregivers should place infants in settings that encourage and stimulate movement experiences and active play for short periods of time several times a day.

3: Infants' physical activity should promote skill development in movement.

4: Infants should be placed in an environment that meets or exceeds recommended safety standards for performing large-muscle activities.

5: Those in charge of infants' well-being are responsible for understanding the importance of physical activity and should promote movement skills by providing opportunities for structured and unstructured physical activity

SHAPE America Guidelines for Toddlers

1: Toddlers should engage in a total of at least 30 minutes of structured physical activity each day.

2: Toddlers should engage in at least 60 minutes -- and up to several hours -- per day of unstructured physical activity and should not be sedentary for more than 60 minutes at a time, except when sleeping.

3: Toddlers should be given ample opportunities to develop movement skills that will serve as the building blocks for future motor skillfulness and physical activity.

4: Toddlers should have access to indoor and outdoor areas that meet or exceed recommended safety standards for performing large-muscle activities.

5: Those in charge of toddlers' well-being are responsible for understanding the importance of physical activity and promoting movement skills by providing opportunities for structured and unstructured physical activity and movement experiences.

Outdoor Environments

Caregivers often do not realize that spending time outside benefits infants and toddlers as much as it benefits older children. However, often when young infants and toddlers are taken outside, the outdoor environments are lacking; they are not comfortable or interesting, and the outdoor environments do not challenge them sufficiently to encourage their physical development.

Outdoor areas for infants and toddlers should:

• Take into consideration all stages of infants’ and toddlers’ physical development including spaces for young babies, crawlers, new walkers, and climbers
• Include soft surfaces to land
• Not contain any choking hazards
• Contain a safe space for exploration
• Provide an area to play with peers
• Contain a comfortable place for adults to sit

Unfortunately, often outdoor spaces for this age group are uninspired, and do not integrate the natural world into the environment. For example, often infant and toddler children only have access to a smooth rubber mat. Adding to the problem, there is little guidance about how to effectively design outdoor spaces for early child care centers. Nor is there much information for caregivers or parents on the topic of outdoor activities.

Enhancing Outdoor Play Areas While it can be expensive to redesign a child care program to enhance outdoor play environments, these easy and cost-effective changes can have an impact: · Add a diaper changing table to your outdoor play area so that caregivers can attend to diapering needs without a break in outdoor play · In a shady area, add a porch swing or hammock to give caregivers a perfect setting to feed and nurture infants · Encourage gross and fine motor development with engaging sand and water activities. For example, use slices of logs, large pebbles, and places to hang shovels, pails, and other items in an outdoor play area · Create a natural habitat with plants (for example, butterfly bushes) or bird feeders to engage children in the outdoors and learn about the creatures in the natural world · Hang wind chimes or mobiles to engage the eyes and ears

The National Association for the Education of Young Children (NAEYC) does give some ideas about outdoor activities in their certification standards:

https://www.naeyc.org/sites/default/files/globally-shared/downloads/PDFs/accreditation/early-learning/standards_assessment_2019.pdf

For playground safety, consult:

• Consumer Product Safety Commission https://www.cpsc.gov/FAQ/Playground-Equipment
• National Program for Playground Safety https://www.playgroundsafety.org/
• National Resource Center for Health and Safety in Child Care and Early Education https://nrckids.org
• Your state child care licensing regulations, local building codes, and other applicable regulations 

Safety concerns notwithstanding, it is incredibly important to understand how developmental skills are different among children younger and older than 3. These developmental differences necessitate that the following considerations be made for the younger than 3 age group: different outdoor equipment, and different kinds of experiences and activities. 

The Community Investment Collaborative for Kids Resource Guide (Pardee, Gillman, & Larson, 2005) offers these recommendations for the younger than 3 age group:

• Places to spend time eating or relaxing outdoors in shaded areas;
• Easy access to diapering area and handwashing;
• Safe areas to crawl in, for example in grass, or other safety surface (such as Trex);
• Strong ledges or railings at a height of 14–16 inches for mobile infants to pull up to stand;
• A non-metal slide with a gentle angle that can be approached by a low climbing ramp with steps and a handrail;
• Bucket swings positioned far enough from other play to avoid injury;
• Short tunnels and areas to play peek-a-boo places;
• Seating at different heights;
• Rocking toys that have room for children to sit inside;
• Push toys or riding wheeled toys; and
• Safe area to explore and play with water and sand and toys to help explore these elements (funnels, cups)

(Pardee et al., 2005, p. 13 )

The Built Environment

The built environment refers to any area which has been acted on by humans, including buildings, spaces, products, and, for example, playgrounds. Researchers have shown a strong connection between time spent outdoors and increased physical activity and fitness in children. Outdoor environments that are well designed can influence a child’s interest in that environment and the activities that take place there. Understanding the relationship between built environments and obesity requires community collaboration. View the website of the Natural Learning Initiative (NLI) at North Carolina State University to see well-designed outdoor learning environments: https://naturalearning.org/programs-projects/. You can also find recommended readings, links to other well-designed built environments, and other resources on topics related to the importance of children participating outdoors in nature.

Conclusion

Early prevention helps prevent children from becoming overweight and obese. To achieve this goal, environments that encourage active, unrestricted free movement are required, not optional. Suggested recommendations for community collaboration include:

• Parents and caregivers balance time spent indoors with time outdoors, and give infants and toddlers with many chances to move their bodies
• Pediatricians coordinate with parents about the importance of healthy choices including physical activity and selecting proper foods to eat
• Child care centers, especially new and future ones, can incorporate “built environment” concepts into the design of their centers
• Existing child care centers can start the process to naturalize their play areas, and use their outdoor environments more for learning and development, they can work to substantially increase time and activity spent outside, and help teachers and caregivers learn how to better use outdoor play areas, incorporating these areas into the curriculum
• State licensure agencies could understand the restrictions imposed on child care centers either by regulations or by the interpretation of regulations.
• Architects and landscape designers who design child care centers could become well-informed about the needs of young children and how important the interaction of their designs are on young children’s unrestricted movement and physical activity.
• Society in general, especially in the U.S.A. could be more understanding of the well-documented needs of infants and toddlers to move, be mobile, and engage in free play, not only on playgrounds and backyards, but also in public venues.

Cited Resources for More Information:

National Institute of Building Sciences: http://www.ncef.org

Community Investment Collaborative for Kids Resource Guide 4 Creating Playgrounds for Early Childhood Facilities: http://www.lisc.org/media/filer_public/c6/c8/c6c8b045-d3c9-46ad-ab6d-65d6b807a666/2005_cick_guide_vol4_playgrounds.pdf

U.S. Consumer Product Safety Commission’s Handbook for Public Playground Safety: https://www.cpsc.gov/s3fs-public/325.pdf

National Program for Playground Safety: https://www.playgroundsafety.org

The Natural Learning Initiative: https://naturalearning.org

Sources cited in original article by Betsy Thigpen:

League, C. A., & Dearry, A. (2004). Obesity and the built environment: Improving public health through community design. Reasearch Triangle Park, NC: National Institute of Environmental Health Sciences/National Institute of Health.

Moore, R., & Cosco, N. (in press). Baseline survey of environmental conditions of outdoor areas in North Carolina childcare centers. Raleigh, NC: Natural Learning Initiative.

Moore, L., Di Gao, A., Bradlee, L., Cupples, A., Sundarajan-Ramamurti, A., Proctor, M., (2003). Does early physical activity predict body fat change throughout childhood? Preventive Medicine, 37, 10–17.

National Association of Child Care Resource and Referral Agencies. (2007). Child care in America fact sheet. 

National Association for the Education of Young Children. (2007). NAEYC accreditation criteria for physical environment standard. 

National Association for Sport and Physical Education. (2002). Active start: A statement of physical activity guidelines for children birth to five years. Reston, VA: Author.

Natural Learning Initiative. (n.d.) Purpose. 

Pardee, M., Gillman, A., & Larson, C. (2005). Community investment collaborative for kids, resource guide 4: Creating playgrounds for early childhood facilities. New York: Local Initiatives Support Corporation.

Pate, R., Pfeiffer, K. A., Trost, S.G., Ziegler, P., & Dowda, M. (2004). Physical activity among children attending preschools. Pediatrics, 114, 1258–1263.

World Health Organization. (2007). Sedentary lifestyle: A global public health problem. 

The summary above is wholly based on this source: Thigpen, B. (2007, September). Outdoor Play: Combating Sedentary Lifestyles. ZERO TO THREE.

Other Resources

Garvin TM, Weissenburger-Moser Boyd L, Chiappone A, Blaser C, Story M, Gertel-Rosenberg A, et al. Multisector Approach to Improve Healthy Eating and Physical Activity Policies and Practices in Early Care and Education Programs: The National Early Care and Education Learning Collaboratives Project, 2013–2017. Prev Chronic Dis 2019;16:180582. DOI: http://dx.doi.org/10.5888/pcd16.180582