2016 Childhood Obesity Strategy – A Plan for Action in Every Sense!

 By Sue Heron - Head of Training Tatty Bumpkin Ltd and Paediatric Physiotherapist 

The government has now published its long awaited obesity strategy. 

https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action

The plan has been critised for lacking the original scope. Dr Wollaston, chairwoman of the health select committee, comments that its "really disappointing" that "whole sections from the original draft have been dropped", including measures on advertising junk food to children and on promotions such as two-for-one deals.

However, the document does support the need for children to have effective, high quality activity opportunities. 

History – The Need 

• Nearly 30% of children aged 2-15 years are overweight or obese
• Younger generations are becoming obese at earlier ages and staying obese for longer

• Reducing obesity levels will save lives as obesity doubles the risk of dying early. If you are obese as an adult you are 7x more likely to become a type 2 diabetic than adults of a healthy weight and will be more likely to suffer from heart conditions and even depression. 

4 Activity Aims of the Obesity Strategy - Helping children be Bendy, Giggly, Clever and Strong!

1. All Children to Enjoy an Hour of Physical Activity Every Day 

CMO Guidelines for Children aged 5-18 years

• The government acknowledges that there is strong evidence that regular physical activity is associated with numerous health benefits for children. The UK Chief Medical Officers’ recommend that all children and young people should engage in moderate to vigorous intensity physical activity for at least 60 minutes every day

• Every school child should get at least 60 minutes of moderate to vigorous physical activity a day (UK Chief Medical Officer's Guidelines). 
• 30 mins should be delivered in school through active break times, PE, extra-curricular clubs, active lessons, or other sport and physical activity events,
• 30 minutes should be completed outside of school time 

• A healthy schools rating scheme. During inspections, Ofsted will assess how effectively schools use the Primary PE and Sport Premium funding and measure its impact on outcomes for pupils 

• Public Health England (PHE) to develop advice to schools for the academic year 2017/18. This will set out how schools can work with the school nurses, health centres, healthy weight teams in local authorities and other resources, to help children develop a healthier lifestyle.
• Interactive online tool will be made available to help schools plan at least 30 minutes of physical activity for their pupils every day

2. Improved Co-ordination of Quality Sport/Physical Activity Programmes for Schools

• From September 2017, every primary school in England should have access to a coordinated offer of high quality sport and physical activity programmes, both local and national. To achieve this aim, the Government has asked the 'County Sports Partnerships' to work with National Governing Bodies of sport, the Youth Sport Trust and other national and local providers
  
• Supporting parents and carers. 'The Sport England Strategy' includes an investment of £40m for projects which offer new opportunities for families and children to get active and play sport together. This investment will focus on helping children acquire a basic level of competence in sport and physical activity as well as supporting them to have fun, regardless of their level of ability. 

Tatty Bumpkin - encouraging EVERYONE to move!

• Walking or cycling to school provides a healthy way to start the day. The Government will continue invest in these schemes and has committed to producing a 'Cycling and Walking Investment Strategy'. The first strategy will set out plans for investing £300m to support cycling and walking. It will set a clear target to increase the number of children walking to school as well as continued support for Bikeability cycle training for children.

3. Creation of a Healthy Rating Scheme for Primary Schools 

• From September 2017, the Government will introduce a voluntary healthy rating scheme for primary schools. This scheme aims to recognise and encourage their contribution to preventing obesity by helping children to eat better and move more
  
• The scheme will help primary schools to demonstrate to parents that they are taking evidence-based actions to improve their pupils’ health
  
• The government will actively seek to involve parents in the rating process so they can be confident their children are attending schools which provide healthy food and opportunities for physical activity
  
• An annual competition will be created to recognise schools with the most innovative and impactful projects which tackle obesity amongst their pupils
  
• In 2017, Ofsted will undertake a 'thematic review on obesity, healthy eating and physical activity in schools.' This will provide examples of good practice and recommendations on what more schools can do in this area

Activity comes in many forms - it should be fun and inspiring!

4. Support for Early Years Settings 

• The Government acknowledges that the early years are a crucial time for children’s development
  
• 20% of children are overweight or obese before they start school and only one in ten children aged two to four meets the UK Chief Medical Officers’ physical activity guidelines for this age group

CMO Activity Guidelines for Children aged under 5 years

• The Government will update the Early Years Foundation Stage Framework to make specific reference to the UK Chief Medical Officers’ guidelines for physical activity in the early years (including active play)

Leading the way? Tatty Bumpkin sessions are fully linked to the EYFS and the Curriculum for Excellence

Love Tatty Bumpkin 

 

To find out about your local Tatty Bumpkin class please to to http://www.tattybumpkin.com/classes/find-class.html. 

Or, ask your child’s nursery or school  if they are doing Tatty Bumpkin Yoga activity sessions as part of their day. 

A New Start with Tatty Bumpkin?  

Or, maybe, you are thinking of a new career which gives you:

• The opportunity to work with kids
• A great sense of job satisfaction and
• Flexible working to fit around your own family

Find out how you could be trained to deliver Baby and Tatty Bumpkin classes in your area at: http://www.tattybumpkin.com/business/index.html. 

The Joy and Benefits of Play for Your Child

By Susan Heron Tatty Bumpkin Training Coordinator and paediatric physiotherapist
 
It's National Play Day, maybe  a good time to reflect on the word 'play' - after all play is free and can be done anywhere!

What is Play?  

Nancy Stewart in her book ‘How Children Learn’ acknowledges that play is ‘an elusive concept, which has been defined on many different ways’. Play can be:

• A type of activity e.g. rough and tumble play or imaginative play or 

• A ‘state of mind' e.g. you may invite your child to help you build a tower out of wooden blocks. To start with they might follow your directions . However, if given time and some space, your child may start to become immersed in balancing the bricks on top of one another and start to build their own structures. At this point the activity becomes truly playful and truly powerful. 

In a report on the Early Years Foundation Stage Helen Moylett and Nancy Stewart described  play as: 'An open ended activity, freely chosen by the child. Play is open to spontaneous ideas as they arise, so any initial plans about what to play, how to play and who to play with, can change from moment to moment. In play the player finds their own purpose - it might be enjoyment, challenge, social interaction, exploring things or ideas, practising and perfecting skills’.  

It's Important for Children to Play

Current research is demonstrating that play is essential to a child's cognitive, socio-emotional, and physical development. When children are fully and freely engaged in play, their play is transformative - that is they will: 

• Learn new things
• Develop emotional, physical and social competencies/abilities
• Experience empowerment and grow in confidence
• Learn to problem solve
• Enhance their creativity.

Nancy stresses the freedom of play and suggests this freedom is what makes play so exciting for children. 

• Freedom when playing allows your child to ‘explore down uncharted pathways, turning this way and that, deciding to continue or change the destination, keeping alert to the possibilities all along the way’. 
• Freedom means there is no right or wrong way with play! Your child feels it's safe to try something new and, because they have chosen the activity, will often end up puzzling over it for a much longer time. (N. Stewart 2012).

Play and Learning

‘Within the early childhood context, play has long been recognised as the most valuable vehicle for children’s learning and development’ (C. Stevens 2013). 
Way back in 1949 Norma Alessandrini, an Occupational Therapist, suggested that:
‘Play is the child’s way of learning and an outlet for his innate need for activity. It is his business or his career. In it he engages himself with the same attitude and energy that we engage ourselves in regular work. For each child it is a serious undertaking not to be confused with diversion or idle use of time. Play is not folly. It is a purposeful activity’ (N. Alessandrini 1949).
 Now research is increasingly showing just how essential play is for learning, particularly when the young child uses play to explore their surrounding world and how it works. 
Piaget separated play activities from learning activities, but current research is directly linking play with:

• Healthy brain development (Bjorklund & Pellegrini, 2000) and the building of new neural connections in the brain which allow flexible and intelligent ways of approaching the world (N. Stewart 2012) 
• Development of cognitive skills. Diamond et al (2007) suggest that play and learning may not be so easily distinguished from each other.   
 

Gross Motor Play – Play Using the Whole Body

Active play using the whole body is a big part of nursery or pre-school life. It is a major part of the Tatty Bumpkin class as well. 
Gross motor play helps a child to develop their physical abilities and also to link what they are sensing from the world around with their movements - 'sensory-motor integration'.
The linking of sensory experiences with movements occurs in the brain - it leads to the child being able to focus on what they are experiencing, then plan and organise their movements. Interestingly, pretend play and physical play (specifically, rough and tumble play) have also been linked to emotional competence. In fact, in a study of physical activity in pre-schoolers, parents described the immediate benefits of gross motor play for their pre-schoolers as “improvements in their children’s mood and mental health” (Harvey-Berino, Geller, Dorwaldt, Flynn & Walfield, 2001).

Play and Academic Success 

Play both with parents and with friends has been shown to lead to longer term academic success. Playing with friends has been positively linked to early understanding, reading and number skills as well as increased engagement with learning activities (Fantuzzo, Sekino, & Cohen, 2004). 
The nurturing and responsive relationships that are strengthened when you play with your child have been shown to have a positive impact on their brain development, especially improving their speaking and literacy skills. (Tamis-LeMonda, Shannon, Cabrera, & Lamb, 2004).
  

The 3 Characteristics of Play

Occupational Therapist and play specialist Anita Bundy suggested 3 characteristics of play. Next time you watch your child playing - look for out for these  ...

Characteristic of Play 1 - Is your child intrinsically motivated?
When children are motivated to do an activity purely for its own sake rather than for a reward i.e. a sticker or a ‘well done!’ they are said to be intrinsically motivated. 
Intrinsic motivation leads to active engagement, persistence and enjoyment. 
You can get an idea of just how intrinsically motivated your child is by:

• Looking at your child’s engagement in the activity - are they fully immersed? If your child is actively engaged in their play - seeming to be ‘in the moment’ they are likely to be intrinsically motivated. Intrinsic motivation and engagement are related to a concept called 'flow'. This concept was put forward by Csikczentmihalyi  in the 1990's. He defined ‘flow’ as: 'a deep, effortless involvement in an activity in which the person loses sense of self and time' . He suggested that the best 'flow' experiences occur when the child (or adult) engages in an activity which provides 'a level of challenge that matches their ability'  I.e. In a playful activity, your child does not feel overwhelmed by the activity but, on the other hand, the activity presents enough of a challenge - so they are not bored by it.  

(Image courtesy of motherswhowork.co.uk)

• Judging your child’s focus doing the activity. If your child is intrinsically motivated they will be enjoying and focusing on the actual doing of the activity rather than the result. E.g. Your child might be interested in the shapes they can make in the sand rather than actually building a sandcastle- that might be Dad's goal! 

(Image courtesy ofletchildrenplay.net) 

• Asking yourself - is your child is persisting in the activity? A good sign that your child is intrinsically motivated is whether they persist despite coming up against obstacles.

• Looking at the effect of the activity on your child. Basically is your child enjoying themselves?! They may not be smiling – instead your child’s joyfulness may be expressed by their uninhibited abandon in the play activity. Often joyfulness is observed through the energetic synchronisation of body, face, and voice. 

(Image courtesy of colurbox.com)

                                                                                                     
Characteristic of Play 2 - Does your child feel 'in control'?
When children feel they are 'in charge of' their own actions or at least some aspect of the result of the activity - the activity is more playful. For a child to feel ‘in control’ they need to feel:

• Safe enough to play
• That they are making the decisions and have choices
• That they can modify the activity at any time
• That they are able to interact with the objects easily.

(image courtesy of dailytelegraph.co.uk)

Characteristic of Play 3 -  Is your child suspending reality for a moment?! 
If children are able to free themselves from the constraints of reality this is a great sign that they are playing. For children to suspend reality they need to feel they can:

• 'Break the rules' a little :-)
• Playfully tease
• Pretend to be something or someone else
• Be the clown a little - tell a joke or do a silly gesture use objects in an unconventional way i.e. a pebble can be a spider!                                              

Happy Playing! 

Love Tatty Bumpkin xxxx

References

Alessandrini, N.(1949). Play - A child’s world. Am. J of Occupational Therapy, 4, 53-55.

Bjorklund, D. F., & Pellegrini, A. D. (2000). Child development and evolutionary psychology. Child Development, 71, 1687-170 in Cornelli Sanderson, R. (2010). "Towards a New Measure of Playfulness: The Capacity to Fully and Freely Engage in Play" Dissertations. Paper 232. http://ecommons.luc.edu/luc_diss/232

Bundy, A. (2013). Play in Occupational Therapy: What is it? What use is it? Lecture to Sensory Integration Network

Cornelli Sanderson, R. (2010). Towards a New Measure of Playfulness: The Capacity to Fully and Freely Engage in Play . Dissertations. Paper 232. http://ecommons.luc.edu/luc_diss/232

Csikczentmihalyi, M (1990). Flow – the psychology of optimal experience. New York. Harper Perennial.

Diamond, A., Barnett, S., Thomas, J., & Munro, S. (2007). Executive function can be improved in preschoolers by regular classroom teachers. Science, 318, 1387–1388.

Fantuzzo, J., Sekino, Y., & Cohen, H. L. (2004). An examination of the contributions of
interactive peer play to salient classroom competencies for urban Head Start children. Psychology in the Schools, 41, 323-336 in Cornelli Sanderson, R. (2010). Towards a New Measure of Playfulness: The Capacity to Fully and Freely Engage in Play . Dissertations. Paper 232

Harvey-Berino, J., Geller, B., Dorwaldt, A., Flynn, K., & Walfield, L. (2001). A qualitative data analysis of parental attitudes towards preschool physical activity. Annals of Behavioral Medicine, 23, 24S.
Hirsh-Pasek, K. Golinkoff R, M. (2008) Why play=learning. In: Tremblay RE, Barr RG, Peters RDeV, Boivin M, eds. Encyclopedia on Early Childhood Development. Montreal, Quebec: Centre of Excellence for Early Childhood Development Available at: http://www.child-encyclopedia.com/documents/Hirsh-Pasek-GolinkoffANGxp.pdf.

Parham, D. (2008). Play and Occupational Therapy in L.D. Parham & L.S.Fazio (eds) Play in occupational therapy for children (2nd edition).St Louis: Mosby pp 3- 39

Skard, G., Bundy, A.C. (2008). Test for playfulness in L.D. Parham & L.S.Fazio (eds) Play in occupational therapy for children (2nd edition).St Louis: Mosby, pp. 71 – 94

Stevens, C. (2013). The Growing Child: Routledge, pp9

Stewart, N. Moylett, H. (2012. Understanding the Revised Early Years Foundation Stage. Early Education.

Tamis-LeMonda,C. S., Shannon, J. D., Cabrera, N J., & Lamb, M. E. (2004). Fathers and
mothers at play with their 2- and 3-year-olds: Contributions to language and
cognitive development. Child Development, 75, 1806-1820

The Benefits to Your Baby of Playing Whilst Sitting on the Floor - or on the grass outside!

Playing whilst sitting on the floor or the grass ....

By Sue Heron Paediatric Physiotherapist and Head of Training at Tatty Bumpkin Ltd.

Life is busy and the floor may be sometimes full of hazards - but sitting on the floor gives young babies so many possibilities and is a real 'gateway' for their development. 

Is Your Baby Ready to Sit? 

Remember take things slowly and respect nature.. 

Your baby will have a very strong 'inner' drive to move and discover the world around them trust this inner drive and respect that they are unique. 
Try to create opportunities so your baby can experiment at their own pace, in their own way - rather than push them too much. Your baby's ability to sit will be built the skills they have mastered in lying. 
In her blog 'Three Things You Might Not Realize Help Baby Learn to Sit Up' Pediatric Occupational Therapist Rachel Coley suggests some simple floor time activities which will help your baby to develop their: head control, body awareness and balance - all needed for sitting. http://www.candokiddo.com/news/sitting-skills.

Getting from Lying to Sitting by Yourself! 

From about 4 - 6 months babies increasingly like the challenge of sitting, it gives them a new perspective on life! 

However - be careful. Make sure your baby doesn't 'fall in love' with sitting at this stage and do make sure they're ready for a baby seat - again I direct you to Rachel's blog post where her excellent video shows you what 'ready and 'unready' look like.

At this stage your baby still needs plenty of time lying on the floor: wriggling, rolling and playing in side lying. It is through these movements that your baby learns the critical skill of getting into sitting by themselves. 

Babies usually learn to move from lying to sitting at around 7 months by moving up onto their hands and knees (crawl position) and then lowering themselves into sitting. You may see your baby trying to sit up from a side-lying position - pushing up through one elbow. In fact your baby will not perfect this way of moving to sitting until they are about 10-11 months old. 

As your baby pushes back into sitting from their hands and knees they will perfect a whole range of skills which they will build on in the years to come. To do this controlled sit movement, your baby will need:

• Good upper body strength - this will be an excellent foundation for writing and self help skills such as dressing

• Good body or 'trunk' control - good trunk control will help your little one develop a good sitting posture for life

• Good hip control and mobility - important for good posture and future walking skills 

• To be able to be able to shift their body sideways (over one knee) - this sideways movement will be refined and 'built on' in crawling and walking 

• To be able to control their body against gravity as they lower their bottom to the ground

It's interesting that the arm, body and hip movements your baby needs to perfect the transition into sitting are the reverse of those they will need to move from sitting to crawling - hence this moving back into sitting is also a practice for crawling :-). 

Sitting with Room to Wriggle Body, Hips and Feet! 

When your baby first starts to sit they are likely to do so in a 'ring sitting' position i.e. with their legs forming a ring out in front of them. Initially, they will use their hands and arms to prop them selves upright.

Ring sitting is nice and stable, a good start - but it does not allow your baby to move very much. Your baby will be unable to move into crawling or twist and turn their bodies whilst n ring sitting - try it yourself! 

So... your baby needs to discover the many different ways to sit as this will allow them to develop their skills further. 

Crucially your baby will need to learn to sit with their legs NOT in the same position (asymmetrical sitting) bringing one foot in closer to their body - now they can lean forwards and bring their weight over their lower leg to move into the crawl position. 

Baby sitting asymmetrically- with one foot tucked closer to body 

These skills are usually learnt when your baby is NOT absorbed in actually handling their toys but more when they are looking for some to play with! Scatter a few toys around your baby to encourage them, to reach and so experiment with moving their sitting position slightly. 

As your baby sits on the floor - encourage them to turn to either side by gaining their attention. As they turn their head to look at your or a toy this will prompt their body to turn.   Initially your baby will turn just their head and shoulders to either side then, as they gain more control at their body and hips, they will be able to turn their body as well.
With practice and lots of chances to play on the floor, your baby will gain enough control so they can turn their whole body and pelvis over their thigh bone (the femur). This is a crucial developmental milestone which will help your baby to develop the hip control they will need for walking. 

Encourage your baby to turn their body as they sit - by putting a few toys around them

From about 8 months you may notice your baby using a side sitting position - again this is a result of their increasing trunk, pelvic and upper leg control. Most babies don't spend a great time in this position - your baby may largely using this position to move from sitting to crawling or from crawling back down to sitting. Again it encourages your baby to build up control and flexibility in their lower body and hip areas.

Exploring side sitting! 

So - just a few reasons why sitting on a flat, firm, but safe surface is so important for your baby. 

Baby seats maybe useful when you need your baby to be safe for a little while - but 

Playing on the ground or floor will give your baby skills for life!   

Love Tatty Bumpkin 

References 

Lois Bly. 'Motor Skills Acquisition in the First Year' (1994)  

Rona Alexander et al. 'Normal Development of Functional Motor Skills - the First Year of Life. (1990). 

Baby Bumpkin Classes 

Always great fun and plenty of action - mixed with times of calmness. 

Find out about your local Tatty Bumpkin class at http://www.tattybumpkin.com/classes/find-class.html. Or, ask your child’s nursery if they are doing Baby Bumpkin Yoga activity sessions as part of their day. 

A New Start with Tatty Bumpkin?  

Maybe, you are thinking of a new career which gives you:

• The opportunity to work with kids
• A great sense of job satisfaction and
• Flexible working to fit around your own family

Find out how you could be trained to deliver Baby and Tatty Bumpkin classes in your area at http://www.tattybumpkin.com/business/index.html.