Early Childhood Education And Care Setting Research Articles

Feasible Peer-Mediated Intervention for Autistic Children Using Minimal Speech: A Qualitative Intervention Development Process.

Qualitative engagement with stakeholders in the development of interventions can provide insight into strategies to maximize feasibility in real-life settings. We engaged stakeholders (autistic adults, early childhood educators, early childhood sector leaders and policy influencers, parents of autistic children, and speech-language pathologists) to inform the development of an educator-led peer-mediated intervention (PMI) for autistic preschoolers who use minimal speech that is feasible to implement in inclusive early childhood education and care (ECEC) settings. A qualitative iterative intervention design process was utilized. Stakeholders (N = 15) attended an online workshop and completed a document review exploring the acceptability and feasibility of the proposed embedded PMI. A two-step analysis procedure using the Theoretical Domains Framework and template analysis was conducted to identify the barriers, enablers, and supports to the implementation of embedded PMI in early childhood settings. While embedded PMI was unanimously acceptable to stakeholders, several participants expressed concerns regarding feasibility. Barriers to the successful integration and implementation of PMI in inclusive preschool contexts included access to skills, knowledge, and resources. Participants identified strategies to overcome modifiable barriers and to enhance the existing enablers. These strategies are reflected in the following themes: build on the familiar, build capacity in augmentative and alternative communication, adopt a whole center approach, adapt to meet the needs of the ECEC setting, and engage in proactive implementation. To address barriers to the implementation of embedded PMI, action is needed at various levels: macro (national/policy), meso (organization/setting), and micro (individual). https://doi.org/10.23641/asha.25155770.

Acts of bridging in communication with newly arrived Ukrainian children in the Norwegian ECEC context

In this paper, we explore emergent communicative practices in a situation where a group of newly arrived children start attending early childhood education and care (ECEC) in a new country. The data are collected in a unique multilingual ECEC setting, organised temporarily for Ukrainian children that had arrived in Norway. Previous research on newly arrived children in ECEC settings in the Nordic context focuses mostly on how one or a few children are integrated into majority-language-speaking groups of children. Our study, however, provides an opportunity to explore communication practices that arise when a group of children share a language with some of the practitioners working with them, but not others. In this paper, we present an analysis of several narratives from practice, where we discuss how children and practitioners use their semiotic resources to accomplish their goals in communicative acts. The narratives show how the ECEC practitioners support children in their communicative efforts and bridge linguistic resources between languages. Inspired by the theory of bridging and bonding social capital (Putnam, 2000), we give a definition to acts of bridging and show that these acts of bridging can be performed by both children and practitioners with different language competences.

Assessing the scalability of evidence-based healthy eating and physical activity interventions in early childhood education and care: A cross-sectional study of end-user perspectives.

ObjectivesTo describe early childhood education and care (ECEC) services: i) perceptions regarding the scalability of healthy eating and physical activity interventions; and ii) associations between scalability and service characteristics. MethodsA cross-sectional survey was conducted with a randomly selected sample of ECEC services across Australia. The scalability of 12 healthy eating and physical activity interventions were assessed using items based on the Intervention Scalability Assessment Tool. Higher scores represented a higher perceived scalability. ResultsFrom 453 participants, the highest scoring healthy eating and physical activity interventions were ‘Providing healthy eating education and activities for children’ (M43.05) (out of 50), and ‘Providing sufficient opportunities for child physical activity’ (M41.43). The lowest scoring was ‘Providing families with lunchbox guidelines’ (M38.99) and ‘Engaging families in activities to increase child physical activity’ (M38.36). Services located in rural areas, compared to urban, scored the overall scalability of both healthy eating and physical activity interventions significantly lower. ConclusionsPerceptions regarding scalability of healthy eating and physical activity interventions in the ECEC setting vary according to service characteristics. Implications for Public HealthFindings identify where government investment and implementation efforts may be prioritised to facilitate scale-up. Investigation into the barriers and support required for lower scoring interventions is warranted.

Teaching Kindness and Compassion: An Exploratory Intervention Study to Support Young Children’s Prosocial Skills in an Inclusive ECEC Setting

In this exploratory intervention study, the aim was to teach 5–7-year-old children prosocial skills in an inclusive Finnish early childhood education and care (ECEC) setting. The intervention programme was based on previous studies and helps fill a gap in how to promote prosocial behaviour in an ECEC setting encompassing children with diverse needs. The theoretical framework draws on research on character strengths in the field of positive psychology, particularly what the literature refers to as the strengths of the heart, namely kindness and compassion. The study follows the methodological framework of pragmatism and a mixed-methods research perspective. Research methods include questionnaires and interviews with children (n = 23), some of their guardians (n = 8) and ECEC teachers (n = 2). The results were two-fold. With the picture-based questionnaire, the pre–post measures showed little advancement. However, individual interviews revealed developments in children’s prosocial thinking that also translated into concrete actions. These findings were further supported by the positive feedback received from teachers and guardians. The contents of the programme can be integrated into daily, inclusive ECEC pedagogy. Methodologically, the intervention design serves as a starting point for the further development of data collection practices that capture children’s voices in ECEC.

Newcomer object ownership negotiations when transitioning from home care to early childhood education and care in Finland

ABSTRACT For those experiencing them, educational transitions include not only the present time but are embedded within institutions that precede and extend beyond the individuals. This article explores how, as an institutional space, the early childhood education and care (ECEC) setting is (re)produced within young children’s encounters with others during a transition period. Video-recorded observations of three infant-toddlers’ first months of attendance to an ECEC setting were analysed following analytic induction and video interaction analysis. Two examples illustrating object ownership negotiations are discussed. The results show that, in their encounters with others, newcomers actively contributed to (re)producing the ECEC setting by advancing their own understandings of objects and ownership, practicing their own ways of being with objects. Moreover, the results indicate that teachers’ contributions strongly influenced the outcomes of the encounters and, consequently, the constitution of shared understandings of objects and object ownership within the ECEC setting.

The impact of an e-newsletter or animated video to disseminate outdoor free-play information in relation to COVID-19 guidelines in New South Wales early childhood education and care services: a randomised controlled trial

BackgroundState-based Guidelines were issued for Early Childhood Education and Care (ECEC) services (caring for children 0–6 years) recommending greater time outdoors and inclusion of indoor-outdoor programs to facilitate social distancing to reduce spread of COVID-19. The aim of this 3-arm randomised controlled trial (RCT) was to examine the impact of different dissemination strategies on increasing ECEC service intentions to adopt recommendations from the Guidelines.MethodsThis was a post-intervention only RCT. A sample of eligible ECEC services in New South Wales (n = 1026) were randomly allocated to one of three groups; (i) e-newsletter resource; (ii) animated video resource; or (iii) control (standard email). The intervention was designed to address key determinants of guideline adoption including awareness and knowledge. Following delivery of the intervention in September 2021, services were invited to participate in an online or telephone survey from October-December 2021. The primary trial outcome was the proportion of services intending to adopt the Guidelines, defined as intention to; (i) offer an indoor-outdoor program for the full day; or (ii) offer more outdoor play time. Secondary outcomes included awareness, reach, knowledge and implementation of the Guidelines. Barriers to Guideline implementation, cost of the dissemination strategies and analytic data to measure fidelity of intervention delivery were also captured.ResultsOf the 154 services that provided post-intervention data, 58 received the e-newsletter (37.7%), 50 received the animated video (32.5%), and 46 received the control (29.9%). Services who received the animated video had nearly five times the odds (OR: 4.91 [1.03, 23.34] p = 0.046) than those in the control group, to report having intentions to adopt the Guidelines. There were no statistically significant differences in awareness or knowledge of the Guidelines between either intervention or control services. Development costs were greatest for the animated video. The extent to which the dissemination strategy was viewed in full, were similar for both the e-newsletter and animated video.ConclusionThis study found potential for the inclusion of interactive strategies to disseminate policy and guideline information within the ECEC setting, in the context of the need for rapid communication. Further research should explore the added benefits of embedding such strategies within a multi-strategy intervention.Trial registrationRetrospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) on the 23/02/2023 (ACTRN 12,623,000,198,628).

Social class as a challenge in educating for diversity—The case of a Finnish preschool

AbstractThis study investigates how the staff in one preschool group in Finland deals with questions of social class. Despite a lack of reference to class in policy documents, social class emerges in three ways in the discussions among the Early Childhood Education and Care (ECEC) professionals: regarding how they view their group of children, in relation to their own inter‐relational dynamics, and in their perception of the practice in another less privileged ECEC setting. The study suggests a need for a more nuanced discussion about social class within ECEC, bearing in mind how it affects relations and the need for consciousness about how inequalities are reproduced.

Healthy eating interventions delivered in early childhood education and care settings for improving the diet of children aged six months to six years.

Dietary intake during early childhood can have implications on child health and developmental trajectories. Early childhood education and care (ECEC) services are recommended settings to deliver healthy eating interventions as they provide access to many children during this important period. Healthy eating interventions delivered in ECEC settings can include strategies targeting the curriculum (e.g. nutrition education), ethos and environment (e.g. menu modification) and partnerships (e.g. workshops for families). Despite guidelines supporting the delivery of healthy eating interventions in this setting, little is known about their impact on child health. To assess the effectiveness of healthy eating interventions delivered in ECEC settings for improving dietary intake in children aged six months to six years, relative to usual care, no intervention or an alternative, non-dietary intervention. Secondary objectives were to assess the impact of ECEC-based healthy eating interventions on physical outcomes (e.g. child body mass index (BMI), weight, waist circumference), language and cognitive outcomes, social/emotional and quality-of-life outcomes. We also report on cost and adverse consequences of ECEC-based healthy eating interventions. We searched eight electronic databases including CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, ERIC, Scopus and SportDiscus on 24 February 2022. We searched reference lists of included studies, reference lists of relevant systematic reviews, the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov and Google Scholar, and contacted authors of relevant papers. We included randomised controlled trials (RCTs), including cluster-RCTs, stepped-wedge RCTs, factorial RCTs, multiple baseline RCTs and randomised cross-over trials, of healthy eating interventions targeting children aged six months to six years that were conducted within the ECEC setting. ECEC settings included preschools, nurseries, kindergartens, long day care and family day care. To be included, studies had to include at least one intervention component targeting child diet within the ECEC setting and measure child dietary or physical outcomes, or both. Pairs of review authors independently screened titles and abstracts and extracted study data. We assessed risk of bias for all studies against 12 criteria within RoB 1, which allows for consideration of how selection, performance, attrition, publication and reporting biases impact outcomes. We resolved discrepancies via consensus or by consulting a third review author. Where we identified studies with suitable data and homogeneity, we performed meta-analyses using a random-effects model; otherwise, we described findings using vote-counting approaches and via harvest plots. For measures with similar metrics, we calculated mean differences (MDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes. We calculated standardised mean differences (SMDs) for primary and secondary outcomes where studies used different measures. We applied GRADE to assess certainty of evidence for dietary, cost and adverse outcomes. MAIN RESULTS: We included 52 studies that investigated 58 interventions (described across 96 articles). All studies were cluster-RCTs. Twenty-nine studies were large (≥ 400 participants) and 23 were small (< 400 participants). Of the 58 interventions, 43 targeted curriculum, 56 targeted ethos and environment, and 50 targeted partnerships. Thirty-eight interventions incorporated all three components. For the primary outcomes (dietary outcomes), we assessed 19 studies as overall high risk of bias, with performance and detection bias being most commonly judged as high risk of bias. ECEC-based healthy eating interventions versus usual practice or no intervention may have a positive effect on child diet quality (SMD 0.34, 95% confidence interval (CI) 0.04 to 0.65; P = 0.03, I2 = 91%; 6 studies, 1973 children) but the evidence is very uncertain. There is moderate-certainty evidence that ECEC-based healthy eating interventions likely increase children's consumption of fruit (SMD 0.11, 95% CI 0.04 to 0.18; P < 0.01, I2 = 0%; 11 studies, 2901 children). The evidence is very uncertain about the effect of ECEC-based healthy eating interventions on children's consumption of vegetables (SMD 0.12, 95% CI -0.01 to 0.25; P =0.08, I2 = 70%; 13 studies, 3335 children). There is moderate-certainty evidence that ECEC-based healthy eating interventions likely result in little to no difference in children's consumption of non-core (i.e. less healthy/discretionary) foods (SMD -0.05, 95% CI -0.17 to 0.08; P = 0.48, I2 = 16%; 7 studies, 1369 children) or consumption of sugar-sweetened beverages (SMD -0.10, 95% CI -0.34 to 0.14; P = 0.41, I2 = 45%; 3 studies, 522 children). Thirty-six studies measured BMI, BMI z-score, weight, overweight and obesity, or waist circumference, or a combination of some or all of these. ECEC-based healthy eating interventions may result in little to no difference in child BMI (MD -0.08, 95% CI -0.23 to 0.07; P = 0.30, I2 = 65%; 15 studies, 3932 children) or in child BMI z-score (MD -0.03, 95% CI -0.09 to 0.03; P = 0.36, I2 = 0%; 17 studies; 4766 children). ECEC-based healthy eating interventions may decrease child weight (MD -0.23, 95% CI -0.49 to 0.03; P = 0.09, I2 = 0%; 9 studies, 2071 children) and risk of overweight and obesity (RR 0.81, 95% CI 0.65 to 1.01; P = 0.07, I2 = 0%; 5 studies, 1070 children). ECEC-based healthy eating interventions may be cost-effective but the evidence is very uncertain (6 studies). ECEC-based healthy eating interventions may have little to no effect on adverse consequences but the evidence is very uncertain (3 studies). Few studies measured language and cognitive skills (n = 2), social/emotional outcomes (n = 2) and quality of life (n = 3). ECEC-based healthy eating interventions may improve child diet quality slightly, but the evidence is very uncertain, and likely increase child fruit consumption slightly. There is uncertainty about the effect of ECEC-based healthy eating interventions on vegetable consumption. ECEC-based healthy eating interventions may result in little to no difference in child consumption of non-core foods and sugar-sweetened beverages. Healthy eating interventions could have favourable effects on child weight and risk of overweight and obesity, although there was little to no difference in BMI and BMI z-scores. Future studies exploring the impact of specific intervention components, and describing cost-effectiveness and adverse outcomes are needed to better understand how to maximise the impact of ECEC-based healthy eating interventions.

Exploring pedagogues’ understanding and detection of vulnerability in Danish early childhood education and care

Abstract The conceptualisation of vulnerability among Danish pedagogues in the context of early childhood education and care (ECEC) is framed by both Danish legislation (Dagtilbudsloven, 2020) and key pedagogical concepts such as well-being, learning, development and formation (Ministry of Children and Education, 2020). Employing a phenomenological approach, this study investigated how pedagogues perceive vulnerability through interviews conducted with 15 informants. Drawing on Abbott’s key concepts of jurisdiction, diagnosis, inference and treatment, the collected data are operationalised to discern pedagogues´ different understandings of vulnerability. The findings highlight the inherent ambiguity surrounding pedagogues’ comprehension of vulnerability, closely tied to their primary responsibilities within the ECEC setting, namely, promoting well-being, facilitating learning, fostering development and enabling formation. The implications of the study shed light on the challenges faced by pedagogues in identifying vulnerability within ECEC, which encompasses both “traditional” and “new” understandings. Pedagogues tend to focus on detecting individual factors, such as personality traits and developmental disorders, or contextual factors related to a child’s family background, without considering the institutional context as a potential source of vulnerability production. This study emphasises the importance of re-evaluating current approaches to vulnerability detection in ECEC, particularly with regard to children in vulnerable positions.

Movement behavior policies in the early childhood education and care setting: An international scoping review.

Meeting 24-h movement behavior guidelines for the early years is associated with better health and development outcomes in young children. Early childhood education and care (ECEC) is a key intervention setting however little is known about the content and implementation of movement behavior polices in this context. To inform policy development this international scoping review examined the prevalence, content, development and implementation of ECEC-specific movement behavior policies. A systematic literature search of published and gray literature since 2010 was conducted. Academic databases (EMBASE, Cinahl, Web of Science, Proquest, Scopus, EBSCO, PubMed) were searched. A Google search was undertaken and limited to the first 200 results. The Comprehensive Analysis of Policy on Physical Activity framework informed data charting. Forty-three ECEC policy documents met inclusion criteria. Most policies originated in the United States, were subnational and developed with government, non-government organizations and ECEC end-users. Physical activity was specified in 59% (30-180 min/day), sedentary time in 51% (15-60 min/day) and sleep in 20% (30-120 min/day) of policies. Daily outdoor physical activity was recommended (30-160 min/day) in most policies. No policy permitted screen time for children <2 years, with 20-120 min/day for children >2 years. Most policies (80%) had accompanying resources but few provided evaluation tools (e.g., checklists; action plan templates). Many policies had not been reviewed since the publication of 24-h movement guidelines. Movement behavior policies in the ECEC setting are often vaguely worded, missing a comprehensive evidence base, siloed in development and often not tailored for the 'real world.' A focus on evidence informed ECEC-specific movement behavior policies proportionally aligned with national/international 24-h Movement Behaviors Guidelines for the Early Years is needed.

Quality early childhood education and care in a time of COVID-19.

Contextual approaches to high quality Early Childhood Education and Care (ECEC) seek to capture the complexity of children's lives, developing pedagogical approaches that are responsive to children's needs and interests. In 2020, the COVID-19 pandemic provided a complex layer to the question of what constitutes quality ECEC. A mixed methods appreciative inquiry of educators' and parents' views of quality in one ECEC setting in England, became an unexpected ethnographic exploration of quality ECEC in the time of a global pandemic. The findings indicate how features of quality, such as offering a range of learning environments and structuring the pedagogic environment to offer free-flowing play, had to be adapted to prevent the spread of COVID-19. The focus on quality shifted, prioritising the health and safety of families and staff, over the quality and variety of the curriculum. Greater emphasis was also placed on children's social and emotional well-being to support their ability to understand and manage the changes to routines in response to the pandemic. The findings demonstrate that the early years workforce remains central to understanding and supporting quality, concluding that quality ECEC is shaped by adaptability - adapting to the needs of children, families, staff, and the unprecedented context of COVID-19. The focus on adaptability seeks to highlight how educators frequently respond to unique contexts in juggling concepts of quality ECEC. Consequently, a recommendation is made for future educator training to consider the importance of adaptability, in providing a useful framework for reimaging quality ECEC post COVID-19.

Effects of multilingualism on Australian infants’ language environments in early childhood education centers

This study investigates differences in the language environments experienced by multilingual and monolingual infants in early childhood education and care (ECEC) settings. The Language Environment Analysis (LENA) technology was used to collect day-long audio-recordings from 181 one-year-old infants (age range from 12 to 21 months). We examined whether infants’ multilingual status predicts the amount of educators’ language input (adult word count, AWC), child vocalizations (CVC) and conversational turns (CTC), as well as interaction effects on AWC, CVC and CTC of infants’ multilingual status and other infant, home and ECEC characteristics. Multilevel mixed effects models revealed no main effect of infants’ multilingual status on the language environment outcome variables. Instead, infant gender significantly predicted adult word count, with female infants hearing more words from educators than male infants. There was a significant interaction effect between the infants’ multilingual status and both their age and length of time in an ECEC setting on child vocalizations. While monolingual infants produced more vocalizations as their age increased, multilingual infants did not show this increase in vocalizations with age. Further, the difference between monolingual and multilingual children’s vocalizations decreased as the length of time in ECEC increased. There were no significant predictors of conversational turns. Findings from this study suggest that early childhood educators do not adjust their talk according to the multilingual status of the infants. However, multilingual infants do not increase their vocalizations as their age increases to the same extent as do their monolingual peers. The interaction effect between multilingualism and the length of ECEC attendance also implies that ECEC environments may be particularly beneficial for supporting multilingual infants’ vocalizations. This study highlights the need to provide pedagogical support to educators to help them to encourage multilingual infants’ vocalizations in ECEC settings.

Caregiver/child ratio and group size in Scandinavian Early Childhood Education and Care (ECEC): a systematic review of qualitative research

The aim of the present systematic review was dual: 1) to systematically identify and present all qualitative research exploring caregiver/child ratio and group size in Scandinavian Early Childhood Education and Care (ECEC) for children aged 0–5 years, and 2) to synthesize the results from included studies in order to explore how the structural aspects of the ECEC setting (ratio and group size) are perceived to influence the everyday life experiences, development, and wellbeing of children. All studies exploring caregiver/child ratio and group size in ECEC in Scandinavia using qualitative methods were included. Systematic electronic searches were carried out in Socindex, PsycINFO, ERIC, Academic Search Premier, Science Citation Index, Sociological s, Cristin, Forskningsbasen, Libris, Norart, Swemed, and BIBSYS between September 2020 and February 2022. Furthermore, hand searches and snowballing strategies were used to identify relevant studies. The final selection included 12 studies in the review. The quality of all included studies was assessed independently by two review authors. After critical appraisal, the thematic analysis was conducted using data from 11 studies as one included study was deemed to be of insufficient quality. Findings within the thematic synthesis highlight ways in which group size and caregiver/child ratio influence caregiver/child interactions, children’s interactions, behavior, development, and learning as perceived by caregivers and observers and the caregivers’ perceptions on what constitutes optimal group size and caregiver/child ratio in ECEC. No study included in the review used interviews with children or parents, and thus future research is needed in order to explore children’s perspectives on these central structural characteristics of the ECEC setting.

Strengthening Early Childhood Education and Care in a "Childcare Desert".

High-quality Early Childhood Education and Care (ECEC) is an important component of thriving communities. It is central to the socio-emotional and intellectual growth of young children, to the ability of parents to go to work, and to the ability of employers to find and retain workers. Despite this centrality, there is a profound shortage of ECEC in many communities, which has only been made worse by COVID-19. This study took place in rural Kentucky pre-pandemic, where approximately half of all residents lived in “childcare deserts”—a situation facing a growing number of communities. This research demonstrates that while financial factors affect the undersupply of childcare in a single community, there are also additional, more opaque, and under-theorized factors at play. Specifically, we argue that misconceptions around families’ ability and willingness to pay for ECEC, what families prioritize in an ECEC setting, and ambiguous terminology result in misunderstandings and miscommunication that, in turn, affect perceived solutions to the problem of the childcare desert. In short, when different stakeholders use different language and assumptions to describe their goals and ideas about ECEC, it is hard to reach community consensus about how to add the high-quality options that families desire and value. Drawing upon survey and interview data collected from parents and childcare providers, as well as local newspaper articles and during community forums, we uncover barriers that may hinder efforts to strengthen ECEC options; notably, many barriers are surmountable. Ultimately, this research points to concrete steps that communities can take to help bolster ECEC and, thus, communities at large.

The role of mother’s education and child gender for children’s vocabulary and math skills in the transition from Early Childhood Education and Care to first grade in Norway

ABSTRACT Parental education and child gender are related to learning and development during childhood and adolescence. The present study investigated the role of mother’s education level and child gender for children’s vocabulary and math skills in Norway. Children’s vocabulary and math skills were assessed in Early Childhood Education and Care (ECEC) centers (M age = 5.8; N = 243, 49.4% girls) and first grade (M age = 6.8 years). Results showed that maternal education predicted children’s vocabulary and math skills in a play-based ECEC setting. There was a small gender difference (favoring girls) in math skills but not in vocabulary in ECEC. However, maternal education and gender did not significantly predict the change in vocabulary or math skills from ECEC to first grade, and gender did not moderate the relationship between maternal education and academic skills in young Norwegian children. Implications of these results are discussed.

A randomised controlled trial of an implementation strategy delivered at scale to increase outdoor free play opportunities in early childhood education and care (ECEC) services: a study protocol for the get outside get active (GOGA) trial

BackgroundIncreased outdoor play time in young children is associated with many health and developmental benefits. This study aims to evaluate the impact of a multi-strategy implementation strategy delivered at scale, to increase opportunities for outdoor free play in Early Childhood Education and Care (ECEC) services.MethodsThe study will employ a parallel-group randomised controlled trial design. One hundred ECEC services in the Hunter New England region of New South Wales, Australia, will be recruited and randomised to receive either a 6-month implementation strategy or usual care. The trial will seek to increase the implementation of an indoor-outdoor routine (whereby children are allowed to move freely between indoor and outdoor spaces during periods of free play), to increase their opportunity to engage in outdoor free play. Development of the strategy was informed by the Behaviour Change Wheel to address determinants identified in the Theoretical Domains Framework. ECEC services allocated to the control group will receive ‘usual’ implementation support delivered as part of state-wide obesity prevention programs. The primary trial outcome is the mean minutes/day (calculated across 5 consecutive days) of outdoor free play opportunities provided in ECEC services measured at baseline, 6-months (primary end point) and 18-months post baseline. Analyses will be performed using an intention-to-treat approach with ECEC services as the unit of analysis, using a linear mixed effects regression model to assess between-group differences. A sensitivity analysis will be undertaken, adjusting for service characteristics that appear imbalanced between groups at baseline, and a subgroup analysis examining potential intervention effect among services with the lowest baseline outdoor free play opportunities.DiscussionIdentifying effective strategies to support the implementation of indoor-outdoor routines in the ECEC setting at scale is essential to improve child population health.Trial registrationAustralian New Zealand Clinical Trials Registry (ACTRN12621000987864). Prospectively registered 27th July 2021, ANZCTR - Registration.

Interventions to Improve Child Physical Activity in the Early Childhood Education and Care Setting: An Umbrella Review.

Early childhood education and care (ECEC) services are a key setting to support improvements in the physical activity of young children. This umbrella review gathered and synthesised systematic review evidence of the effectiveness of interventions in the ECEC setting on the physical activity levels of children aged 0–6. We also mapped the current evidence to the existing ECEC sector-specific physical activity practice recommendations. Five electronic databases were searched to identify systematic reviews that evaluated the impact of any ECEC-based interventions on the physical activity levels (e.g., moderate-to-vigorous physical activity, total physical activity) of children aged 0–6. One reviewer extracted data on intervention effectiveness and quality of the reviews, checked by a second reviewer. Ten reviews were included. Overall, the majority of the reviews found interventions delivered in ECEC improved child physical activity. Across reviews, the impact of six intervention strategies were identified, mapped to four (of eight) broad recommendations (i.e., providing opportunity, offering educator training, educators promoting the benefits of physical activity, creating a physical activity-promoting environment). The impact of the majority of recommendations, however, did not have systematic review evidence. Further investigation of the effectiveness of ECEC-based physical activity strategies is required to demonstrate support for the existing recommended practices.

Domesticated Smartphones in Early Childhood Education and Care settings. Blurring the lines between pedagogical and administrative use

ABSTRACT In Norway’s ‘Framework Plan for kindergartens’ digital tools are to be implemented for learning, play and creativity. Implicitly the concept of digital tools, or ICTs, tend to be tablets, computers, and interactive whiteboards, smartphones are as such not taken into account. However, we find that the smartphone is particularly interesting because it differs from the other types of ICTs used in Early childhood education and care (ECEC) institutions. Tablets, computers and interactive whiteboards, are all implemented as distinctly pedagogical tools, potentially fulfilling the framework plan, while smartphones have been implemented primarily as administrative and documentational tools. Yet, in this case study on the use of ICTs in a Norwegian ECEC we found that such administrative use of smartphones was blended with undercurrents of ‘filler use’ for pedagogical purposes. In this article we build on the literature on ICT’s in ECEC by exploring the outcome such filler use of smartphones may have. To do this we draw on the domestication theory to describe the practice, symbolic and meaning dimensions in the enactment of smartphones in an ECEC setting.

Social and emotional learning in early childhood education and care: a public health perspective

Mental health and behavioural disorders account for one of the largest and fastest-growing categories of burden of disease globally, and mental ill-health is the leading cause of health-related disability in children and youth.1 In Australia, 13.6% of children aged 4 to 11 years meet diagnostic criteria for at least one mental health disorder.2 Approaches such as Social and Emotional Learning (SEL) in educational settings can play an important role in fostering the social-emotional skills that promote future wellbeing and prevent chronic health problems including depression, anxiety, obesity, diabetes, heart disease and substance abuse.3, 4 SEL intervention supports educators to foster children's social-emotional development through explicit teaching, modelling, practice and integration within other areas of learning.5 In schools, it has been positioned within a public health framework, recognising that universal programming, tiered layers of support, and integration across classrooms, schools, families and communities may offer public health benefits.6 Research evidence suggests SEL programming in Early Childhood Education and Care (ECEC) can similarly have a significant positive impact on children's mental health.7-10 However, SEL research in ECEC has focused on the classroom level, with less emphasis on systemic approaches that encourage individual, interpersonal, organisational and community factors to promote children's social-emotional functioning and potentially prevent outcomes of mental and physical illness. This commentary considers SEL intervention in early childhood through a public health lens and introduces a conceptual public health model of SEL in ECEC. It examines the meaning and dimensions of a ‘public health model’, the features of and evidence-base for public health approaches in educational settings, and the opportunities and challenges to systemically embed SEL within the early learning environment. Public health is described as the art and science of preventing disease, prolonging life, and promoting health through the organised efforts of society.11, 12 Public health approaches address health conditions or social problems using evidence-informed, multidisciplinary and population-based strategies, supported by assessment, service provision, and policy.13-15 Initiatives respond to the proximal, distal, and socio-political risk and protective factors that influence health outcomes, focusing on health at the population-level, regardless of individual variations in risk status,16 and offering integrated and multilevel strategies targeted to diverse groups based on risk.17 This is facilitated through tiered systems of intervention across three levels. Universal (Tier 1) prevention strategies are population-wide measures offered prior to the onset of the health problem. Targeted or selective (Tier 2) strategies focus on groups at greater risk of exposure to factors associated with the health problem, while intensive or indicated (Tier 3) strategies are aimed at minimising the effects of and reducing the likelihood of re-exposure in groups who have been exposed to the health problem.14 Epidemic problems including obesity, suicide, bullying, food insecurity, poverty, family violence, illiteracy and restricted academic attainment cause significant trauma in the lives of children, their families and communities.18, 19 These pervasive problems demand multi-tiered and long-term public health approaches that focus on both prevention and treatment.20 Studies have identified benefits of applying public health principles, such as multi-tiered models of support, within educational systems to tackle issues such as physical activity,21 bullying22 and mental health.23, 24 While several public health frameworks exist, two have emerged as important for school-based intervention: Response-to-Intervention (RTI)25 and the Health Promoting Schools Framework.26 The latter suggests three critical components for public health impact: i) changes in formal health curriculum; ii) ethos and environment of the school; and iii) engagement with families and communities. RTI is a popular tiered-model in educational settings that includes universal programs delivered to all children, selective programs (Tier 2) offered to approximately 20% of the school population, and intensive supports (Tier 3) for those needing dedicated services with health professionals or special educators (approximately 5% of the population).27 The principles that underpin education-based public health programs are relevant to fostering children's social-emotional skills. SEL programs in schools can strengthen pro-social behaviour and academic performance, and reduce conduct and internalising problems,28 with benefits that are sustained over time.29 While many SEL approaches target proximal influences such as teaching practice, teacher-child interactions and peer relations using classroom-based programs,30 SEL literature increasingly explores systemic school-wide approaches,5, 30, 31 emphasising: i) comprehensive and coordinated SEL strategies offered at multiple ecological levels (classroom, school, family, and community); ii) competence-promoting, prevention and early intervention activities through universal, selective and intensive intervention; and iii) educational systems, policies and funding models to support effective implementation.6, 32 The challenge of system-wide SEL programming is even more pronounced in early childhood settings. Existing programs offer universal intervention at the child and classroom level,7 with fewer Tier 2 and Tier 3 supports available for children at risk or showing signs of social-emotional difficulty.8, 9 In addition, limited exploration of other layers of intervention that could support SEL and align with a systems approach (e.g. engagement with families), is evident. The Pyramid Model is an example of an early learning framework that has taken a more holistic approach.33 It offers evidence-informed strategies at universal, targeted and intensive levels, while recognising the workforce systems needed to ensure continuity, effective training and sustainability. In a recent efficacy trial, teachers trained and coached in the Pyramid Model showed significant improvement in teaching practices compared to control peers, while children displayed strengthened social skills and reduced challenging behaviours.34 ECEC programs face challenges to integrated and sustained SEL practices, including variations in ECEC quality across settings and inconsistent interaction and relationship quality for children to achieve optimal development.35-37 Workforce challenges include incommensurate pay,38 high levels of work-related stress,39 lack of professional status and public recognition of their professionalism, high rates of turnover, and limited career development opportunities38 all impacting on an educator's ability to provide high-quality and sustained SEL supports within their day-to-day practice. By applying public health principles to SEL intervention, the components and levels within the early learning system are more likely to be considered, therefore encouraging embedded practices and sustained benefits. The proposed conceptual model of SEL in ECEC using a public health lens is detailed in Figure 1. It recognises national and state education systems and policy that influence ECEC providers’ ability to resource and support high-quality SEL programming. Educators are unlikely to have the resources or time to embed SEL practices without organisational commitment, including service-wide policies that encourage SEL, training and professional development, ongoing evaluation and improvement, promotion of communities of learning, connection to community partnerships, and support to manage their own social-emotional wellbeing. This organisational support will enable educators to partner with caregivers and other health professionals to: i) foster all children's social-emotional functioning through high-quality interactions, role-modelling and explicit SEL instruction (Tier 1); ii) identify children in need of more intensive support; iii) work in partnership with allied health and special education professionals to embed tailored Tier 2 and 3 programs and supports within the classroom while strengthening their own professional knowledge; iv) reflect on and respond to changes in children's behaviour and social-emotional competencies; and v) encourage children's skill generalisation beyond the ECEC setting. A public health approach to promoting early childhood mental health. Exposure to nurturing, consistent and responsive educator–child relationships and access to deliberate and consistent SEL opportunities may negate detrimental outcomes associated with risk factors, including economic disadvantage and adversity, improve social-emotional competence and school readiness, reduce behaviour challenges, and potentially increase the likelihood of positive health outcomes across the life span. This conceptual model contributes to the discussion regarding the promotion of young children's mental health through tiered layers of SEL intervention, partnerships between teachers, families and allied health professionals, and investment and resourcing at the organisational and policy levels.

Obesity Prevention within the Early Childhood Education and Care Setting: A Systematic Review of Dietary Behavior and Physical Activity Policies and Guidelines in High Income Countries.

As a strategy for early childhood obesity prevention, a variety of dietary behavior and physical activity policies and guidelines published by leading health agencies and early childhood education and care (ECEC) licensing and accreditation bodies exist. Given the potential diversity in recommendations from these policies, this narrative review sought to synthesize, appraise and describe the various policies and guidelines made by organizational and professional bodies to highlight consistent recommendations and identify opportunities to strengthen such policies. An electronic bibliographic search of seven online databases and grey literature sources was undertaken. Records were included if they were policies or guidelines with specific recommendations addressing dietary behavior and/or physical activity practice implementation within the ECEC setting; included children aged >12 months and <6 years and were developed for high income countries. Recommended dietary behavior and physical activity policies and practices were synthesized into broad themes using the Analysis Grid for Environments Linked to Obesity framework, and the quality of included guidelines appraised. Our search identified 38 eligible publications mostly from the US and Australia. Identified guidelines were largely consistent in their recommendation and frequently addressed the physical and sociocultural environment and were well-aligned with research evidence. Broader consideration of policy and economic environments may be needed to increase the impact of such policies and guidelines within the ECEC setting.