Early Education Settings Research Articles

Making space for children’s agency with playful learning

ABSTRACT Playful learning has garnered supporters and research evidence, and also can be seen as nebulous and, therefore, reliant on practitioners’ intuitions in early education settings. In this paper, we offer an explicit theoretical account, grounded in developmental psychology of how play might support the acquisition of broad skills and dispositions for lifelong learning. We argue that play develops self-regulation and motivation, both of which support the child’s agency in their learning. We discuss a culturally inclusive view of agency that is distinct from autonomy, and which is visible in many existing early childhood pedagogies. We conclude by suggesting practical strategies that educators can adopt to enhance learning through play and children’s agency in their learning.

An examination of patterns of caregiver responsiveness and toddler communication in early childhood classrooms

ABSTRACT Young children’s communication is dependent upon caregivers’ responsiveness to their behaviors; however, little is known about the responsiveness of toddler teachers to children in their classrooms. To increase teachers’ responsiveness to children’s behavior, a peer-coaching model was implemented in three Early Head Start classrooms. The peer-coaching model was developed to (a) increase frequency of appropriate infant/toddler teacher responses to children in their classroom, (b) increase engagement of children, and (c) support early communication of infants and toddlers. This study documented toddlers’ communication with their teachers to examine trends in toddler communication and teacher responsiveness. Results of this descriptive study suggest a pattern whereby child communication acts were higher when teachers’ responsiveness was higher. This finding supports the need for future research regarding best practices in increasing quality interactions between toddlers and caregivers to support communication development in early care and education settings.

A Text-Based Intervention to Promote Literacy: An RCT.

Children entering kindergarten ready to learn are more likely to thrive. Inequitable access to high-quality, early educational settings creates early educational disparities. TipsByText, a text-message-based program for caregivers of young children, improves literacy of children in preschool, but efficacy for families without access to early childhood education was unknown. We conducted a randomized controlled trial with caregivers of 3- and 4-year-olds in 2 public pediatric clinics. Intervention caregivers received TipsByText 3 times a week for 7 months. At pre- and postintervention, we measured child literacy using the Phonological Awareness Literacy Screening Tool (PALS-PreK) and caregiver involvement using the Parent Child Interactivity Scale (PCI). We estimated effects on PALS-PreK and PCI using multivariable linear regression. We enrolled 644 families, excluding 263 because of preschool participation. Compared with excluded children, those included in the study had parents with lower income and educational attainment and who were more likely to be Spanish speaking. Three-quarters of enrollees completed pre- and postintervention assessments. Postintervention PALS-PreK scores revealed an unadjusted treatment effect of 0.260 (P = .040); adjusting for preintervention score, child age, and caregiver language, treatment effect was 0.209 (P = .016), equating to ∼3 months of literacy gains. Effects were greater for firstborn children (0.282 vs 0.178), children in 2-parent families (0.262 vs 0.063), and 4-year-olds (0.436 vs 0.107). The overall effect on PCI was not significant (1.221, P = .124). The health sector has unique access to difficult-to-reach young children. With this clinic-based texting intervention, we reached underresourced families and increased child literacy levels.

Suspension and expulsion in Colorado early care and education settings: Child, program, and community-level predictors.

Expulsion presents a significant risk in Early Care and Education (ECE) settings due to its association with early disadvantage and frequency of use. A statewide survey was conducted to characterize ECE suspension and expulsion (S/E) in Colorado. Child, program, and community-level factors were examined as predictors of S/E, alongside preventative intervention supports capable of reducing S/E. Six hundred and sixty three licensed child care programs participated in the survey, providing information on 19,848 enrolled children, 312 suspensions, and 74 expulsions. A series of multilevel hierarchical regressions were conducted, examining predictors for S/E. Children with IEPs/IFSPs were disproportionately suspended; 2-3-year-olds were disproportionately expelled; and boys, 5-6-year-olds, and children with disabilities were disproportionately suspended and expelled. Center-based programs, lower quality ratings, and "zero tolerance" policies predicted greater use of suspension. In contrast, school-district affiliation and knowledge of how to access infant and early childhood mental health consultation (IECMHC) decreased suspension. Lower levels of regional child poverty predicted higher use of expulsion. Affiliation with a school-district, IECMH consultant-led training, and use of quality coaches predicted decreased expulsion. This study identifies the need for ongoing protection for children with IEPs/ IFSPs and the preventative interventions that mitigate risk for S/E.

The role of ECEC teachers for the long-term social and academic adjustment of children with early externalizing difficulties: a prospective cohort study

ABSTRACT Using data from more than 7000 children from the Norwegian Mother, Father and Child (MoBa) study, this study explored the role of school readiness and teacher–child closeness in the early child education and care (ECEC) setting for the prospective academic and social development of children with early externalizing problems. Mother, ECEC teachers, and schoolteacher ratings were applied. Latent moderated mediation analyses within a SEM framework were performed. Early externalizing problems at age three were associated with less school readiness at age five, but this association was weaker among children with closer teacher–child relationships. School readiness mediated the link from early externalizing problems to later academic and social adjustment difficulties, but this long-term indirect effect also decreased with increasing levels of teacher–child closeness. With regards to intervention efforts, the study demonstrates the potentially important role of ECEC teachers for the long-term social and academic adjustment of children with early externalizing problems.

Connecting Families to Food Resources amid the COVID-19 Pandemic: A Cross-Sectional Survey of Early Care and Education Providers in Two U.S. States.

Early care and education (ECE) settings are important avenues for reaching young children and their families with food and nutrition resources, including through the U.S. federally funded Child and Adult Care Food Program (CACFP). Researchers conducted a cross-sectional survey of ECE providers in two U.S. states in November 2020 to identify approaches used to connect families with food and nutrition resources amid the COVID-19 pandemic. Logistic regression models were used to estimate odds of sites reporting no approaches and adjusted Poisson models were used to estimate the incidence rate ratio of the mean number of approaches, comparing sites that participate in CACFP to those that did not. A total of 589 ECE sites provided responses. Of those, 43% (n = 255) participated in CACFP. CACFP participating sites were more likely to report using any approaches to connecting families to food resources and significantly more likely to report offering “grab and go” meals, providing meal delivery, distributing food boxes to families, and recommending community food resources than non-CACFP sites. This study suggests that CACFP sites may have greater capacity to connect families to food resources amid emergencies than non-CACFP participating sites.

Examining correlates of feeding practices among parents of preschoolers.

Background: Parent feeding practices play a critical role in children's eating behaviors. Limited research has explored child-level correlates of parent feeding practices. Aim: To identify correlates of feeding practices (responsive and controlling) among parents of preschoolers US. Methods: Participants included parents (n = 273) of preschoolers (3-5 years), recruited from Early Care and Education settings (n = 24) located in a metropolitan city in the US. Analysis included descriptives, correlations, and multiple regression. Results: For responsive feeding practices, positive associations included child's weight with unintentional modeling (β = .17, 95% CI [0.12, 0.53]), child vegetable consumption with behavioral role modeling (β = 0.22, 95% CI [0.17, 0.44]), and parent monitoring with verbal modeling (β = 0.21, 95% CI [0.12, 0.34]). For controlling feeding practices, parent restriction was positively associated with child weight concern (β = 0.22, 95% CI [0.13, 0.39]) and parent monitoring (β = 0.13, 95% CI [0.01, 0.19]), whereas child vegetable consumption was negatively associated (β = -0.16, 95% CI [-0.27, -0.05]). Pressure to eat was negatively associated with child weight concern (β = -0.18, 95% CI [-0.45, -0.09]), child fruit consumption (β = -0.12, 95% CI [-0.37, -0.01]), household income (β = -0.13, 95% CI [-0.30, -0.02]), and parent weight (β = -0.14, 95% CI [-0.60, -0.05]), Conclusions: Findings highlight the importance of child characteristics when examining correlates of parent feeding practices, demonstrating bidirectional interactions between parent feeding practices and children's eating behaviors. Considering child-level correlates may improve the implementation of responsive feeding practices and reduce controlling feeding practices.

The Effectiveness of Early Childhood Teachers

The complexity of teaching and the intricacies of the varied early childhood education systems contribute to the multiple considerations regarding development, method of delivery, intended and needed outcomes, and issues and next steps for professional development in early childhood education. There are several promising practices and directions currently underway for professional development and learning. Recommendations from professional organizations as well as emerging research are providing guidance for next steps. They are calling attention to professional learning and effective teachers and their essential role in the children’s high-quality experiences in early care and education settings and in developing early childhood education as a profession.

Start Strong: A Culinary Nutrition Education Training for Family Child Care Providers

The Center for Disease Control and Prevention developed the Spectrum of Opportunities Framework to help communities target obesity prevention in early care and education (ECE) settings.1 Professional development is one of the opportunities identified in the framework. Training family child care providers (providers) on how to prepare healthy foods for children in their care is 1 way to improve the food environment in child care settings. University of Minnesota Extension (Extension) recognized the majority of culinary nutrition education training and curricula for ECE settings were designed for child care centers.

Child Care Policy as an Anti-Poverty Strategy: The Need to Address Neurophysiological Self-Regulation

High-quality early care and education can mitigate the short- and long-term effects of poverty on young children’s development. Therefore, policies that expand access to high-quality early care and education can be an effective anti-poverty strategy. A number of programs demonstrably foster volitional processes of self-regulation—the capacity to control emotions, thoughts, and behaviors—among young children in poverty. However, relatively little is known about how the activity of the neurophysiological systems that form the interface between brain and body supports these processes of self-regulation in early care and education settings. Maximizing the efficacy of early care and education as an anti-poverty strategy requires adopting policies to advance three interrelated goals: understanding, accommodating, and reconfiguring young children’s neurophysiological function in the early care and education environment.

P109 Responsive Feeding During COVID-19: Evaluation of a Specialized Training for ECE Providers and Stakeholders.

<h3>Background</h3> Practicing family style meal service in early care and education (ECE) settings supports children's autonomy and improves self-regulation of energy intake. However, during COVID-19, CDC passed a directive to ECE to pause family style meal service. Therefore, we conducted an ECE webinar focused on how to feed children responsively during plated meal service to help providers support children's autonomy and self-regulation. <h3>Objective</h3> To evaluate changes in the level of understanding, behavioral intention to implement knowledge, and confidence about how to feed children (2-5 years) responsively during plated meal service. Also, to determine need for future training opportunities. <h3>Study Design, Setting, Participants</h3> Retrospective pretest-posttest study. The webinar was advertised through an email newsletter disseminated by a national-level platform, Penn State Extension Better Kid Care. Participants attended the online webinar for 1 hour on August 11, 2020, had access to an Extension publication (http://bit.ly/3pnJ71X) and responded to a follow-up survey (Qualtrics Link: http://bit.ly/3jMWvvv). Participants identified themselves as either ECE providers (n = 77) or other stakeholders (n = 30), who can offer opportunities or guidance to providers. <h3>Measurable Outcome/Analysis</h3> Change in self-reported evaluation score (range 1=low to 7=high) for understanding, behavioral intention to implement knowledge, and confidence about how to feed children responsively during plated meal service. Paired sample <i>t</i> tests (alpha = 0.05) followed by Sidak-Bonferroni correction (adjusted <i>P</i> = 0.007). <h3>Results</h3> Both providers and stakeholders reported significantly higher (<i>P</i> < 0.001) level of understanding, intention to implement knowledge obtained, and confidence regarding implementing responsive feeding during plated meal service after the webinar compared to before the webinar. Participants expressed need for online nutrition trainings with emerging themes such as feeding infants, safe food preparation and storage, flexibility of CACFP rules, and physical distance during meals. <h3>Conclusion</h3> Intentional mealtime conversations, giving children small tasks supporting their autonomy, and setting clear expectations while adjusting mealtime routines can offer a promising avenue for implementing responsive feeding during plated meal service.

Associations Between Community Nutrition Environments and Early Care and Education Classroom Nutrition Practices

ObjectivesPoor child diet is influenced by nutrition environments surrounding schools and homes; influence of these environments on Early Care and Education (ECE) settings is not understood. The purpose of this study was to determine associations between community nutrition environments and ECE classroom nutrition practices, by ECE context [Head Starts, community-based childcare (CBCs), and family child care homes (FCCHs)]. MethodsCross-sectional study including licensed Oklahoma ECEs. Locations of 457 grocery stores were determined in-person. Locations of participating ECEs and grocery stores were geocoded and analyzed in ArcMap 10.6. ECEs were considered located within a “Food Desert” if no grocery stores were available within a 0.25-mile radius for urban ECEs, or 10-mile radius for rural ECEs. ECE directors completed the Nutrition and Physical Activity Self-Assessment tool (i.e., NAP SACC); items were reported on a Likert-type scale and subscores were calculated for nutrition practices. Wilcoxon Rank Sum test was performed to compare practice scores among those located within a Food Desert versus Non-Desert. Benjamini Hochberg calculations for False Discovery Rate were applied (α< 0.004). Results54 Head Starts, 159 CBCs, and 160 FCCHs participated with 24%, 27% and 37%- respectively- being located within a Food Desert. ECE descriptive characteristics including food purchasing and meal planning strategies varied by ECE context. Head Starts demonstrated the highest classroom nutrition scores for mealtime practices, and nutrition education and policy. Food Desert status was not related to classroom nutrition practice scores for any ECE context (P > 0.004). ConclusionsContrary to studies in residential areas and schools, nutrition environments were not related to nutrition practices in ECEs. This suggests that ECEs may serve as protective micro-environments supporting health for children more vulnerable to the health environments of their nearby residing communities. Supporting health practices for ECEs may be achieved most effectively through within-center intervention and policy. Funding SourcesThis study was funded by the Early Care and Research Scholars: Head Start Graduate Student Research Grant (HHS2017-ACF-OPRE-YR-1219), OUHSC College of Allied Health Student Research and Creativity Grant, and Department of Nutritional Sciences.

REALISING THE CHILD'S RIGHTS IN EARLY CHILDHOOD IN THE CONTEXT OF CHILDREN’S SOCIAL PARTICIPATION: THE CASE OF THE CHILD’S RIGHT TO A FAMILY

The article presents the need to make the culture of children's rights fundamental from the earliest years of their lives, given the idea of children's social participation. Creating and practising such a culture throughout childhood is a task that requires not only a thorough knowledge of the child’s rights among both parents and teachers but also the wider acceptance of these ideas and the creation of the right environment for sharing and speaking up for them both at home and in early education settings. The academic and colloquial discourse on parental practices and institutional childcare often overlooks the dimension/significance of recognising children's participation in safeguarding their human rights. Meanwhile, the processes of early normative socialisation are of great importance to their development and their future attitudes towards law in general and towards their human rights and others' rights. Social participation is where the child can experience his or her rights and learn about respecting others' rights. With this in mind, a question must be asked about how children's rights are realised in early childhood in the context of their participation in the socialisation process. The author uses the example of the child’s right to a family as a lens to observe how the idea of the children’s participation in securing children’s rights may be realised or violated. The article is based on an analysis of the subject's literature, in which legal discourse and teachings on child-rearing and early education are used as the interpretative context.

Testing a holistic conceptual framework for early childhood teacher well-being

Using a holistic conceptualization of teacher well-being in concert with the Job Demands and Resources (JD-R) framework, our interdisciplinary study examined associations among various job demands and resources and whole teacher well-being (i.e., professional, psychological, and physical well-being) in early care and education settings. First, we investigated direct associations of job demands and resources with teachers' professional well-being. Second, we tested two models of potential mediation for the relationship of job demands and resources to well-being using structural equation modeling techniques: (a) that psychological and physical well-being mediate the relationship between demands, resources, and professional well-being; and (b) that professional well-being mediates the relationship between demands, resources, and psychological and physical well-being. Although our sample of early childhood teachers (n = 262) reported high levels of professional well-being (i.e., work commitment, self-efficacy), a substantial number of them experienced challenges in both psychological (e.g., perceived stress, depressive symptoms) and physical (e.g., ergonomic pain) well-being. As expected, teachers' work-related stressors and work resources (positive work climate, quality of the physical environment) were directly associated with teachers' professional well-being. Contrary to our expectations, however, instrumental resources (i.e, wages, health insurance) did not predict any aspects of teachers' professional well-being. Our data only supported the first of the two tested mediation hypotheses (i.e., that psychological and physical well-being mediated the associations between working conditions and professional well-being), but with one caveat: physical well-being preceded psychological well-being in mediating the associations. These results advance our understanding of the challenges present in the early childhood workforce and have implications for policies and programs to improve teacher working conditions and well-being.

How I Feel About My School-Adaptation and Validation of an Educational Well-Being Measure among Young Children in Sweden.

The well-being of children has received increasing attention in recent years. Nevertheless, we lack adequate brief self-report tools that enable us to consider young children’s well-being in policy evaluations and educational research. This study describes the adaptation and first validation of the Swedish version of How I Feel About My School (HIFAMS), a subjective well-being questionnaire suitable for children aged 4 to 12 years, which was originally developed in the United Kingdom (UK). Descriptive statistics with analysis of psychometric properties and confirmatory factor analysis (CFA) are based on the perceived well-being of 228 children in preschool and school aged 5 to 8 years old. The CFA endorsed a good fit to a one-factor model, and the scale showed moderate internal consistency (rα = 0.63). The results are largely in line with the findings of the original HIFAMS. We conclude that the Swedish version can be applied in early preschool/school settings and could provide first-hand information about children’s well-being from the first years of education until elementary school grades. Practitioners in early education settings might benefit from HIFAMS assessments when seeking to understand children’s current well-being to provide support to children with special educational needs or children at risk for mental health issues. Researchers could use the HIFAMS to standardize child well-being evaluations in policy evaluations and interventional studies.

Work discussion groups in Greek nurseries: the experience of facilitators and participants

ABSTRACT The paper presents qualitative research on the experience of facilitators and participants in work discussion groups in Greek nurseries. Work discussion groups offer a powerful mode of learning and development, not only in psychoanalytic oriented training but in educational settings in general, as they focus on the understanding of the emotional processes that underlie teaching and learning. Although there is evidence that provision of work discussion groups to teaching staff can have a far-reaching impact (i.e., they can help teachers manage the challenges of their work, reduce work-related stress, and promote the development of reflective practice), research on work discussion groups in early education settings is scarce. The present research aspires to contribute to this topic. Five facilitators and six nursery teachers who had participated for at least one year in work discussion groups run in Greek nurseries were interviewed on their experience. Their accounts were analysed using thematic analysis. The themes extracted from their accounts are compared and contrasted. The results demonstrate the generally positive experience from the work discussion groups in Greek nurseries, as reported by facilitators and teachers. The experience of being in a discussion group had an important impact on most nursery teachers, both on a professional and personal level. Suggestions for improvement of the experience, including the clear definition and safeguarding of the work discussion group’s setting, are discussed.

Stakeholder selected strategies for obesity prevention in childcare: results from a small-scale cluster randomized hybrid type III trial

BackgroundTogether, We Inspire Smart Eating (WISE) is an intervention for the early care and education setting to support children’s exposure to and intake of fruits and vegetables. WISE emphasizes 4 evidence-based practices (EBPs): (1) use of a mascot; (2) educators’ role modeling; (3) positive feeding practices; and (4) hands-on exposures. The current study reports on a small-scale implementation trial aimed at improving the use of WISE EBPs by teachers.MethodsA Hybrid Type III Cluster Randomized Design compared a Basic and Enhanced implementation strategy. The Basic Strategy included training and reminders only; the Enhanced strategy was a multi-faceted package of stakeholder-selected strategies including a leadership commitment, an implementation blueprint, a local champion, an environmental reminder of the EBPs, facilitation, and tailored educational resources and incentives. All study sites were Head Starts. Sites were randomized using a balancing technique that considered site characteristics; 4 sites (20 classrooms, 39 educators, 305 children) received Enhanced support; 5 sites (18 classrooms, 36 educators, 316 children) received Basic support. RE-AIM guided the evaluation, and implementation fidelity was the primary outcome. Strategies were assessed using examination of data distributions and unadjusted comparisons (t tests) as well as general linear and mixed effects models controlling for covariates.ResultsFor the primary outcome of fidelity, the Enhanced group had significantly higher means for 3 of 4 EBPs. Multivariate models explained a significant portion of variance for both mascot use and hands-on exposure with a significant positive effect observed for treatment condition. The Enhanced group also had higher rates of Appropriateness and Organizational Readiness for Implementing Change (as indicators of implementation and adoption, respectively). There was no significant difference between groups for indicators of Reach, Effectiveness or Maintenance. Formative interviews indicated key targets for iteration and potential mechanisms. Key events were catalogued to provide context for interpretation (e.g., 61% of classrooms with turnover).ConclusionsFindings were mixed but suggested promise for the Enhanced strategy, especially considering key events of the study. Implementation fidelity improvements occurred mainly in the last 3 months of the school year; additional time may be needed to translate to improvements in child outcomes.Trial registrationNCT03075085 Registered 20 February 2017.

Food Program Participation Influences Nutrition Practices in Early Care and Education Settings

ObjectiveTo determine differences by Child and Adult Care Food Program (CACFP) participation on nutrition requirements and best practices and barriers to implementing both in early care and education programs (ECEs) stratified by context (centers vs home-based ECEs). DesignCross-sectional survey. SettingThree-thousand and fourteen licensed Nebraska ECEs in 2017. ParticipantsOne-thousand three hundred forty-five ECEs. Main Outcome Measure(s)Director-reported nutrition practices in classrooms serving children aged 2-5 years (8 requirements for foods served, 5 best practices for foods served, and 14 best practices for mealtime behaviors). AnalysisChi-square analysis adjusted for multiple comparisons. ResultsOf the sample, 86.8% participated in CACFP, 21.7% were center-based, and 78.3% were home-based. Overall, CACFP participation was related to the higher implementation of CACFP requirements for foods served (P < 0.004 for all) and receiving professional development on nutrition (P < 0.012). In home-based ECEs only, CACFP participation was related to a higher prevalence of serving meals family-style (P = 0.002); however, these practices had low implementation overall. Conclusion and ImplicationsFindings suggest strengthening of requirements to include staff mealtime behaviors beyond service of healthful foods. Improving CACFP enrollment and including CACFP standards in state licensing requirements may be key strategies for improving nutrition practices in ECEs.

Opportunities to Promote Healthy Weight Through Child Care Licensing Regulations: Trends in the United States, 2016-2020

BackgroundPolicies that support healthy nutrition and physical activity environments in early care and education (ECE) settings can help promote healthy weight in children. State child care licensing regulations are a critical mechanism for setting such policies. ObjectivesTo develop a research instrument to evaluate the promotion of healthy child weight in state child care licensing regulations and assess the strength of the regulations over time. DesignFor measure development, systematic reviews of evidence on the impact of healthy weight strategies relevant to the ECE environment were combined with expert stakeholder input to identify 15 healthy weight promotion policy standards and a coding tool to measure the strength and comprehensiveness of regulatory language matching these standards. For assessing the strength of regulations, the coding tool was applied to child care regulations nationwide in 2016 and again in 2020. Subjects/settingChild care licensing regulations in 2016 and 2020 for all 50 US states plus Washington DC. Outcome measuresStrength and comprehensiveness scores for state licensing regulations. Statistical analysesIntraclass correlation coefficients were calculated to estimate interrater reliability of the coding tool. Paired t tests were used to compare scores within states from 2016 to 2020. ResultsInterrater reliability for the coding tool had intraclass correlation coefficients of 0.81 for strength and 0.87 for comprehensiveness scores. Strength and comprehensiveness of states’ healthy weight promotion policies increased significantly over time (P < .001). However, most states still lack important healthy weight policies in their licensing regulations, such as prohibiting serving sugary drinks. ConclusionsThis study presents a reliable research instrument for measuring the strength and comprehensiveness of healthy weight promotion standards in child care licensing regulations. States have increased their incorporation of strategies for healthy weight into state policy.

Assessing health disparities in foods and beverages served in early care and education programs across Georgia.

Obesity disproportionately impacts children who are Black and Hispanic, those who live in rural communities and those who have low income. Predisposition to obesity early in life is profoundly impacted by feeding habits during the preschool years. The early care and education (ECE) setting impacts children's health by providing daily meals. The goal of this study was to identify whether or not health disparities in foods and beverages served in ECE programs in Georgia exist based on socioeconomic, demographic and geographic variables. A random sample was drawn from 3054 ECE programs across the state of Georgia. The likelihood of serving specific foods and beverages in ECE programs in the previous day was measured. Percentages and frequencies, logistic regressions, Spearman's rho and Odds ratio tests determined outcomes. A total of 974 surveys were returned. Data were stratified based on the income level of the participant families, race of enrolled children and geographic location of the ECE program. Disparities existed between programs based on race of enrolled children and geographic location. For example, although the odds of providing sweets increased by 0.6% as the percentage of Black children enrolled increased, the provision of healthier foods, such as the odds of providing fruits (P=.001), vegetables (P=.001) and protein (P=.001) also increased. However, after results were adjusted for covariates findings did not remain significant. Future research focused on evaluating the foods and beverages provided in ECE programs and the relationship of how income, race and location are related may provide further understanding about the disproportionate childhood obesity rates in America.