1. UK physical activity guidelines
UK-wide (joint CMOs)
Global evidence of the health benefits
Life course
Includes sedentary
Recommended amount for general health benefit
Apply to all
This set of guidelines, first published in July 2011 and titled Start Active, Stay Active, is the first time all four home countries have had the same guidelines – first joint report endorsed by all four Chief Medical Officers.
The guidelines are based on comprehensive reviews of research evidence and take account of publications which consider the revised guidelines in other developed countries such as USA, Australia and Canada.
These guidelines cover all age groups across the lifespan and for the first time include guidelines for early years (0-5 years).
The recommendations are based on prescribing a minimum level of physical activity to benefit health and focus on prevention of disease and are therefore not disease specific.
These guidelines apply to all, irrespective of gender, race, or socio-economic status, but should be interpreted with consideration of individual physical and mental capabilities.

2. Why the need for UK physical activity guidelines for the early years?
New evidence available
Follow lead of other major countries
Previous children and young people guidelines not appropriate for early years
The early years, ie, children aged 0-5 years, has not previously been included as their own population group in UK public health guidelines for physical activity.
These guidelines reflect a growing awareness that early life experiences impact upon future health outcomes, and draw on notable recent advances in the science of physical activity and health.
The UK has followed the lead of other countries including USA and Australia who published early years guidelines in 2009, prior to the release of the 2011 CMO UK physical activity guidelines.
5-18 years guidelines specify an intensity – not developmentally appropriate for the early years. Early years need time to develop fundamental movement skills and master their physical environment. This cannot be accomplished in one hour. They need ample time spread throughout the day and to reflect the sporadic nature of this age group’s activity patterns.

3. UK physical activity guidelines: Early years1
Guideline 1 (infants who cannot yet walk unaided) Physical activity should be encouraged from birth, particularly through floor-based play and water-based activities in safe environments.
There is considerable expert opinion from many international sources that letting children crawl, play and roll around on the floor in the home or childcare setting is essential during the early years, particularly for children who cannot yet walk.

4. Types of physical activity: Non-walkers1
Guideline 1
Crawl, roll, play on floor
‘Tummy time’
New movements using large muscle groups
Reaching for and grasping objects, pulling, pushing and playing with other people
‘Parent and baby’ swim sessions
Crawl, roll, play on floor
- lots of unrestricted time to move and play on the floor. Important for development of children’s early motor skills, to learn how to control their bodies and move well, to discover their hands and feet and space around them - ‘making sense of the world’.
Tummy time
- as well as time on their back, it is important to have daily opportunities to move on their tummies. This is important for strengthening the muscles in babies’ arms, legs, back and neck. ‘Little and often’ is best as some babies find it hard to tolerate this position for too long. Back to sleep campaign due to cot death fears have meant babies are spending much less time on their fronts than they used to. Remember tummy time is only for when babies are awake and supervised. Babies should always be placed on their backs to sleep.
New movements
- need time to practise new movements. Babies learn new skills when their bodies are ready – physically strong enough but also when the brain and nerves are developed enough to send the right messages to the muscles. This will vary in different children. Development is age related but not age-determined. Tend to develop movements in the same order, although differences in how and when, eg, bottom shufflers vs crawlers and how long it takes to walk.
Reaching for and grasping objects, pulling and pushing objects
- Later, children need opportunities to practise rolling, creeping and crawling before being able to pull up, cruise around furniture and walk unaided.
Playing with other people
- Important for bonding, visual and language development. Movements such as gently spinning, swinging and rocking a baby, help to develop their balance (vestibular) system (how we deal with gravity and remain upright while moving).
Parent and baby swim sessions
- Offered at many local leisure centres.

5. UK physical activity guidelines: Early years1
Guideline 2 Children of pre-school age who are capable of walking unaided should be physically active daily for at least 180 minutes (3 hours), spread throughout the day.
Recommendations for the early years refer to all levels of physical activity, ie, light, moderate or vigorous (more energetic activity) without specific reference to intensity. Recommendations specifying a particular intensity of activity are not developmentally appropriate for this age group.
For this age group, it is the amount and nature of activity that is important, not the intensity.
Physical activity can be accumulated throughout a whole day and suits the intermittent nature of children’s play of this age. Also helps to break up too much ‘sitting time’.
By ‘physical activity’ we are referring to activities that involve movements of all the major muscle groups, ie, the legs, buttocks, shoulders and arms, and movement of the trunk (body) from one place to another.

6. Types of physical activity: Walkers1
Guideline 2
Unstructured, physically active play
Energetic play
Develop motor skills (locomotor, stability and object control)
Active travel and everyday activities
Unstructured physically active play
- Likely to make up the most of the 180 minutes.
- Should involve using large muscle groups and practising a wide range of movements
- Experience a wide range of play equipment
- Have fun and feel good about themselves
- Self exploratory
Some structured activity such as dancing, gymnastic-type movements and swimming can also make a valuable contribution.
Energetic play
- eg, running and chasing games which make children ‘huff and puff’ in short bouts are good for the development of the heart and lungs
- burns calories (important for maintaining healthy weight).
Developmental activities
- Locomotor - ie, travelling, eg, running, jumping, hopping, galloping, sliding
- Stability, eg, balancing activities, riding a bike, climbing, scooting
- Object control, eg, rolling, kicking, catching, throwing, striking a ball
Active travel
- Walking, cycling, scooting - even part way to places can help to build up stamina.
Everyday activities
- Both at the setting and in the home, encourage these activities
- Eg, setting the table and tidying away after meal times, tidying up and putting away toys, self-care activities (dressing, buttoning, putting on and taking off shoes).

7. UK physical activity guidelines: early years1
Guideline 3 All under-fives should minimise the amount of time spent being sedentary (being restrained or sitting) for extended periods (except time spent sleeping).
Although there is limited research exploring the health consequences of sedentary behaviour in children under five, there is emerging evidence that sedentary behaviour in the early years is associated with overweight and obesity as well as lower cognitive development.
Sedentary behaviour goes against the child’s natural tendencies to be active. Physical restraint, such as long periods in pushchairs or highchairs, is a common barrier to physical activity that is unique to this age group.
Reducing sedentary time can influence health but also provides more time to be active.

8. Sedentary behaviour1
Sedentary behaviour refers to a group of behaviours that occur whilst sitting or lying down and that typically require very low energy expenditure.
Research is at an early stage and consequences are not fully understood.
A risk factor for poor health independent of physical activity.
Research into the health consequences of sedentary behaviour is at an early stage. The main evidence references overweight and obesity across the life course. There is emerging evidence of a link between sedentary behaviour and lower cognitive development in the early years.
Patterns of sedentary behaviour are relatively stable over time so it’s important to minimise this type of behaviour from an early age.
Sedentary behaviour is a risk factor for poor health independent of physical activity (ie, being sufficiently active whilst being sedentary for long periods in between can still have negative health consequences). Therefore it is important to limit sedentary behaviours AND be physically active throughout the day.

9. Minimising sedentary behaviour1
Guideline 3
Reducing time spent in highchairs, infant carriers or buggies.
Reducing time spent in front of the TV or other screens.
Replacing motorised travel with active travel all or part of the way.
There are times when children will need to sit in a buggy, highchair or car seat. Reduce these times and break them up where possible. Some suggestions could be:
allow extra time on long journeys and take regular breaks
try not using the car for short trips
try just using the highchair at mealtimes
think about not leaving the TV on during mealtimes or when children are playing
children copy adults so care must be taken with how often they see adults watching television or playing with the computer.

10. Active children… Active adults?
Physical activity patterns established in the early years persist at a moderate level into the primary school years
Establishing a high level of physical activity early on in life may have implications for activity levels in later childhood and beyond
Data from tracking studies show support for a link between higher levels of physical activity leading to more sustained participation in physical activity in later years.
It is important to establish a high level of physical activity at the earliest age in order to provide the best start, to encourage physical activity patterns and habits later in childhood that are sufficient to benefit long term health. It is also understood that as activity levels tend to decline with age, it is important to establish high levels during early childhood in order that activity levels in later childhood are sufficient to benefit health.

11. Impact of physical activity on whole child1
Health and wellbeing
Improves cardiovascular health
Promotes healthy weight
Enhances bone and muscular development
Develops motor skills, movement and co-ordination
Improves cognitive development
Supports learning of social skills
Improves self-confidence
Evidence from observational research and a small number of experimental studies indicates that regular physical activity is valuable in developing motor skills, promoting healthy weight, enhancing bone and muscular development, and for the learning of social skills. Physical activities involving the use of large muscle groups are likely to be more energetic activities and especially good for the development of the heart and lungs.
The physical activity guidelines highlight the essential role of physical activity in promoting physical and psychological development during these years and contributing towards establishing patterns of behaviour that may persist into later childhood and adulthood.

12. Impact of physical activity on the whole child2-4
Health and wellbeing
Essential component for energy balance and weight control.
Higher levels of inactivity are associated with increased levels of obesity.
Critical role in the brain development of young children.
Obesity
Strongest evidence of health benefits in the early years is around preventing obesity and maintaining a healthy weight.
Higher levels of television viewing has been linked with obesity in the early years.
Cause and effect relationship is still unclear however as obese children may choose to watch television rather than activities that require higher energy expenditure. Physical activity or early movement experiences and interactions with close adults have a large role to play in this critical early development.
Brain development
In recent years, there has been a growing awareness about the importance of physical activity for babies and young children - through increased research and knowledge, especially around the neurosciences and the effects of early life experiences on the brain.
This evidence is telling us that the critical time for the development of the brain is between birth and the age of three.

13. Impact of physical activity on the whole child
Cognitive ‘thinking’
Creativity and discovery
Problem solving skills
Good listening skills
Enhanced memory skills
Creativity and discovery - experimentation and exploration, developing imagination, thinking in different ways. FREE PLAY.
Problem solving skills - thinking critically and making choices for themselves; ability to set challenges and desire to seek solutions to problems and challenges.
Good listening skills - the ability to listen in a range of situations, listening to others and responding appropriately.
Enhanced memory skills - repetition and practice of different movements help to develop this.

14. Impact of physical activity on the whole child
Physical development
Stamina
Strength
Mobility
Motor skills
Stamina – developed through continuous bouts, eg, walking and more energetic activity, eg, running, scooting.
Strength and mobility – developed through exposure to a wide variety of different play experiences and equipment.
Motor skills – learning to move with confidence and control including: stability (core, shoulder, hand), agility, hand-eye-foot co-ordination, rhythm and timing (musicality), balance and spatial awareness.

15. Impact of physical activity on the whole child
Personal, social and emotional outcomes
Fair play
Co-operation
Language and communication
Confidence
Optimism
Resilience
Sense of self belief
Behavioural flexibility
Fair play – knowing how to behave and what is acceptable
Cooperation – taking turns, sharing, playing by the rules in play and games situations.
Language and communication – listening attentively, responding with comments, questions or actions, speaking confidently in a familiar group, understanding movement vocabulary.
Confidence – trying new activities, working in a group, asking for help if needed.
Optimism – enjoying their own achievements, wanting to try out new activities even if they sense they may not achieve success first time but willingness to ‘have a go’.
Resilience – coping with stressful situations.
Sense of self belief – adopting a ‘can do’ approach and perseverance that they will be able to achieve in the end.
Behavioural flexibility – being able to adapt emotionally to new situations without becoming stressed.

16. Key messages: Early years1
Frequency: daily
Intensity: no specific intensity
Time: at least 3 hours
Type: physically active play
Frequency: Some health benefits result from acute responses in the hour period following physical activity. There is a dose-response relationship between physical activity and health benefits which indicates that ‘more is better’.
Intensity: For walkers, the 180 minutes can be physical activity of any intensity. This aligns with the types of physical activity most naturally occurring during the early years, including intermittent and sporadic patterns.
Time: 180 minutes or 3 hours refers to the minimum amount of time required to gain health benefits. However, participation in physical activity at a level greater than this will provide additional health gains.
Type: Walkers - activities that tend to be spontaneous, unstructured and intrinsically motivated, but which involve movements of large muscle groups and involves movement of the trunk (body) from one place to another. Non-walkers – lots of unrestricted free movement on the floor.

17. Factors influencing physical activity
Physical activity is a complex, multi-dimensional behaviour influenced by a wide range of factors.
Young children have relatively little control over their behaviours.
Understanding the correlates of physical activity is important in changing behaviour.
Physical activity is a complex, multi-dimensional behaviour influenced by a wide range of factors (typically referred to as correlates) operating at individual, social and environmental levels.
Young children have relatively little control over their behaviours, therefore social and environmental characteristics that facilitate or impair physical activity may be particularly important.
Understanding the correlates of physical activity helps to identify population groups that should be targeted for intervention and indicates how we may go about changing behaviour.
The following slides summarise the influence of various factors on physical activity patterns in the early years, drawing from recent reviews of the literature.
For more information download the early years practice briefing:

18. Factors influencing physical activity: Early years5,6,7
Demographic factors
Boys are generally more active than girls.
Activity levels in this age group are generally stable and do not change significantly with age.
Unclear whether a child’s ethnicity or BMI/weight has an impact on their activity levels between the ages of 0-5 years.
Compared to older children, the gender gap in physical activity levels is relatively small in this age group (0-5 years) although boys are generally more active than girls.
Across this age group the time spent being physically active does not vary greatly.

19. Factors influencing physical activity: Early years6,7,8
Social/cultural factors
A child who watches more television or spends much of their time sitting may have lower overall physical activity levels.
Parent-child interactions and role modelling appear to encourage higher levels of physical activity in young children.
A parent’s weight and physical activity levels have mixed effects on their children’s physical activity levels.
*TV viewing: Note, some studies have reported no association between TV viewing and physical activity levels.
While parental encouragement does not appear to change physical activity in the early years, parent-child interactions and role modelling appear to encourage higher levels of physical activity in young children.
Unrelated/mixed effects:
Parental education level has shown mixed influences on their child’s physical activity levels
Socio-economic status is not related to the time a child spends being physically active.

20. Factors influencing physical activity: Early years6,7,8,9
Environmental factors
Fewer children within a setting, shorter breaks and more time between breaks can increase levels of physical activity.
Children who spend more time playing outdoors have higher levels of physical activity.
Settings with fewer children, shorter breaks and more time between breaks were found to have higher levels of physical activity. Children in the same setting often had similar physical activity levels.
Weather has been found to have a mixed effect on children’s physical activity levels.

21. Physical activity levels in England: Survey data10
Based on the 2011 UK physical activity guidelines, in England, in 2012:
9% of boys and 10% of girls aged 2-4 years were classified as meeting the current guidelines for children aged under 5 of at least three hours of physical activity per day.
84% of children of this age were classified in the ‘low activity’ group.*
*‘Low activity’ meaning that they did less than an hour of activity a day, or did not do sufficient physical activity each day.
The proportion of children meeting this guideline did not vary significantly by BMI category. According to data from the National Child Measurement Programme for the 2012/13 school year, in Reception, over a fifth (22.2%) of the children measured in England were either overweight or obese (12).
There is currently no appropriate data for Scotland, Northern Ireland and Wales.

22. Sedentary levels in the early years
In the UK, for children aged 3 and 4 years, the average time spent being sedentary is hours a day11.
In the early years, typical sedentary behaviours might include watching TV, travelling by car, bus or train, or being strapped into a buggy.
Sedentary behaviour refers to a group of behaviours that occur whilst sitting or lying down and that typically require very low energy expenditure.
Sedentary time above was based on a systematic review of papers measuring sedentary behaviour in the early years.
These are some examples of typical sedentary behaviours, but any seated activity that limits opportunities for movement can be classified as sedentary. It is recommended to reduce these sedentary times in order to increase physical activity. Sleep is the exception to this.
Time spent being sedentary limits the time available to be active. The 2011 CMO guidelines recommend that young children need a minimum of 180 minutes (3 hours) of physical activity a day for good health and wellbeing and to learn new developmental skills - any less is not sufficient to do this.

23. Key recommendations for promoting physical activity
Early years
Planning and developing physical activity initiatives.
Working with parents and carers.
Increasing physical activity in early years settings.
Current available evidence suggests key components of successful interventions to promote physical activity in the early years fall into these three categories:
Planning and developing physical activity initiatives: These slides outline the evidence-based recommendations for actions that should be taken or components that should be put into place when planning and developing physical activity initiatives for the early years.
Working with parents and carers: These slides outline the evidence-based recommendations for working directly with parents and carers in either a community or early years setting which are essential for ensuring children in the early years have sufficient opportunities to be physically active.
Increasing physical activity in early years settings: These slides outline the evidence-based recommendations to help those working in early years settings effectively increase physical activity and decrease sedentary behaviour in children under five.

24. Planning and developing physical activity initiatives
Recommendation 1
Develop initiatives that target adults who interact with children in the early years.
Recommendation 2
Consult with parents and carers to identify their needs and barriers.
These evidence-based recommendations are BHFNC suggestions for actions that should be taken or components that should be put into place when planning and developing physical activity initiatives for the early years.
Recommendation 1
Target activities and resources at those who have responsibility for the child and their day to day activities.
Work with those who have high levels of contact with children in the early years, such as early years practitioners, parents and carers.
Recommendation 2
Provide practical solutions for issues that might hinder attendance, for example, provide options for childcare at the venue or make the session child friendly.
Work with parents and carers during sessions to help identify what may be hindering their child from being active and provide them with practical examples of how to overcome these barriers.
For example, if the child is shy or reluctant to play in groups, they may need gentle encouragement from an adult to play with them or another child.

25. Planning and developing physical activity initiatives
Recommendation 3
Use an integrated approach to help target information at parents and carers.
Recommendation 4
Use multi-component approaches when delivering information.
Recommendation 3
Use nurseries, children’s centres and schools to provide information to parents and carers on the importance and benefits of physical activity and provide ideas on what they can do with their children to help them be more physically active.
Work in partnership with local medical, health and social services in order to send consistent messages on physical activity to parents and carers.
Recommendation 4
Use a variety of different communications, such as leaflets, posters or texts to relay physical activity messages to parents and carers.
Work in partnership with local services to provide parents and carers with consistent physical activity messages, eg, agree with health visitors or early years settings about how and what information is provided to parents and carers.

26. Working with parents and carers
Recommendation 1
Provide parents and carers with information on the importance of physical activity and the adverse effects of too much sitting time.
Recommendation 2
Educate parents and carers about what counts as physical activity.
Recommendation 3
Create age inclusive promotional materials for education and activity sessions.
Recommendation 1
Provide parents/carers with a leaflet from a school or trusted source or include it as an element of a parenting class.
Where appropriate, provide informational materials for parents and carers in multiple languages and at a suitable reading level for the target population.
Verbal communication may be more appropriate for some parents.
Recommendation 2
Provide parents with concrete examples of what physical activity looks like at different stages of development, eg, tummy time for non-walkers
Motivate parents and carers to critically evaluate the types of activities their children participate in, eg, sedentary vs. energetic activities
Provide parents and carers with a range of stage appropriate indoor and outdoor activity ideas for their child.
Work with parents to identify how long their child participates in each type of activity and provide parents with ideas on how they can balance sedentary activities with more energetic ones.
Recommendation 3
Use an inclusive title and description when creating promotional materials, e.g. ‘Do you want a baby/child that sleeps well at night? Find out how physical activity can help’.
Use the age or stage, eg, babies or non-walkers, of the child as the only inclusion criteria on promotional materials, eg, use stage not weight status.

27. Increasing physical activity in early years settings
Recommendation 1
Ensure appropriate levels of practitioner training and support are in place.
Recommendation 2
Partner with external agencies to help practitioners develop their physical activity knowledge and expertise.
Recommendation 1
Consult with setting managers to ensure appropriate levels of practitioner support are in place.
Work with practitioners at each setting to identify and fulfil training and support needs.
Provide ‘booster’ training and information sessions to refresh practitioners’ skills and knowledge for promoting physical activity and reducing sedentary behaviour within their setting which may help to develop their confidence.
Provide practitioners with a range of activity ideas for both outdoors and indoors.
Recommendation 2
Identify community based support systems, such as a physical activity co-ordinator or local authority health improvement team, which can work with practitioners to help provide physical activity sessions for the children or can facilitate practitioners’ training sessions.
Consider the individual needs of the setting and practitioners to determine how best to provide support.

28. Increasing physical activity in early years settings
Recommendation 3
Involve parents and carers both directly and indirectly in the activities to ensure they are also carried out in the home environment.
Recommendation 4
Offer more frequent short periods of outdoor play.
Recommendation 5
Provide more ‘activity friendly’ portable equipment.
Recommendation 3
Get parents involved directly through the setting, eg, invite them for a ‘Stay and play session’ or put on educational sessions.
Provide practitioners with specific training on how to promote physical activity for children in the early years to parents and carers
Involve parents and carers indirectly by speaking with them or providing visual prompts which let them know what physical activities their child has been doing during the day.
Provide parents and carers with physical activity ideas for the home environment.
Recommendation 4
Modify break times in order to provide shorter breaks, eg, minutes, and more frequent outdoor play sessions rather than fewer, longer breaks, eg, 2 x 30 minutes.
Recommendation 5
Provide a variety of smaller objects for children to play with, such as balls, push or pull toys and tricycles rather than just large fixed equipment.
Provide parents with physical activity ideas along with a ‘take home bag’ of activity friendly equipment or list of everyday household items which can be used to promote physical activity, such as lengths of materials with different textures, eg, chiffon, scrunched paper, cotton wool, or balls of different sizes and colours.

29. Increasing physical activity in early years settings
Recommendation 6
Include adult-led activities to improve motor skills.
Recommendation 7
Use physical activity as a medium through which to integrate all areas of learning and development.
Recommendation 8
Ensure a balance of free play and adult-led physical activity opportunities.
Recommendation 6
Provide adult-led activity sessions throughout the day which offer children an opportunity to practise and improve motor skills
Work towards providing older children (pre-schoolers) with longer activity sessions.
Recommendation 7
Consider, when planning any activities, how they can be made more active.
Use physical activity to support other areas of the curriculum, eg, language and communication development by using lots of movement vocabulary in the activities played.
Recommendation 8
Provide specific opportunities for appropriate stage of physical development, such as tummy time and crawling activities for babies and movement games for walkers, within the early years setting’s daily routine.
Assess indoor and outdoor environments, and if possible rearrange them to offer more free space for active play.
Balance adult-led activity sessions with opportunities for indoor and outdoor free play.
Repeat activities to allow for lots of ‘practice time’, so young children have ample opportunities to master their environment and refine their newly learned skills.

30. Policy levers
Health risk of sedentary behaviour Sedentary behaviour in the early years is associated with overweight and obesity and lower cognitive development. Overweight and obesity Children who are overweight and obese in the early years are more likely to grow up to be overweight and obese as adults.
A policy lever is a feature/angle which can be used to gain government interest and support and which is already aligned to their agenda priorities.
Programmes are more likely to gain funding/support if the government recognises these features as important.
Health risk of sedentary behaviour
Beginning to know that patterns of sedentary behaviour (especially TV viewing) are relatively stable over time.
There is a need to establish healthy patterns of behaviour during the early years to protect against possible health detriments in the future.
Accepted that sedentary behaviour displaces time to be physically active.
Being less active gives less time for young children to develop cognitively through the physical activities they would otherwise be engaged in.
Overweight and obesity
There is growing awareness that early life experiences impact on future health outcomes. (1)
The National Child Measurement programme data for 2012/2013 highlights in England how the incidence of children who are overweight and obese in reception increases from 21.2% (girls) and 23.2% (boys) in reception to 31.8% (girls) and 34.8% (boys) by year 6 (12).
Data on the patterns of physical activity among children and young people suggest that they decline as they age (13). Therefore it would seem critical to encourage a high level in the early years to help offset the inevitable decline and associated health detriments.

31. Policy levers Health and wellbeing benefits
Physical activity is central to optimal growth and development in the under fives.
Physical development
Physical development is now recognised as being important to children’s overall development in the early years in all four UK early years curriculums.
Health and wellbeing benefits
Physical activity in the early years provides immediate and long term benefits for physical health and psychological wellbeing.
Studies have shown that physical activity in the early years is important for developing motor skills, promoting healthy weight, enhancing bone and muscular development and for the learning of social skills.
One study has suggested that by acquiring basic motor skills in the early years, this can lead to children developing more confidence and wanting to participate in more physical activity (14).
Physical development
Early movement opportunities and physical activities are the primary activity which enables babies and young children to develop physically, especially their gross motor skills.
In the Early Years Foundation Stage in England, physical development is one of the three prime areas of learning (along with communication and language and personal, social and emotional development) (15).
In the Foundation stage/phase in Northern Ireland and Wales, respectively, physical development is a statutory area of learning (16,17).
In the Curriculum for Excellence (age 3-18 years) in Scotland, development in movement skills, competencies and concepts are an experience and outcome expected in the Health and wellbeing curriculum area.

32. Policy levers4 Brain development
Physically active play can contribute to the development of many important brain structures
‘In the early life period, interactions and experiences determine whether a child’s brain architecture provides a strong or weak foundation for their future health, wellbeing and development’18
Brain development
Development of neural structures (the ‘firing up’ of synapses and connections) between birth and the age of three is an important ‘window’ for development. When babies are born, 25% of their brains are developed. By age 3, their brains are 80% developed (18).
This neural development is considered to be especially important for their social and emotional development (18).
Aspects of social and emotional development can include:
behavioural flexibility
confidence
self esteem and sense of self belief
resilience
language and communication - listening attentively, responding with comments, questions or actions, speaking in a familiar group
co-operation - taking turns, sharing, appropriate behaviour in group play.

33. Implications for policy makers
Promote physical activity through new policy measures.
Review early years curriculums and consider how to incorporate physical activity sessions.
Ensure all families are able to use suitable play areas in the local communities.
Consider appropriate training and support to early years practitioners and teachers to help successfully deliver physical activity programmes.

34. Implications for practitioners
Provide children with opportunities to learn new skills.
Ensure children have regular access to equipment and the outdoor environment/space.
Modify break times to encourage more focused sessions of outdoor play.
Practitioners can also:
utilise training courses and resources to increase knowledge and understanding
work with parents to help them understand the importance of early movement experiences.
Children learn by copying and modelling behaviour so it is important that adults (including practitioners) are seen to be physically active throughout the day.

35. Implications for parents/carers
Provide opportunities for children to be active daily, in a variety of outside environments.
Be an active role model by participating in physical activity with and without their child.
Give both boys and girls the same chance to try a variety of active play experiences.
Further implications for parents/carers
Work with their child’s early years setting to:
stay informed about the physical activity experiences their child is having
provide similar/new movement opportunities at home
send their child suitably dressed to participate in both indoor and outdoor activities whatever the weather.

36. BHFNC resource: Early years guidelines
These booklets provide early years professionals with:
an overview of the guidelines and the importance of physical activity
examples of the types of activity suitable for infants who are walking and not walking
ways to reduce sedentary behaviour and promote physical activity.
The BHFNC has produced these booklets for early years professionals working with young children who have started walking, and those who have not.
They interpret the UK physical activity guidelines by:
Setting the context - explain why they are needed, health benefits, physical activity levels and state what the guidelines are.
Interpreting the guidelines - provide detail on each guideline to explain what they mean in practice with lots of practical examples.
To download these resources visit

37. BHFNC resource: Practice briefing
This practice briefing is designed to give practitioners and managers of early years settings practical ideas for promoting physical activity with the under fives
The recommendations in this briefing are based on research evidence and recognise that early years practitioners, as well as parents and carers, can strongly influence the physical activity opportunities available to young children.
To download this resource visit

38. BHFNC resources: Fact sheets
This series of three BHFNC fact sheets provide on overview of the facts on physical activity for the under fives.
This series of three BHFNC fact sheets provide the facts on physical activity for the under fives. They are ideal for practitioners who want the facts and figures relating to physical activity in the early years.
To download these resources visit go to early years --> our resources --> fact sheets

39. BHF resources: Parent leaflets
These leaflets are designed for parents and carers and include information on why being active is important, what types of activity are best and ideas for active play at home.
To download these resources visit and put Help your child move and play or Help your baby move and play into the search box
The Help your baby move and play every day leaflet is designed for parents and carers of young babies who have not yet started to walk. It includes information on how much physical activity babies need to do to benefit their health as well as practical physical activity ideas and how these can be incorporated into a daily routine.
The Help your child move and play every day leaflet includes information on why being active is important and what types of activity are best, ideas for active play at home and outdoors, how to reduce sitting time and healthy eating for young children.
You can also order hard copies by ing or calling

40. BHF resources: Early movers
Helps early years practitioners plan and organise physically active play environments for children under five. It supports a whole setting approach to physical activity and also provides innovative ideas to extend physical activity provision.
This pack is designed to help early years practitioners plan and organise physically active play environments for children under five.
Written and collated by the BHF National Centre for Physical Activity and Health, the Early movers guide helps early years settings build on existing practices by supporting a whole setting approach to physical activity. It also provides innovative ideas to extend physical activity provision.
This guide is relevant to all settings who provide care to children from birth up to the age of five. It can also be used by professionals who provide support to settings, such as health improvement officers or early years advisers, where physical activity may be one element of a focus on healthy lifestyles.
The pack includes seven booklets for early years practitioners to help plan, organise and deliver physical activity with the under fives.
To download this resource visit and search Early movers
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41. References
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