MIDDLE CHILDHOOD

Healthy Lifestyles

Parents are a major influence on a child's level of physical activity. By participating in physical activity (e.g., biking, hiking, playing basketball or baseball) with their children, parents emphasize the importance of regular physical activity and show their children that physical activity can be fun. Parents' encouragement to be physically active significantly increases a child's activity level.3 Children are also influenced to participate in physical activity by other family members, peers, teachers, and people depicted in the media.

Teachers also influence a child's level of physical activity. Physical education should be provided at school every day, and enjoyable activities should be offered.

To achieve optimal growth and development, children need a variety of healthy foods that provide sufficient energy, protein, carbohydrates, fat, minerals, and vitamins. They need three meals per day plus snacks. During middle childhood, mealtimes take on more social significance, and children become affected by external influences (e.g., their peers, the media) regarding eating behaviors and attitudes toward food. Children also eat more meals away from home (e.g., at child care facilities, school, homes of friends and relatives). Parents and other family members continue to have the most influence on children's eating behaviors and attitudes toward food. Parents need to make sure that healthy foods are available, and they can be positive role models by practicing healthy eating behaviors themselves. In addition, parents need to provide guidance to help children make healthy food choices away from home.

Building Partnerships

Partnerships among health professionals, families, and communities are essential for ensuring that families receive guidance on physical activity. Health professionals need to give families the opportunity to discuss physical activity issues and concerns, and need to identify and contact community resources to help parents promote physical activity in children. However, there are many barriers. Some children do not have opportunities for participating in physical activity, and some live in unsafe neighborhoods. Communities need to provide physical activity programs through schools, recreation centers, and churches and other places of worship, and provide safe places for children to play.

Strengths, and Issues and Concerns

During health supervision visits, health professionals should emphasize the physical activity strengths of the child, family, and community (Table 9) and address any physical activity issues and concerns (Table 10).

Table 9. Physical Activity Strengths During Middle Childhood

Child	Family	Community
Participates in physical activity Enjoys physical activity Develops a positive attitude toward physical activity Is aware of and has opportunities to participate in physical activity Wants to improve motor skills Feels competent when participating in physical activity Is developing a sense of responsibility for own health Has positive role models for physical activity	Encourages the child to participate in physical activity Provides opportunities for the child to participate in physical activity Supervises the child during physical activity Ensures that the child uses appropriate safety equipment (e.g., helmet, wrist guards, elbow and knee pads) during physical activity Participates in physical activity with the child Provides positive role model by participating in physical activity	Promotes physical activity Provides programs that teach families about physical and motor skill development Provides opportunities for children to participate in physical activity Maintains policies (e.g., preservation of green space) and provides environmental support (e.g., well-maintained sidewalks, bicycle racks outside public facilities) that promote physical activity Provides safe environments for indoor and outdoor physical activity (e.g., walking and biking paths, playgrounds, parks, recreation centers) Provides support for families of children with special health care needs

 

Table 10. Physical Activity Issues and Concerns During Middle Childhood

Child	Family	Community
Has health problems Experiences motor skill or developmental delays Lacks opportunities to participate in physical activity Lacks friends or siblings to be physically active with Does not enjoy physical activity Does not feel competent when participating in physical activity Is embarrassed about appearance or lack of coordination Is shy or fearful of physical activity Has had unsuccessful or unpleasant experiences with physical activity Is more interested in sedentary behaviors (e.g., watching television and videotapes; playing computer games)	Does not encourage the child to participate in physical activity Does not advocate for physical education in schools Does not provide positive role model by participating in physical activity Does not participate in physical activity with the child Has health problems that affect the amount of time spent with the child Has a work schedule or other commitments that reduce the amount of time spent with the child Lacks space or equipment for physical activity	Lacks programs that promote physical activity in children Lacks safe environments for indoor and outdoor physical activity (e.g., walking and biking paths, playgrounds, parks, recreation centers) Lacks policies (e.g., preservation of green space) and does not provide environmental support (e.g., well-maintained sidewalks, bicycle racks outside public facilities) that promote physical activity Does not provide support for families of children with special health care needs

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