Toolkit for Integrating Healthy Physical and Mental
Development in Early Learning Guidelines
Toolkit Background, Development, and Components

A child’s health status is comprised of physical, emotional and social well-being. “Ongoing research confirms that children’s readiness for school is multifaceted, encompassing the whole range of physical, social, emotional, language and cognitive skills that children need to thrive” (Rhode Island KIDS COUNT, The National School Readiness Indicators Initiative, 2005, p. 3). Thus health figures importantly in children’s ability to engage in learning with their peers so, “readiness for school should be measured and addressed across the five distinct but connected domains:
  1. Physical Well-Being and Motor Development
  2. Social and Emotional Development
  3. Approaches to Learning
  4. Language Development
  5. Cognition and General Knowledge” (p. 6).

As states and territories develop Early Learning Guidelines (ELGs) to support the consistent quality of the education of young children, these domains or content areas are often represented. The Toolkit for Integrating Healthy Physical and Mental Development in Early Learning Guidelines was developed to assist in the evaluation and integration of healthy physical and mental development content into the state’s ELGs.

The Toolkit for Integrating Healthy Physical and Mental Development in Early Learning Guidelines is based upon the National Resource Center for Health and Safety in Child Care and Early Education’s study of health and safety topics in states’ early learning guidelines (ELGs). Online documents from 48 states and the District of Columbia were reviewed between November 2006 and January 2007. The reviewed documents were in varying stages of development. The guidelines and standards addressed children ages birth to five, birth to three, and three to five. States/territories typically focus their guidelines on the child’s learning tasks. Some documents also include program–focused guidelines or standards, as program, teacher, or caregiver tips, especially for younger age groups. Thus, the NRC studied both child-focused and program-focused health and safety content.

The NRC found that the domain of Physical and Motor Development (titles vary among documents) was usually present in ELGs, but the depth of treatment of health and safety learning tasks varied widely (National Resource Center for Health and Safety in Child Care and Early Education, 2007). The Toolkit may be used to facilitate the addition or revision of health and safety content in the state’s ELGs. level.

Fifteen 15 health and safety topics were chosen for inclusion in the Toolkit for Integrating Healthy Physical and Mental Development in Early Learning Guidelines. These are topics that support children’s well-being and readiness to learn, including children’s own learning to keep themselves safe and healthy. Selection of topic areas for inclusion in the Toolkit was guided by the findings of the NRC study, current pediatric research findings, and the NRC’s experience in assisting families and caregivers with their health and safety concerns. Also important to the selection process was consideration of 13 key indicators that have been identified as “the most critical standards to protect children from harm in out-of-home child care” (Fiene, 2002). The topics are (those related to the 13 indicators are denoted by an asterisk):
  1. Hand Washing*
  2. Illness (cough, cold, etc.)
  3. Immunizations*
  4. Medication Administration*
  5. Nutrition
  6. Speech/Language Development
  7. Toileting
  8. Oral Health
  9. Vision
  10. Aggression/Self-Control
  11. Child Abuse*
  12. Emergency Preparedness*
  13. Fire Drills*
  14. Inaccessibility of Toxic Substances*
  15. Outdoor Playground Safety*

For each topical area, the Toolkit for Integrating Healthy Physical and Mental Development in Early Learning Guidelines provides:
  • The text of relevant Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care, 2nd Edition (CFOC) standards;
  • Links to related topics in Healthy Kids, Healthy Care (HKHC), the parent-friendly version of CFOC standards; and
  • States’ ELG examples.
CFOC standards serve as benchmarks for comprehensive treatment of health and safety issues. Healthy Kids, Healthy Care (HKHC) links provide examples of consumer friendly language.. Excerpts from states’ ELGs demonstrate how some states/territories address health and safety topics.

The Toolkit for Integrating Healthy Physical and Mental Development in Early Learning Guidelines form includes an area where teams can note whether health and safety content is: Absent, should be strengthened, or approaches the level of a national standard (CFOC). An Overall Health and Safety Profile is provided to summarize their findings and note potential action steps. This form can be printed out with the state's specific assessment.


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