Physical Fitness

Physical fitness is crucial in everyone’s life, but is especially crucial in a child’s life during the early childhood years. The importance of physical fitness for young children includes the following in order to:

• Instill healthy fitness habits at a young age.
• Encourage development and growth.
• Practice new movement skills.
• Increase movement skill level.
• Prevent obesity.

There are many skills children are learning during the early childhood years. Some of those skills include running, jumping, climbing, throwing/catching a ball, and riding a tricycle. Practicing those skills can only lead to increased skill level. Physical activities such as an obstacle course and ball toss help children practice some of these skills and increase their skill level (Goodway & Robinson, 2006).

Lack of Physical Activity Consequences
Many things can go wrong if children do not engage in physical activity. For instance, development and growth can become delayed. I have a child in my classroom that is three years old. At home, he has been kept in a playpen or his car seat throughout his infancy and toddlerhood, and he still sits in a high chair at mealtimes. Because of the lack of physical activity during infancy and toddlerhood, he is very clumsy, and has very little gross motor skills. He was enrolled in my classroom in November. Upon the initial assessment of his skills, he was unable to hop in place, run without stumbling/falling, or work a simple puzzle. With the help of the other children and staff in the classroom, we have been able to teach him to hop in place, and he can now work a six-piece peg puzzle. I still have difficulty with him staying in his seat at mealtimes, due to the recent information that he still sits in a high chair at home. I am striving to educate his parents on the importance of physical activities and working with him at home at mealtimes.

Obesity/Overweight
Another health aspect that can go wrong in the absence of physical fitness activities includes obesity/overweight. It can lead to cardiovascular disease, including hypertension, high cholesterol, and diabetes. Obese children are also more likely to become obese adults. Low self-esteem is another aspect of obesity and being overweight that can hinder a child’s performance in school relationships with peers and adults (Childhood Overweight and Obesity, 2008). I have another child in my classroom that is overweight. Upon enrollment in my classroom, he was very shy, had very little self-help skills, and limited gross motor skills. He was enrolled in my classroom in March 2008. Now, he is the fastest tricycle rider in my class, he is completely potty-trained, and he will carry on a conversation with me. He is still overweight, but the implementation of physical activity in his lifestyle has transformed him into a pleasant, active, and independent child.

Family Involvement
Families can help children develop good fitness habits by incorporating well-balanced meals and frequent physical activities throughout the week. For example, my family strives to eat well-balanced meals and snacks. Our physical activities as a family are implemented at least two times a week. Activities in which we participate include throwing and catching a baseball, badminton, hiking/walking trails, and bike-riding. During the summer, we work in the garden, swim, and walk/run around our local walking track.

Teacher Involvement
Teachers can help children develop good fitness habits by incorporating nutrition activities and music and movement activities in the curriculum. We also strive to teach the children new skills. An activity the children in my classroom are working on or have already mastered includes the game “Duck, Duck, Goose.” The children not only learn the concepts of taking turns and one-to-one correspondence, but also gain gross motor skills by running in a circle. The second activity includes snipping or cutting with scissors. I begin fine-motor skills such as tearing paper in order for children to move onto the skill of snipping with scissors. Some of the children have already mastered this skill, others can only snip paper, while others do not know the proper way to hold scissors, depending on the age and skill level of the child.

Personal Attitude/Philosophy
I used this quote in one of my General Education courses, and again in a Sociology course. I refer to this quote again as an inspiration that captures my attitude and philosophy in fostering children’s healthy growth and development. “It takes a whole village to raise a healthy child” (Schilling & McOmber, 2006). No one person can take the credit for raising a child. Teachers, parents, siblings, grandparents, and other people in a child’s environment contribute to raising that child.

Positive Impact of Physical Activity
The positive impact that physical activity has on children’s health includes the following points:

• Physical activity helps foster development and growth, and improves skill level.
• Physical activity can lead to a more active, sociable lifestyle, resulting a positive relationships and high self-esteem.
• Physical activity patterns developed in childhood can last through adulthood. (Goodway & Robinson, 2006).
• Physical fitness, along with good nutrition habits can help “reduce health risk” (Team Nutrition Iowa, 2009). It can help prevent health problems, such as obesity/overweight and cardiovascular disease.

References

Centers for Disease Control and Prevention. (2008, November). Childhood overweight and obesity. Retrieved March 30, 2009 from http://www.cdc.gov/nccdphp/dnpa/obesity/childhood/

Goodway, J. D., & Robinson, L. E. (2006, March). SKIPing toward an active start: Promoting physical activity in preschoolers. Beyond the Journal: Young Children on the Web. Retrieved March 31, 2009 from http://www.journal.naeyc.org/btj/200605/GoodwayBTJ.asp

Robertson, C. (2007). Safety, Nutrition, and Health in Early Education. (3rd ed.). Clifton Park, NY: Thomson Delmar Learning.

Schilling, T., & McOmber, K. A. (2006, May). Tots in action on and beyond the playground. Beyond the Journal: Young Children on the Web. Retrieved March 31, 2009 from http://journal.naeyc.org/btj/200605/SchillingBTJ.pdf

Team Nutrition Iowa. (2009). Physical Activities and Healthy Snacks for Young Children. Retrieved March 25, 2009 from http://healthymeals.nal.usda.gov/hsmrs/Iowa/Physical_Activities_%20Healthy_Snacks.pdf

Nutrition and Children

Good nutrition and eating habits are very important in everyone’s life, but especially in a child’s life. Developing these good habits early in life will lead to a healthy lifestyle in adulthood. Good nutrition and eating habits are crucial during childhood in maintaining overall health and providing the necessary nutrients for growth and development. They are also important in fighting off infections, colds, and other communicable diseases, and providing energy to play and socialize with other children (Robertson, 2007).

Active Help
Adults should actively help children develop good nutrition and healthy eating habits because children lack the skills to choose nutritional foods. Children need supervision and education in good nutrition and eating habits. Role modeling is one way this active help can be accomplished. This encourages the children to eat healthy as well. Adults can also help children develop good eating habits by exposing infants to solid foods, one food at a time, beginning with the vegetables first. This allows the infants to acquire a taste for the healthy foods before exposure to the sweet foods, such as fruits. This also exposes the child to a well-balanced, nutritional diet. Adults can help children develop good nutrition and eating habits by eating meals in family style. Engage in conversations with the children about the importance of the foods they are eating, and why they are important. Involving children in the selection and preparation of foods can also help them develop good nutrition and eating habits.

Child Involvement
Involve the children in the preparation of foods. It will be a learning experience for them. Children can learn about colors, numbers, shapes, and measuring while helping adults prepare meals. Children as young as two years old can help prepare meals by wiping table tops and washing vegetables and salad greens. Three-year-olds can help by mixing ingredients and throwing things in the trash. Four-year-olds can help by mashing bananas and setting the table. Five and six-year-olds can help by measuring ingredients and using a blunt knife (Team Nutrition Iowa, 2009). These are examples of help for each age group. Children love to feel like an adult. Allowing children to help in the kitchen is a very good way to give them self-confidence that they are doing something that adults normally do.

Recipes

Pyramid Yogurt Sundae - Young children can help with this recipe by pouring the yogurt, cereal and nuts into a bowl, and by topping the yogurt with the bananas. Older children can help by measuring the foods and slicing the bananas.

2 cups of nonfat vanilla flavored yogurt
3 bananas
1/2 cup coarsely crushed cereal
1/2 cup chopped nuts

Divide yogurt between 5 serving bowls. Slice the bananas and place in a bowl. Place crushed cereal in a bowl. Place chopped nuts in a bowl. Have the kids top their yogurt with bananas, cereal and nuts. Enjoy! Serves 5.

Symphony of Fruit Pizza - Young children can help with this recipe by arranging the fruit on top of the cream cheese. Older children can help by spreading cream cheese on the muffin and slicing the fruit.

1 English muffin
2 tablespoons whipped fat-free strawberry cream cheese
¼ cup strawberries, sliced
¼ cup red grapes, quartered
¼ cup canned mandarin oranges, drained

Toast the English muffin until golden brown. Spread cream cheese on toasted muffin. Arrange sliced strawberries, grapes, and orange slices on top of the cream cheese. Slice into quarters and “yummy – fruit pizza!” Serves: 1

Nutrition Information per serving: calories: 228, total fat: 1.3g, saturated fat: 0g, % calories from fat: 5%, % calories from saturated fat: 0%, protein: 10g, carbohydrates: 46g, cholesterol: 5mg, dietary fiber: 4g, sodium: 374mg
Each serving provides: An excellent source of vitamins A and C, and a good source of folate and fiber.

Veggie Dip - Young children can help with this recipe by mixing the ingredients together. The older children can help by measuring, or even cutting up the vegetables to serve with the dip.

1 cup low-fat sour cream
1 cup low-fat yogurt, plain or vanilla
1 1-oz. pkg. dry ranch salad dressing mix

Combine ingredients. Refrigerate for 1/2 hour. Serve with assorted vegetables such as broccoli, cauliflower, carrots, celery, green pepper, mushrooms, or cucumber slices.

Nutritional Value of the Recipes
The nutritional value of the Pyramid Yogurt Sundae recipe includes the fact that it contains foods from four different food groups. Those groups include milk, fruit, grain, and meat. This is considered to be a well-balanced snack. The nutritional value of the Symphony of Fruit Pizza recipe includes the fact that is contains foods from three food groups: grain, milk, and fruit. It also contains 1.3 grams of fat, 0 grams of saturated fat, and is a good source of vitamin C and fiber. The nutritional value of the Veggie Dip recipe includes the low-fat foods within the recipe. The Veggie Dip is also nutritional in that it is to be eaten with fresh vegetables.

References

Farner, B. (2009). Food for thought. University of Illinois. Retrieved March 23, 2009 from http://urbanext.illinois.edu/foodforthought/

Fruits & veggies more matters. (2008). Produce for Better Health Foundation. Retrieved March 23, 2009 from http://www.fruitsandveggiesmorematters.org/?page_id=442

Robertson, C. (2007). Safety, Nutrition, and Health in Early Education. (3rd ed.). Clifton Park, NY: Thomson Delmar Learning.

Team Nutrition Iowa. (2009). Physical Activities and Healthy Snacks for Young Children. Retrieved March 25, 2009 from http://healthymeals.nal.usda.gov/hsmrs/Iowa/Physical_Activities_%20Healthy_Snacks.pdf

CPR and Choking Emergencies

Emergencies occur unexpectedly, without warning. Emergencies involving children are very crucial in that time is of essence. The more time that passes during emergencies involving children, the more damage that can be sustained. Adults who work with or have children should be prepared to handle any type of emergency, because, with children, anything can happen.

Scenario #1
The first scenario I have created for this assignment is as follows: A 4-year-old boy is eating at the meal table at school, with his teacher sitting beside him. The child begins to choke on a piece of food. He is still able to cough, trying to dislodge the food from his throat.

Scenario #2
The second scenario I have created is as follows: The same 4-year-old boy as in the previous scenario, but is unable to dislodge the food by coughing. His cough becomes very weak, and he uses the universal choking signal, wrapping his hands around his throat. After giving abdominal thrusts to dislodge the food, the child becomes unconscious.

Emergency Procedures
Proper emergency procedures should be followed, no matter the type of emergency that is at hand. The procedures that are to be practiced in the two scenarios above include the following:
1. Remain calm and act immediately.
2. Assess the victim from head-to-toe, observing any unusual behaviors such as wrapping hands around the throat or difficulty breathing.
3. Give reassurance to the child that you can help. Provide help within your scope of training. Assign the teacher aide or other staff member to keep the other children calm.
4. Call for emergency help, or have someone else call while you help the victim.
5. Contact the parents of the victim and agree on an action plan. If the parents are unavailable, call other emergency contacts. Notify the victim’s physician.
6. Treat the victim for shock if necessary. Cover him with a blanket to keep him warm.
7. Stay with the victim until the parents or emergency help arrives. If you are to meet the parents at the hospital or physician’s office, accompany the victim.
8. Fill out a report. Assess the report to see if the incident could have been avoided.
(Robertson, 2007)

The emergency procedure I would follow in scenario #1 includes encouraging the child to continue coughing until the food comes out. If the child wishes me to, I would give abdominal thrusts. The emergency procedure I would follow in scenario #2 includes abdominal thrusts until the food comes out or until the child becomes unconscious. In this scenario, the child becomes unconscious. I would then proceed to perform CPR until emergency help arrives.

Advance Planning
Advance planning is the best way to respond or prevent an emergency situation. Advance planning ensures being prepared for any and all types of emergencies. It also ensures being able to act immediately in an emergency situation. Time is crucial in any emergency situation; the less the response time, the less damage inflicted on the victim and other people in the environment by the situation. Advance planning can also boost self-confidence in being able to act immediately.

Training
I work for Head Start. It is a requirement that all employees have a specific type and amount of training. First aid, CPR, and AED training are required. Bloodborne pathogen training is also required. Two trainings that are not required but should be offered, or at least optional include injury prevention and Heartsaver Pediatric First Aid provided by the American Heart Association. The Pediatric First Aid training is provided for any adult who works with children on a daily basis including teachers, coaches, counselors, and youth groups. This training specializes in how to handle illnesses and injuries in children during the first few minutes until emergency help arrives (Pediatric First Aid, 2009).

Additional Steps for Preparation
Additional steps that can be taken to ensure preparation for emergencies include keeping training sessions up-to-date, and to incorporate different types of training. Another step includes keeping all family emergency contact information in one place. This is a step I personally need to work on. Information is available in several different places, and need to be compiled into one specific location.

References

Heartsaver Pediatric First Aid. (2009, March 21). American Heart Association. Retrieved on March 17, 2009 from http://www.americanheart.org/presenter.jhtml?identifier=3060228

Prepare for Emergencies with American Red Cross First Aid, CPR and Automated External Defibrillator (AED) Courses. (2009). American Red Cross. Retrieved on March 17, 2009 from http://www.redcross.org/

Robertson, C. (2007). Safety, Nutrition, and Health in Early Education. (3rd ed.). Clifton Park, NY: Thomson Delmar Learning.

Emergency Preparedness: Natural and Human-Generated Disasters

A healthy and safe early childhood environment consists of many very important factors. One of these factors includes emergency preparedness. Emergency preparedness and the safety of the children and staff members is taken into consideration when evaluating the effectiveness of an early childhood environment. In order for a facility to be prepared in case of emergencies, planning is the key factor. I will discuss two different scenarios that could threaten early childhood environments, and devise a plan on how to deal with each of the scenarios.

Tornadoes/Tornado Warnings

Scenario
Tornado warnings are typical in my area. In fact, we just experienced a warning about a month ago. This scenario includes a tornado warning being issued around 2:15 p.m. The warning comes from the National Weather Service through a weather radio in the front office. The preschool children have already loaded the buses and are in transit to go home. The infants, toddlers, and the extended care children are still in the center, along with the preschool teachers and management. The assistant director sounds the warning for tornadoes. The preschool teachers disperse throughout the building to assist the infant, toddler, and extended care teachers with their children. The main dangers posed by this situation include harm to staff and children from flying debris and destruction to the center. Teachers, children, and other staff are at risk.

Preparedness
Everyone should be prepared in case of any type of emergency that is typical for their area. Being prepared can prevent the loss of lives or harm to anyone; it helps save lives. Being prepared also means being calm. If the teachers and staff aren’t calm, the children won’t be calm. Children act and react based on the adults in their environment. The teachers and other staff remaining calm can also give the children comfort in knowing that they are safe, as long as the adults are calm and prepared. Being prepared means being able to survive through an emergency. The consequences of not being prepared can result in a loss of a life or harm to children and staff. Not being prepared can also result in panic among the children and staff alike, causing a panic-stricken center.

Plan
In order to develop a plan for tornadoes/tornado warnings, I would first assess the weather patterns and history of tornadoes for the area in which I live. I have experienced a tornado within the last ten years; therefore, I would plan for tornadoes as a seasonal disaster. Going through the steps in planning for tornadoes from Robertson's Safety, Nutrition, and Health in Early Education, our center receives notification of tornadoes and warnings through a weather radio and the local radio and news stations. The management then communicates the warning to the rest of the center via blowing a horn.

Teacher’s responsibility
Each classroom not only has a list of emergency personnel phone numbers, but also has a list of the phone numbers for each of the children in their classroom. Each classroom should also have their own first aid kit and supplies in case of injury during the warning or in the event of an actual tornado. Designated shelter is assigned, which in this case is the hallway, with all doors closed. Evacuation is not recommended during a tornado warning. The responsibilities of the teachers is to keep the children safe by following the procedure for tornado disasters, and notifying the children's parents if necessary. The management is responsible for notifying emergency personnel when necessary. Throughout the year, the center practices various drills, including tornado drills. The teachers also incorporate tornado awareness in the curriculum.

Adjustments to existing plan
There are a few adjustments I would suggest in the existing plan. During this tornado warning, we had children and staff members in transit on the school buses. Those buses should not have been loaded; the center should have delayed loading the buses until the threat of a potential tornado warning had passed. If a tornado warning is issued while the children are in transit, the bus driver should take the children to a sturdy building or home. Tornadoes can form very quickly, with little or no warning (Tornado, 2007). The other adjustment I would make includes putting the center in lockdown until the tornado warning had expired. No one should enter or exit the building during the warning. I am basing these two suggestions on the plan of the county public school system plan. During the warning, all schools were under lockdown, and none of the buses were loaded until the warning had expired.

Stranger/Intruder Alert

Scenario
Stranger safety is incorporated into our curriculum through “Keeping Kids Safe”. It is very important that children learn about strangers and how they can pose a danger to the children. Sometimes, however, intruders are not strangers to our children. The second scenario involves a parent who has been denied access to his child by the state. He arrives to the center, very angry but unarmed. The main dangers posed by this situation is the potential to cause harm to management, other staff members, even the children, and a potential hostage situation. The children, staff, and management are at risk.

Preparedness
Everyone in the center should be prepared in this situation. Being prepared can save lives, and prevent a very bad situation from getting worse. Being prepared also means being calm and controlled. If the teachers are calm, then the children are calm. The consequences of not being prepared in this situation could mean harm to a child's or staff member's life. Not being prepared can cause panic among the children and other staff members.

Plan
In order to develop a plan for an intruder alert, I would begin by stating that this situation occurs with no warning at all, especially for staff who work in the front office. The only warning available to the classrooms is a specific statement announced over the intercom. The management calls emergency personnel for help. They also attempt to calm the irate parent, while at the same time detain him in the front office area away from the children.

Teacher’s responsibility
Upon hearing the announcement, teachers in each classroom turns off the light, locks the classroom doors, and takes the children to the designated area. The designated area should already be equipped with first aid supplies, bottled water, and blankets, depending on the amount of time anticipated during this scenario. Family emergency contact information should also be available. If a class is outside at the time of the announcement, the teachers will escort the children away from the building to a safe, designated area. As with the tornado awareness, teachers incorporate intruder awareness into the curriculum and practice the intruder drill occasionally.

Family Involvement
In order to involve the families in these emergencies, or in any emergency, awareness should be the beginning point. Inform parents of the possibility of scenarios and the policies involved in them. This is not to scare the parents but to let them know that the worst can happen anywhere. Reassure them that there are policies and procedures that are practiced and followed, with the safety of the children being the main goal. Give them opportunities to discuss the scenarios with their children at home. I involve the families of the children in my care by giving them at-home projects to do with their children. During fire safety week, the family is to devise an evacuation plan for the household. At some point during the school year, the family is to devise a plan in case of a tornado. They also discuss with their child the importance of fire, tornado, and intruder drills.

References

Prepare your school and students. (2009). American Red Cross. Retrieved March 12, 2009 from http://www.redcross.org/

Robertson, C. (2007). Safety, Nutrition, and Health in Early Education. (3rd ed.). Clifton Park, NY: Thomson Delmar Learning.

Tornado. (2007, September 4). Federal Emergency Management Agency. Retrieved March 12, 2009 from http://www.fema.gov/hazard/tornado/index.shtm

Safety Practices and Policies

Safety is a very crucial aspect of all child care programs, no matter what age group the programs service. I chose to focus on the risks for injuries associated with the developmental level of preschoolers. I currently work with the three-year-old children and am familiar with safety issues, practices, and policies relating to this age group.

There are many potential hazardous situations and safety threats that are common to the preschoolers. The situations and threats that I am focusing on include choking, poisoning, temperature, burns, and bites/stings. These are the situations and threats with which I have the most experience. Each of these threats are taken very seriously within our Head Start center, and has a safety policy on how to prevent threats and to deal with situations.

Choking
Choking is a common threat among the preschoolers. Safety policies surrounding this threat include the following: examining toys for age appropriateness, performing the “film canister” test (if an object will fit inside a 35mm film canister, it is considered a choking hazard and should not be within the reach of children), and inspecting the classroom/playground for possible choking hazards.

These policies also define some of the measures that should be taken to prevent choking. Another prevention method includes banning foods that pose a choking hazard from the menu. Foods that pose a hazard include hot dogs, popcorn, grapes, cherries, and peanuts. If a child is choking on food or an object, abdominal thrusts should be performed until the object is coughed up, or until the child becomes unconscious (Robertson, 2007). If the child becomes unconscious, CPR should be performed while someone calls 911.

Families should be aware that choking is a very serious threat, even in the home. Families should know the policies of the child care center, and incorporate these policies within the household. Parents should have the knowledge to inspect their home for choking hazards, to examine toys for age appropriateness, and which foods pose a choking threat to their children. Offering first aid training would be effective in extending this knowledge to parents.

Poison
Poisoning is common threat that can be lethal if not prevented or dealt with appropriately. The safety policy and measures to prevent poisoning includes inspecting the classroom and playground for poisonous plants, storing cleaning supplies in a locked cabinet, and leaving any medicine at home. If medicines should be brought to the center, they should be locked up, and should not be taken or given in the view of the children. In the event that poisoning does occur, the Poison Control Center should be called right away. Any instructions given by them should be followed. Families should have the knowledge about the potential hazards surrounding poisoning, and how to prevent it. The Poison Control Center phone number should be a common household necessity.

Temperature
The weather can pose a safety threat to young children, and our policy surrounding this threat is based on the Tennessee State Licensing and Regulations. Children should be exposed to different types of weather. The limitations for outdoor play includes high wind advisory and temperatures below 32 degrees and above 95 degrees Fahrenheit (Tennessee regulations, 2008). During these weather conditions, children are not to be outside.

The measures taken to prevent temperature threats include keeping the children inside during the previously mentioned weather conditions. The measures taken to deal with temperature issues are as follows: heat exhaustion – place child in a cool, shady place and offer lots of liquids to drink; frostbite – warm the area affected by soaking in warm, not hot, water; hypothermia – move child out of the cold, remove wet clothing, and give him something warm to drink (Robertson, 2007). Families can follow the same procedures that are stated in our policy to ensure the safety of the children in their home.

Burns
Burns are not very common for our center, but they are common for the age group with whom we work. Our safety policy on burns includes no smoking around children, no lighters or matches, and cover electrical outlets. The policy is also the measures taken to prevent burns, along with measures such as teaching children to avoid lighters and matches, incorporating fire safety in the curriculum, and practicing fire drills on a regular basis.

Measures taken to deal with burns are as follows: stop the burning by removing child from the area and put out the fire. Cool the burn by flushing with water. When the burn has cooled, cover with a dry, clean, and sterile dressing. Call the child's parents and suggest they take the child to a physician (Robertson, 2007).

Bites/Stings
Animal bites and stings are rare at our center. Human bites, however, are very common. Our policy states that if a child bites and it is the first offense, the teacher explains to the child that biting hurts and is not allowed. The child is observed to help understand what caused the behavior to prevent future incidents. If the child bites a second time, a parent/teacher conference will be held to discuss the behavior and the policy. If the biting continues, the child will be temporarily excluded from Head Start services for the safety of other children in the classroom.

The measures taken to prevent biting include the following:

• Plan activities that allow children to release frustration.
• Provide biting substitutes such as teether, wet wash cloths, etc. for toddlers.
• Provide age appropriate toys which stimulate interest and decrease frustration or boredom.
• Talk to the children about rules for sharing.
• Make sure there are plenty of toys and ample space for the amount of children.
• Have plenty of adult supervision.
  (When a Child Bites, 2000)

The measures taken to deal with a biting incident, whether human or animal, include washing the bite area with soap and water, and applying ice to the area. If the bite has broken the skin, cover with a sterile dressing and contact parent or physician. Measures taken to deal with stings include removing stinger with tweezers and washing the area with soapy water. If an allergic reaction occurs with a sting, call 911, or administer an Epipen if one is available.

All of these safety threats are common among the preschool age group. Each threat requires attention and prevention methods. In order for the families to ensure the safety of the children at home, the teachers and other staff members need to relay to the families any information on each of the threats. The families can then follow the same procedures as the child care centers, therefore working in partnership with teachers to ensure safety of the children.

References

Robertson, C. (2007). Safety, Nutrition, & Health in Early Education (3rd ed.). Clifton Park, NY: Thomson Delmar Learning.

Tennessee regulations: Chapter 1240-4-3 Licensure rules for child care center. (2008). National Resource Center for Health and Safety in Child Care and Early Education. Retrieved March 1, 2009 from http://nrckids.org/STATES/TN/tn_9-3-06.htm#0_pgfId-1007730

When a Child Bites (Biting). (2000, July). CAS/Morgan County Head Start Parent Handbook. Early Childhood Development & Health Services, 1235, 38-39.