Author: Catherine Noonan, PT, DPT, PCS, CEIM

Edited by: Laurie Ray

13.9% of children aged 2 to 5 are obese, which places them at risk for metabolic disorders, Type 2 diabetes, and poorer cardiovascular and mental health.1

Other research has demonstrated that fundamental skill development (learning to walk, throw a ball ,etc.), and particularly self-perception of mastery of fundamental skills, translates into greater levels of physical activity and better health outcomes.

Take home message (we know this SeekFreaks!): Children who feel successful at movement move more.2-6 Finally, the early childhood years are a time of great neuroplasticity and, thus, learning. Movement, it turns out, is critical to learning, and it helps kids with their communications skills, spatial relations, fine motor skills, and visual motor integration.7-10

For all these reasons and more, increasing physical activity in the early childhood years should be a priority for therapists, parents, and teachers. So just do it! Try out these tips to increase physical activity in the early childhood years.


  1. Provide durable portable & fixed play equipment4,11
    • A combination of portable and fixed play equipment provides children with multiple opportunities for movement, both indoors and out. Examples include:
      • Portable: soft, ‘catchable’ balls or ‘slower’ beach balls or scarves for catch games trucks, bikes, hoola hoops, jump ropes
      • Fixed: climbing structures, swings, playhouses
  2. Incorporate a paved or outlined path or track in the learning environment11 — indoors or outdoors!
    • Play spaces with tracks, particularly loops, encourage kids to move and keep going. Children can push wheeled toys, ride bicycles or walk or run on the track.
  3. Allow space for movement in the classroom4,11
    • 35 square feet per child allows room for optimal learning and movement; 50-70 square feet per child is optimal. Decluttering counts as physical activity!12
  4. Be a role model! Set an example of being physically active4,11,13
    • Do you stretch during the day? Talk about what you do for exercise. Share how it felt to try a new skill out. Join a community team and wear your jersey to school.
  5. Have a physical activity policy at your school or in your classroom11,14
    • Physical activity policies outline time spent moving during the day; inclement weather exercise plans; and can stipulate limits on screen time. A recent study revealed that, although many childcare providers were aware of physical activity recommendations, few centers had physical activity policies.11
  6. Incorporate at least 60 minutes of physical activity per day into your lesson plans for all children13
    • According to the American Academy of Pediatrics, children need at least 60 minutes of physical activity per day to remain healthy, but this goal can be met in short burst of activity that match how kids naturally play.15
  7. Include 60 minutes of structured physical activity/games (teacher-led Hokey Pokey) and 60 minutes of unstructured physical activity/play (playing on the playground, music/dance) throughout the school day for preschool-age children4,11
    • Check out your local library or the Internet for great ideas for structured physical activity, and seek advice from physical education providers and physical and occupational therapists, or try one of the suggestions below. Remember to participate yourself; exercise will benefit your health and set an example for others.
    • Provide teachers, parents and children ‘game of the month’ each month or other way to give ideas for age appropriate, accessible play ideas/games
    • Assign weekend ‘homework’ for physical activity or outside games with family and do show and tell on Monday. Maybe try some out and incorporate into class?
    • Use books to promote movement/activity and peer modeling/mirroring (e.g. Brown Bear, Brown Bear, What Do You See? or On a Snowy Day)
    • Use movement during instruction, for example jumping (up and down or jumping rope) while rote counting, using full body (assign one child a number and ask them to walk from one side to the other when they ‘are counted’ or acting out more/less, lots/a little) for counting/pre-math concepts, making letter shapes with bodies or body parts, Twister for color identification…
    • Have children suggest, lead or choose physical activities…Montessori it up!!
  8. Have strategies to help kids wind down after being active
    • Slow breathing, gentle movements or dancing to slow music can all be ways to calm down and re-focus after a bout of movement.
  9. Teach children games (e.g., Red Rover, Red Rover; Freeze Tag; Kick the Can Red Light, Green Light).
    • Games provide movement opportunity but also teach children problem-solving and social skills.16
  10. Universally design activities (e.g., swim noodles for Freeze Tag, taking turns to be ‘it’) or develop strategies to help children with disabilities get the recommended levels of physical activity17,18
    • Children with disabilities are less physically active than their typically-developing peers. This places them at risk for chronic health conditions and deprives them of opportunities for social and cognitive development that often accompany self-produced movement in their environment.
  11. Provide more active time as a reward11


  1. Restrict physical activity as a punishment or consequence11
  2. Permit extended screen time11,12
  3. Limit physical activity due to weather4
  4. Forget children with disabilities17,18

Dr. Catherine ‘Kate’ Noonan is a board certified specialist in pediatric physical therapy, an assistant professor at Campbell University (NC), a writer, a blogger, mother of two and all around go getter! Despite her busy teaching schedule and academic duties at Campbell University, Kate has a passion for working with parents, young children, childcare professionals and all interested parties to contribute to quality development for young children. She has done (and is doing) research in this area and has taken the time to create a post for all SeekFreaks with research-based, practical suggestions to incorporate physical activity into each young child’s day! Print this one out and distribute to parents, pre-school teachers and child care professionals you encounter. Keep it Moving, SeekFreaks!


  1. Centers for Disease Control and Prevention: National Center for health Statistics. National health and nutrition examination survey. December 2017. Accessed October 9, 2018.
  2. Kambas A, Michalopoulou M, Fatouros IG, et al. The relationship between motor proficiency and pedometer-determined physical activity in young children. Pediatric exercise science. 2012;24(1):34.
  3. Dawes NP, Vest A, Simpkins S. Youth participation in organized and informal sports activities across childhood and adolescence: Exploring the relationships of motivational beliefs, developmental stage and gender. Journal of Youth and Adolescence. 2014;43(8):1374-1388.
  4. Adamo KB, Wilson S, Harvey AL, et al. Does intervening in childcare settings impact fundamental movement skill development? Med Sci Sports Exerc. 2016;48(5):926-932. doi: 10.1249/MSS.0000000000000838 [doi].
  5. Bonvin A, Barral J, Kakebeeke TH, et al. Effect of a governmentally-led physical activity program on motor skills in young children attending child care centers: A cluster randomized controlled trial. Int J Behav Nutr Phys Act. 2013; 10:90-5868-10-90. doi: 10.1186/1479-5868-10-90 [doi].
  6. Niekerk Lv, Toit Dd, Pienaar AE. The correlation between motor proficiency and physical activity in senior phase learners in the potchefstroom area. Health SA Gesondheid: Journal of Interdisciplinary Health Sciences. 2016; 21:348-355.
  7. Pienaar AE, Barhorst R, Twisk JWR. Relationships between academic performance, SES school type and perceptual‐motor skills in first grade South African learners: NW‐CHILD study. Child: Care, Health and Development. 2014;40(3):370-378.
  8. van der Fels, Irene M. J, te Wierike, Sanne C. M, Hartman E, Elferink-Gemser MT, Smith J, Visscher C. The relationship between motor skills and cognitive skills in 4-16 year old typically developing children: A systematic review. Journal of science and medicine in sport. 2015;18:697-703.
  9. Campos J. Travel broadens the mind. Infancy. 2000; 1(2): 149-219.
  10. Jones M, McEwen I, Neas B. Effects of Power Wheelchairs on the Development and Function of Young Children With Severe Motor Impairments. Pediatr Phys Ther. 2012; 24:131–140.
  11. McWilliams C, Ball SC, Benjamin SE, Hales D, Vaughn A, Ward DS. Best-Practice Guidelines for Physical Activity at Child Care. Pediatrics. 2009;124:1650-1659.
  12. Rhode Island Child Care Facilities Fund. Child Care Physical Environment Checklist. Local Initiatives Support Corporation/Rhode Island Child Care Facilities Fund. February 2006. Accessed 11/1/18 from
  13. Cheng C, Martin-Biggers J, Quick V, Spaccarotella K, Byrd-Bredbenner C. Validity and reliability of HOP-up: A questionnaire to evaluate physical activity environments in homes with preschool-aged children. Int J Behav Nutr Phys Act. 2016;13:91-016-0417-3. doi: 10.1186/s12966-016-0417-3 [doi].
  14. Falbe J, Kenney EL, Henderson KE, Schwartz MB. The wellness child care assessment tool: A measure to assess the quality of written nutrition and physical activity policies. J Am Diet Assoc. 2011;111(12):1852-1860. doi: 10.1016/j.jada.2011.09.006 [doi].
  15. Centers for Disease Control. Youth physical activity guidelines toolkit: Youth physical activity guidelines. June 28, 2017. Accessed on 11/1/18 from
  16. Ginsburg K. The importance of play in promoting healthy child development and maintaining strong parent-child bonds. Pediatrics. 2007; 119(1): 182-191. Doi: 10.1542/peds.2006-2697.
  17. Guerette P, Furumasu J, Tefft D. The positive effects of early powered mobility on children’s psychosocial and play skills. Assistive Technology. 2012; 25 (1): 39-48.
  18. Rowland J, Fragala-Pinkham M, Miles C, O’Neil M. The Scope of Pediatric Physical Therapy Practice in Health Promotion and Fitness for Youth With Disabilities. Pediatric Physical Therapy.2015; 27(1): 2–15.

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