Holistic App Child Health

Holistic Approaches to
Child Health (Higher)
Support Material
June 2005
Scottish Further Education Unit

Holistic Approaches to Child Health (Higher)
Acknowledgements
SFEU is grateful to Learning and Teaching Scotland for permission to use material from
the Higher Still Development Unit Document Early Years Care and Education, Holistic
Approaches to Child HealthTeacher Resource Pack Published 2002 from which this
support pack has been adapted. Learning and Teaching Scotland is the current copyright
holder of HSDU materials.
Scottish Further Education Unit 2005

Holistic Approaches to Child Health

Unit DM40 12
Introduction
These notes are provided to support teachers and lecturers presenting the Scottish
Qualifications Authority Unit DM40 12 Holistic Approaches to Child Health. This can be
offered as a stand alone Unit and is also a component Unit of the National Certificate
Group Award in Early Education and Childcare.
Copyright for this pack is held by the Scottish Further Education Unit (SFEU). However,
teachers and lecturers have permission to use the pack and reproduce items from the
pack provided that this is to support teaching and learning processes and that no profit is
made from such use. If reproduced in part, the source should be acknowledged.
Enquiries relating to this Support Pack or issues relating to copyright should be

addressed to:
Information and Publications Co-ordinator

The Scottish Further Education Unit
Argyll Court
Castle Business Park
Stirling
FK9 4TY
Website: www.sfeu.ac.uk
Further information regarding this Unit including Unit Specification, National

Assessment Bank materials, Centre Approval and certification can be obtained
from:
The Scottish Qualifications Authority

Hanover House
24 Douglas Street
Glasgow
G2 7NQ
Website: www.sqa.org.uk
Whilst every effort has been made to ensure the accuracy of this Support Pack, teachers
and lecturers should satisfy themselves that the information passed to candidates is
accurate and in accordance with the current SQA arrangements documents. SFEU will
accept no responsibility for any consequences deriving either directly or indirectly from
the use of this Pack.

Contents
Introduction 4
Unit content 4
Statement of standards 5
Evidence requirements 5
Section 1: Guidance for teachers 6

Approaches to learning and teaching 6
Unit induction 6
Learning environment 7
How to use the pack 7
Using the materials 8
Extending more able students 9
Scheme of work 10
Section 2: Student activities and information 12

Outcome 1 12
Outcome 2 56
Outcome 3 76
Section 3: Resources 104

Resource information 104
Websites 106

Introduction
This unit enables candidates to gain an understanding of the basic health needs
of children from 0-12 years. Candidates will also examine the role of
professionals, carers and agencies in the promotion of child health. They will
also investigate influencing factors on the health of children.
This unit forms part of the course: Early Years Care and Education (Higher) and
is a mandatory unit in the National Certificate Group Award: Early Education and
Childcare, but is also suitable for candidates wishing to study the unit on its own.
The unit is suitable for candidates who wish to gain employment, or may already
be employed, in the childcare and education sector support working under
supervision or to progress onto higher level early education and childcare
qualifications.
Unit content
The unit has three outcomes:
1. Explain the basic health needs of children from 0-12 years.
2. Explain the contribution of agencies, professionals and carers in maintaining and

promoting child health.
3. Evaluate the main influencing factors which affect the health of children.
The unit content can be summarised as follows:
theoretical approaches to basic health needs Maslow, Mia Kellmer Pringle, Jennie
Lindon
basic health needs in children including children for whom additional support is
required; including physical, cognitive, social and emotional needs
benefits of meeting these needs and ways of ensuring health needs are being met
medical check ups, screening, immunization, health education
the role and responsibilities of an early years worker in recognising signs of illness in a
child and being aware of common allergies
statutory and voluntary agencies contributing to the promotion of child health including
government initiatives, UNICEF Baby Friendly Initiative, the UN Convention on the
Rights of the Child and the European Association for Children in Hospital Charter
the role of agencies in the promotion of child health
the role of professionals and carers in promoting child health
positive and negative aspects of family, socio-economic, cultural and environmental
factors on the health of children
impact of social trends on the health of children.

Statement of standards
Outcome 1
Explain the basic health needs of children from 012 years.
Performance criteria
(a) Describe current theoretical approaches in relation to the basic health
needs of children.
(b) Explain the basic health needs of children.
(c) Investigate a range of ways in which the basic health needs of children are
met.
Outcome 2
Explain the contribution of agencies, professionals and carers in maintaining and
(a) Explain the role and responsibilities of early education and childcare
workers in recognising signs of illness in a child.
(b) Explain the contribution of a range of agencies to the promotion of child
health.
(c) Explain how professionals and carers can contribute to the promotion of
child health.
Outcome 3
Evaluate the main influencing factors which affect the health of children.
(a) Describe how the family and socio-economic factors affect childrens
health.
(b) Explain environmental factors and their influence on childrens health.
(c) Evaluate the impact of social trends on childrens health.
Evidence requirements for the unit

Outcomes 1, 2 and 3
Written and/or recorded oral evidence is required to demonstrate that the
candidate has achieved all outcomes and performance criteria.
The evidence for this unit should be obtained under controlled conditions and
should last no more than one hour. A single question paper based on a case
study with both extended and restricted response questions, such as one that is
illustrated in the National Assessment Bank item for this unit could be used. This
single question paper should be taken on the completion of the unit.
Achievement can be decided by the use of a cut off score.
Where candidates fail to reach the agreed threshold score, reassessment should
follow using an alternative instrument of assessment.

SECTION 1
Approaches to learning and teaching
In delivering this unit it is useful if teachers/lecturers achieve a balance between

teacher/lecturer exposition and experiential learning. Students can be
encouraged from the beginning to draw on their own experience and previous
and current learning. Where students have experience of working in an early
years care and education setting these experiences can be drawn on to explore
the theories and information covered in this unit.
Students should be encouraged from the beginning of the unit to gather leaflets,
newspaper and magazine articles related to child health. Attention should be
drawn to television programmes, items on the Internet and local and national
child health initiatives. Visiting speakers can also broaden the students learning.
In delivering the unit it is important that a multicultural approach is taken.

Approaches and attitudes to child health are culturally specific and therefore
peoples views on some aspects of child health can vary according to their
cultural background. Teachers/lecturers can ensure a multicultural focus is
adopted during exercises and discussions on differing perceptions of maintaining
and promoting child health.
Unit induction
Teachers/lecturers should ensure that students understand the nature, purpose

and outcomes of the unit, the learning and teaching approaches to the unit and
the assessment requirements of the unit. The necessity for induction exercises
will depend on the particular group, their familiarity with each other, their
familiarity with the teacher/lecturer and the education setting and the Course or
Group Award they are undertaking. If the group is a new one, induction
exercises to ensure that students feel comfortable talking to each other should be
included.

Learning environment
Teachers/lecturers should aim to create a supportive and motivating learning

environment. The unit examines some issues of a sensitive nature and it is
essential that the needs of students in the learning environment are considered
and met wherever possible.
The people element in the classroom is therefore of paramount importance. The
following conditions should always be in place:
the provision of a learning climate in which students feel supported to share

their own thoughts and feelings
a teaching style which promotes a supportive learning climate
teaching and learning methods which draw on students past and present
learning experience and which enable them to integrate new ideas and skills
into their interactions with others.
The learning environment is established at the outset through factors such as the
style adopted by the teacher/lecturer and the physical layout of the room.
How to use the pack
Purpose of the pack
This pack is designed to provide guidance and support materials to help

teachers/lecturers in the delivery of the unit. The student information sheets and
activities are designed to be used by teachers/lecturers in whatever way suits
their preferred style of delivery and the needs of their particular student group.
The pack has not been designed for open learning purposes. Answers and group
discussions relating to the exercises and worksheets will be provided and
facilitated by the teacher/lecturer. The student exercises and activities will need
to be followed up and brought together by the teacher/lecturer in whatever way is
appropriate for the particular student group. The student activities in the pack
cover the three outcomes and their performance criteria. The material is
presented to cover Outcomes 1, 2 and 3 in sequence. The materials are a
resource for teachers/lecturers to use, adapt and add to in whatever way best
meets the needs of the student group.

Using the materials
The materials in Section 2 of this pack have been identified as either student
activity or information sheets
The materials can be photocopied, adapted, altered, presented in a different

order, added to and delivered in the way that best suits the particular teaching
situation. Many of the worksheets and exercises could be written onto OHTs,
blackboards or flipcharts where photocopying is not possible. PowerPoint
presentations could be used. The essential knowledge required for the unit has
been covered on the pages that have the information symbol. These information
sheets could be used as the focus for input by the teacher/lecturer and to
promote question and answer sessions and group discussions.
The information sheets can be photocopied as a separate pack if the

teacher/lecturer prefers to use them either as teaching notes or as separate
handout material. The materials could be assembled into smaller topic packs or
into a pack for each outcome.
Exercises and activities
All the worksheets, assignments, group activities, etc., have the student activity
symbol. The exercises and activities have been suggested for individuals, pairs
and small groups to carry out. Teachers/lecturers may well wish to alter the way
in which these exercises and activities are carried out according to their
particular group. It is not suggested that all of the exercises must be used and
equally there are many additional activities that could be used.
Current media articles, videos, situations from soap operas and students own
experiences are likely to provide other sources of material for discussion and
exercises. There are many suitable Internet resources which are relevant to this
subject. Where students have work placement experience this is likely to provide
a rich source for discussion.
Preparation for assessment
Many of the worksheets are for formative assessment purposes and will allow
teachers/lecturers to monitor the understanding of their students on an ongoing
basis.
The test yourself questions at the end of the material for each outcome can be
used by teachers/lecturers, in whatever way they wish, prior to internal
assessment. They could be taken in and marked by the teacher/lecturer or
students could mark their own as the teacher/lecturer explains the correct
answers. Alternatively they could be marked in peer groups facilitated by the
teacher/lecturer.

Completion of them should give the student and the teacher/lecturer a good
indication of whether students are ready for internal assessment. Following each
test yourself question sheet is an information sheet giving a brief summary of
the expected answers. Teachers/lecturers may wish to give this information sheet
to students, to reinforce what they are expected to know prior to internal
assessment.
Extending more able students
Some individual students and some student groups may benefit from being given
work to extend their knowledge and understanding. Where students are
completing this unit as part of a Group Award there may well be time to extend
the material delivered in this unit. Ideas for extension work include:
consideration of some of the models of health promotion

extended research on a particular aspect of child health
research covering a wider range of childhood illnesses.

Scheme of work
On this page and the next is an exemplar teaching plan showing how the pack
could be used to deliver the unit. This example is based on a delivery pattern of
three hours a week over twelve weeks. Where the delivery pattern is different,
eg. one hour a week or less over a longer period, then each three-hour lesson
can be subdivided into three or four shorter sessions.
Week Content Outcomes

1 Input: Introduction to unit Understanding of concepts of
Input: What is health? health.
Student Activity: What is health?
Input: Dimensions of health Understanding of theoretical
Input: Theoretical approaches approaches to health needs of
Student Activity: Theories of children.
needs
2 Input: Basic health needs of Understanding of the basic needs
children of children and the importance of
Student Activity: The health needs meeting needs.
of children
Input: Nutrition
Student Activity and Research:
Nutrition
Input: Hygiene, rest and sleep
Student Activity: Sleeplessness
3 Input: Basic health needs of Understanding of the basic needs
children exercise, fresh air, of children and the importance of
clothing, warmth and shelter meeting needs.
Student Activities: Exercise and
clothing Application of knowledge relating
Input: Love and affection, security, to needs of children.
play and responsibility
Student Activities: Identification of
needs and meeting needs
4 Input: Child health promotion Investigation and understanding of
Input: Immunization a range of ways in which the basic
Student Research and Activity: health needs of children are met.
Immunization
5 Input: Child health surveillance Investigation of a range of ways in
and screening which the basic health needs of
Student Research/Guest Speaker children are met.
6 Input: Health Education Investigation of a range of ways in
Student Research and Group which the basic health needs of
Activity: Relating to how health children are met.
education needs of children are
met
Input: Inequalities of access
Test Yourself Questions: Outcome
1

Week Content Outcomes

7 Input: Introduction to Outcome 2 Understanding of the role of the
Input: Recognising signs of illness early years worker in recognising
Input: Agencies which contribute signs of illness.
to the promotion of child health
statutory and voluntary Investigation and understanding of
Student Research: Voluntary a range of agencies that contribute
organisations which support to the promotion of child health.
families and children
8 Input: Professionals involved in Investigation and understanding of
the promotion of child health a range of professionals involved
Student Research and Activity: in the promotion of child health.
The role of professionals in
promoting child health
Test Yourself Questions: Outcome
2
9 Input: Introduction to Outcome 3 Understanding and application of
Input: Factors affecting the health knowledge of factors affecting the
of children inequalities, social health of children.
class, unemployment and housing
Student Activity: The effect of poor
housing on health
10 Input: Cultural and environmental Investigation and understanding of
influences on child health environmental influences on child
Student Research: Environmental health.
influences
11 Input: Impact of social trends on Understanding of the impact of a
child health range of social trends on child
Student Activities: Changes in health.
family composition and changing
roles
Test Yourself Question: Outcome
3
12 Rsum of Outcomes 1, 2 and 3
Internal Assessment
Outcomes 1, 2 and 3

SECTION 2
Outcome 1
This Unit forms part of the course: Early Years Care and Education (Higher) and is a
mandatory Unit in the National Certificate Group Award: Early Education and Childcare
but is also suitable for candidates wishing to study the Unit on its own.
Unit content
The unit has three outcomes:
1. Explain the basic health needs of children from 012 years.
2. Explain the contribution of agencies, professionals and carers in maintaining and

3. Evaluate the main influencing factors which affect the health of children.
The unit content can be summarised as follows:
theoretical approaches to basic health needs Maslow, Mia Kellmer Pringle, Jennie
Lindon
basic health needs in children including children for whom additional support is
required; including physical, cognitive, social and emotional needs
benefits of meeting these needs and ways of ensuring health needs are being met
medical check-ups, screening, immunization, health education
the role and responsibilities of an early years worker in recognising signs of illness in a
child and being aware of common allergies
statutory and voluntary agencies contributing to the promotion of child health including
government initiatives, UNICEF Baby Friendly Initiative, the UN Convention on the
Rights of the Child and the European Association for Children in Hospital Charter
the role of agencies in the promotion of child health
the role of professionals and carers in promoting child health
positive and negative aspects of family, socio-economic, cultural and environmental

factors on the health of children
impact of social trends on the health of children.
It is important that the study of child health takes into account the needs of all children
and that an inclusive, integrative approach to child health should be taken.

Outcome 1
In this outcome we will be investigating the basic health needs of children from
012 years.
The outcome begins with a discussion of what is meant by the word health and
an examination of the different aspects of health that contribute to well-being.
Different theoretical approaches to health needs are then considered
concentrating on Maslow, Kellmer Pringle and Lindon.
A range of basic health needs of young children will be reviewed encompassing

physical, cognitive, social and emotional needs. The importance of these needs
in contributing to the health of children and the benefits of meeting these needs
will be explored.
Finally the ways in which the health needs of all children are met will be
investigated. Different aspects of primary, secondary and tertiary child health
promotion will be discussed including immunization, child health surveillance
screening and health education.

Outcome 1
What is health?
Health is a concept which means different things to different people.
For example:
health is not being ill
health is being able to work and get through the day
health is living to a ripe old age
health is feeling happy
health is being fit and active.
A persons idea of what being healthy means is not static and their definition can change
with time and circumstances.
Many studies into concepts of health have shown that peoples ideas of health are
shaped by a number of factors such as experience, knowledge, culture, values and
expectations.
In 1948 The World Health Organisation (WHO) defined health as:
A state of complete physical, mental and social well-being and not merely the
absence of disease or infirmity.
This definition was far-sighted for the time, presenting a positive concept of health (well-
being) rather than viewing it as only the absence of disease. It also presents a holistic
view of health encompassing physical, mental and social well-being.
Social Mental
Health
Physical

Outcome 1
This is still the most frequently quoted definition of health but it does have some faults.
Critics comment that it is too idealistic and that it is unrealistic to expect a state of
complete well-being all of the time. It does not allow for people to have an illness or
disability and still be healthy.
For example, someone who has asthma may still feel very healthy.
In 1984 the WHO updated their definition of health.
[Health is] the extent to which an individual or group is able, on one hand, to
realise aspirations and satisfy needs; and, on the other hand, to change or cope
with the environment. Health is, therefore, seen as a resource for everyday life, not
an object of living; it is a positive concept emphasising social and personal
resources, as well as physical capacities.
This is a much more complex definition which acknowledges the positive and constantly
changing nature of health. It also defines health as a holistic concept considering social
and personal resources as well as physical conditions.
The word health itself is derived from the Old English hael which means whole. This
reflects the fact that health embodies the whole person and includes all aspects of health:
physical, emotional, mental, social and spiritual well-being.

Outcome 1
Dimensions of health
The different dimensions of health may be classified as follows:
Physical Health: This is perhaps the most obvious dimension of health and the easiest
to measure. It is concerned with the physical functioning of the body.
Emotional Health: This relates to the way in which we express emotions such as
happiness, fear, grief and anger. It also involves coping strategies for anxiety and stress.
Cognitive Health: This relates to the ability to think clearly and logically. Cognitive
(mental) health is closely linked to emotional and social health.
Social Health: This is concerned with how we relate to others and form relationships.
Spiritual Health: This can include religious beliefs but for many it relates to personal
principles and values and the quest for inner peace.
In addition to this the health of the individual is dependent upon everything surrounding
him/her.
Societal Health: This refers to the interconnection between health and the way society is
structured. It is not possible to be healthy in a society that does not provide resources for
physical, emotional and cognitive health. For example, it is difficult to be emotionally and
spiritually healthy in a country that does not allow personal freedom.
Environmental Health: This refers to the physical environment in which the person lives,
eg. housing, transport, pollution, etc.

Outcome 1
Dimensions of health (continued)
societal
spiritual physical
HEALTH
social emotional
mental
environmental
The WHO states that:
The enjoyment of the highest attainable standard of health is one of the

fundamental rights of every human being without distinction of race,
religion, political belief, economic or social condition
Early years workers provide a valuable contribution to meeting the physical,

cognitive, emotional and social needs of the child and contributing to the well-
being of the child.
The early years of development have a great effect on learning, behaviour and
health throughout life.
Child health is therefore an investment for the future.

Outcome 1
Small group activity What is health?
1. Take a few minutes to consider the following questions. Note down your answers.
(a) What does being healthy mean to you?
(b) Think of someone you know that you think is very healthy. What is it
about them that makes you think they are healthy?
Discuss your findings in a small group (3-4 members).
2. On a large piece of paper write a definition of health that your group is happy with.
You will be asked to share and compare your definition with the other
groups in the class.
3. After reviewing the definitions of health from the different groups, compare and/or
contrast them with the official WHO definitions of health.

Outcome 1
Theoretical approaches to basic health needs
Theories are the ways in which people, or groups of people, explain their own particular
ideas and opinions about things.
Several different theorists have looked at the needs of children. In this section we are
going to look at three of the best known opinions on needs.
Maslow
Mia Kellmer Pringle
Jennie Lindon.
Maslow
Abraham Harold Maslow (1908 1970) was a psychologist who lived and worked in
America. During his early career, whilst studying laboratory monkeys, Maslow noticed
that some needs took precedence over others, eg. if you are hungry and thirsty you tend
to take care of the thirst first thirst is a stronger need than hunger. People can survive
without food for longer than they can survive without fluids. It was from observations such
as this that Maslow developed his theory of human needs which became known as
Maslows Hierarchy of Needs.
Maslow placed needs in an order or priority with basic needs (those necessary for
survival) at the bottom of the pyramid working up to a pinnacle of complete well-being.

Outcome 1
Maslows Hierarchy of Need
CREATIVITY
NEEDS
Self-actualisation,
achieving full
potential
SELF-ESTEEM
Being respected, recognised,
productive
SOCIAL NEEDS
Belonging, being valued, friendship
SAFETY NEEDS
Protection from danger and threat
PHYSICAL NEEDS
Food, Water, Warmth, Shelter, Clothing
Maslow believed that each level must be met before progressing to the next stage, eg. a
person must have his/her physiological needs (food, water, warmth, etc.) satisfied before
trying to satisfy higher needs. There is some overlap between the levels but in general if
lower needs are met then progression can be made towards the top of the pyramid.
Maslow felt that it would be difficult to reach your full potential unless most of the other,
lower level needs had been met.

Outcome 1
Although childrens needs are different from adults, Maslows theory is still relevant to the
needs of children children will only achieve their potential if they have been cared for
physically in a suitable environment, given emotional support, encouragement and
opportunity to learn.
For example, it would be difficult for a child to concentrate on learning if they were cold,
hungry and frightened.
Mia Kellmer Pringle
Mia Kellmer Pringle was a psychologist involved in the study of developmental needs of
children. She believed that all needs are inter-related and interdependent. She argued
that if children are to develop to their full potential, all needs physical, cognitive, social
and emotional must be met. She believed that needs should be met using a holistic
approach rather than viewing needs in a hierarchical manner. She felt that experiences
and opportunities in the early years of life greatly influence later development. She
stressed the importance of the environment that the child is raised in and the effect that
this may have on child development.
Kellmer Pringle felt that, in general, physical needs were adequately understood and in
most circumstances met. She, therefore, concentrated on psycho-social needs. She
identified four basic emotional needs which require to be met throughout life.
1. The need for love and security
2. The need for new experiences
3. The need for praise and recognition
4. The need for responsibility
The relative importance of these needs and the ways in which they are met will change
with different stages of development.
Jennie Lindon
Jennie Lindon states that all children have universal physical, emotional and cognitive
needs but the way in which these needs are met may differ for each individual child.
She stresses the importance of a holistic approach to the care of children and
emphasises the strong links between different areas of needs.

Outcome 1
Individual activity Theories of needs
In this section we have looked at three theories of needs:
Maslow
Kellmer Pringle
Lindon.
1. Using your own words, produce a short summary of the three theories.
2. Compare and contrast the three theories by
(a) detailing the similarities
(b) detailing the differences
3. Summarise the perceived strengths and weaknesses of each approach.
This information will be useful when you are preparing for assessment.

Outcome 1
Basic health needs of children
A need is a requirement of life that must be satisfied in order for people to survive,
grow, develop and reach their full potential.
Needs are not static, they vary according to age and stage of development and according
to circumstances.
In text books, needs are often split into different categories:
physical needs
cognitive needs (intellectual needs)
social needs
emotional needs.
It is important to emphasise that when caring for children a holistic approach to meeting
needs is essential. In real life there is no concrete divide between physical, cognitive,
social and emotional needs. A holistic approach involves meeting the needs of the whole
child.
In this section we are going to look at some of the basic health needs of children.

Outcome 1
Activity in pairs The health needs of a child
PHYSICAL NEEDS COGNITIVE NEEDS
These needs relate to the body These needs relate to the mind
and are required for growth and and learning, eg. communications
development, eg. food
EMOTIONAL NEEDS SOCIAL NEEDS
These needs relate to feelings and These needs relate to relationships,

emotions, eg. security fitting into society, acceptable
behaviour, eg. friendship
1. The following are some of the basic needs of the child. Put each need into the
area that you feel is most relevant. You may feel that some words fit into more
than one box.
responsibility new experiences social skills

opportunity for play pleasure friends
exercise protection from danger morals and values
stimulation independence time for adults
love rest and sleep fresh air
2. Add three further needs to each of the boxes.

Outcome 1
Food
Food is essential for four reasons:

to establish growth, repair and replacement of tissues
to provide energy and warmth
to help fight disease
to maintain proper functioning of body systems.
In order to grow and develop children need a balanced diet containing a range of
different nutrients in the correct proportions.
The Healthy Eating plate gives an indication of the proportions of different food
groups which should be included in the diet
healthy eating plate
Bread,
cereals
Fruit and and
vegetables potatoes
Meats and
alternatives Milk and dairy
Fats and sugars products
Babies
Babies start on a pure milk diet, provided either by breast-feeding or bottle-
feeding. After 4-6 months the baby is weaned onto a mixture of solids and
liquids.
Early Childhood
Eating habits are established in early childhood. It is important to introduce
children to a nutritious diet and encourage them to try different types of food at
an early age. Studies also show that the food we eat during childhood may affect
long-term health.

Outcome 1
Later Childhood
Once a child starts school, there is less control over their eating habits. There
may be a choice of foods available for school dinners: packed lunches may be
swapped with friends; peer pressure becomes important and some children,
particularly girls, may become much more aware of body shape. This is also a
time when there may be growth spurts girls in particular have a growth spurt
between 10 and 14.
Encourage good eating patterns by:
acting as a good role model

making meal times enjoyable (the meal table should not be a battle ground)
providing a variety of tastes and textures
presenting food attractively
serving appropriately-sized portions
ensuring that the child is comfortable at the table with appropriate seating and
feeding utensils
keeping sweets and snacks for after meals.
Parental involvement
It is important that early years workers discuss the dietary needs of the child with
the parent(s) as some children may have medical conditions that might affect
their diet, others may have dietary restrictions due to religious or cultural beliefs.
Other health benefits of mealtimes

As well as providing essential nutrients, food and meal times should also provide
a wealth of learning opportunities and offer the opportunity for children to
socialise.

Outcome 1
Individual worksheet Nutrition
All foods consist of one or more of seven types of substances listed below. A
variety of foods needs to be eaten to provide the body with sufficient of each
substance in order to grow and develop properly, to be active and to keep
healthy.
Complete the chart below in relation to the diet of children
Substance Three good sources Why they are

required
Proteins
Carbohydrates
Fats
Minerals
Calcium
Iron
Fluoride
Vitamins
Vitamin A
Vitamin B
Vitamin C
Vitamin D
Fibre
Water

Outcome 1
Activity in pairs Meal plan
1. You are looking after an active three-year-old child for the weekend. Plan the
meals for Saturday including a packed lunch to take to the park.
2. Explain how the meals would cover the nutritional requirements of the child.
3. Your niece and nephew aged eight and 10 are coming to spend the weekend
with you. Plan the meals and snacks you would have on Sunday you are
planning to go swimming in the morning and spend the afternoon working in
the garden.

Outcome 1
Research activity Dietary requirements
1. Research, and make notes on, the different types of diet listed below.
2. Note any differences in food preparation and customs associated with meals
from different cultures.
Health Requirements Cultural Requirements Lifestyle
Diabetic Judaism Vegetarian

Gluten-free Hinduism Vegan
Allergies Islam
Sikhism

Outcome 1
Hygiene
Personal hygiene
Good standards of hygiene in childhood are important for the following reasons:
helps prevent infection
allows skin to function properly
helps prevent skin problems
increases self-esteem and social acceptance
good habits developed in childhood establish a pattern for later life.
Young children need help and supervision with personal hygiene. As children
develop they should be encouraged to become increasingly independent in
caring for their own personal hygiene.
Environmental hygiene
Cleanliness is an important safety aspect in any childcare setting. Policies and
routines relating to environmental hygiene should be in place in all childcare
establishments to ensure the well-being of children.
This should include aspects such as:

basic cleaning routines
food hygiene
disposal of waste and body fluids.

Outcome 1
Rest and sleep
Children vary in their need for sleep. The amount of sleep children need depends on their
age and stage of development, the amount of exercise taken and their own personal
needs.
Sleep and rest are needed for several reasons:
allows the body to recuperate muscles and metabolic processes recover
growth hormones are released during sleep to renew tissues and produce new bone
and blood cells
allows the central nervous system to rest.
Adequate sleep and rest benefits all areas of development:
physical greater resistance to infection
more energy
healthy appetite
growth hormone is released when sleeping
intellectual alert and eager to learn
able to concentrate
emotional more able to cope with stress and frustration
social more tolerant of others
more sociable

Outcome 1
Individual activity Sleeplessness
Dear Nanny Brown
I seem to have no time on my own with my husband. Our four-year-old daughter refuses
to go to sleep at night, frequently getting out of bed to sit with us and now wants to sleep
in our bedroom.
I try to have Amy ready for bed before my husband comes home from work but she likes
to stay up to see him.
Due to his work commitments he arrives home at a different time each evening. When he
comes in he likes to play exciting games with her as he feels he is missing out on all the
fun.
When she does go to bed she will not settle and shouts for drinks, blankets to be taken
off her bed, that there are monsters in the cupboard anything to get our attention. We
have tried to ignore her shouts but she then comes downstairs or into our bedroom.
She never seems tired at night-time but seems to need regular naps during the day to
catch up with her sleep.
Please rescue us!
_______________________________________________________________
Reply to this letter advising parents of a suitable bedtime routine.

Outcome 1
Physical activity and exercise
Because of changing lifestyles children in developed countries are participating less in

physical activity. Research shows that this may lead to health problems in later life, eg.
heart disease, obesity, osteoporosis.
Physical activity benefits all areas of development:
physical stimulates appetite and aids digestion
strengthens muscles and joints and increases bone density
improves posture
promotes sleep
improves resistance to infection
strengthens heart and lungs
improves balance, co-ordination and flexibility.
intellectual provides learning opportunities
improves concentration.
emotional raises confidence and self-esteem
route to express feelings and relieve tension.
social promotes interaction and co-operation
provides arena for meeting people.

Outcome 1
Small group activity Exercise
Work in small groups of three or four.
Suggest ways in which you could encourage physical activity with children in the following
age groups.
Peter aged 12 months:
Anwar aged three years:
Marie aged six years who is a wheelchair user:
Sunita aged 10 years:
You will be asked to share your answers with the whole group.

Outcome 1
Fresh air and ventilation
All children benefit from fresh air:
it stimulates the central nervous system
it dilutes the number of micro-organisms (germs)
sunlight on the skin provides Vitamin D (but care must be taken to avoid over-
exposure to sun).
Ideally children should be given plenty of opportunity to play outdoors. Indoor rooms
should be well ventilated to provide fresh air and to prevent a build-up of carbon dioxide.
Warmth and shelter
Provision of a warm, safe and stimulating environment not only helps physical
development but also gives children a sense of security and the opportunity to learn.

Outcome 1
Clothing and footwear
Clothing for children should be hardwearing, safe, comfortable, suitable for the weather
conditions and suited to the purpose. All clothing should allow the child to play and join in
other activities without restriction.
Children do get dirty, therefore it is also important that clothing is easy to wash and dry.
Clothing must be appropriate for the stage of the childs development and design factors
such as ease of putting on and taking off should be considered, eg. it may be difficult for a
young child to unfasten dungarees when going to the toilet.
The bones in childrens feet are very soft and can be easily damaged by badly fitting
socks and shoes.
Guidelines for Care of the Feet
allow children to go barefoot as often as possible babies do not need shoes until
they are walking out of doors
wash and carefully dry feet every day, cut toe-nails straight across
all-in-one baby suits should not be tight at the feet
shoes should be fitted by a trained childrens shoe-fitter
feet should be measured regularly at least every three months
well-fitting, low-heeled shoes should be worn for most of the time fashion shoes are
fine for short periods, but not for everyday wear to school.

Outcome 1
Activity in pairs Clothing
(a) Choose an outfit suitable for a three-year-old child to wear to nursery.

(b) Choose clothes suitable for a fashion conscious 11-year-old to take on holiday.
Explain why you have chosen these outfits consider factors such as type of material,
cost, stage of development of the child, suitability for activity, etc.

Outcome 1
Love and affection
Children need love and affection. They need to know that they are valued for who they
are rather than what they do this is termed unconditional love.
Bowlby and other researchers suggest that if children do not receive unconditional love
during their early stages of development then they may have problems forming
relationships in later life.
If children feel valued they feel secure, have improved self-esteem, greater confidence
and a greater sense of well-being.
Security
A secure child feels safe. They know that there is stability, that there is always an adult
there for them and a place for them to go.
Establishing routines often provides children with a feeling of stability and security.
Setting boundaries and letting children know what is expected of them also gives them a
feeling of stability. Pre-adolescent children try to push the boundaries as they strive to
attain independence. Peer pressure is significant at this stage.
When children feel secure they are more likely to be independent. Children who feel
insecure can become timid and withdrawn or can become demanding in order to gain
attention.
Often insecurity can result in regression children revert to an earlier stage of

development, eg. when there is a new baby in the family the older child may feel jealous
and insecure and regress to wetting his or her pants despite being previously toilet
trained.

Outcome 1
Play
Play is an important part of a childs life. The Charter for Childrens Rights (1989) states
that every child in the world should have the right to play.
Children play because it gives them pleasure but it is also an essential learning tool and
has an important role in socialisation.
Play benefits all areas of development:
physical develops fine and gross motor skills
physical activity
intellectual develops ideas
learning concepts
allows concentration
develops reasoning and thinking
develops imagination
creative
emotional allows children to express emotions
enjoyment
work off negative feelings and frustrations
social sharing and co-operating
accepting rules and boundaries
awareness of needs of others
leadership skills
Children also learn through the introduction of new experiences.

Outcome 1
Responsibility and independence
Encouraging and supporting children to act independently and allowing children to take
some degree of responsibility will help boost confidence and self-esteem.
It is important that expectations of what the child is able to do are realistic and that
responsibilities offered to the child are not overwhelming.
Consider a family with children aged three, seven and 11. Suggest suitable
responsibilities within the home for each child.

Outcome 1
Activity in pairs Needs
The basic needs of a child remain the same at any stage. However, each child has
specific needs that vary according to its stage of development and life circumstances.
Read the following case studies carefully:
Mary is a nine-month-old baby who is starting to crawl. She lives with her mother in bed
and breakfast accommodation. They have to share bathroom and kitchen facilities and
space is very limited.
Stewart is a lively, inquisitive two-year-old who lives with his mother and father in a large
house with a garden. He enjoys stories and is beginning to learn nursery rhymes and
songs. His mother is expecting a second child shortly.
Khalid is nearly five years old. He is an only child and is shy and quiet at nursery. His
parents are Somali Muslims who have lived in Britain for many years. They are keen to
encourage Khalid to learn about their culture and speak their native language at home.
Katy is nine years old. She is hearing impaired and is encouraged to use hearing aids as
well as using sign language. She lives with her parents and three siblings in a small town
where she attends the same school as her sister.
Identify the needs of each of the children in the case studies. Work should include
physical, cognitive, emotional and social needs.
During this exercise you should have noticed that different areas physical,
cognitive, emotional and social are strongly inter-related.
For example, Stewarts emotional need for love and attention and his intellectual need for
stimulation could both be met by his mother or father reading stories to him.
For each of the case studies identify one way in which needs are inter-related.

Outcome 1
Small group activity Meeting needs
Plan a day in the life of a child in your care.
You should consider carefully the needs of the child in relation to the age and stage of the
childs development.
Explain how your day meets at least two needs from each of the areas:
physical, cognitive, social and emotional needs.
Plan a day for either:
(a) Peter aged 12 months
(b) Anwar aged three years
(c) Marie aged six years who is a wheelchair user
(d) Sunita aged 10 years.

Outcome 1
Meeting the health needs of children
Child Health Promotion is a generic term that covers any planned intervention that is
designed to improve health or prevent disease, disability or premature death.
immunization
child health screening

surveillance health
education
safety, diet,
etc.
Child Health Promotion
Primary Promotion is aimed at reducing the number of children affected by a disease or

disorder
It involves activities such as:
immunization
prevention of accidents
prevention of dental caries
promotion of healthy lifestyles.
Secondary Promotion is aimed at detecting departures from good health early so that
the impact of poor health can be reduced by prompt detection and effective intervention.
It involves activities such as:
child health surveillance
screening programmes.

Outcome 1
Tertiary Promotion is aimed at reducing disabilities caused by disease and helping

children and parents adjust to diseases that can not be cured.
Immunization
The two public health interventions that have had the greatest impact on the
worlds health are clean water and vaccines. World Health Organisation
Immunization is the use of vaccines to protect people against disease. By injecting

vaccine, the body is stimulated into making antibodies to fight the disease and the person
becomes immune to the disease.
In developing countries, where the availability and uptake of vaccination programmes is

poor, almost four million children die every year from common childhood diseases and
their potentially disabling side-effects. Wide-scale uptake of immunizations reduces the
number of people in the population who are susceptible to the disease, giving protection
to those unable to be immunized and helping with the total eradication of the disease.
Immunization timetable
When to immunize What Vaccine is given How it is given
Two, three and four Diphtheria, tetanus, pertussis (whooping One injection
months cough), polio and Hib
(DTaP/IPV/Hib)
Men C One injection
Around 13 months Measles, mumps and rubella (MMR) One injection
Three years four Diphtheria, tetanus, pertussis and polio One injection
months to five years (DTaP/IPV)
Measles, mumps and rubella (MMR) One injection
10 to 14-years-old BCG (tuberculosis) Skin test, then if

(sometimes shortly needed one injection
after birth)
13 18 years Tetanus, diphtheria and polio One injection
Full details of immunization schedules can be found at

www.healthscotland.com/immunisation/additionalsupport/index.cfm

Outcome 1
In Britain the incidence of childhood diseases has fallen over the last few
decades due to the uptake of national immunization programmes. In recent years
medical reports of the adverse side-effects of some vaccines have led to a
decrease in the uptake of immunization, raising concerns about a future increase
in the number of children contracting childhood diseases.
Parents must always be given full information about the benefits of immunization,
potential side-effects and contra-indications to immunization to enable them to
make informed choices and give consent for the procedure.

Outcome 2
Activity in pairs Immunization
After researching information from books, current journals, newspapers and web
sites, give referenced arguments for both the benefits of wide-scale
immunization programmes and the dangers associated with immunization.
Benefits of immunization Potential dangers

Outcome 2
Role-play Immunization
Work in groups of three on the following role-play, with each student taking one
of the roles.
Mrs Thomson has asked to see the Health Visitor to discuss her concerns about
her sons forthcoming mumps, measles and rubella (MMR) vaccination.
Enact the meeting.
Mrs Thomson Mrs Thomson is very concerned about recent media publicity
about immunization leading to autism. She also feels that immunization is no
longer necessary as childhood diseases are on the decline.
Health Visitor The health visitor wishes to emphasise the benefits of

immunization but must give full information, allowing Mrs Thomson to make
an informed choice.
Observer The observer should note down issues raised during the
conversation. Note arguments both for and against immunization. Note how
clearly the health visitor communicated these to Mrs Thomson.

Outcome 1
Child health surveillance
Child health surveillance involves close observation, monitoring and review of the
childs health. The purpose is to detect any abnormality in development at an
early stage so that the child can be offered treatment. It is a continuous process
which looks at the whole child in the context of his/her surroundings. Parents
know their own child better than anyone else and therefore child health
surveillance should involve a partnership between parents and health care
workers. Child health surveillance provides opportunities for discussion and
guidance on health topics.
Screening
Screening in childhood is the checking of all children at certain stages of
development for the presence of abnormalities.
Screening tests are performed by health professionals doctors, health visitors

and school nurses. The tests identify children with problems who may need
further investigations.
Childhood screening programmes concentrate on:

development
hearing
vision
specific medical conditions.

Outcome 2
Research activity Child health surveillance programmes
Research the child health surveillance programme in your area.
1. Find out about personal child health records.
what type of information is stored in them?

what are the benefits of the personal child health record system?
2. Find out about screening programmes.
which screening tests are performed?

at what age are the tests performed?
who performs the tests?
what happens if people do not attend for the checks?
This could be done as a research project or you may wish to invite a local health
visitor to talk to the group about child health surveillance programmes and
development screening tests.

Outcome 2
Small group activity Health education
The main aim of health education is to improve health by enabling people to take
responsibility for their own and their childrens health.
This involves:
raising awareness of health issues

providing knowledge
empowering people to make informed choices.
Everyone can be involved in promoting health, and early years workers should
take every available opportunity to promote positive health practice.
Research activities
1. Research a recent local or national health education campaign aimed at

child health, eg. healthy diet, physical activity, road safety, dental health,
bullying, etc.
(a) What were the aims of the campaign?
(b) What methods were used to present the campaign?
2. In small groups design some activities suitable for a class in a primary

school to promote health in one of the following topic areas:
personal hygiene
oral health
diet
personal safety.
Identify which age group you have selected.

Outcome 1
Inequalities of access
Unfortunately those most in need of child health promotion are often the least
likely to use the services provided or attend clinics. The amount of health care
and advice available to and accessed by people is inversely proportional to the
level of need. This is known as the inverse care law.
This can be due to a number of reasons:
lack of knowledge
lack of access to services
fear or distrust of services.
It is important that health professionals strive to make access to health care

achievable for all members of the population.
The recent introduction of NHS24 and other Out of Hours procedures may cause
problems for many people in accessing primary health care outwith the normal
working day.
List reasons why it may be difficult for people to access child health services
consider the difficulties both for people who live in rural and urban areas.

Outcome 2
Test yourself questions
The following questions will help test your knowledge and understanding of the
work covered in Outcome 1.
1. Describe either Maslows or Kellmer Pringles theoretical approach to the

health needs of children.
(5 marks)
2. Read the case study below and use the theoretical approach chosen in
question 1 to explain Susans health needs.
(5 marks)
Susan is four years old. She lives with her mother, Lynn, in a two-bedroom flat on
the outskirts of the city. The flat is situated on a busy road but there is a play
park nearby which they visit on dry days. Lynn believes that children should be
given time and attention and although she works part-time she always makes
time to spend with Susan reading stories and playing games. When Lynn is at
work Susan stays with her grandparents who live nearby. Susan loves going to
her gran and grandad's as they have a large garden and there is always lots to
do.
Susan attends the nursery which is attached to the local primary school. She
often brings home pictures and hand-made presents for her mother and
grandparents. The pictures that she makes are proudly displayed on the walls of
both houses.
Susan is looking forward to starting school after the summer and has already
chosen her schoolbag and lunchbox.
3. Explain five different ways in which the holistic health needs of children
can be promoted.
(10 marks)

Outcome 1
Answers to test yourself questions
The following gives an indication of some of the expected answers to the test
yourself questions.
1. Maslow:
Maslow felt that some needs took precedence over others Hierarchy of
Needs.
Needs placed in order of priority.
Physical needs, safety needs, social needs, self-esteem needs and
creativity needs.
Must meet needs at one level before progressing to the next level.
Will only be able to reach full potential if lower needs are met.
Theory relevant to everyone adults and children.
Kellmer Pringle:
Kellmer Pringle specifically studied the needs of children.
Believed that all needs are interrelated and interdependent.
If children are to develop to their full potential all needs must be met but
not necessarily in a hierarchical sequence.
Concentrated on psychosocial needs.
Identified four basic emotional needs love and security, new
experiences, praise and recognition, responsibility.
She felt that early experiences and the environment that the child is raised
in could greatly influence child development.
2. Maslows theory used to explain Susans health needs:

Susans basic health needs those necessary for survival include the
need for food and water, warmth and shelter, rest and sleep and fresh air
and exercise.
Susans safety needs include protection from danger, a safe home
environment and safe play area.
From Maslows theoretical perspective if these needs are not met then
Susan will be unable to progress to higher needs such as self-esteem and
creativity needs.
Susans social needs include belonging and friendship.
Susans self-esteem needs include praise and recognition and time from
adults.
Susans creativity needs include a sense of purpose and achievement.

Outcome 1
Answers to test yourself questions (continued )
Kellmer Pringles theory to explain Susans health needs:

All of Susans needs are interrelated and interdependent physical,
intellectual, emotional and social.
Physical needs food, warmth, clothing, rest, sleep, exercise etc.
Intellectual needs new experiences, nursery education, stimulation.
Emotional needs time from adults, praise and recognition, responsibility,
love and security.
Social needs family and friends.
Kellmer Pringle felt that early experiences and the environment greatly
influence the health and well being of children. Susan therefore needs a
secure and stimulating environment in which to develop.
3. The five different ways in which the holistic health of children can be
promoted could have been selected from the following:
Immunization vaccination stimulates the immune system to make

antibodies against the disease, giving immunity to that particular disease.
In Britain there is an established immunization programme which offers
protection against many childhood diseases.
Prevention of accidents child safety is of paramount importance. Toys,

equipment, etc. all have to meet strict codes of safety.
Prevention of dental caries regular visits to the dentist and oral

hygienist helps promote good dental hygiene. Registration and dental
treatment are free for children. Oral health promotion for children and
parents encourages behaviours that promote good dental hygiene.
Promotion of healthy lifestyles health promotion events, the national

curriculum and positive role models all help to promote and encourage
healthy lifestyles.
Child health surveillance health professionals in partnership with

parents observe, monitor and review the progress and health of children.
Any abnormalities are detected at an early stage, making early treatment a
possibility.

Outcome 1
Answers to test yourself questions (continued)
Screening programmes screening programmes concentrate on

development, hearing, vision and specific medical conditions. They are
performed by a range of professionals: GP, health visitor, practice nurse,
school nurse, etc.
Access to health care it is important that there is adequate access to

health care for all children regardless of socio-economic background,
culture or geographical location.

Outcome 2
Explain the contribution of agencies, professionals and carers in maintaining and

Performance criteria:
(a) Explain the role and responsibilities of early education and childcare
workers in recognising signs of illness in a child.
(b) Explain the contribution of a range of agencies to the promotion of child

health.
(c) Explain how professionals and carers can contribute to the promotion of
child health.
In this outcome we will consider the role of an early education and childcare
worker in recognising signs of illness in a child. We will investigate a range of
agencies, both statutory and voluntary, which contribute to the promotion of child
health. We will also review the different ways in which a wide range of
professionals and carers are responsible for the holistic health and well-being of
children.
The importance of inter-agency working and collaboration between different

professionals will be emphasised.
The government places high priority on child health and many government
initiatives are designed to improve the life circumstances and health of families,
children and young people.

Outcome 2
Recognising signs of illness
Role of an early education and childcare worker

One important role in helping maintain and promote childrens health is to be able
to recognise when a young child may be unwell.
Early education and childcare workers have important knowledge of the usual
behaviour patterns of the children in their care and should take notice of changes
in these normal behaviour patterns which could indicate the onset of illness.
Early education and childcare workers are responsible for recognising the
possible onset of illness in children in their care and making a decision about the
course of action to take.
They should know where to go for advice and assistance, such as contact
numbers of:
parents
family doctors
health visitors
the nearest accident and emergency unit.
Early education and childcare workers in a setting such as a nursery should

follow any procedures, within that setting, for dealing with situations when it is
suspected that a child has an illness.
This is likely to involve informing the key worker/ head teacher/ manager/
supervisor, etc., as well as alerting parent(s) and/or medical professionals. It is
essential that someone within an early education and childcare setting takes
responsibility for the course of action to be taken. It is the responsibility of all
workers in the setting to be aware of the procedures to be followed.
Indicators of illness in a young child could include:

crying and appearing to be in pain or discomfort
appearing tired and listless
reverting to baby behaviour
wanting comfort
looking flushed and feverish
looking very pale
the presence of a rash
loss of appetite
coughing, sneezing, etc.
loss of voice
sickness and/or diarrhoea.

Outcome 2
Recognising signs of illness (continued )
There are other indicators which you may have come across that could mean that
a child is unwell. Alternatively, the changes in behaviour may be due to factors
other than illness.
The older the child, the more they are likely to be able to explain how they feel
and what their symptoms are.
It is most important that an early education and childcare worker does not
dismiss or ignore changes in behaviour that could mean a child is unwell.

Outcome 2
Research Recognising signs of illness
Early years workers should be able to recognise signs and symptoms that could
indicate the onset of both minor and serious illnesses and ailments. They should
also be aware of when they should take action and what this action should be.
The illnesses and ailments include:

Meningitis
Chickenpox
Measles
Mumps
Prolonged diarrhoea and/or vomiting
Coughs, colds and raised temperatures.
Working on your own, compile a reference chart that summarises the main
signs and symptoms of the above illnesses and ailments. Make a note of the
course of action that should be followed.
You may find it helpful to refer to:

information leaflets
books
the Internet.
The chart you produce will be of use to you when you are responsible for
promoting and maintaining the health of children in your care.
It is important to be aware that some older children may experiment with alcohol,
illegal drugs and substances such as glue, lighter fuel, etc. It is important that
you are aware of the possible signs of substance abuse.

Outcome 2
Agencies which contribute to the promotion of child health
The purpose of health services for children is to enable as many children as

possible to reach adulthood with their potential uncompromised by illness,
environmental hazard or unhealthy lifestyle.
British Paediatric Association
There are a wide range of services concerned with the health and welfare of
children. It is important that these services work in a co-ordinated manner in
partnership with parents and carers to provide an accessible child and family
centred service.
The statutory sector
In 1948 the Government established the welfare state and the National Health
Service (NHS) to provide care for all people free of charge.
Healthcare is delivered at three levels:

1. Primary care
2. Secondary care
3. Tertiary care.
Primary health care

This term relates to those services that are the first point of contact for people
who require health care.
Secondary health care

When a person has been diagnosed as having an illness or needs specialist help
they are generally referred to a hospital this is the secondary level of health
care.
Most people going into hospital or attending hospital clinics have been referred
by a General Practitioner or another member of the Primary Health Care Team.
Most secondary hospital care is provided by NHS Trusts.
Tertiary health care

This includes long-term care, rehabilitative care and highly specialised care.
The secondary care providers to specialist units or practitioners who have the
expertise to deal with the condition usually refer people.

Outcome 2
The Primary Health Care Team
The Primary Health Care Team (PHCT) provides a service to the local
community, which includes detection and treatment of illness and health
promotion services such as health education, surveillance and screening.
The PHCT is usually the first point of contact for people who require health care.
The team consists of the general practitioner (GP), practice nurse, health visitor
(HV), district nurse, community midwife, community psychiatric nurse, community
nurse for learning disabilities, and sometimes a social worker.
community nurse community

for learning psychiatric
disabilities nurse GP
PHCT
practice nurse
district nurse
district health
midwife visitor
Services offered by the PHCT may include:
antenatal clinics
child health clinics
family planning
well men and well women clinics
specialist clinics, eg. asthma, diabetes, weight management.

Outcome 2
School health services
The school health service is staffed by nurses, doctors and dentists.
The aims of the service are to:
promote the physical and mental health of school-age children

enable children to achieve their full potential.
The role of the staff includes:
liaison with school staff, parents, the primary health care team, social
services and secondary care services to meet the health and social care
needs of children
health surveillance and screening of school-age children
delivery of immunization programmes
assessment of specific health needs of individual children
health care advice to children, parents and school staff
health promotion programmes.
Community dental services

Community dental units carry out routine school dental examinations. They
provide a comprehensive screening programme, monitor oral health, undertake
oral health promotion and offer treatment to children who cannot access
independent dentists.
Child development units

Every health authority should provide a child development unit providing
specialist assessment, support and treatment for chronically ill children and
children with disabilities. These units are run by multi-disciplinary teams trained
in assessing child development. They provide specialist care and support to
enable children to reach their full potential.
The team may consist of the following professionals: paediatricians, paediatric

nurses, early years practitioners, occupational therapists, speech therapists,
psychologists, dieticians, play therapists and physiotherapists. Together with the
parents they will plan the most appropriate care for the child and the family.

Outcome 2
Other agencies involved in promoting and maintaining the health of

children
Education Department
Education departments have a statutory duty to ensure provision of education for
all children between the ages of 516 years. In addition to this, where children
have special educational needs, the range of facilities is extended to
accommodate children from the age of 219 years.
Pre school provision is made for all children from the age of 3. This may be in a
Nursery school or class or it may be in an early years centre, run jointly by the
Education Department and Social Work Department.
Social Work Department

Every local authority has a Social Work Department with social workers who
provide advice and support to those in need of help. Some people require long-
term help while others may only need temporary support in a time of crisis.
The Social Work Department can be of help to children, young people and
families in a number of ways, for example:
provision of home help/home carer

provision of day care
supervision of children in care
provision of fostering and adoption services
support for children and families
investigation of suspected child abuse.
They work closely with other professionals health workers, teachers and the
police to provide protection services for children and young people.
Department of Social Security

Provides government funded financial assistance through allowances such as
child benefit, family credit, income support, one-parent benefit, maternity
allowance, etc.
Psychological Services
Delivers psychological services to children, young people and their families. The
service also contributes to the development of policy and practice in relation to
the education and well-being of children.
The psychological service offers the following services:

consultation, assessment, advice and intervention with children and families
formal assessment leading to written reports at the request of the Education
Authority, schools, the Social Work Department, doctors, the Reporter to the
Childrens Panel, and others

Outcome 2
advice and consultative support to education, social and health workers,

parents, Childrens Panels and others working directly with children and
families.
The Scottish Commission for the Regulation of Care

(The Care Commission)
This is a national organisation which was set up under the Regulation of Care (Scotland)
Act 2001. Its role is to regulate and inspect care services in Scotland. Previously this
was carried out by Local Authority and Health Boards Registration and Inspection units.
The Care Commission is an independent body which regulates care throughout Scotland
in accordance with the National Care Standards.
The Scottish Commissioner for Children and Young People.
This post was first filled in April 2004 as a result of the Commissioner for
Children and Young People (Scotland) Act 2003. The remit of the Commissioner
is to:
promote and safeguard the rights of children and young people
ensure that the views of children are listened to in relation to important
aspects of their lives
ensure that adults uphold the promises made to children in the United
Nations Convention on the rights of the child (www.therightssite.org.uk)
review law and policy as it relates to children and young people
promote best practice by care providers
involve and consult with children and young people
investigate any issues which are relevant to children and young people and
which are not covered in any other area.
More information and relevant links can be found on the SCCYP website
www.cypcommissioner.org

Outcome 2
Activity
Look at the National Care Standards for Early Education and Childcare. They are
available online at http://www.scotland.gov.uk/Topics/Health/care/17652/9328
or may be available in the library / in your work placement, or your tutor may have a copy.
List the ways that the Care Standards help to promote and maintain the health of
children.

Outcome 2
Voluntary sector
The voluntary sector provides services through organisations which are not
controlled by the state. These organisations are also known as charities, non-
statutory organisations and non-profit making organisations. Although most of
these organisations finance their services through fund raising, some may also
receive grants from local or central government.
Voluntary organisations tend to focus on specific groups and can draw public
attention to specific issues, raising public and government awareness of a
particular problem. One example is ChildLine. These organisations can provide
new methods of dealing with problems and can often respond to needs more
quickly than the state sector as they are not bound by such rigid rules and
regulations.
Name of Type of work Web site

organisation
ChildLine 24-hour helpline which children www.childline.org.uk
can call with any problem at any
time. Calls are confidential
0800 1111
Children 1st Children 1 st aims to give every www.children1st.org.uk
child a safe, secure childhood
Parentline Provides support for parents. www.parentlineplus.org.
Scotland Helpline and local groups. uk
0808 800 2222 (Links to Parentline
Scotland)
NCH Action for Works to improve childrens lives www.nchafc.org.uk
Children and end child poverty. Provides
residential and community care
family centres, counselling
sessions, etc. Promotes Internet
safety for children.
Save the Works within the UK and www.savethechildren.or
Children overseas to campaign for the g.uk
rights of children.
Barnardos National charity working for www.barnardos.org.uk
vulnerable children and young
people in the community.
Kidscape Works to teach children to www.kidscape.org.uk
protect themselves from bullying
and abuse. Provides support
and teaching materials. Runs a
bullying helpline.

Outcome 2
Voluntary sector (continued)
Name of Type of work National contact

organisation address
SPPA An educational charity committed www.sppa.org.uk
Scottish Pre to the development of quality
School Play care and education for pre-
Association school children.
Action for the Offers family support through www.actionforsickchildre
Sick Child advice lines and booklets. n.org
(formerly Campaigns for improvement in
NAWCH) standards of health care for
children.
Scottish Aims to improve conditions for www.childminding.org
Childminding childminders, parents and
Association children to enhance the status of
childminding.
Young Minds A website aimed to support www.youngminds.org.uk
mental health of children and
young people
Scottish out of A charity which supports school www.soscn.org
School Care aged care, play and learning
Network
Home Start A charity which recruits and www.home-start.org.uk
trains volunteers to support
families in their own home.

Outcome 2
Small group research Organisations supporting children and

families
In small groups of three or four, investigate a national or local voluntary

organisation which provides services for families or children.
When you have collated your research prepare a presentation informing the rest
of the group about the work of the organisation.
(Note: when writing to a voluntary organisation for information always enclose a

stamped addressed envelope to help cover the cost.)

Outcome 2
Professionals involved in the promotion of child health
There are a wide variety of professionals who contribute to the health and well-
being of young children. They all have individual, identifiable roles but work in a
co-ordinated manner to help children achieve the highest level of physical and
mental well-being possible. It is now widely accepted that the key to enhancing
child health lies in collaboration and co-operation across agencies and
disciplines and collaboration with parents and families.
In this section we will look briefly at the roles of a range of different personnel
involved in the care of children.
General Practitioner (GP)

The GP is usually the first person to be consulted when there is a health
problem. GPs diagnose and treat illness and if necessary refer patients to
specialist services.
Health Visitor (HV)

Health visitors are qualified nurses who have completed further training including
midwifery experience. They work in the community to promote health, monitor
development and give advice on child health. They primarily work with children
up to the age of five although they may be involved with any age group.
Their role in the community may include:
taking over the care of babies from the midwife 10 days after birth
providing support and advice on child health and development
carrying out screening and holding child health clinics
supporting families in times of crisis
involvement in investigation of suspected abuse or neglect
referring families / children to other professionals if necessary.
Paediatric Nurse
Paediatric nurses are qualified nurses who specialise in child health. They often
work in hospital settings with children who have illnesses or require operations.
There are now many community paediatric nurses as sick children are nursed at
home rather than having long hospital stays.
School Nurse
School nurses are part of the school health service. They promote the health of
school-aged children and enable them to make healthy choices throughout life.

Outcome 2
They are involved in a range of health promotion activities, perform health

screening and provide care, advice and support to children with identified health
needs.
Physiotherapist
Physiotherapists assess motor development and skills and provide exercises and
activities to encourage better mobility and co-ordination and reduce the disabling
effects of illness.
Speech and Language Therapist

Speech therapists identify, assess and treat adults and children with
communication problems. They provide exercises and activities to encourage
language development and improve communication skills. They may be involved
with children who have difficulty eating due to physical problems.
Occupational Therapist
An occupational therapist is involved in the assessment and development of the
practical and social skills necessary for everyday life. They aim to develop as
much functional independence as possible, physically, psychologically and
socially. When necessary they advise on specialist equipment that can help to
support independent living skills.
Dietician
Dieticians assess nutritional problems such as food refusal, weight loss, obesity,
allergies, etc. They give advice and support to those on special diets.
Dentist
Dentists monitor dental health and perform preventative work to maintain oral health.
They promote dental hygiene and provide oral and general health education. They
diagnose and treat diseases and disorders of the mouth and teeth.
Dental Hygienist
Dental hygienists promote dental health and perform preventative work to maintain oral
health. They provide education on diet, tooth brushing and all aspects of oral health.
Psychologists
Educational psychologists assess educational needs and give advice and
support to the family, school and other agencies on ways in which these
needs can be met
Clinical psychologists specialise in helping children who have difficulties with
relationships with other people
Behavioural psychologists use behaviour therapy techniques to modify
unwanted behaviour.

Outcome 2
Social Worker
Social workers are employed by the Social Work department. They assess the
needs of the child and offer support and advice about available resources and
benefits that will help the well-being of the child.
Teacher
Teachers are primarily responsible for the education of children according to the
national curriculum. They plan, implement and assess learning.
Classroom Assistant
Classroom assistants work under the direction of class teachers to enhance the
learning experiences of children. They work with small groups of children to
further promote effective teaching and learning. They assist the teacher with
practical activities, the preparation of materials and supervision of children.
Early Education and Childcare Practitioners

Early Education and Childcare Practitioners are employed in private and local
authority nurseries. They provide care and education for young children. Through
planned activities, they promote the all-round development of children in their
care.
Childminder
Childminders work in their own home looking after one or more children. Childminders
must be registered by the local authority and must be able to provide the facilities and
experience required to offer a good standard of childcare.
Play Therapist
Play therapists help children to express their emotions through play. They often
work with children in hospital or with children in times of crisis.
There are many more professionals who have either a direct or indirect role in
the promotion of the health of the population:
public health workers dealing with housing, water and sewerage, pollution,
environmental health, etc., all have a role in health promotion
public service workers such as police, fire fighters, road safety officers,
accident prevention officers, etc., all strive to improve the well-being of the
population.

Outcome 2
Group research The role of professionals and carers in promoting

child health
Many professionals contribute to promoting the health of young children.

However, the role of carers and especially close family members parents and
other relatives is crucial in promoting child health. It is essential that
professionals work in partnership with carers in promoting childrens health.
Work in small groups and arrange to conduct a series of short interviews:
the first with a parent of a young baby

the second with a parent of a pre-school child
the third with a parent of a child aged 5-12.
The purpose of the interview in each case is:
to find out which professionals are currently involved with promoting the
health and well-being of the child
to determine the role of the professionals involved
to discuss the role the parent(s) and other carers play in promoting the health
and well-being of the child
to find out if the professionals and carers work in partnership to promote the
health of the young child.
Write a review of your findings, outlining the range of professionals involved in

promoting child health in different situations and at different stages of
development. Describe the roles of both the professionals and carers involved
and evaluate how closely they work in partnership with each other.

Outcome 2
Activity in pairs Promoting child health
Work in pairs to read the scenarios and answer the questions that follow.
Scenario 1
Mrs Campbell is concerned that her only child Pauline, who is 10 months old, is
refusing food. She seems to be losing weight and sometimes goes for days
without eating.
Scenario 2
During a routine health check for the new Primary 1 children it is noticed that one
of the children, Mhairi, is having difficulty communicating because of a stutter.
Scenario 3
Kulbinder is a six-year-old Asian boy. He lives with his parents and four-year-old
sister in the top flat of a tenement building. Until he was two Kulbinder was an
active, bright little boy who was developing in line with expected milestones in all
areas. Shortly after his second birthday Kulbinder developed meningitis. The
onset was rapid and although he received treatment quickly the infection has
been severe enough to cause widespread brain damage. Kulbinder has lost most
of his vision, has poor head control and is unable to walk. He screams when
approached by strangers and does not tolerate affection even from his family.
Questions
Which professionals might be involved in supporting the parents and children in
each of the scenarios given?
Explain the role of the professionals identified.
How might the professionals work in partnership with the parent(s) and other
carers?

Outcome 2
1. Explain the role and responsibilities of an early education and childcare

worker in recognising the signs of illness in a child.
(4 marks)
2. Explain the ways in which four different agencies can contribute to the
promotion of child health:
choose two from the statutory sector
choose two from the voluntary sector.
(8 marks)
3. Explain the ways in which four different professionals / carers contribute to

the promotion of child health.
(8 marks)

Outcome 2
The following answers give an indication of some of the expected responses to

the test yourself questions.
1. Role of early education and childcare worker is to recognise changes in

normal behaviour patterns and common possible indicators of illness. To
make a decision and take responsibility for the course of action to be
followed. To act in line with the procedures/policy of the childcare setting.
To know who to go to for advice and assistance. To have contact numbers
for parents, GP and health visitors.
2. Many different agencies could be chosen two from the statutory sector
and two from the voluntary sector. It is expected that the answer will
explain briefly the ways in which the chosen agencies contribute to the
promotion of child health.
Examples of agencies from the statutory sector:

Primary Health Care Team
School Health Service
Community Dental Service
Social Work Department
Education Department
Psychological Services
Examples of agencies from the voluntary sector:

Children 1st
Save the Children
Barnardos
Kidscape
Scottish Pre-School Play Association
3. Many different professionals/carers could be chosen. It is expected that

the answer will explain briefly the role of the professional/carer in helping
to promote child health.
Examples of relevant professionals/carers:

Health Visitor
School Nurse
Range of paramedical services physiotherapist, occupational therapist,
speech and language therapist
Dentist
Teacher
Early education and childcare practitioner
Parent(s)

Outcome 3
Evaluate the main influencing factors which affect the health of children.
(a) Describe how the family and socio-economic factors affect childrens
health.
(b) Explain environmental factors and their influence on childrens health.
(c) Evaluate the impact of social trends on childrens health.
In this final outcome we will investigate the range of factors that affect the health
of children. We will review the ways in which socio-economic and environmental
factors influence the health of families and young children both positively and
negatively. The extent to which the family shapes the personality, behaviour and
health of children will be considered. Demographic changes will be reviewed and
evolving social trends examined to assess and evaluate the impact that various
factors have on the health of children.

Outcome 3
Factors affecting the health of children
The Convention on the Rights of the Child states:
Children have a right to an adequate standard of living that allows for their
full development. This is for parents to provide, but when they are unable to
provide for their children, the Government should help parents reach this
standard.
http://www.unhchr.ch/html/menu3/b/k2crc.htm
Despite this statement many children in todays society do not have the
opportunity to grow, play and learn in a safe and healthy environment. The most
important objective in promoting the health and well-being of children is to
improve their life circumstances.
The vision of the Scottish Executive in its report Social Justice ... a Scotland
where everyone matters (1999) is:
A Scotland in which every child matters, where every child, regardless of their
family background, has the best possible start in life.

Outcome 3
Inequalities in health
Research has shown that within the population there are inequalities in health
status.
Studies indicate that deprivation and inequality in income, housing and

employment status all contribute to inequalities in health. Those who are from
lower social classes, who are least educated, who have least money and least
material resources are the most likely to experience poor health.
Social class and health

Most research aimed at identifying the major determinants of health has focused
on the links between social class and health.
The most commonly used classification of social class is derived from the
Registrar Generals scale of five occupational classes ranging from professionals
Class 1 to unskilled manual workers Class 5.
The Registrar Generals social classification
Social class Examples of occupation

in each class
Middle class Class 1 Doctor, lawyer,
Professional people accountant, architect.
Class 2 Manager, teacher,

Managerial and librarian, farmer, airline
technical people pilot.
Class 3A (non-manual) Sales representative,

Clerical and minor office worker, police
supervisory people officer.
Working class Class 3B (manual) Electrician, tailor, cook,
Skilled people butcher, bricklayer.
Class 4 Farm worker, packer, bus

Semi-skilled people conductor.
Class 5 Porter, labourer, window

Unskilled people cleaner, messenger,
cleaner.

Outcome 3
Inequalities in health (continued )
This classification is not adequate for todays work trends and was changed for
the Census in 2001 to include self-employed and unemployed.
There are many problems with social class allocation by occupation, for example:
it is based on the occupation of the head of the household
it does not account for unemployment
it does not reflect that social class experiences are different for men and
women and for people from different cultures.
Social class, however, is still regarded as an important indicator of life-chances.

Social class is strongly inter-linked with other factors such as income, housing
and education.
The World Health Organisation (WHO) states that the disadvantages of the lower
classes may include having few assets, having a poor education, having insecure
employment or none, living in poor housing or trying to raise a family in difficult
circumstances.
In 1977 the government commissioned a working group, under the chairmanship

of Sir Douglas Black, to review information about differences in health status
between social classes.
The report was published in 1980 and became known as The Black Report. The
findings clearly indicated a marked difference in health status between social
classes. Rates of mortality (death) and morbidity (illness) were substantially
higher in Class 5 than in Class 1.
Later reports The Health Divide (Whitehead 1988) and The Acheson Report
(1998) confirm that these inequalities still exist, with people in Class 1 living
longer and having better health than those in Class 5. Evidence suggests that the
health/wealth gap may in fact be widening.

Outcome 3
Small group activity Social class and health
James was born into Social Class 1. His father is an accountant and his mother a
lawyer.
Hugh was born into Social Class 5. His father is a labourer and his mother works
part-time as a cleaner in the local hospital.
In small groups discuss ways in which the life chances of these children may
differ.
You may wish to consider possible differences in housing, environment,

education, material resources, etc.
You will be asked to share your responses with the whole group.

Outcome 3
Poverty and health
There are two types of poverty:
Absolute poverty exists when there is not enough money to meet basic
needs food, shelter, clothing. This type of poverty is rare in Britain due to
the welfare state.
Relative poverty exists when people cannot afford the minimum acceptable
standard of living. In the UK a family is said to be living in relative poverty
when its income is less than half the national average income.
Despite the existence of the welfare state poverty has not been defeated. The
number of people in Britain living in relative poverty has more than doubled in the
last 20 years. Reports show that in the UK one in three families with children
under five are living below the poverty line.
Groups most at risk of poverty are:

elderly people
one-parent families
unemployed people and their dependents
those on low income and their dependents
disabled people/long-term sick and their dependents
members of minority cultural groups.
The effects of poverty

Poverty affects every aspect of life. Most succinctly poverty affects choice
choice of where to live, what to eat, what to do. People can only choose what
they can afford, not what they want or feel is best.

Outcome 3
Poverty and health (continued)
Physical health
poor nutrition
respiratory problems
increased risk of accidents
spread of infection
Cognitive health Emotional health

low expectations POVERTY stress
poor achievement depression
low self-esteem
Social health
family breakdown
limited social experiences
lack of opportunity
The effects of poverty on health can be described under the following headings.
Physical
the life expectancy of children living in poverty is shorter
the height and weight of children from low-income families is below that of
other children
children from low-income families are more likely to be affected by obesity
and malnutrition
children from low-income families are five times more likely to have an
accident.
Cognitive
Living in poverty reduces the opportunity for children to play and learn in a safe
and stimulating environment. All areas of development and educational
attainment seem to be affected by poverty, with children from lower income
families less likely to succeed at school.
This may be due to several inter-related factors:

teachers may have low expectations of children from poorer families
children themselves lack confidence and have low expectations
children from low-income families are more likely to miss school
children may not have adequate resources, eg. books, suitable environment
to learn
parents may be unable to provide support at home.

Outcome 3
Poverty and health (continued)
Emotional and social

Poverty increases family problems. Stress may lead to arguments, depression
and sometimes even violence. Due to lack of material resources children may
feel inferior and thus develop feelings of inadequacy and low self-esteem. They
may find it difficult to make friends and may be embarrassed to invite them home.
Cost may make it difficult for them to take part in outings and after school
activities.
Behaviour
Links have been made between poverty and the following behaviours:
truancy
teenage pregnancy
juvenile crime
substance misuse.
(These findings, however, may be due to a disproportionate number of studies
carried out in areas of deprivation.)
It has been recognised that there may be a cycle of disadvantage which

suggests that children born into poverty will live in poverty and die in poverty.
child born into poverty
ill health
unemployed social deprivation
low paid job feelings of failure
under achievement
Effective government policies aimed at defeating child poverty and improving life
circumstances for children and vulnerable families would help to reduce
inequalities in health and break the cycle of disadvantage.

Outcome 3
Group discussion
In May 2001 Scottish Executive Health Minister Susan Deacon allocated 1.9
million for 25 child health improvement projects across Scotland.
A total of 10.3 million has been made available over three years to support the
development of childrens health services and tackle inequalities in health care.
Projects include:
improving neonatal support
greater joint working between hospitals, health and social care agencies and
local communities
improving respite care
parent education
addressing the impact of remoteness and rurality on childrens health.
SNP shadow health minister Nicola Sturgeon welcomed the initiatives but
insisted the Executive should go further. She said The Executive cannot get
away from the fact that poverty remains the biggest influence on child
health.
Imagine you are politicians with the power and resources to improve child health.
In small groups discuss what measures you would introduce to reduce the
inequalities in child health in Scotland.
Agree a list of six measures that you would introduce.
You will be asked to share this list with the whole group.

Outcome 3
Unemployment and health
Most research illustrates that there are strong links between unemployment and
poverty and unemployment and ill health. Families without at least one person in
full-time employment are likely to be living in relative poverty. In the 1980s Britain
was in a period of recession which resulted in high rates of unemployment.
Towards the end of the century the economy of Britain became stronger,
employment increased and levels of inflation fell. The number of jobs in heavy
industry and in unskilled labour markets, however, did not rise and the position of
the poorest communities did not improve. Despite the introduction of the
minimum wage, the wages of those in the lowest income brackets have been
slow to rise.
These changes have resulted in a widening of the health/wealth gap and have
increased inequalities in health.
The number of children being raised in workless households has doubled over
the last 20 years.
Percentage of children in Scottish households with no working adults
26.4
13.7
1979 1996/97
Source: DSS Households Below Average Income taken from Scottish Executive
paper Social Justice a Scotland where everyone matters (1999)

Outcome 3
Housing and health
Poor housing
It is difficult to prove the effects of poor housing on health as those subjected to
inadequate housing usually have other social and economic disadvantages,
mainly poverty. However, it is generally acknowledged that damp, inadequate
and dangerous housing leads to:
poor health
illness and accidents
spread of infection due to poor facilities.
Low-income families and single parents are more likely to be housed in areas
that are unattractive, have high crime rates and poor facilities such as lack of:
play areas and open spaces
health centres and GPs
shops, etc.
Rented accommodation
Rented accommodation is expensive and often of poor quality. Damp, poorly
insulated homes are also expensive to heat.
Homeless families
It is difficult to measure the number of homeless families but, as a guide, in
1991/92 local authorities had almost 170,000 housing applications from homeless
families with children.
Bed and breakfast accommodation

A shortage of council housing has resulted in more families being temporarily
housed in Bed and Breakfast accommodation. This accommodation is often
cramped with families sharing one room that is used for living, cooking and
sleeping in. This affects not only physical health, but also social and emotional
health and restricts opportunities for playing and learning.
It has now been agreed that families with children should not be housed in Bed
and Breakfast accommodation for more than 14 days.

Outcome 3
Individual activity Poor housing
Read the following case study:
Shona is five years old. She lives with her mother and two-year-old brother Peter.
They have been living in privately rented accommodation for six months. They
live in one room on the third floor of an old Victorian house.
There is a toilet on the second floor which they share with three other families.
They have access to a communal kitchen but it is dirty and there is no secure
place to store food. Shonas mother prefers to cook in their room on a portable
stove.
Shona shares a bed with her mother and Peter sleeps in a travel cot under the
window. There is no garden, no space to play and the nearest park is a bus ride
away.
The local authority has given them priority housing status but cannot say when a
house may become available. If it is in a different area Shona will have to move
school.
Describe the effect that living in these circumstances may have on Shonas
health and well-being.

Outcome 3
Cultural diversity and health
Studies suggest that there is an association between ethnicity and ill health,
however there is very little epidemiological information on the health of different
ethnic minorities.
Many people from black and ethnic minority groups live in deprived inner-city
areas and therefore the factors affecting their health may be linked to their socio-
economic circumstances rather than to their culture.
Ill health may result from racism and institutional discrimination by the health
service and other organisations. Evidence shows that ethnic minority groups
make lower use of hospital services and screening programmes.
Some conditions are directly related to certain ethnic minority groups, eg. sickle
cell anaemia and thalassaemia.

Outcome 3
Demographic trends
Populations change because of changes in one or more of the following factors:

the birth rate
the death rate
the numbers leaving or entering the country.
Over the last few decades the age distribution of the UK population has changed.
This is primarily due to:
(a) an increase in life expectancy

(b) a decrease in the birth rate.
This has resulted in growing numbers of elderly people and also a greater
proportion of older people within the total population.
In 1971 those aged 65 or over made up 13% of the UK population.

It is estimated that by 2051 this age group will make up 24% of the UK
population.
Although the net population of Britain has not changed significantly due to
migration (people entering the country) the ethnic composition of the population
has changed. Britain is now a multi-ethnic society.
The population of people from minority ethnic groups varies from area to area
with marked geographical separation amongst ethnic groups.
In 1991 the proportion of rural population from ethnic minority groups was
1% whereas in central London it was 5%.

Outcome 3
Individual activity Socio-economic factors
Working on your own, compile notes to describe how the family and socio-
economic factors affect childrens health.
Consider both the positive and negative aspects of the various factors (although
sometimes it is hard/impossible to think of any positive aspects of factors such as
poverty).
These notes need not be very long or detailed but should be designed to be
helpful as a revision tool prior to assessment.
You may use a variety of information sources such as information sheets, books,
government reports, etc.
The family and socio-economic factors that affect childrens health should
include:
The Family
Poverty
Unemployment
Education
Cultural Diversity
Social Stratification
Disability
Homelessness
Demography.

Outcome 3
Environmental influences on child health
There are numerous factors in the physical and social environment that can
affect the health and well-being of children. The environment includes not only
the childs immediate surroundings, but also extends to the town, country and
even the world in which the child lives.
Pollution
Environmental pollution can seriously affect the health of adults and children.
Even with strict government controls, pollution seems to be an increasing
problem with a rise in car exhaust fumes, industrial waste, noise and litter.
Some pollutants have been linked to delay in cognitive development, some are
said to be carcinogenic and others are blamed for congenital deformities.
Pollution can also act as a trigger for asthma and other respiratory disorders.
Environmental Poverty
This term refers to areas where there is lack of access to parks, play spaces,
health centres, social facilities and shops.
Living in areas of environmental poverty can be stressful, affecting emotional and

social health as well as physical health. There is little opportunity to play and
socialise and accident rates are high in areas with few or no play facilities.
Rural/Urban Divide
Geographical location can influence health with different problems arising in
different types of environment, for example:
people in urban areas usually have reasonable access to healthcare facilities

whereas access may be problematic for people in remote rural areas
pollution is usually associated with inner cities and industrial areas
environmental poverty and areas of deprivation are more common in cities
rural poverty due to unemployment, low wages and high transport costs is
problematic in remote areas.

Outcome 3
Research in pairs Environmental influences
There are many topical environmental issues which have the potential to
influence health.
Working in pairs, choose one of the following topics, or an environmental topic of

your choice, and investigate the possible positive and/or negative effects that it
may have on childrens health:
fluoridation of water
genetically modified foods
telephone masts
global warming
type of housing (rural, urban, new development)
retail complexes
pesticides
food chain
accident prevention.
Compile a short summary that can be shared with other members of the
group.

Outcome 3
Social trends
Changes in the family

Many people view the family as the cornerstone of society as it plays a crucial
role in the development of individuals and in maintaining social order.
The family within which an individual develops has a major influence on health
status:
birth parents determine the genetic make-up of the child which plays an
important part in health
the family determines initial socio-economic status
the family is a very powerful agent of socialisation and plays a major role in
shaping the personality and behaviour of children. Most behaviour is learnt
within the family including lifestyle behaviours and attitudes which influence
health.
Within Britain there is increasing diversity in family composition and lifestyle. The
traditional nuclear family consisting of two married parents and their children has
decreased, whilst the number of lone parent families and step-families has
increased.
There are also cultural differences in family structure, eg. many Asian families
have extended family networks.

Outcome 3
Different family structures
Structure Characteristics
Nuclear family One man, one woman and their dependent children
Extended family A nuclear family with other relatives living as part of the
family (for example, grandparents, aunts and uncles)
Lone-parent family A single parent and their dependent children
Reconstituted family Two parents who may or may not be married and whose
dependent children are step- or half-brothers and sisters
with another parent living outside of the family following
break-up of the original family through separation or
divorce

Outcome 3
Small group activity Changes in family composition
Statistics show demographic changes in family composition within the UK:

a decrease in the number of marriages
an increase in couples living together without marrying
an increase in divorce (second highest divorce rate in European Union)
an increase in the number of lone parents (21% of all families)
an increase in the number of children born outside marriage
a decrease in the average number of children (average 1.9 children in a
family)
an increase in people moving away from their family base.
In Britain today there is no such thing as a standard family.
In small groups identify both the positive and the negative effects on the health
of children living in:
an extended family
a nuclear family
a lone-parent family
a reconstituted family.

Outcome 3
Changing roles
The general pattern of family life changed dramatically during the last century. At
the start of the Twentieth Century male and female roles were clearly defined
the father was the breadwinner and decision maker and the mother was the
carer and homemaker.
These traditional roles have now become blurred. In many families the mother
and father have no distinct roles both parents work, each contributing to the
family finances, and child-rearing and household tasks are shared. In an
increasing number of families traditional roles have been reversed and the father
cares for the children and stays at home while the mother works.
The changing role of men and women has been the result of several factors:
the introduction of laws which give women more independence

the opportunity for women and men to follow the same career paths
labour-saving devices in the home has freed time
changes in family structure lone-parent families, fewer children
increasing male unemployment.

Outcome 3
Structured debate Changing roles
In Britain today twelve and a half million women are in work, one of the highest
rates in Europe.
Statistics show that 51% of women with children between the ages of 0 and 4
years are in some form of employment.
Attitudes and opinions vary about the effect that mothers working has on the
health and well-being of children.
Split into two groups:
Group 1 are in favour of working mothers.
Prepare the case arguing that mothers working outwith the home enhances
the health and well-being of the child.
Group 2 are against working mothers.
Prepare the case arguing that mothers working outwith the home is
detrimental to the health and well-being of the child.
Hold a structured debate, allowing each group to put their case forward.

Outcome 3
Changing lifestyles
Over the last century, rates of child mortality (death) and morbidity (illness) have
fallen due to advances in health care, improvements in the environment,
provision of welfare benefits and better standards of education.
We have investigated a range of factors which influence health health care

services, socio-economic status, housing, unemployment, etc. These are all very
important factors but changing lifestyle patterns also influence the health and
well-being of families and children, both positively and negatively.
Diet: The number of overweight and obese children has risen dramatically during
the last decade. Convenience foods are used increasingly these tend to be high
in fat, sugar, salt and additives.
Exercise: Research shows that children are becoming less physically active and
are spending more time on sedentary activities such as watching television,
playing computer games and reading.
Technological revolution: This is linked to lack of exercise in children. It can

also contribute to social isolation. Allows adults to work from home more easily
and can be an excellent educational tool.
Stress: In modern society stress is one of the major causes of ill health, affecting
both physical and psychological health. Children can be stressed by life events,
eg. family breakdown, educational demands, bullying, etc., or they can be
indirectly affected by stress felt by parents, eg. financial worries, unemployment,
etc.
Sexual behaviour: The number of teenage pregnancies is rising, with the UK

having the highest teenage pregnancy rate in Europe. A large number of these
pregnancies occur in deprived areas with mothers and children locked into a
cycle of deprivation.
Crime: Over the last few decades there has been a rise in all types of crime
except sexual offences. There have been many suggested reasons for this, for
example:
rise in unemployment
decline in family influence
influence of media
poor social conditions
changes in type of policing.

Outcome 3
Drug and alcohol misuse: Figures indicate that drug misuse is becoming more
frequent and excess drinking, for both men and women, is on the increase.
Transport patterns: Increasing numbers of families have private cars, making

travel and access to leisure facilities, out-of-town shopping areas, services such
as clinics, etc., easier. Increasing use of private cars has also resulted in fewer
children walking to school, therefore decreasing the amount of exercise.
The increase in private car ownership, and the resultant decrease in public
transport facilities, has widened inequalities, making services less accessible for
those without private transport. This has a particularly marked effect on those
families without private transport that live in rural areas.
Health/wealth gap: There is a bigger divide between those families and children
who are wealthy and affluent and those who live in poverty. This leads to
inequalities in childrens health.

Outcome 3
Nature/nurture
The health status of a child is decided by heredity (nature) and the

environment determines the extent to which that health status develops
(nurture).
Write a short essay (500 words) discussing the extent to which you agree with
this statement.
In considering the effect of the environment on health status you may wish to
consider factors such as the family, socio-economic factors and physical
environmental factors such as pollution.

Outcome 3
1. Read the following case study.

Describe ways in which
(a) the family
(b) socio-economic factors
might affect Susans health.

(6 marks)
Susan is four years old. She lives with her mother, Lynn, in a two-bedroom flat
on the outskirts of the city. Susans mother and father divorced three years ago
and her father has since remarried. He has no contact with Lynn or Susan and
makes no financial contribution for Susan. Lynn finds it hard to make ends meet
despite her part-time job and often relies on help from her parents. The flat is
situated on a busy road and has no play facilities. Lynn believes that children
should be given time and attention and although she works she always makes
time to spend with Susan reading stories and playing games. When Lynn is at
work Susan stays with her grandparents who live nearby. Susan loves going to
her gran and grandads as they have a large garden and there is always lots to
do.
Susan attends the nursery which is attached to the local primary school. She
often brings home pictures and hand-made presents for her mother and
grandparents. The pictures that she makes are proudly displayed on the walls of
both houses.
Susan is looking forward to starting school after the summer and has already
chosen her schoolbag and lunchbox.
1. Explain the ways in which two different environmental factors can

influence the health of children.
(6 marks)
2. Research reports indicate that health inequalities are widening.

Evaluate the way in which this social trend affects the health of children.
(4 marks)

Outcome 3
The following answers give an indication of some of the expected responses to

the test yourself questions.
1. (a) Susan is growing up within a lone-parent family. She has no contact

with her father but she does have a male role model provided by
her grandfather.
She is part of an extended family and has close contact with her
grandparents.
She is part of a stable, loving and supportive family which will
impact positively on Susans health and well-being.
Family and socio-economic factors are closely related. The divorce
of her parents has left her mother with financial problems.
(b) Socio-economic factors are strongly related to family

circumstances. Lynn receives no support from her ex-husband and
finds it difficult to manage financially.
Lack of money could impact on all aspects of health physical,
intellectual, emotional and social health. In Susans case it may
affect things such as diet, housing, educational and social
opportunities. Financial difficulties may also lead to stress for Lynn
and in turn Susan.
In this situation help is available from the extended family.
2. A number of different environmental factors could be selected. The answer

should contain details of the ways in which the chosen factor could
influence the health of children.
Examples of factors:
Housing. Poor housing can affect:

physical health damp causes chest complaints; overcrowding and
unhygienic surroundings increase the chance of infections, accidents,
etc.
cognitive health lack of facilities reduces opportunity to play and
to learn
mental health increases stress
social health may be unwilling to invite friends to house.
Good quality housing can impact on health positively.

Outcome 3
Answers to test yourself questions (continued)
Pollution. Many different types of pollution, eg. air quality, noise,

waste, chemical, nuclear, etc., can affect the health of children.
Research has shown links with birth defects, asthma, cancer and
developmental delay.
Global warming will cause climate changes throughout the world which will
impact on the health of the world population.
3. Reports such as The Black Report, The Health Divide and The Acheson
Report illustrate that there are inequalities in health between different
sectors of the population and that these inequalities are in fact widening.
The reports clearly demonstrate that a child born into social class 1 has a
much better chance of living longer and of having better health than a
child born into social class 5.
This may be related to income differences between the different social

classes. This could affect diet, housing, schooling, opportunities, etc.
The differences may also be linked to differences in knowledge and
lifestyle between the different social classes.
Although it is very wrong to assume that people with low income cannot
provide a health-promoting environment and experience for young
children, there is little doubt that poverty has a negative effect on child
health.

SECTION 3
Resources
Books
Griffiths, D. (1996) Politics of Health. 2nd ed. Pulse Publications.
Keene, A. (1999) Care of the Child in Health and Illness. Stanley Thornes.
Kellmer Pringle, M. (1975) The Needs of Children. Routledge.
Lindon, J. (1993) Caring for the Under-8s. Macmillan.
Meggitt, C. (2001) Baby and Child Health. Heinemann.
Meggitt C, Stevens J. and Bruce T. (2000) An Introduction to Childcare &

Education. Hodder & Stoughton.
Nazroo, J. (1997) The Health of Britains Ethnic Minorities. Policy Studies

Institute.
Townsend & Whitehead. (1992) Inequalities in Health: The Black Report.

Penguin.
Useful Contacts/Reports
Convention on the Rights of the Child is available free from the Department of
Health, PO Box 777, London, SW1 6XU. Tel: 01623 724 524.
Department of Health. (1996) Child Health in the Community: A guide to good

practice, NHS Executive (available from Health Literature Line 0800 555 777).
Health for All Children, A programme for child health surveillance, (1996) Oxford
Medical Publications.
Health Education Board for Scotland, Woodburn House, Caanan Lane,

Edinburgh, EH10 4SG. Tel: 0131 536 5500.
Childrens Traffic Club Scotland Nursery and Play Group Pack - Early Years
education pack available free to all Nurseries and Play Groups in Scotland.
Includes activities and games to engage children in Road Safety and contains a
storybook, colouring masters and templates, song and story tape, books 1 6,
discussion, posters height, number and alphabet chart. To get your free pack
contact the Scottish Road Safety campaign on 0131 472 9200.

Scottish Office/Executive Publications
The following Scottish Office/Executive publications are available from:

The Stationery Office Bookshop, 71 Lothian Road, Edinburgh EH3 9AZ. Tel 0870
6065566 www.tso.co.uk
Working Together for a Healthier Scotland. (1998) Cm 3584, The Stationery

Office.
Inequalities in Health (The Acheson Report). (1998) The Stationery Office.
Meeting the Childcare Challenge A Childcare Strategy for Scotland. (1998) The
Stationery Office.
Eating for Health A Diet Action Plan for Scotland. (1996) HMSO.
Towards a Healthier Scotland. (1999) The Stationery Office.
The Oral Health Strategy for Scotland. (1996).
Some reports are available from www.scotland.gov.uk,

eg. Health in Scotland, (1999).
Social Justice a Scotland where everyone matters, (1999).

Useful websites
There are many websites which are useful sources of current, relevant
information. The following are some useful examples:
http://www.kidsmart.org.uk/ This includes guidance on the safe use
of the Internet for young people
www.scotland.gov.uk The Scottish Government Website
www.who.int The World Health Organisation website
http://www.hebs.com/topics/childh Health Education Board for Scotland
ealth/index.htm
www.parents.org.uk Parents online a website to support
parents of school aged children
www.cpag.org.uk Child Poverty Action Group
http://www.unhchr.ch/html/menu3/ Link to the UN Convention on the Rights

b/k2crc.htm of the Child
http://www.scotland.gov.uk/Topics/ National Care Standards
Health/care/17652/9328
www.childlink.co.uk An on line database which focuses on
legislation, policies and practices
regarding children, young people and
families.
www.cypcommissioner.org Children and Young Peoples
Commissioner
www.healthscotland.com/immunis Current Immunization Schedules
ation/additionalsupport/index.cfm
www.nutrition.org.uk British Nutrition Foundation
http://www.foodfitness.org.uk/ Nutrition based resources suitable to

use with children
http://www.food.gov.uk/scotland/sc Scottish Diet Strategy
otdietstrat
http://www.srsc.org.uk/ Scottish Road Safety Campaign
Journals / Magazines
Nursery World www.nurseryworld.co.uk

Care and Health magazine
Children in Scotland www.childreninscotland.org.uk

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Holistic Approaches to

Child Health (Higher)

Scottish Further Education Unit

Scottish Further Education Unit 2005

Scottish Further Education Unit 1

Holistic Approaches to Child Health

Enquiries relating to this Support Pack or issues relating to copyright should be

Information and Publications Co-ordinator

Further information regarding this Unit including Unit Specification, National

The Scottish Qualifications Authority

Scottish Further Education Unit 2

Section 1: Guidance for teachers 6

Section 2: Student activities and information 12

Section 3: Resources 104

Scottish Further Education Unit 3

1. Explain the basic health needs of children from 0-12 years.

2. Explain the contribution of agencies, professionals and carers in maintaining and

The unit content can be summarised as follows:

Scottish Further Education Unit 4

Evidence requirements for the unit

Scottish Further Education Unit 5

Approaches to learning and teaching

In delivering this unit it is useful if teachers/lecturers achieve a balance between

In delivering the unit it is important that a multicultural approach is taken.

Teachers/lecturers should ensure that students understand the nature, purpose

Scottish Further Education Unit 6

Teachers/lecturers should aim to create a supportive and motivating learning

the provision of a learning climate in which students feel supported to share

How to use the pack

Purpose of the pack

This pack is designed to provide guidance and support materials to help

Scottish Further Education Unit 7

Using the materials

activity or information sheets

The materials can be photocopied, adapted, altered, presented in a different

The information sheets can be photocopied as a separate pack if the

Exercises and activities

Preparation for assessment

Scottish Further Education Unit 8

Extending more able students

consideration of some of the models of health promotion

Scottish Further Education Unit 9

Week Content Outcomes

Scottish Further Education Unit 10

Week Content Outcomes

Scottish Further Education Unit 11

The unit has three outcomes:

1. Explain the basic health needs of children from 012 years.

2. Explain the contribution of agencies, professionals and carers in maintaining and

The unit content can be summarised as follows:

the role of agencies in the promotion of child health

the role of professionals and carers in promoting child health

positive and negative aspects of family, socio-economic, cultural and environmental

impact of social trends on the health of children.

Scottish Further Education Unit 12

A range of basic health needs of young children will be reviewed encompassing

Scottish Further Education Unit 13

Health is a concept which means different things to different people.

health is not being ill

health is being able to work and get through the day

health is living to a ripe old age

health is feeling happy

health is being fit and active.