A new study concludes that while three-fourths of preschool-age children in the United States attend child care, many are not getting enough outdoor physical activity, which may be due in part to parental and societal values about injury prevention and kindergarten readiness.

Researchers included Kristen Copeland, MD, division of General and Community Pediatrics at Cincinnati Children’s Hospital Medical Center and a Robert Wood Johnson Foundation Faculty Scholar, and her team.

The group analyzed 53 child care providers from 34 child care centers in Cincinnati to examine their perceptions of potential barriers to children’s physical activity in child care.

The researchers found three main barriers to children’s physical activity, including, injury concerns, a focus on academics over outdoor play, and financial constraints, which limits a child’s physical activity, explained Dr. Copeland, as many children spend all daylight hours in care, and because some lacked a safe place to play near their home.

Childcare providers told the researchers that they felt pressured from parents to make sure the children didn’t get hurt and were sometimes asked not to have a child engage in vigorous physical activity.

But teachers noted that the children were using playground equipment in ways that it is not intended for making it unsafe, such as walking up a slide as oppose to sliding down it.

“Child care providers mentioned that they appreciated having state inspections of their playground equipment and strict licensing codes because it helped them feel confident about the safety of the equipment,” says Copeland.

“But several of them expressed how overly strict standards had rendered some of the equipment unchallenging and uninteresting to the children, which hampered the children’s physical activity.”

The researchers explained that although these overly strict parents and pressured teachers are afraid that their child will get hurt by playing in the playground, daily physical activity is essential for preschool-aged children's development and for preventing obesity.

“Given that childhood obesity is a national epidemic and a major cause of childhood morbidity, and that time in child care may be the child’s only opportunity for outdoor play, licensing standards may need to explicitly promote physical activity in as much detail as is devoted to safety.”