State regulations require documentation that the child has received vaccines and screening tests according to the recommendations of the American Academy of Pediatrics and the Advisory Committee on Immunization Practices. Any document (including an electronic printout from the child's medical record) that provides this information is acceptable. The Office of Child Development and Early Learning (OCDEL) offers a form that allows health care providers to say whether the child is up to date, the CD 51. This Child Health Report form was last revised in 2008. It does not require the dates and results of the recommended screening tests. It has a check box to indicate "yes" or "no" that the child has received all the recommended screenings. The only screening information it requests is the results of any abnormal vision, hearing or lead screening. These are important, but not all the screenings that assess whether a child is healthy and ready to learn. 

This fact sheet provides general information about repetitive behaviors  (e.g. Tics) for parents and caregivers of children in early education and care programs. it describes how to define the behaviors and develop strategies to decrease the frequency of their occurrence. Updated 6/2018

Resilience in the face of stress comes from having the necessary social and emotional skills to cope successfully. Resilient children demonstrate initiative, self-regulate, and draw on established relationships to cope in adverse circumstances. These skills make them resilient in school and in life. Resilient children can focus, follow directions, share, solve problems, and show they care about others.

Devereux is a non-profit organization that operates a national network of behavioral health services. The early childhood initiative is based in the Devereux Center for Resilient Children (DCRC). The three essential components of resilience described by Devereux are: Initiative, Self-regulation and Relationships.

Adults know that electronic gadgets with screens entertain young children. Handing a cell phone to a child in a grocery store can make shopping easier. However, adults should focus learning with language rich, socially interactive opportunities for the child to learn about what is in the store.

Screen experiences from TV, smartphones, computers and tablets do not promote personality development. Real world social interactions are necessary. Screen devices substitute viewing images for exploration of the environment. While children can learn something from what they see and hear on screen devices, they learn more easily from interactions with people and objects they can see, touch and manipulate. The bottom line is that screen time for young children should be limited to provide more opportunity for play and learning in the real world. The American Academy of Pediatrics says that children less than 2 years of age should have NO screen time.*

Zero-to-Three published guidelines for use of screen devices in 2014.** The guidelines reviewed the research findings, the implications and limits to place on use of screen devices. For example, Zero-to-Three reported that, on average, children less than 3 years old are exposed to more than 5 hours of background TV. This exposure has a negative effect on the children’s development of language and other brain functions. It reduces the quality and quantity of play that is vital to learning.

 Screen Time, Digital Media Literacy:  What’s an ECE Practitioner to Do?

Two expert policy statements make recommendations about the appropriate use of media by young children. One is a statement from the National Association for the Education of Young Children (NAEYC) in partnership with the Fred Rogers Center for Early Learning and Children’s Media (FRC). The other is from the American Academy of Pediatrics (AAP).

The rapid development of digital media has evolved ahead of available research about their effects on children. Increasingy, we see parents putting their cell phones in the hands of their infants and toddlers to distract them while the parent is busy with something. Children have access to i-pads, cell phones, digital cameras and computers. Scientists who study brain development have evidence that early exposure to screens changes the way the brain is "wired" in ways that may lead to problems learning and relating to others. Definitive research is growing about how these devices affect young children. For now, we must rely on the expert policy statements from NAEYC-FRC and AAP. 


Screening young children’s development and behavior should be routine. Screening identifies children who need further evaluation to see if they have a problem. With early identification, children can receive services when they benefit the most from them.

This fact sheet provides general information about Spina Bifida appropriate for parents and caregivers of children attending early education and care programs. Updated 2004. Reviewed and reaffirmed 11/2012. For more detailed information about this condition, see Managing Children with Chronic Health Needs in Child Care and Schools, 2010, available from the bookstore of the American Academy of Pediatrics at

  • Managing Infectious Diseases 
  • Dental Check-up Resources 
  • Q&A: Cold Packs, Hearing Screens 
  • Why Not to Spank 
  • Caring for a Child with Special Needs: Diabetes, Tics  
  • Websites: USDA, Kids’ Questions, 
  • ECELS-Healthy Child Care PA 
  • Praise for WellCareTracker™  
  • Safe Scooting and Biking Tips 
  • Early Intervention 
  • Training for directors, health consultants, and early education staff 
  • SIDS-Infant Death Survival Guide
  • Eyes Must See Well 
  • Safe Sunscreen 
  • Domestic Violence Hurts Children 
  • The Daily Health Check 
  • Screen Time 
  • Exercise in Child Care — A Research Report 
  • Physical Activity in Afterschool Child Care 
  • Transitions 
  • Shaving Cream as an Art Material 
  • Recipes Kids Can Make 
  • Food Allergy Action Plan 
  • Food Thermometers
  • Screen Time: Digital Media Literacy:; What's An ECE Practitioner to Do:
  • First Aid Corner: Bruises & Swelling
  • Active Supervision: What is Required?
  • Nutrition and Wellness Tips for Young Children
  • Breastfeeding & Early Childhood Educators
  • Lead Poisoning - PA News