Table 4 Differences in the Australian Guidelines compared to the Canadian Guidelines

  Canadian 24-Hour Movement Guidelines for the Early Years (0–4 years): An Integration of Physical Activity, Sedentary Behaviour and Sleep.

Australian 24 Hour Movement Guidelines for the Early Years (birth to 5 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep.

To identify the relevant country and age group

 These guidelines are relevant to all apparently healthy infants (less than 1 year), toddlers (1–2 years), and preschoolers (3–4 years), irrespective of gender, cultural background, or the socio-economic status of the family. These guidelines may be appropriate for young children with a disability or medical condition; however, a health professional should be consulted for additional guidance.

These guidelines are relevant to all apparently healthy infants (less than 1 year), toddlers (1–2 years), and preschoolers ( 3–5 years) , irrespective of gender, cultural or language background, geographic location, or socio-economic status of the family. These guidelines may be appropriate for young children with a disability or medical condition; however, a health professional should be consulted for additional guidance.

In Australia, a child must start school before they are aged 6 years old. However some children start aged 4 years old, if they are close to turning 5 years old. Given this variation, the group came to consensus in stating the age group as 3–5 years. This is repeated throughout the Guidelines.

Australia is a large country with densely populated capital cities and regional centres. Additionally, there are many rural and remote areas that are geographically isolated due to the Australian climate (wet and dry season in the north of the country). Australia has had a strong migration policy and has attracted a culturally diverse population, especially from Europe and Asia. The Consensus Committee agreed that this wording was more suited to the Australian context.

 To encourage healthy growth and development, young children should receive support from their parents and caregivers that allows for an active lifestyle with a daily balance of physical activities, sedentary behaviours, and sleep. Young children should participate in a range of developmentally appropriate, enjoyable and safe play-based and organized physical activities in a variety of environments (e.g., home/child care/school/community; indoors/outdoors; land/water; summer/winter), both independently as well as interacting with adults and other children. For infants, supervised activities could include tummy time, reaching and grasping, pushing and pulling, and crawling. The quality of sedentary behaviour matters; for example, interactive non-screen based behaviours (e.g., reading, storytelling, singing, puzzles are encouraged. Developing healthy sleep hygiene in the early years is important, this includes having a calming bedtime routine with consistent bedtimes and wake-up times, avoiding screen time before sleep, and keeping screens out of the bedroom.

To promote healthy growth and development, young children should receive support from parents and family, educators and caregivers that allows for an active lifestyle with a daily balance of physical activities, sedentary behaviours, and sleep. Young children should participate in a range of developmentally appropriate, enjoyable and safe play-based and structured physical activities in a variety of environments (e.g., home/early childhood education and care/community; indoors/outdoors; land/water; summer/winter), both independently as well as interacting with adults and other children. For infants, supervised activities could include tummy time, reaching and grasping, pushing and pulling, and crawling. The quality of sedentary behaviour matters; for example, interactive non-screen based behaviours (e.g., reading, storytelling, singing, puzzles) are encouraged. Developing healthy sleep hygiene in the early years is important; this includes having a calming bedtime routine with consistent sleep and wake times, avoiding screen time before sleep, and keeping screens out of the bedroom.

Australia included educators into this sentence as the Consensus group agreed they were important to identify, separate to caregivers

The Australian group agreed on the use of the word structured in place of organised.

Early Childhood Education and Care is the common terminology used to describe the learning environment of children prior to school entry.

Australian group did not use school environment as these children would fall under the Child and Youth Guidelines.

Agreed that sleep time is more appropriate than bed time in that the latter does not indicate the time from which a child actually falls asleep and is inclusive of daytime sleep. This change is repeated throughout the Guidelines. Bedtime in Australia also infers night sleep and we needed to account for full 24-h sleep duration. This is repeated for toddlers and preschoolers.

  Toddlers (aged 1–2 years)

Toddlers (aged 1–2 years)

For toddlers, a healthy 24 h includes:

 • At least 180 min of a variety of physical activities at any intensity, including energetic play, spread throughout the day; more is better;

For toddlers, a healthy 24 h includes:

• Physical activity: At least 180 min spent in a variety of physical activities including energetic play, spread throughout the day - more is better.

The Australian group chose to utilise sub-headings for the three key areas despite the integrated approach. It was agreed that the use of subheadings assists the reader in understanding the context. These also appear for infants and preschoolers.

 • Not being restrained for more than 1 h at a time (e.g., in a stroller or high chair) or sitting for extended periods. For those younger than 2 years, sedentary screen time is not recommended. For those aged 2 years, sedentary screen time should be no more than 1 h; less is better. When sedentary, engaging in pursuits like reading and storytelling with a caregiver is encouraged;

• Sedentary Behaviour: Not being restrained for more than 1 h at a time (e.g., in a stroller, car seat or high chair) or sitting for extended periods. For those younger than 2 years, sedentary screen time is not recommended. For those aged 2 years, sedentary screen time should be no more than 1 h; less is better. When sedentary, engaging in pursuits like reading and storytelling with a caregiver is encouraged.

The Consensus group removed the term ‘at any intensity’ as it was agreed this was redundant given the inclusion of ‘energetic play’.

 • 11 to 14 h of good quality sleep, including naps, with consistent bed- and wake-up times.

• Sleep: 11 to 14 h of good quality sleep, including naps, with consistent sleep and wake-up times.

The Consensus group agreed to include car seat as one of the examples of equipment where children can be restrained for extended periods. This is repeated in the Infant Guidelines.

 Replacing time restrained or sedentary screen time with additional energetic play, and trading indoor for outdoor time, while preserving sufficient sleep, can provide greater health benefits.

For greater health benefits, replace time restrained or sedentary screen time with additional energetic play, while preserving sufficient sleep.

The Australian group agreed we had not assessed evidence to enable consideration of whether or not to include the statement “trading indoor for outdoor time”.

Rephrasing of the sentence was also preferred.