At Perea Preschool in Memphis, Tennessee, a teacher introduces mango to a circle of 16 4-year-olds for the first time. Another day, the children discover pumpkin during a play activity. Most of these children come from impoverished families where lettuce is considered a luxury item. According to Vicki Sallis Murrell, a professor of counseling, educational psychology, and research at the University of Memphis, parents are making tough choices between a $1 head of lettuce and five boxes of macaroni and cheese.

“In the middle of a food desert, grocery stores with reasonably priced, quality produce and fish are difficult to find,” Murrell said. But parents are making sacrifices to provide healthy food for their families because they know their kids want and need it. “If my kids didn’t go to Perea, they wouldn’t want to eat vegetables,” said Scharica Martin, a former Perea parent. But because all three of her children attended the school, healthy food is one of her family’s biggest budget items.

Perea is funded by a local health care organization, and nutrition is a key component of the curriculum. The school operates with the idea that students and their families do best when they know that good nutrition aids brain development—and ultimately, the development of cognitive skills. Enrollment has grown by more than 300 percent since the school was founded in 1999.

The school isn’t unusual. As brain science has evolved and more attention has been paid to the link between health and education, more preschools across the country seem to be focusing on providing not only academic and social support, but health education, too. Educare, which operates a network of schools across the country, focuses on health and nutrition. Recently, Priscilla Chan, a philanthropist married to the Facebook founder Mark Zuckerberg, helped launch a school for low-income children that is partnering with a health center to holistically educate children and their families.

Most physical brain development occurs before age 5 or 6 when the brain reaches 90 percent of its adult size, Murrell said. “The intake of healthy fat is particularly important for the process of myelination. Myelin is like the grease that coats the synaptic connections, making the transfer of information faster. Without proper nutrition both in utero and after birth, the brain cannot develop as it should.” In other words, a lifetime brain map for social, emotional, and cognitive functions is formed during preschool and kindergarten.

Play is the best way to influence behavior and teach lessons about health in early years, according to Murrell. For example, Perea never introduces a food by having a cafeteria employee plop a scoop on a plate—there is always an explanation or exploration, Alicia Norman, the school’s principal, said. During a pumpkin-centered activity, children see a raw pumpkin before seeds are roasted or pies are made. They’re encouraged to stick their hands in and feel the texture of both the seeds and the pumpkin meat. If they want to try raw pumpkin, that natural curiosity is indulged.  

A child that graduates from Perea can explain the health benefits, taste, and texture of every food they’ve been introduced to, Norman said. The preschool’s philosophy is that while pie itself isn’t the epitome of nutritional perfection, the concept of food not coming from cans encourages the use of fresh ingredients and the avoidance of preservatives. Talking to the children about foods instead of making them eat new foods without a choice or explanation is why her students want to eat healthy while other schools have had trouble achieving similar results, she said.

Preschools like Perea that have adopted health as a focus don’t just cover physical wellness and nutrition. They often cover the emotional side of wellness, too. For instance, if a school serves students who already have parents providing and encouraging nutritious meals, teachers may focus more on emotional regulation and cognitive functions. For Perea students, emotional regulation is part of every lesson. “You can’t get to the root of any problem, nutrition or otherwise, without exploring emotional regulation and getting the child to explain what problems they are having,” Murrell said. “We can understand problems and get clues of the overall health of the child when we ask how they are feeling.”

To further focus on emotional growth, Perea has developed an approach where teachers and administrators become part of the students’ extended families. Teachers do at least one home visit per year. The home visits help them see what a child’s family life is like, and they also help the children trust their instructors. A child might show her teacher her Spiderman, Dora, and princess toys. When tough lessons are taught in school, such as conflict resolution, kids are more likely to remember their teacher played with them at home and then listen to their advice and guidance at school.

A big part of conflict resolution is helping kids learn to express their feelings instead of resorting to violence or anger. Gender roles are untaught at Perea, Murrell said. Girls are traditionally taught it’s okay to be sad, happy, or scared, while boys are traditionally taught it’s not okay to show fear or sadness, but it is okay to be angry or happy. Perea students are taught that all emotions are okay as long as they’re expressed calmly, which helps them learn to regulate their emotions, she said.

Perea knows that to help students develop emotionally and physically, it needs to work with parents to ensure that the adults in students’ lives are physically and mentally healthy, too. This means providing supportive resources for parents.

Martin saw firsthand how much the school cared about her family when her child’s teacher helped her after a job loss. “I was walking around depressed, and she went home and talked to her husband to see what they could do to help me,” Martin said. “They paid my light bill and helped me find a new job. I’ll never forget her, and we still keep in touch. My children refer to her as if she were an aunt.”

The help Martin received from Perea wasn’t rare. Perea has a parent liaison that connects parents with community resources for employment, getting their GED, and enrolling in or returning to college. Some parents say they have a stronger support system than they’ve ever had through the friends and teachers they meet at Perea.

Martin’s Perea story started when she volunteered there with her cousin before she even had a child in the preschool. She said she was so impressed that she wanted to send her children there. Her cousin was fulfilling part of the 30-hour annual parent volunteering and engagement requirement. Parent engagement isn’t just volunteering in the classroom; it’s also taking parenting classes.

“Parents tend to parent as they were parented,” Murrell said. “With education, Perea parents learn different tactics to take with our children. For example, we teach parents that punishment is not effective for long-term behavioral change, and can, in fact, promote avoidance behaviors and secrecy.” Instead, parents are taught about other ways to deal with problem behaviors, such as refocusing attention and talking with their children about their emotions. The purpose is to help the children develop the cognitive processes required to self-regulate. But if the parents don’t know about their options, then they can’t make change.

Perea’s been so successful with parenting training that it created a parenting center the community will soon have access to. The center will educate parents about how to provide a healthy environment for children, including about the importance of nutritionally balanced meals.

Perea hopes that by equipping parents with the tools teachers use in class, what children learn at school will be reinforced at home and vice versa. While Martin sees children she knows getting into physical fights in middle school, her eldest is not only avoiding physical fights, but he is also quoting his Perea teachers about how to correctly handle disagreements by talking to resolve conflicts.

Without conflict-resolution skills, students can fall prey to toxic stress as they get older, according to Murrell. Toxic stress is stress that is so severe because of childhood trauma that it leads to “physical health issues that manifest later in life because of stress that is strong, frequent, and prolonged in the absence of protective relationships,” she said.

In a study of more than 17,000 people conducted in the mid-1990s by the Center for Disease Control and Kaiser Permanente, children with four or more adverse childhood experiences, such as an incarcerated parent, neglect, or physical abuse, “were much more likely to have hepatitis, chronic obstructive pulmonary disease (emphysema or chronic bronchitis), depression, auto-immune diseases, and one or more sexually-transmitted diseases,”  Murrell said.

“We have a short time to reach both kids and parents,” Murrell said. “As children enter middle childhood, they tend to become more interested in other kinds of play, such as rule-based games. They become less influenced by what adults think or want. By adolescence, many kids will do the opposite of what an adult expects or wants, just to test boundaries. That makes introducing new concepts, including conflict-resolution tactics, learning approaches, and foods early important.“

“Children leave Perea confident and knowing they have a voice in the world,” Norman said. “Parents leave knowing the same.”