The American Academy of Pediatrics (AAP) released a clinical report on Aug. 20 titled “The Power of Play: A Pediatric Role in Enhancing Development in Young Children.” Dr. Andrew Garner, pediatrician, clinical professor of pediatrics at Case Western Reserve University School of Medicine, University Hospitals Medical Practices and one of the authors of the report, defines play as joyful and voluntary, motivated by natural curiosity, developmentally appropriate and social.
“The magic of learning happens when all of these elements meet,” he says. “Science tells us play is practice for life and how we learn 21st century skills. These include cognitive, social-emotional, language and executive function or self-regulation skills, which help manage stress. Play encourages the development of empathy and also offers practice for negotiating and resolving conflict with peers.”
The report underscores the importance of play for building skills and nurturing relationships and calls for pediatricians to write a “prescription for play” at well visits during the first two years of life to help children meet developmental milestones.
According to the 2018 report, “Pediatricians have a critical role to play in protecting the integrity of childhood by advocating for all children to have the opportunity to express their innate curiosity in the world and their great capacity for imagination.”
The barriers to play include less parent time and engagement, digital distractions like video games, and fewer safe places to play, the report states. Neighborhood threats pose safety concerns, particularly in low-income urban areas, and it is important to create opportunities for children with special needs who cannot take part in activities during crowded routine hours.
The experts do warn that play deficits can pose personal and public health risks. While young children rely on caregivers to help regulate emotions, older children must build coping mechanisms to deal with frustration and combat stress.
Dr. Rick Solomon, developmental and behavioral pediatrician, is author and founder of The PLAY Project, an autism early intervention program that uses play to engage children with autism.
“Fancy electronic toys aren’t necessary,” Solomon says. “The best toys are more hands-on, and the real value comes from the interaction.”
A 2007 AAP report, “The Importance of Play in Promoting Healthy Child Development and Maintaining Strong Parent-Child Bonds,” showed the benefits of play and also cautioned parents on over-scheduling children’s lives in favor of free play, but the new report incorporates what is known about brain development.
“Genetics play a critical role in the blueprint and architecture, but experiences drive what parts of that plan get read,” Garner says.
Dr. Stuart Brown, author and founder of the National Institute for Play, prioritizes play as a public health necessity.
“The AAP report as a guide for pediatricians is wonderful,” Brown says. “What’s missing in the report are the consequences of severe play deprivation, particularly in preschool and early elementary school age children.”
As a psychiatrist, Brown has conducted extensive research in this area. “Risks include depression, stress-related diseases, interpersonal violence, addiction and other health and well-being problems,” he says. “However, given its biological underpinning or instinct, we can rebound from lack of play by integrating it into life at most any stage.”
Play in Therapy
While the 2018 AAP report only briefly touched on special needs, the experts remind us the benefits of play are universal and include children with developmental delays or learning differences.
“A lot of what we know has been established, but we have been ignoring it,” Solomon says. “Research shows young children learn best through play and relationships with others. If you want a lifelong learner, learning has to be fun. Play has a quality of joy, intimacy and richness that directed interactions don’t have.”
Over 70 percent of Ohio counties offer The PLAY Project through early intervention. The parent implemented, evidence-based model uses a developmental, relationship-based approach.
“It empowers parents to be the child’s best play partner, and that is precious,” Solomon says.
The program is filtering into the school setting. The Teaching PLAY model for educators is expanding in Ohio preschools. Solomon previewed a soon-to-be published paper on research, which shows PLAY had a major impact on teacher engagement with children and classroom acceptance of children with autism, leading to an overall better classroom experience.
In Cuyahoga and Lorain counties, the Connecting For Kids family support organization offers its own program, Teach Me to Play, led by an early intervention specialist and speech-language pathologist for children 18 months to 6 years who are struggling in an area of development.
Judy Ruggiero-Ptaszek, speech-language pathologist, integrates play into all aspects of her practice, Accurate Speech Inc., including one-on-one sessions and social skills groups for children ages 2 to 18.
“Play’s role in therapy is two-fold: Play helps the therapist establish a positive rapport and trusting relationship with the child, and it encourages the development of many skills, including communicative intent, speech production, receptive and expressive language, listening, joint attention and turn-taking,” Ruggiero-Ptaszek says.