Prescribing Play?

Here’s an unusual topic that, it turns out, seems to have direct bearing on “sustainable living,” because of the abilities that are developed through play.

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Kids are so over-scheduled

that doctors are being

told to prescribe play


Jenny Anderson


August 21, 2018


For many parents, back-to-school season incites a mad scramble to organize kids’ activities—from music lessons to math club and after-school tutoring. But a new policy report from the American Academy of Pediatrics suggests we’d do better to pencil in big blocks of time devoted to nothing but free play.

“Play is not frivolous,”

…the report says. Rather, research shows that play helps children develop language and executive functioning skills, learn to negotiate with others and manage stress, and figure out how to pursue their goals while ignoring distractions, among other things. The report warns that parents and schools are focusing on academic achievement at the expense of play, and recommends that pediatricians attempt to turn the tide by prescribing play during well visits for children.

“At a time when early childhood

programs are pressured to add

more didactic components and

less playful learning, pediatricians

can play an important role in em-

phasizing the role of a balanced

curriculum that includes the impor-

tance of playful learning for the pro-

motion of healthy child development,”


… write the authors, led by Michael Yogman, chairman of the AAP committee on psychosocial aspects of child family health.


The importance of play

It’s a well-known fact that American kids are playing a lot less these days. From 1981 to 1997, children’s playtime decreased by 25%, the report says. A national survey of 8,950 preschool children and parents found that only 51% of children went outside to walk or play once per day with either parent. And because of increased academic pressure, 30% of US kindergarten children no longer have recess.

Plenty of people argue this trend bodes poorly both for childhood and for kids’ future employment. At Davos, the uber-elite gathering of global power brokers, AI experts and global CEOs argued that free play encourages kids to develop agency, collaboration and creativity — just the skills that workers will need to maintain an edge over the robots.

And psychologists not associated with the report, including Peter Gray from Boston College, have said the consequences of a lack of play could be dire, including rising rates of mental health problems in teens. That’s why the Academy says it’s time to collectively reboot our thinking about play, understanding it not as a trivial, expendable pastime but as an essential activity that science shows is core to children’s healthy development.


The many benefits of play

The AAP identifies four kinds of play, noting that they change as children grow up. Object play starts with an infant putting everything in her mouth, and later using objects as toys (“Look mama, I am on the telephone!” says a child holding a banana).

Then there’s physical or locomotor or rough-and-tumble play, which starts with pat-a-cake and moves to pillow fights and negotiating free play at recess. The authors write …


“Rough-and-tumble play, which is akin to the play

seen in animals, enables children to take risks in

a relatively safe environment, which fosters the

acquisition of skills needed for communication,

negotiation, and emotional balance and encour-

ages the development of emotional intelligence.”


Outdoor play allows kids to integrate a bunch of senses: throwing balls or playing tag lets them learn to use the body and mind in tandem. Perhaps that’s why research shows that countries that offer more recess to young children see greater academic success among the children as they get older.

There’s also social or pretend play (which can happen alone or with others), when kids experiment with taking on roles — teaching a classroom full of stuffed animals, or playing house.

The AAP cites a laundry list of evidence underpinning the benefits of play. Randomized trials of physical play in 7- to 9-year-olds showed that play enhanced attentional inhibition, cognitive flexibility, and brain functioning that suggested better executive control. Pretend play helps kids build self-regulation because children have to collaborate on just how the imaginary world they are living in will work, thus …


“Improving their ability to reason

about hypothetical events.”


Play is also particularly important for kids exposed to toxic levels of stress. The report says …


“The mutual joy and shared communication and

attunement (harmonious serve and return inter-

actions) that parents and children can experience

during play regulate the body’s stress response.”


Getting play back on track

While the report’s authors worry that parents’ laser-focus on achievement has eaten away at play time, they attribute the problem to social pressures rather than poor intentions. They write:


“Parental guilt has led to competition over who

can schedule more ‘enrichment opportunities’

for their children. As a result, there is little time

left in the day for children’s free play, for paren-

tal reading to children, or for family meal times.”


To change this, the AAP recommends that preschools encourage more playful learning, both to foster stronger caregiver–infant relationships and to promote executive functioning skills. It also suggests that doctors not only encourage parents to protect children’s unstructured playtime, but have parents let their children take the lead — for example, if a child is doing a puzzle, it’s okay to suggest a piece of a puzzle that might fit, but not do the puzzle yourself.

Of course, “scheduling” free play is easier said than done. For a lot of parents, it’s logistically challenging, requiring caregivers or environments that support affordable free play that also keeps kids safe, fed, and close to school or home. That’s a lot harder than booking kids into a coding club. But our pediatricians want us to give it a try.

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Personally, I grew up with my mother simply saying, “Go play.” Before I was old enough to cross the street, I got together with other kids on the same side of the street and we’d do simple things, such as throwing a baseball or football.  Girls would mark up the sidewalk and play Hop-Scotch.

Once we were allowed to cross the street, we’d go to a school playground two blocks away; with more kids gathering there.  We could have baseball or football games, two-to-a-side, four-to-a-side, etc. … depending on how many showed up on a given after-school or weekend day.  Reflecting back, we did develop our ability to build a broader range of relationships.  And we did learn to organize ourselves to play the sports we wanted to play.

I’d never thought of all that playground play as an important component in our later professional development. But the report does make sense.

I think playing also sparked greater creativity. We had to create some fun activity out of nothing, and with no money and little-to-no equipment.  In recent years, I have encountered situations in which kids were completely unable to decide what they’d like to do, when given the freedom and asked.

What might the impact be on a democracy, in which the citizenry comes together to shape its destiny, as opposed to waiting for a leader – whether an autocratic dictator or an elected official with autocratic tendencies – to say which way we should all go?

That kind of makes us sheep.

Play is unstructured. It pushes creativity.  And it’s desperately needed for … joy … a key component to truly sustainable living.

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