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Helping Families Reclaim the Power of Play


Michael W. Yogman , MD, FAAP
August 27, 2018

The 3-year-old girl arrived at my office for her annual check-up, hiding behind her parents and frowning. I could tell it was going to be a challenge to help my young patient feel at ease.

So, along with a stethoscope, otoscope and eye chart, I’d need a few other tools of my trade. I reached for a jar of bubble solution.

As I began blowing bubbles and asked the girl to try and catch them, she began to soften and smile. I invited her family to bring the container of wooden blocks from the waiting area back to my consulting room so that she could play while we talked. Within minutes, as her parents and I reviewed the past year’s events and history, the girl was happily engaged in stacking towers of blocks and then knocking them over with a 3-year-old’s joyful exuberance.

It was not easy to transition to the examining room for her physical exam, but the bubbles again came in handy. So did the hand puppet I used to help relax and encourage her. “Audrey” the duck asked her to use the stethoscope to listen to her duck heart, giving her a sense of expectation and control when it was time for her exam.

In #AAPvoices, Dr. Michael Yogman explains why AAP now encourages pediatricians to write prescriptions for daily play.

It was not easy to transition to the examining room for her physical exam, but the bubbles again came in handy. So did the hand puppet I used to help relax and encourage her. “Audrey” the duck asked her to use the stethoscope to listen to her duck heart, giving her a sense of expectation and control when it was time for her exam. 

 

Incorporating play into the girl’s well-child visit did more than calm and comfort her. It let me demonstrate for the family first-hand one of the many ways play can benefit children. A new American Academy of Pediatrics (AAP) clinical report, “The Power of Play: A Pediatric Role in Enhancing Development in Young Children,” highlights how playing with parents and peers helps children optimize social, cognitive, and physical development. It also helps them establish safe, stable, nurturing relationships that buffer the stress of traumatic experiences that can harm children’s health over time.

To emphasize just how important play is, the AAP report recommends pediatricians write a prescription for daily play at well-child visits through age 2.

Loosely defined, play means engaging in an activity for the sake of fun and joyful discovery. Whether it’s chasing bubbles, playing puppets, and stacking blocks--or one of the countless other ways children delightedly interact with their world—play builds socio-emotional, language, cognitive, and self-regulatory skills. All of these are needed for executive function and a prosocial brain, increasingly important in a 21st century world that emphasizes collaboration, creativity and innovation.

"Whether it's chasing bubbles, playing puppets, and stacking blocks--or one of the countless other ways children delightedly interact with their world—play builds socio-emotional, language, cognitive, and self-regulatory skills. All of these are needed for executive function and a prosocial brain, increasingly important in a 21st century world that emphasizes collaboration, creativity and innovation.”

 

As important as play is, though, the amount of time children spend playing has been on the downswing in recent decades. Research shows that 30 percent of U.S. kindergarteners no longer have recess, for example. Another study found that only 51 percent of preschool children went outside to walk or play once a day with a parent.  More didactic teaching components in early childhood education programs, fewer safe places to play, and rising media use and screen time are just a few of the factors taking away from free play children need for healthy development.


As pediatricians, we can help children and families reclaim the power of play. We can advise them to look for early education programs that help children learn by tapping into their natural urge to play, for example, as a complement the Reach out and Read initiative. We can encourage them to create a family media plan, to help ensure screen time doesn’t displace real-world play.

As I talked with my 3-year-old patient’s parents about health and development milestones and anticipatory guidance, the girl was still engrossed in play, practicing her skills of task persistence, mastery, and triumphant discovery. I encouraged the family to continue the fun at home, recommending household objects--wooden spoons, empty bowls and dishes that could be stacked—as perfect playthings. I also reminded them that as parents, they are among their young child’s first and best playmates.


Then I handed them my prescription, enjoying the smile this simple but important recommendation brought to their faces.

“Play every day,” I said with a smile of my own. “Doctor’s orders.”


* The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.

About the Author


Michael W.  Yogman, MD, FAAP, is lead author of the new American Academy of Pediatrics clinical report, “The Power of Play: A Pediatric Role in Enhancing Development in Young Children.” He is past Chair of the American Academy of Pediatrics (AAP) Committee on Psychosocial Aspects of Child and Family Health and AAP’s Massachusetts Chapter Child Mental Health Task Force. He is an assistant professor of pediatrics at Harvard Medical School and has practiced pediatrics in Cambridge, Massachusetts, for two decades after several years working full-time at Boston Children's Hospital with developmental behavioral pediatrics pioneer T. Berry Brazelton, MD. Dr. Yogman also serves as chair of the Boston Children’s Museum board of trustees.​