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Pediatricians say play is the medicine our kids need

It brings a smile to their faces and ours, while lowering stress and building little brains. Play is such an important part of childhood, but opportunities for play in modern life are shrinking, and the American Academy of Pediatrics suggests they need to grow so our kids can grow, too.

In 2018 the AAP published a clinical report stressing the importance of play in child development and urging parents to play with their children every day.

The report suggests pediatricians should offer a prescription for play to new parents, advising moms and dads to make time for playtime, and suggesting schools do the same. "I think we're continuously learning that play is really essential for kids — it's not just an afterthought or an accessory," Dr. Kathy Hirsh-Pasek, a professor in the psychology department at Temple University and one of the report's lead authors told AAP News.

A growing body of research on the subject shows that play—and the bonds we build when we play with our kids—helps kids learn important skills, leads to changes in neuronal connectivity, encourages prosocial behavior and protects kids from toxic stress.

"Collaboration, negotiation, conflict resolution, self-advocacy, decision-making, a sense of agency, creativity, leadership, and increased physical activity are just some of the skills and benefits children gain through play," the report's authors explain, noting that the science suggests play also leads to brain changes at the molecular and cellular levels.

"Play is really brain-building, and we tried to give examples of how play enhances the structure and function of the brain," says Dr. Michael W. Yogman, M.D., FAAP, a lead author of the report and chair of the Committee on Psychosocial Aspects of Child and Family Health, according to AAP News.

Yogman and the report's other authors point to animal studies as well as real-world studies of children's behavior in the report. One of the studies referenced involved 3 and 4-year-olds who were nervous about starting preschool. Half the kids were assigned a 15 minute play session while the other half listened to an adult read a story. The group that got to play showed a two-fold decrease in anxiety.

Another study of preschoolers exhibiting disruptive behavior found that when they were assigned one on one playtime with an adult (who allowed them to take the lead in play while narrating the children's behavior out loud and discussing emotions as they played) the kids' salivary cortisol stress levels went down and their behavior improved.

Early play with parents builds baby's brain architecture

The pediatricians are advocating for more playtime in schools, but they also want parents to include more playtime at home, and this should start way before school does.

"This evolution begins in the first three months of life, when parents (both mothers and fathers) interact reciprocally with their infants by reading their nonverbal cues in a responsive, contingent manner. Caregiver–infant interaction is the earliest form of play, known as attunement, but it is quickly followed by other activities that also involve the taking of turns," the report's authors write.

As Harvard University's Center on The Developing Child has previously pointed out, this kind of parental play known as "serve and return" builds the foundation of baby's brain architecture. It starts so simply with babies pointing at something or looking at something, serving up us parents and opportunity to engage with them by returning their interest. Games like peek-a-boo or point-and-name can happen any time, anywhere, giving little brains an opportunity to grow while bonding with mom or dad.

From peek-a-boo to problem solving

The authors of the AAP's report note that in the second year of a child's life, play becomes more complex. As our kids grow, we move on from those serve-and-return interactions into a whole host of interactive games and activities.

"Fantasy play, dress up, and fort building now join the emotional and social repertoire of older children just as playground activities, tag, and hide and seek develop motor skills. In play, children are also solving problems and learning to focus attention, all of which promote the growth of executive functioning skills," they explain.

Some parents love getting down on the floor to play pretend with their kids, but for some it can be hard to prioritize play when you've also got a huge to-do list to tackle.

Dr. Yogman suggests parents should see playtime not as a thief of time, but as a chance to "re-experience the joy of their own experiences in childhood play...and to notice the kind of nonverbal cues that their kids display during those … experiences, which are really critical to improving their interactions and their relationships with their children," he told AAP News.

Basically, making a fort or playing dress up is good for both of you.

You don't have to get fancy

The AAP's experts aren't suggesting parents blow the budget on toys—in fact, it's just the opposite. Dr. Yogman suggests the stuff you've already got around the house—wooden spoons, blocks, balls, puzzles, crayons and cardboard boxes—is enough to enhance playtime. "Sometimes simple objects with the least accoutrements allow kids to really be creative about how they're using them," Yogman explains via AAP News.

Get outside with your kids

The report notes that while "outdoor play provides the opportunity to improve sensory integration skills," a lot of families don't get enough time outside these days.

"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," the AAP's experts note. Concerns over the safety of outdoor spaces was one reason parents did not engage in outdoor play with their children, but if you've got access to a safe neighborhood playground or a backyard space, getting outside and playing with your child invites all kids of opportunities for sensory development and bonding.

A cultural shift

The AAP's prescription for play is actually a prescription for a cultural shift. The report's authors note that demanding parental work schedules, fewer safe places for outdoor play, more screen-based media and a shrinking opportunities for play at school are having a negative impact on a generation of kids.

"These factors may negatively affect school readiness, children's healthy adjustment, and the development of important executive functioning skills," the report's authors note.

There is a silver lining though, and we are it. Parents can make a huge difference, even if we don't have as much time for play as we would like. We can make play a priority every day, and even bring play into everyday activities to make the most of the time we do have with our kids.

Dr. Yogman says even a trip to the grocery store can be a playful bonding experience that builds little brains. "Giving kids the opportunity to, say, count the apples in the supermarket. Those are the kinds of joyful experiences [that are good] for kids as opposed to just sitting tacitly in their shopping cart," Yogman tells AAP News.

Those are also the kinds of joyful experiences that make memories.

[Correction: August 21, 2018: Clarified attribution of quotes to AAP News.]

[A version of this post was originally published August 20 2018. It has been updated.]

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