AAP report: Prioritize play for young children

I wholeheartedly agree with the new American Academy of Pediatrics clinical report, “The power of play: A pediatric role in enhancing development in young children.” We should not be surprised that play – and not play structured by predetermined rules such as those in sports or those that are part of lessons such as piano – has such a meaningful role in development. For thousands of years, humans grew up without schools, electricity, and sports leagues and with only apprentice-level training in survival skills. As a result, thousands of hours of children’s activities were self-generated, and these activities, by their nature, encouraged the development of physical, social, and cognitive abilities.

And we still see elements of natural play, especially as we observe babies and toddlers playing – before our culture begins to channel this play activity into more structured, less spontaneous, and less social forms. As Jean Piaget, PhD, observed, play stems from a child’s “need to function” – to move, explore, learn, understand, and integrate the world around them. Watch a 9-month-old drop a toy and learn that it still exists and that dropping it is an interpersonal, fun game. Or watch how a toddler figures out how to stack and knock over some metal pots and pans on the kitchen floor or how 5-year-olds climb all over rocks or jungle gyms in a local park.

Of course, in a complex society like ours, these evolving activities have to be channeled into school, specific skills, and even homework. What the AAP clinical report suggests is that we may be pushing the structure, expectations, and isolation of learning too far, too rigidly, and too prematurely. We may be decreasing natural play below some threshold essential to necessary for skill development, especially that of self-esteem and social skills.

Children have a wide range of developmental paths and adaptability, but too much structure, too much isolation, too much screen time, overly high expectations, and now too little play all can have unanticipated and unhappy consequences.

Michael S. Jellinek, MD, is professor emeritus of psychiatry and pediatrics at Harvard Medical School, Boston. He was asked to comment on the AAP clinical report (http://pediatrics.aappublications.org/content/early/2018/08/16/peds.2018-2058).