The impact of play in the life of children has long been debated. Throughout American history, dating back to colonial times, adults have struggled with understanding the importance and value of play in the lives of our youngest citizens. Over time, however, it has been recognized as a key driver of child development, even recognized by the United Nations Commission on Human Rights as a basic privilege that should be afforded to all children.
Over the decades, much research has been done on play, and although many advantages have been described and accepted, little quantitative information exists to illustrate its importance. At its very core, play allows for self-expression and communication of the point of view of a child who may not have all of the vocabulary to explain their thoughts on the things going on in the adult world around them. It allows for engagement in society, with peers and with those in authoritative positions without seeming threatening. Play allows for a safe environment to learn and solve problems, acquire language skills and support novel behaviors to hone important life skills. Free play can help children acquire a new set of skills that allow them to make sense of the world, decrease stress and help define personal responsibility to society. It can allow a glimpse into the desired future state from the child’s point of view, inherently filled with potential and hope.
As the most important tool in a child’s repertoire, imagination needs to be protected. Play must belong to the child and must not be directive. When adults do get involved in play, which can be a very powerful form of connection, there needs to be a recognition that authority gradient is erased during the activity. There is acceptance of the child driving the rules and power sharing in the experience. And while many adults may view child’s play as simple, it is comprised of many complex factors. Small children are often guided by fantasy and symbolic play, which can be frustrating to adults who see it as suspending reality rather than recognizing it as a complicated mosaic of processing the surrounding world. Older children may have in-depth, detailed rules for which they have a total reverence for keeping intact. This can often result in the playing field becoming a minefield for well-intentioned grown-ups.
There is a set of adults, however, who can immerse themselves in play and do so every day. Child life specialists are individuals who have degrees rooted in child development. Teams of child life experts have multiple venues to impact the lives of the young, particularly in the health care setting. In therapeutic play, these experts have the ability to allow kids to release the emotional expressions about how they feel about their health care experience. This can permit the child to process what is happening to them. The child, often tagged with a diagnosis he or she cannot control, can find a space in the context of play where they can exert some power and make some choices. The diagnosis and stay in the hospital can result in significant feelings of conflict, internally and externally. This conflict can induce stress in the child, who often has few outlets to resolve this angst. Play will allow processing of events and feelings without the risk of adult disapproval. This can eventually lead to mastery of positive coping mechanisms and acceptance of the situation at hand.
Child life experts understand the power of play in the lives of the kids they treat. They can help the child in numerous ways, including returning from a place of fear to one of comfort, expressing their feelings so that they have a relief valve, and communicating to doctors and parents what is important to them in the situation. In addition, they can instruct on medical procedures and equipment, taking some of the unknown and trepidation out of the situation. This teaches young patients to be active participants in their health care from a young age, allowing for better self-advocacy in all ways as they grow up. Child life specialists are also key players on the medical team, designing physiologically enhancing play regimens such as blowing bubbles and karaoke exercises to improve lung health, a different type of prescription for wellness. While there is evidence that when these specialists are consulted, there can be decreased use of pain medication and sedation, the purest evaluation is in the eyes of the patients and families they serve, all of whom talk about their child life specialist for years after they have left the healthcare arena. There is no stronger evidence than high praise from a child.
Recently, child life specialists have partnered with the community in novel ways to continue to support all types of play in children tethered to the health care setting. Take, for example, the Teammates for Kids Foundation. This group has made a mission of building play spaces within the confines of children’s hospitals all over the country. These child life zones recognize the power of play in the lives of kids, injecting a bit of joy, a bit of cognitive processing and just some happiness into an otherwise tough experience. The zones are set up to assist in therapeutic play but also make sure the some normalcy of childhood is maintained in the middle of the health care tsunami. There is an oasis of respite for both kids and caregivers right in the middle of the hospital. And while it may seem totally unstructured and out of control, there is much work going in every minute of play that occurs in each zone. And there are the Playmakers from the Life is Good Kids Foundation who are teaching healers how to incorporate the aspects of play into their lives and their work to spread the optimism to children.
The attributes that come from play read like the list of qualities on a job description for any CEO in the country: adaptation to change; strength finding; innovative, cooperative, fostering engagement; conflict resolution skills and the art of negotiation; resiliency; and critical and higher level thinking. Perhaps if we want our children to be leading the world someday, we should slow down, stop overscheduling and insisting every moment is filled with structured enrichment activities. Perhaps we can step back and allow play to grow organically – every messy, sticky, silly, inconvenient moment of it. And just maybe, we adults in charge of leading our economy, government, health care system and other critical functions of the grown-up world should consider stepping into the sandbox. It certainly seems that we as a society could take a lesson from the smallest of teachers.
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