The Importance of Play in Promoting Healthy Child Development and Maintaining Strong Parent-Child Bond: Focus on Children in Poverty abstract
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Guidance for the Clinician in Rendering Pediatric Care
CLINICAL REPORT
The Importance of Play in Promoting Healthy Child
Development and Maintaining Strong Parent-Child
Bond: Focus on Children in Poverty
abstract Regina M. Milteer, MD, Kenneth R. Ginsburg, MD, MSEd,
and the COUNCIL ON COMMUNICATIONS AND MEDIA and
COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND
Play is essential to the social, emotional, cognitive, and physical well-
FAMILY HEALTH
being of children beginning in early childhood. It is a natural tool for
KEY WORDS
children to develop resiliency as they learn to cooperate, overcome children, development, parents, pediatrician, play, poverty
challenges, and negotiate with others. Play also allows children to ABBREVIATIONS
be creative. It provides time for parents to be fully engaged with their AAP—American Academy of Pediatrics
children, to bond with their children, and to see the world from the This document is copyrighted and is property of the American
perspective of their child. However, children who live in poverty often Academy of Pediatrics and its Board of Directors. All authors
face socioeconomic obstacles that impede their rights to have play- have filed conflict of interest statements with the American
Academy of Pediatrics. Any conflicts have been resolved through
time, thus affecting their healthy social-emotional development. For a process approved by the Board of Directors. The American
children who are underresourced to reach their highest potential, Academy of Pediatrics has neither solicited nor accepted any
it is essential that parents, educators, and pediatricians recognize commercial involvement in the development of the content of
this publication.
the importance of lifelong benefits that children gain from play.
Pediatrics 2012;129:e204–e213 The guidance in this report does not indicate an exclusive
course of treatment or serve as a standard of medical care.
More than 15 million children in the United States younger than 18 Variations, taking into account individual circumstances, may be
years live in poverty.1 These children experience disparities in edu- appropriate.
cation, health care, and socioeconomic resources.2–6 Children living in All clinical reports from the American Academy of Pediatrics
automatically expire 5 years after publication unless reaffirmed,
poverty may also be deprived of the benefits of safe and creative revised, or retired at or before that time.
playtime and access to age-appropriate extracurricular activities. The
implications of play deprivation may be substantial, because play is
essential to the social, emotional, cognitive, and physical well-being of
children beginning in early childhood.7 In addition, play offers an
opportunity for parents to view the world from their child’s per-
spective as they engage fully with their children during playtime; all
families deserve ready access to this bonding opportunity. Even be-
fore the United Nations High Commission for Human Rights cited play
as a right of every child, philosophers and psychologists, such as
Plato, Piaget, and Friedrich Froebel, recognized the importance of play
www.pediatrics.org/cgi/doi/10.1542/peds.2011-2953
in healthy child development.8–10
doi:10.1542/peds.2011-2953
This report addresses issues that may deprive children who live in PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
poverty from gaining the maximum benefit from play. Because it
Copyright © 2012 by the American Academy of Pediatrics
follows an earlier report that focused on factors reducing free
playtime for children whose families have resources, this report
addresses issues specific to children from lower-income families.7
Although some of the factors covered in the previous report may also
apply to children from lower-income and poor families, 3 issues
disproportionately affect these children and merit special attention.
First, access to recess and other in-school creative and physical
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outlets (eg, physical education, art, cherished memories of growing up, including their frustrations, through
music), as well as after-school youth it allows children to develop creativity play, allowing their parents an oppor-
development programs are reduced. and imagination while developing phys- tunity to better understand their needs.
Second, out-of-school opportunities for ical, cognitive, and emotional strengths. Above all, the intensive engagement
play may be compromised by a lack of A previous manuscript described the and relaxed interactions that occur
safe play areas, because parks and benefits of play in fuller detail.7 while playing tell children that their
playgrounds are less abundant in Play enhances physical health by build- parents are fully paying attention to
lower-income areas and, in some cases, ing active, healthy bodies. Physical them and, thereby, contribute to a
may be unsafe because of drug deal- activity beginning in early childhood strong connection.17,32,33 Play also
ing, violence, and vandalism.11,12 Finally, prevents obesity.13 In fact, play may helps forge connections between chil-
because lower-income parents have to be an exceptional way to increase dren. It allows them to learn how to
deal with additional social, emotional, physical activity levels in children and, share, to negotiate and resolve con-
and economic stressors of daily living, therefore, may be included as an im- flicts, and to learn self-advocacy skills
they may have less time, energy, and portant strategy in addressing the when necessary.34,35 It teaches them
resources available to provide active obesity epidemic.14,15 leadership as well as group skills that
and creative playtime at the park, may be useful in adult life.
Play contributes to healthy brain de-
playground, or even in the home.
velopment.16–18 Children engage and Play should be an integral component
All children deserve the opportunity to interact with the world around them of school engagement. School en-
reach their highest potential. The op- through play from a very early age. gagement is best realized when the
timal developmental milieu for children Even in the academic environment, play educational setting attends to the so-
includes academic enrichment, as well helps children adjust to the school cial and emotional development of
as opportunities for physical, cognitive, setting, thereby fostering school en- children as well as their cognitive
social, and emotional growth offered in gagement, and enhances children’s development. The challenge is to make
school, home, and community settings. learning readiness, learning behaviors, each child feel competent in a school
There are different forms of play—free and problem-solving skills.19–31 In ad- setting, because the experience of
unstructured play, which uses unlim- dition, play and recess may increase success forms positive associations
ited creativity, and semistructured children’s capacity to store new in- with school attendance.9 Although we
play, which is guided play with joint formation, as their cognitive capacity hope for each child to demonstrate
attention by parent and child. It is be- is enhanced when they are offered a academic strengths, opportunities to
yond the scope of this report to define drastic change in activity.19,20 exhibit social, physical, and creative
and divide, but poverty may prevent strengths optimizes the chances that
Play is essential to developing social
challenges to both unstructured and children will realize their areas of
and emotional ties. First, play helps to
guided play. strength. Play, recess time, and classes
build bonds within the family. Child-
Free unstructured play, as well as ren’s healthy development is mediated that foster creative aptitude and
creative and physical outlets, con- by appropriate nurturing relation- physical fitness allow for peer inter-
tribute to social and emotional growth. ships with consistent caregivers.16 actions that contribute both to school
This report offers guidance on how Play allows for a different quality of engagement and social-emotional
pediatricians can advocate for chil- interaction between parent* and child, learning. Social-emotional learning
dren by helping families, school sys- one that allows parents to “listen” in should not be thought of as distinct
tems, and communities consider how a very different, but productive, way. from academic learning, because it
best to ensure play is protected and When parents observe their children can creatively be integrated with
promoted as the optimal developmental playing or join them in child-driven academic learning and has been
milieu for positive child and youth de- play, they can view the world through shown to enhance children’s ability to
velopment is explored. their child’s eyes and, therefore, may learn.36–38
learn to communicate or offer guidance Play is a natural tool that children can
THE BENEFITS OF PLAY more effectively. Less-verbal children and should use to build their resil-
It could be argued that active play is so may be able to express themselves, ience. At its core, the development of
central to child development that it resilience is about learning to over-
*The word “parent” is used in this report to
should be included in the very definition represent the wide range of adult caregivers who come challenges and adversity. As
of childhood. Play offers more than raise children. mentioned, children learn to deal with
PEDIATRICS Volume 129, Number 1, January 2012 e205
Downloaded from pediatrics.aappublications.org by guest on September 25, 2015social challenges and navigate peer a break from the standard academic The No Child Left Behind Act of 2001,
relationships on the playground. In subjects, foster creative and physical designed to decrease the achievement
addition, even small children use expression, and teach relaxation and gap of disadvantaged students, allo-
imaginative play and fantasy to take on stress-reduction skills that will last a cated additional educational resour-
their fears and create or explore a lifetime.9,13 Finally, even after-school ces and enrichment programs while
world they can master. Play allows them activities have shifted away from play decreasing recess time to allow more
to create fantasy heroes that conquer and physical activity and toward being formal educational encounters.47 At its
their deepest fears. It allows them to an extension of academics and a space inception, child development experts,
practice adult roles, sometimes while for homework completion.43 This re- including educators and pediatricians,
playing with other children and some- port focuses on reduced recess for il- voiced caution about the demise of
times while play-acting with adults.34, lustrative purposes. playtime for young children with the
39–41
Sensitive adults can observe Many of these trends are dispropor- proposed increased curriculum time
this play and recognize the fears and tionately affecting underresourced of the program.9 The experts sup-
fantasies that need to be addressed; school districts because of targeted ported the Alliance for Childhood re-
however, in many cases, play itself efforts to reduce significant academic commendations that children from
helps children meet their own needs. disparities. It is a national imperative low-income families be afforded time
As they experience mastery of the that all children are given the oppor- to learn how to play and time to play.9
world they create, children develop tunity to reach their academic poten- Perhaps in recognition of the impor-
new competencies that lead to en- tance of the social and emotional
tial, and efforts to reduce disparities
hanced confidence and the resil- development, as well as academic
between children with varying levels
ience they need to address future success of children who live at or
of resources are urgently needed.
challenges. 34,42 below the poverty line, the US De-
It remains important, however, that
what is known about child develop- partment of Education in 2009 an-
FACTORS THAT REDUCE PLAY FOR ment, including social and emotional nounced the Race to the Top Program,
CHILDREN IN POVERTY AND THE learning, remains at the forefront of an education initiative that financially
POTENTIAL IMPLICATIONS consideration as policies to raise ac- rewards school districts that support
Reduced Access to Play in ademic standards and performance improving social, cognitive, physical,
Schools for children are created and imple- and emotional school readiness of
mented. Play, in all its forms, needs to disadvantaged students. In bids to
There has been a national trend over
be considered as the ideal educational receive the rewards, school districts
the past decade of reducing playtime as
and developmental milieu for children must demonstrate focused programs
an integral part of the school day. This
is created. Because poorer children that prepare students in the core aca-
trend is most easily observed in the
are most dramatically affected by demic subjects and other subjects that
reduction and, in some cases, elimina-
these policies, stakeholders must re- contribute to the development of well-
tion of recess; however, there are more
main vigilant in ensuring that children rounded students, such as physical
subtle changes throughout the school
do not inadvertently suffer from the education and the arts.48 Thus, children
day that reduce children’s opportunity
diminution of play in their lives while who might otherwise not be afforded
to play. First, the approach to early
education that naturally incorporated exploring potential solutions to benefit opportunities for physical activity
play into the school day is shifting them academically. and enrichment programs outside of
toward a more academically oriented A report by the National Center for the school day have designated time
instructional approach as new stan- Education Statistics revealed that to enhance their total development.
dards for reading readiness have children who attend schools with high The disparity between access to recess
changed for even kindergarten stu- minority and high poverty rates in between middle-income and lower-
dents.9 Second, in many districts, urban settings are more likely to have income districts may be explained by
there is less school time allocated to reduced recess time as compared with factors other than recess time being
the creative arts and physical educa- their peers in more affluent suburban transferred to reading and math in-
tion.9,43,44 These subjects contribute areas.44–46 Twenty-eight percent of struction. It has been suggested that
to a well-rounded education for a vari- schools with students who have the reduced recess in poorer areas is
ety of reasons but share some of highest poverty rates had no recess reflective of adult concerns that it is
the benefits of play. They allow for at all. not safe for poorer children to have
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unstructured time; yet, it has not been success. If the overall goal is to de- children to participate in physical
proven that recess is unsafe. A time to crease school failure, which could ul- activity. 56 In its “Physical Activity
play is different from the environment timately lead to depression, entry into Guidelines for Americans,” the US De-
in which play occurs. When children the juvenile justice system, and con- partment of Health and Human Serv-
have toys and equipment with which to tinued economic deprivation, a re- ices recommends 1 hour or more of
play and attention is paid to helping sponse to the problem has to include physical activity per day, with a major
the children transition back to class, efforts to promote school engage- part of the hour dedicated to moder-
the benefits of recess in terms of ex- ment.49 As previously discussed, op- ate to vigorous physical activity at
pressivity, exercise, and socialization portunities for play and social and least 3 times per week for children
suggest its vital role in the child’s emotional learning enhance school and adolescents.57 Physical education
school day and overall well-being. engagement. Quite simply, school en- curricula should enhance attitudes,
Some experts believe the real dan- gagement occurs when children habits, and behavioral skills that re-
ger is that the misunderstanding succeed academically, have other non- sult in continued physical activity
has led to the removal of playtime.49 academic opportunities for success throughout life.14 Overall, recess offers
The reduction of recess and other in- (creative arts, physical education), the most available opportunity for
school opportunities to play affect all and consider school a place in which children to play and to engage in
children but may have a particularly they feel safe and enjoy spending physical activity, followed by physical
detrimental effect on poorer children, time. education classes and after-school
because they are likely to have activities. 58
Play in the school day offers benefits
fewer opportunities to play outside to academic as well as social and
of school.11,12 In addition, because emotional learning. A recent report Reduced Out-of-School
school is often the first true social- by Barros and others stated that a Opportunities for Play
ization environment for vulnerable break during the school day of ≥15 Children cannot play safely outside of
children, the opportunity for social minutes was associated with better the home in many poor communities
and emotional learning must not be teachers’ ratings of classroom behav- —urban, suburban, and rural—unless
compromised. ior scores.19 Good behavior in the they are under close adult supervision
Poor children enter the educational classroom is associated with a more and protection. This is particularly
system at a lower level of readiness, productive learning environment sec- true in areas that are unsafe because
averaging 2 years behind their middle- ondary to increased attentiveness.19,20 of increased violence or where other
and upper-class peers.50 This may be In addition, children’s ability to store environmental dangers exist.11,12 In
explained in part by their increased new information is increased, because the past, when neighbors knew each
exposure to social stressors (higher their cognitive capacity is enhanced by other and often supervised each oth-
rates of single mothers who lack so- a drastic change in activity.51–53 A er’s children, there was an extra layer
cial supports and financial resources, change in academic subject and even of protection for neighborhood chil-
absent fathers, limited access to early physical education class may not offer dren when they played outside. In
childhood education, unsafe neighbor- the same benefit as free-play recess.49 today’s society, it is not unusual
hoods, lack of preventive health care). A reduction of time for physical activity for neighbors not to know one an-
They mainly enter schools in poor may have even greater implications for other. Therefore, parents are alone
communities that lack financial re- boys. Schools that use only sedentary in protecting and supervising their
sources to enhance the educational styles of learning may be a more dif- children, which can severely limit out-
process.51 Schools, under pressure to ficult environment for boys to navigate side playtime.
increase academic performance and successfully and contribute to the dis- Children who are not engaged in play
to decrease the achievement gap of cordant academic abilities between and physical activity outside of school
students, have increased direct educa- boys and girls.54,55 These findings sug- hours spend time engaged in seden-
tional time, including after-school en- gest that decreasing and eliminating tary activities, such as viewing hours
richment and tutorial programs. recess for students at risk for school of television, playing video games, or
Although it is important to decrease failure may be counterproductive. listening to music. This time is often
academic disparities, enhanced non- Finally, it is recognized among educa- spent in isolation without social in-
academic interactions are also es- tors that recess represents the most teraction and without adult supervision.
sential to prepare children for future powerful strategy to get the most In sharp contrast to the benefits of
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evidence that excessive screen time has in which the parents are more likely reading.70
adverse effects.59–64 The AAP policy to have a lower educational level or Lower-income parents may have fewer
statement on media education pre- be single heads of households. Minor- resources, including time, to invest in
sented research that associates media ity households (black and Hispanic) playing with their children. Because
exposure with negative physical and and immigrant parents are at increased play holds so many benefits, including
behavioral health problems in children, risk of having children who live in fostering connection between parents
including obesity, violent and aggres- poverty.1,68 There is more likely to be and children, less play may be an
sive behavior, depression, anxiety, ear- a history of substance abuse in poorer added, although rarely mentioned, risk
lier sexual behaviors, poor academic families. The neighborhoods in which of poverty. No one is certain what skills
performance and self-image, night- they live lack community resources, will be needed for our children to be
mares, and tobacco and substance such as community centers, parks, and best prepared to lead us into the fu-
abuse. 63,64 fully equipped supervised playgrounds ture, but we do have insight into which
The sedentary lifestyle is associated that offer safe places for children to character traits will produce children
with obesity, for which children from play and to gather. Children have fewer capable of navigating an increasingly
low income and minority families are opportunities to participate in orga- complex world. These include confi-
already disproportionally at risk.65 The nized sports. Because of fear of vio- dence, the ability to master the envi-
AAP and others have reported that lence, families do not venture outside ronment, and a connection to others.
children who are obese in early with their children for fun physical In addition, to be resilient—to retain
childhood are more likely to be obese activities, such as walking, bike riding, hope and to be able to overcome
adults and to be at risk for the swinging, swimming, playing tennis, or adversity—young people need the
comorbidities associated with obesity, jogging.11,12,69 In a safe environment added character traits of honesty,
including type 2 diabetes mellitus, with community resources, these ac- generosity, decency, tenacity, and
hypertension, coronary artery disease, tivities would not be an additional fi- compassion.71 Children gain these
hypercholesterolemia, hyperlipidemia, nancial burden to already challenged essential traits within a home, when
asthma, and sleep apnea.14,66,67 In ad- families. parents and children interact in a
dition to the long-term health effects, supportive manner and share un-
Poor families may also be at a disad-
obesity may be associated with im- conditional love.71–76 Play is a time-
vantage in a material-driven culture
mediate social and emotional con- tested way for families to have
in which marketing messages, often
sequences, including low self-esteem, these types of interactions.
claims without proof, abound about
negative body image, depression, teas-
what children need to prosper. They
ing and bullying, social marginalization, WHAT ARE THE SOLUTIONS?
may absorb the messages that the
and discrimination.63,64,66,67 Obesity can
best toys are those that are the most Because there are many causes for the
have socioemotional effects on academic
expensive or that children are only decreased amount of play in the lives
achievement and opportunities and can,
academically prepared for preschool if of lower-income and poor children,
therefore, thwart educational trajec-
exposed to a variety of enrichment there is no single solution. In addition,
tories associated with long-term
tools and activities that claim to pro- simplistic proposed solutions might
success.66,67
duce high-achieving children. Parents not take into consideration the com-
who cannot afford these market-driven plex interplay of factors that have led
Family Considerations materials may feel disempowered to to decreased play, including the need
Although lower-income parents have actively play with and enrich their for safety. For example, if a child does
the same desires for their children to children using the most effective not reside in a safe neighborhood, it
succeed and reach their full potential known tools—themselves. Children’s may be unwise to simply propose more
as do parents with greater economic creativity is enhanced with the most outdoor child-centered play. Similarly,
and social assets, they must focus basic (and least expensive) toys, blocks, it may be naïve to insist on more re-
primarily on the family’s day-to-day dolls, and art supplies. Children’s ac- cess without simultaneously coming
survival. When food and shelter are at ademic preparedness may be most up with solutions that address the
risk, ensuring time for the children to developed with low-cost time spent very substantive issue of educational
have free and creative playtime may reading with parents. They will learn disparities. It is critical, however, that
not be a priority. Economic hardship to love books when they associate as strategies are developed that
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address educational needs and safety, Community-based programs that offer ADVICE FOR PEDIATRICIANS
the recognition of children’s need to a wide variety of services, ranging As caring, objective child health pro-
play be strongly advocated, because from homework assistance to athletic fessionals, pediatricians have a natu-
play is known to promote healthy programs and from character devel- ral role to advocate for the conditions
development and resilience.46,52,55,58 opment to the creative arts can that allow for the optimal physical,
To effectively preserve play in the lives contribute heavily to the positive emotional, and social development of
of economically disadvantaged children, development of youth. Keeping school children and adolescents. Because play
its presence in schools, communities, facilities open for use by community contributes substantially to the healthy
and homes must be supported. families in the evenings and on development and well-being of children,
In schools, the need to support social weekends when they are usually it is important that pediatricians pro-
and emotional learning and healthy closed may increase engagement mote the inclusion of play in homes,
child development must be held in these activities. Communities can schools, and communities.†
alongside the need to increase ac- also offer strategies to link families Pediatricians can educate parents
ademic scores. Otherwise, school at or below the poverty level to early about the importance of free, un-
engagement might suffer and efforts education, health care, family sup- structured play in the normal de-
at creating a better-prepared genera- port, and parenting education. velopment of children.
tion might fail. The bottom line to Parents of all income levels should use Parents may be influenced by mar-
school engagement is that schools time together at home to engage in keting messages that suggest the
should be the kind of places that both free and structured play with best toys are those that are finan-
children and adolescents want to be. their children. Playtime is bonding cially out of reach. They should be
This means that educators and policy
time for families. A first step may be educated that simple, inexpensive
makers must make opportunities for
education about the value of play that toys, such as dolls, jump ropes,
lower-income children to gain the blocks, balls, and buckets, are more
simultaneously refutes false notions
benefits offered from physical educa- effective in allowing children to be
that for play to be effective, it must
tion, recess, and the arts so they can creative and imaginative than more
involve expensive toys. Parents from
reach their highest potential for cog- expensive toys, which can make
across the economic spectrum need to
nitive, social, and physical development play a more passive and less phys-
understand that it is their presence
and so children and adolescents will ically involved experience.
and their attention that enrich their
like school. Advocates can also promote
programs such as Head Start, the
children and that one-on-one play is Pediatricians can educate parents
a time-tested, effective way of being about the benefits of using play as
purpose of which is the promotion of
fully present. In parallel, we must be an opportunity to engage fully with
school readiness for low-income chil-
sensitive to the fact that time itself is a their children. Playtime offers op-
dren. Head Start provides an envi-
commodity when struggling for eco- portunities for parent-child bond-
ronment that enhances students’
nomic survival. The most compre- ing. Playtime offers parents the
emotional, social, and cognitive de-
hensive solutions, therefore, must opportunity to promote healthy
velopment and has demonstrated ef-
address broader economic disparities social-emotional development in
fectiveness.77 One of the keys to the
and other factors that create stress- their children through active en-
success of Head Start has been the
es for economically disadvantaged gagement and shared imagination.
involvement of parents in social in-
teraction with their children in play- parents. Pediatricians can encourage pa-
ing, reading, and reading-related Certainly, these solutions are broad rents to use love and understand-
activities.78 and societal, going beyond the purview ing to encourage children to try
again even when at first they fail.
Policy makers and community leaders of the pediatrician’s office. But as child
Parents can be informed that
must work together to prioritize the health professionals committed to the
need for safe spaces for families attainment of optimal physical, men-
†The guidance in this report is offered by the AAP
to gather and for children to play. tal, and social health and well-being and, therefore, is targeted to pediatricians. Other
Supervised after-school programs can for all infants and children, pedia- health professionals who serve children and
be critical to children who live in tricians have a role in advocating for adolescents, including other physicians, pediatric
and family nurse practitioners, and physician
communities where outside playing broad-based solutions that will pre- assistants are welcome to consider incorporating
might be dangerous or unsupervised. serve child play. this guidance into practice.
PEDIATRICS Volume 129, Number 1, January 2012 e209
Downloaded from pediatrics.aappublications.org by guest on September 25, 2015positive reinforcement goes further Pediatricians can educate parents and children playing on neighborhood
than negative responses as chil- about the importance of children’s playgrounds the exception. School sys-
dren engage in play alone and with play outdoors in nature. Spending tems are focused on overcoming their
others. unstructured time in nature, sur- academic deficiencies in a safe envi-
Pediatricians can use well-child en- rounded by dirt, trees, grass, rocks, ronment often at the expense of time
counters to educate parents about flowers, and insects inspires child- for arts, recess, physical education
the benefits of play to enhance phys- ren’s play and offers physical and classes, and after-school activities
ical activity that can help prevent emotional benefits. that include playing, despite evidence
childhood obesity. Parents should Pediatricians can advocate for safe that supports that what happens in
be educated about the potential for play spaces for children who live play contributes substantially to social
lifelong obesity in obese children, in communities and attend schools and emotional learning, even in the
with a high proportion of low-income classroom.
the lifelong health morbidities asso-
ciated with obesity, and the long- and poor children by emphasizing Regardless of their socioeconomic
term psychosocial impact of obesity. that the lifelong success of children status, all children have the right to
Parents should be encouraged to is based on their ability to be cre- safe places to play regularly, during
participate in physical activities with ative and to apply the lessons which they develop cognitive, com-
their children that will not have a fi- learned from playing. munication, problem-solving, negotia-
nancial impact on the family. Pediatricians may consider offering tion, and leadership skills. They have
the right to engage in safe and regular
Pediatricians can provide parents presentations to help educators, com-
physical activity that will decrease the
with information about resources munity leaders, faith-based groups,
and politicians understand the de- incidence of lifelong health disparities.
that can provide financial, educa-
velopmental benefits of play to The physically and emotionally healthy
tional, and mental health assis-
children. children of today will become the
tance to families that have been
marginalized by poverty. This may Pediatricians may advocate for productive citizens who will contribute
policies that reduce educational positively to society in the future.
address the underlying stressors
that interfere with parents’ ability disparities while supporting the
inclusion of recess, physical out- LEAD AUTHORS
to engage fully in play activities. Regina M. Milteer, MD
lets, and the creative arts as
Pediatricians can educate parents means to enhance social and
Kenneth R. Ginsburg, MD, MSEd
about the negative impact of media
emotional learning and school
exposure on children and encour- COUNCIL ON COMMUNICATIONS AND
engagement.
age them to limit screen time and MEDIA, 2011–2012
substitute other activities, including Deborah Ann Mulligan, MD, Chairperson
Nusheen Ameenuddin, MD, MPH
playtime and outdoor activities, for
Ari Brown, MD
screen time. This is an opportunity CONCLUSIONS Dimitri A. Christakis, MD, MPH
to educate parents about the AAP Corinn Cross, MD
Children who live at or below poverty Holly Lee Falik, MD
recommendations regarding no
level in the United States experience David L. Hill, MD
media time for children younger
educational and health disparities Marjorie J. Hogan, MD
than 2 years and fewer than 2 Alanna Estin Levine, MD
from early childhood. These children de-
hours per day for older children. Gwenn S. O’Keeffe, MD
serve additional resources to achieve
Pediatricians can provide parents academically, foster school engage-
Wendy Sue Swanson, MD, MBE
and families with information ment, and develop their social and
about community resources that emotional competencies. Many chil- FORMER EXECUTIVE COMMITTEE
provide physical activities for chil- MEMBERS
dren reside in families that face Gilbert L. Fuld, MD, Immediate Past Chairperson
dren, such as team sports and stresses related to daily survival, in- Tanya Remer Altmann, MD
camps. They should provide infor- cluding whether they will have food or Kathleen Clarke-Pearson, MD
mation about organizations that safe shelter, leaving less energy to Benard P. Dreyer, MD
Regina M. Milteer, MD
provide “scholarships” or grants focus on enrichment opportunities, in- Kathleen G. Nelson, MD
that pay for activities that have cluding play. Some live in neighbor- Donald L. Shifrin, MD
associated costs. hoods where violence may be the norm Victor C. Strasburger, MD
e210 FROM THE AMERICAN ACADEMY OF PEDIATRICS
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LIAISONS COMMITTEE ON PSYCHOSOCIAL Terry Carmichael, MSW – National Association of
Michael Brody, MD – American Academy of ASPECTS OF CHILD AND FAMILY Social Workers
Child and Adolescent Psychiatry HEALTH, 2010–2011 Mary Jo Kupst, PhD – Society of Pediatric
Jennifer Pomeranz, JD, MPH – American Public Benjamin S. Siegel, MD, Chairperson Psychology
Health Association Mary I. Dobbins, MD D. Richard Martini, MD – American Academy of
Brian Wilcox, PhD – American Psychological Marian F. Earls, MD Child and Adolescent Psychiatry
Association Andrew S. Garner, MD, PhD Mary Sheppard, MS, RN, PNP, BC – National
Laura McGuinn, MD Association of Pediatric Nurse Practitioners
STAFF John Pascoe, MD, MPH
Gina Ley Steiner David L. Wood, MD, MPH CONSULTANT
Veronica Laude Noland George J. Cohen, MD
LIAISONS
Ronald T. Brown, PhD – Society of Pediatric STAFF
Psychology Karen S. Smith
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