Jaime Lewis (Host): This is Children's Health Checkup, where we answer parents' most common questions about raising healthy and happy kids. I'm your host, Jamie Lewis. Did you know that according to a report by the American Academy of Pediatrics, children's free playtime has decreased 25% over the past two decades? An increase in screen time, structured activities, and academic pressures all play a part in this trend. But playtime is a crucial part of childhood development. So, how do you know if your children are getting the playtime they need?

In this episode of Children's Health Checkup, we're speaking with Sara Loftin, a clinical therapist and registered play therapist at Children's Health. She'll highlight the benefits of play and give tips on how parents can prioritize playtime at home. Hello, Sara. It's great to be chatting with you.

Sara Loftin: Hi, Jamie. Yeah, thanks so much for having me.

Host: So, we know play is something children do naturally. What are the benefits of play for children and why is it so important?

Sara Loftin: As a play therapist, I obviously know and believe that play is extremely important for children. So, it is their natural mode of communication, the same way that adults talk with words, children use their language of play, and toys as their words to communicate. So, it is the universal right of childhood, and it's necessary for development. Virtually, every child has an instinct for play that begins immediately after birth and is in full force by the age of two or three.

So, there are several benefits to play. Research shows that play contributes to healthy brain development, reduces obesity and associated diseases, manages stress, helps families bond, and contributes to academic skills. It's how children learn adaptability, flexibility, problem-solving. Our brains are wired for play, and that's what our brains expect. They expect play as a way to learn and experience. So, there are several sections of benefits. So cognitively, with enough play, our brains actually work better, and children and adults feel more optimistic and more creative. As I mentioned, it's how children learn and explore and experiment. They practice skills needed for survival. They try on adult roles and skills. It's how they assimilate the world to match their concepts, essentially, how they make sense of the world around them. So, children think concretely, and words are abstract, and play helps bridge that gap to help them understand.

There are also social benefits, so it's the way that they connect to others and become close to others. They learn social skills, understand that give and take within those social dynamics. And it also builds confidence and mastery.

Something else is that play is regulating. So, play helps to regulate emotions, relieve stress, recover from emotional distress, and build coping skills. So, it's a way that they fill their cup with mastery, or power and control. So for example, when they're feeling helpless, they can do something powerful. So if a kindergartner is really struggling to learn to read, they may come home and paint a picture that they feel really proud of and show their parents as a way to connect and then they fill their power cup so that they can build their own self-esteem.

Another situation is that they may play something out that's stressful for them. So, a child who's experienced the death or attended a funeral may play that out for several weeks. This can really concern parents, but it shouldn't be, because it's just a way that they are trying to figure out what they have experienced. In the same way that we wouldn't tell an adult to not talk about the funeral, that is how a child communicates, is through play and how they understand what's happened. So, we know that emotional healing occurs when a child plays out that stressful situation.

And then lastly, it builds creativity. So, it stimulates creative thinking and exploration and relieves boredom. So, boredom is an opportunity for creativity. I think that kids are not bored enough nowadays. You mentioned screen time. And I see it as a mom when my child is bored. So, I know my daughter, Clara, the other day said, "I'm so bored, mom." And I said, "Great, I'm so excited to see what you come up with." And she ended up creating a parade out of her stuffed animals. So through creativity, they can express their individuality and tap into those internal resources.

Host: Fantastic. And it makes a lot of sense. So, about how much playtime would you say children should have each day?

Sara Loftin: It's a tricky question, because play is how a child communicates. So, in my mind, a child should be playing throughout the day. And the CDC's guidelines actually correspond with that as well, saying they should have activity throughout the day for children under the age of seven. So, they should be engaging in play at school. I know that society values skill and competence and obedience and attempts to achieve this with packed schedules, but free play actually helps children reach those goals.

So, a lot of parents, myself included, you know, we ask, "Am I doing enough for my child?" Which can cause parents to become helicopter parents, or we hyper-parent, over-protect, over-program, which leads to a play deficit within society. So, if an answer is required, then I'd say maybe an hour to two of unstructured free play a day. And the CDC recommends that as well. I've sadly seen some blogs and other guidelines that recommend 30 minutes three times a week, but that's just not enough.

Host: What are the different kinds of play that children should be engaging in for their development? You've already touched on some of it. But if you had to compartmentalize the kinds of play that they should be doing, what would you say?

Sara Loftin: I think the most important type of play is unstructured free play. So, these self-directed play experiences nourish and support the child's maturing abilities. It addresses making friends, learning empathy, emotional regulation, interpersonal and social skills, creativity, Innovation, and perseverance.

Some other types that are actually pretty discouraged by adults would be risky play and rough-and-tumble play. So, you know, we see boys playing together and we often set limits on that when they're pushing each other or roughhousing. So, risky play actually involves a child self-dosing fear and risk by maybe climbing the highest structure on the playground, or going down a slide backwards, but they do this to grow their window of tolerance with anxiety and to stretch their abilities. So, a lot of studies have actually looked into adults with anxiety now, and opportunities that they had for risky play as a child, and we see that adults that didn't have as much risky play as a child are actually more anxious as adults. So, rough-and-tumble play examples include wrestling or playfully pushing or hitting. I know I definitely see this at my four-year-old's tee-ball games, where there's a dog pile on the pitcher's mound every few minutes, because they have that need for rough-and-tumble play. And then, I also think that it leads to social play with others, you know, which begins around ages three or four, because they're participating in more parallel play before that.

And lastly, imaginative or fantasy play. So, this is another important type of play. They begin to develop empathy through fantasy play as they're able to take on the roles of others. A lot of children engage in imaginative storytelling in the younger years. Parents will tell me that their child is a pathological liar, when they are really just trying to make sense of the world around them through imagination. So, fantasy play is therapeutic, as children may engage in play to act out a scenario they were involved in. So, for example, what I see a lot here at the hospital is a doctor's appointment. But now, they play that they're the doctor. So, through this type of play, a child can gain mastery over materials that they may have caused so much anxiety previously. They'll feel powerful, which can counteract that anxiety. So through this type of play, they're able to build coping skills and begin to see how to express themselves when they have really big emotions.

Host: Well, for older kids and children who maybe already very familiar with screen time technology, how would you encourage them to try different types of play?

Sara Loftin: So, older children are spending about seven to eight hours a day on screens. And I know you said older kids, but this is an issue for younger kids too. I see babies on screens quite often throughout the day and younger children are actually on screens for about two to five hours daily. So, I like to focus on the opportunity costs there. So, what are children missing? They're missing sleep, social time, and play. I know recently in a book, The Anxious Generation, the author Haidt states that we've transitioned from a play-based childhood to a phone-based childhood, and I completely agree.

So, I think that this is twofold. You know, what can kids do, but also what can parents do? Kids will not choose a different activity over screen time. They just won't. And there's a lot of reasons there, because of dopamine and the reward centers of the brain. So, parents really need to set those limits and follow the APA guidelines that are there for screen time. There's an ability to make a Family Media Use Plan. Common Sense Media is a wonderful resource for this as well. And then, as far as the younger kids go and older kids, we can talk to them about the statistics. I know my seven-year-old complains all the time that she doesn't have a tablet and wants to be on screens all the time as well. And I even talked to her about dopamine in the brain and what screens do to your brain and why it's so hard to stop when you're on a screen. Companies see kiddos as consumers. And adolescents really respond well when you talk to them about how those companies and technology is really trying to trick you to stay on them longer, using that reverse psychology, but with appropriate information as well. Kids are smart. And so, they're able to hopefully engage in decision-making for their own health as well.

Host: You mentioned boundaries. Are there certain boundaries that should be put in place around playtime itself? Not necessarily screen time, but around playtime.

Sara Loftin: I think, honestly, the fewer boundaries, the better, which I'm sure may come as a surprise to the answer for this. But, of course, it depends on the type of play and boundaries are important. But all too often, I think adults are imposing their own boundaries and discomfort to the children's play. So, for example, we talked about rough-and-tumble play and how important that is. We have boundaries in our house. We engage in rough-and-tumble play, but they know that we aren't for hitting, we aren't for kicking. If someone says, "Stop, please," then we stop.

But often, children make their own boundaries when they're playing with each other, and this is the goal. We want them to set boundaries within the social norms and the context of their friendships and relationships without adults imposing those on them. Oftentimes, there are so many rules in a playground, and a child isn't able to engage in risky play. And especially with play within the school setting, there's quite a lot of boundaries there as well. It can be incredible if they can set those within the context of their relationship. I learned this when I told my daughter to not yell at my son the other day. And my son said, "Mom, I'm the baby wolf and can't hear. She has to yell at me." So, he was okay with that. I learned that they were okay with the boundaries that they had set up with each other, and how important that skill is for them to learn on their own without adults imposing those boundaries on them.

Host: Well, what other tips would you offer parents to help them prioritize play at home?

Sara Loftin: I think one thing is to realize that the goals that we are wanting for our children, determination, perseverance, grit, flexibility, the ability to get along with others, learning new skills, and information that this is achieved through play. We try and overschedule our child to set them up for success, but that could actually harm them in a way. So, some kind of easier ways to do this are to start a free play group at home. So, maybe get some of your neighborhood friends or family friends to go to a playground all together and let kids kind of figure it out on their own to play and engage in play without adults jumping in as frequently. Also, things like having a technology Sabbath. Families sometimes often give up screens all Saturday or Sunday. Have a family game night where people can take turns making up the rules. Play with your child and let them have control within that play session. So, we have child-parent relationship training here at Children's. That's where we teach parents play therapy skills to use with their children in a special playtime at home. Those are also available in the community. So, taking one of those, I think, can be really beneficial for parents in learning how to play and remembering what it was like to be a kid and to enjoy playing.

Delay giving a child a smartphone and delay social media access until later, as they age a little bit more and their brains are a little bit more developed. Model play for your children. Adults definitely don't play as much as they used to. Schedule play dates and then spend time with the adults so that the kids can actually get unstructured time together. And then, try to model and normalize children playing for other people in the community to see that play is important and play isn't just something that we can do with our leftover time, that we actually need to prioritize play to help our children's brains develop in the way that they should, as well as these other skills and benefits that come from unstructured free play.

Host: Well, Sara, thanks so much for talking with us about play today.

Sara Loftin: Of course. Thank you, Jamie.

Host: Thank you for listening to Children's Health Checkup. If you found this podcast helpful, please rate and review or share the episode and please follow Children's Health on your social channels. For more information on our play therapy program at Children's Health, please visit childrens.com/playtherapy.