Building Resilience Through Play

The Brain Architects

Building Resilience Through Play

February 22, 2022

Contents
Podcast
Panelists
Additional Resources
Transcript

These days, resilience is needed more than ever, and one simple, underrecognized way of supporting healthy and resilient child development is as old as humanity itself: play. Far from frivolous, play contributes to sturdy brain architecture, the foundations of lifelong health, and the building blocks of resilience, yet its importance is often overlooked. In this podcast, Dr. Jack Shonkoff explains the role of play in supporting resilience and five experts share their ideas and personal stories about applying the science of play in homes, communities, and crisis environments around the world.

Panelists

Andres Bustamante, Assistant Professor, University of California Irvine School of Education

Laura Huerta Migus, Deputy Director, Office of Museum Services at Institute for Museum and Library Services

Lynneth Solis, Researcher and lecturer at the Harvard Graduate School of Education

Erum Mariam, Executive Director, BRAC Institute of Educational Development, BRAC University

Michael Yogman, Pediatrician, Harvard Medical School, Cambridge Hospital

Additional Resources
Resources from the Center on the Developing Child

Resources from Our Guests
Panel

Play in Humanitarian Settings

Prescription for Play

- The Power of Play: A Pediatric Role in Enhancing Development in Young Children
- Preventing Childhood Toxic Stress: Partnering with Families and Communities to Promote Relational Health

Transcript

Sally Pfitzer, host: Welcome to the Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m your host, Sally Pfitzer. Our Center believes that advances in science can provide a powerful source of new ideas that can improve outcomes for children and families. We want to help you apply the science of early childhood development to your everyday interactions with children and take what you’re hearing from our experts and panels and apply it to your everyday work.

So in today’s episode, we’re going to get serious about the topic of play. For children, play is a fundamental building block of child development, but its role in supporting resilience is often overlooked. And after the past few years, we surely need resilience now more than ever! For me, as a former preschool teacher, I’m especially excited about this episode and speaking with today’s experts, because I’ve seen first-hand how important play is for young children’s development. But what can science tell us about it? And what can be done to support more play in everyday life, even in crisis contexts? In this podcast, we’ll dive into the science of play and resilience, and then we’ll explore how people are using that knowledge to support child development around the world. To explain the science, we’ll start with Dr. Jack Shonkoff, Professor of Child Health and Development and the Director of the Center on the Developing Child at Harvard University. So Jack, what do we mean by resilience and what do we know about how people develop it?

Jack Shonkoff: What we mean by resilience is that we’re talking about the ability to do well, the ability to cope, the ability to overcome hardship, or adversity, or threat to your well-being. So the key about resilience is it doesn’t occur in a vacuum.

Resilience is something that you actively build, and you build it in the context of relationships in an environment that helps you learn how to cope with challenges, cope with stress, cope with hardships. And it starts very early. It starts in infancy. And infants need to have some sense of participation in that.

But also, you don’t do it totally on your own. You need the support and the security, when you’re a baby, of adults who basically help provide a manageable environment in which you can learn resilience. So, if stresses and threats are overwhelming, they can overwhelm the system. And you don’t really get a chance to build resilience. If every time something happens that challenges you, somebody jumps in to protect you, that’s not good for you either because you have to build that yourself.

So the environment has a lot to do with how you develop resilience and skills, but so does your own activity on the environment, your own sense of being a player rather than just a receiver.

But no two children are the same, even children in the same family, growing up in the same environment. From birth, children differ in how adaptable they are. If you go into a newborn nursery in a hospital, the nurses who work there can tell you about how those babies are all different from each other. Some kids are just more easygoing, constitutionally. Some kids roll with the flow, a little bit easier than others. So in a sense, we don’t all start off with the same way of reacting to stress or hardship.

Sally: That’s great. And thinking about how resilience is built, are there specific building blocks that you need to think about? In this case, could you talk a little bit more about how play might support those building blocks?

Jack: Play, by definition, is an interactive process or a kind of self-directed process. It’s not by chance that all children, regardless of where they live in the history of the species, use play as a way to develop skills. It’s the way children learn to master their environment. And they learn to try things out. They test things. They test limits. It’s driven by curiosity, and it’s driven by an inborn drive to master the environment.

And if you think about what resilience is all about, resilience is mastering your environment. It’s building the skills to be able to cope, building the skills to have strategies, to deal with your own reactions, be able to have some control over what’s going on around you. And none of that would develop as well as it does if you depended on just being taught how to be resilient. No. Your ability, your natural ability to play, is one of the most important strategies that we have developmentally to build resilience in the face of adversity.

Sally: So, what is the science that underlines this connection between healthy development and how play supports it?

Jack: God, there are mountains of science that help us to understand the process of development. And three principles, three concepts, just continue to stand out among all of the research, evidence, and knowledge we have about development. And they are the keys to healthy development.

The first is the importance of supportive relationships. Children develop in an environment of relationships. So, supportive relationships are critically important for healthy development. The second is the need to reduce significant sources of stress—not eliminate stress, but reduce stress, so it’s manageable. And then the third is building core skills, the kinds of skills that are needed for just about anything that we’re expected to do at any point in our life. So these are the core skills that are the building blocks of learning, and behavior, and good health.

And if we put those three things together—supportive relationships, reducing sources of stress, and building core skills—they are essential for us to understand not only how resilience develops over time, but also what an important role play occupies in that process. Particularly in a young child, there is this sense of trying to figure out what the world is all about. So core skill development, which is essential for building resilience, is very much tied into the ability to learn actively through play and through interaction with others.

There has been so much research done on resilience in a variety of circumstances, trying to understand what is it that explains how some children overcome adversity and do well in spite of hardship and threats. The one thing that comes out in just about every single study is whenever there’s evidence of resilience, you can always identify at least one very important relationship that was critical to the development of resilience. Very often, it’s a parent. It doesn’t have to be a parent. It can be another member of the family. It doesn’t have to be a family member. It could be a neighbor. It could be a preschool teacher. It could be a child care provider. It could be a coach. It doesn’t really matter who it is. It certainly doesn’t have to be a blood relative, but there has to be at least one relationship that basically provides a scaffold in which children develop the skills to be able to cope themselves.

That’s the ultimate answer to the question of, can you build your own resilience? The answer is for all the studies that have ever been done, no, you can’t. You can’t become resilient yourself. You can’t will yourself to be resilient. You have to be able to be supported by at least one nurturing relationship.

If we look across the incredible range of experiences and conditions that children grow up in, the principles remain the same. Children are all busy actively mastering their environment, regardless of what that environment is. The challenge is to understand what’s individually different about each child and what is the nature of the environment in which the child is living. And everything else is just figuring that out based on basic principles of what science tells us about development.

Sally: So Jack, you spoke earlier about how play helps build resilience. I’m wondering if you could you give us an example of what that might look like at different ages—for example, what would it look like for an infant?

Jack: What play is about is early on, beginning in the earliest of infancy, really, shortly after birth, is if you think about what babies do, and once babies become attuned to the people who are caring for them, it’s the kind of thing that gets everybody all excited—the eye contact, the beginning of a smile, the cooing, and the vocalizations, and all that stuff that elicits back and forth, serve and return interaction between very young infants and adults. The vocalizing back and forth, the smiling, the looking around and then looking at the same thing, and then handing something, and grabbing it, and giving it back. And, all of those very simple interactions early on are playful interactions.

And then, as you move out of the very earliest of infancy and get into the second half of the first year, when babies become more mobile, and they’re rolling over, and then they’re crawling, being able to reach for things, and grab things. You find the right balance between allowing the child some room to do things in a protected environment and also initiating some things with you. So you initiate interactions. You respond to interactions. You let a child move around. You put stuff out on the floor for a child to play with. And sometimes, hopefully, you leave the child alone in a safe place and let the child explore.

All of this, a lot of people may not think of that as play. They may think of play as more organized kinds of activities. But that is the beginning of play. It’s the beginning of active learning, discovery, curiosity, trying things, learning from what happens when you do something, action and reaction, all that stuff. And then, as you get older and you start to play more organized games, play peekaboo, play Simon Says with a child that’s a little bit older, play all these kinds of games that have rules attached to them, rules about taking turns, rules about following instructions, all of this, board games as kids get older, and then as they get into the school age years, organized games, sports, more challenging board games, again, now most people would say, oh, yeah, that’s like play. That’s what play is all about. But it started much earlier, and it started with the foundation that was all about discovery, creativity, exploration, learning.

In the best of all worlds, play doesn’t end until you die, because play is a way of thinking and engaging with the world. Play is one of the most important vehicles for having some sense of mastery and control over the world that you live in, which is getting us very close to the definition of what resilience is all about. It’s not being able to just deal with predictable things that you’re expecting and you’re prepared to cope with, but being able to deal with anything that life sends your way.

Sally: Could you talk a little bit more about how play might actually support health? What are we learning from our current research?

Jack: This is a really important question and a really important expansion of how we think about play. It’s easy to understand that most of the conversation and most of the thinking about play for the last, let’s say, last 20 years as we’ve been learning more and more about the science of early development is it naturally connects to learning and behavior. It was very brain-focused.

But it’s not just the brain that’s developing. It’s the immune system and metabolic systems. Just like the brain is experience-dependent, the immune system is experience-dependent. It’s learning about different bacteria and viruses that are out there and it’s exposed to. And as a result of that, the immune system is building resistance to those infections early on and preparing you for better physical health. And the same thing with metabolic systems. A well-regulated environment every day is affecting all of these systems. And a dysregulated environment or a highly stressed environment, as it affects the immune system, can cause increased inflammation, which is part of the stress response.

And early behavioral regulation, it leads to more health-promoting adult behaviors, less likely to engage in risk-taking behaviors, less likely to engage in addictive behaviors, problems with smoking, problems with alcohol, problems with risky physical activities that get you into trouble.

So the link with play—there’s no question that somewhere down the road over the next 10 to 20 years, we will all have an understanding that playful learning and the role of play in building resilience is as much about physical and mental health as it is about early learning and school achievement.

Sally: You’ve given us so much to think about, as always, Jack! Thanks so much for your time and being here with us today. When we come back, our panel is going to give us some examples of how they’re putting that science into action.

Musical interlude

Sally: Okay, so we’ve learned a bit about how play affects our biology. Let’s bring it out of the lab now, and into our daily lives. Most of us think about play happening in child care and on playgrounds, but play can honestly happen anywhere! In our next segment, I’m so excited to talk to our panel members, who have lots of examples to share. Joining us on today’s podcast, we have Andres Bustamante, who is an assistant professor in human development in context at the University of California Irvine. Thanks for being here today.

Andres Bustamente: Thank you, Sally. It’s such a pleasure to be here.

Sally: Also on today’s podcast, we have Lynneth Solis, who’s a researcher and lecturer at the Harvard Graduate School of Education. It’s so nice to talk to you today, Lynneth.

Lynneth Solis: Thank you, Sally. It’s a pleasure to be here.

Sally: And also on today’s podcast, we have Laura Huerta Migus, who is the deputy director of the Office of Museum Services at the Institute of Museum and Library Services. Nice to see you today.

Laura Huerta Migus: So happy to be here, Sally.

Sally: Lynneth, I know you’ve looked at research on play and how it helps to build resilience in a lot of different places and contexts. How might opportunities for play look different in some of these different contexts?

Lynneth: The interesting thing is that we see play supporting children’s coping with stress and developing resilience in all kinds of contexts. So you may find it in a simple drop-off at preschool. So that can be really stressful for a child. What we have seen is that children that are allowed a few minutes between drop-off and the start of the day to play on their own or with peers, depending on their choice, actually show reduced levels of stress, both behaviorally and biologically.

But we also can think about other settings with children being exposed to prolonged adversity, like war or being in a refugee setting, where having the opportunity to play, for example, in play groups with caregivers or with other children gives the children an opportunity to create bonds with their caregivers and with other children. And it gives them opportunities to practice some of the coping skills to deal with the difficult emotions and effects of prolonged stress.

We’ve also seen it in situations where children have hospital stays or hospital interventions, which, again, can be very foreign for children, can be very stress-producing. And when health care staff use play to introduce to children what the procedures might be, to give them some space between the introduction of these procedures and the actual medical intervention, what we see is that children show reduced levels of stress prior to the medical intervention but also post the medical intervention.

So their ability to reduce the stress after coming out of that experience also seems to allow them to regulate their stress levels more quickly and more effectively. And so what we see is that both cross-culturally but also in different types of settings, play can be very beneficial for children and for the adults and caregivers in their lives.

Sally: That was the perfect tee-up, Lynneth. Thank you. Laura, what are some examples you’ve seen that encourage play that were created by museums and libraries? I think that’s a really interesting place to be thinking about how play is happening.

Laura: Yeah. Thanks for that, Sally. So it actually builds quite a lot on what Lynneth was telling us about the evidence. So the practice of children’s libraries and children’s areas being interactive, sometimes looking like mini children’s museums for example, having “making spaces” or craft spaces is a relatively new pursuit that is now pretty mainstream practice in library design.

You’ll see the same in museums. Obviously, we have children’s galleries. We have children’s programming, even children’s tours in mainstream museums. And, of course, we take it to the extreme in museums. We actually have children’s museums, right, the entire museum that’s designed with the child’s needs and development in mind.

We also think about playful experiences, like story times. And story times that are starting for the youngest families and the youngest children to help build that sense of playfulness but also helping parents build great relationships with their babies from day one in enriched environments. And then we’re helping to be part of really a public education effort in helping to teach caregivers—so not just parents, but any adult caregiver, which could also include educators—about the value of play as learning and how important it is for child development.

Sally: Laura, I was really struck by that phrase, you said it was a public education effort. And that was making me think, Andres, of your work, thinking about engaging community. And I was wondering if you could tell us a bit more about how you engage community members authentically to help devise playful learning opportunities.

Andres: Yeah, absolutely. So I’m part of a larger project called the Playful Learning Landscapes Initiative, which was started by Kathy Hirsh-Pasek and Roberta Golinkoff—who are my mentors and close collaborators. And that project is all about designing everyday spaces, spaces where children and families naturally go and naturally spend time. You can think bus stops, parks, grocery stores, doctors’ offices, laundromats, anywhere where families go in their everyday routine, and trying to enrich those spaces with play and learning value. Because, like our other guests Lynneth and Laura have shared with us, that has so much value. Those interactions and that play time is so enriching for kids.

We are partnering with a local community organization called SAELI. SAELI stands for the Santa Ana Early Learning Initiative. And we’re partnering with SAELI in order to design public spaces so not only that they have the learning value and stay true to what developmental science tells us about what creates high-quality learning situations, but also so that they reflect the community’s values and goals and strength and culture.

And this is really important because it can have a big impact on the way that families interact and engage with the sites and really build a sense of ownership, which can really increase learning value and also longevity and usability of these sites in the community. And so SAELI has over 200 members, and it’s local parents, it’s teachers, it’s school administrators, it’s local politicians, it’s community organizing and nonprofit organizations.

And so all people coming together to promote enrichment activities and supports for families with kids 0 to 9. And so through this partnership with SAELI, we’ve held design sessions where we have about 40 mothers from Santa Ana come in and just share their vision for their community. So we have them tell stories about their childhood and their experiences growing up, sometimes in other countries or sometimes here in Santa Ana, and what they did in those spaces. What did they do at the bus stop? Or what did they do at the park? Or how was it going to the market or the grocery store? And then from those stories, we’re able to distill themes and commonalities across families’ experiences and then try to represent those experiences in the designs that we create. And then we actually have families build stuff, so we’ll bring arts and crafts kits and have them actually build out a bus stop or a game for the park.

And so families end up sharing these really special stories and games that they played as kids and that now they want to play with their kids and show other people in their community. And these games are so rich with learning value. And so it becomes this situation where we accomplish all the goals that we wanted to from a science perspective about making learning situations that create these high-quality caregiver-child interactions, but are deeply embedded in the community’s lived experiences.

Many of our families are from Mexico, and they talked about how the abacus was a really common tool for them to learn math. And so we’re going to make a bus stop that has a giant abacus. And so kids can count things and engage in math conversation while they wait for the bus. And it’s a way that we’re really building on families’ strengths and experiences of like, this is how they learned math, and so they’re really equipped to communicate math and engage in this activity with their kids.

Another game, another bus stop idea was a Loteria bus stop. So Loteria is a really popular local game. It’s kind of like bingo. You spin a wheel and then you get a symbol. And then we’re going to make a bus stop that has a big version of Loteria. And then when you get a symbol, you flip it, and there’s different activities that kids and families can engage in that are play-oriented but have a learning value. I think that there’s going to be a real deep sense of ownership, because the families are the ones who really created these designs.

Laura: I just wanted to respond, Andres, to something really important about those examples that you gave. And that often when we’re talking about children and children’s learning and play, we talk about children as if they are isolated and they’re experiencing these activities on their own or in a child-only environment.

And we know how important play can be for strengthening or building really positive adult-child relationships and what you’re talking about here in terms of identity development and cultural identity building and generational transmission of knowledge. And I just think that that’s really important, at least also think about play as not just for the child but for the child and everything around and everyone around the child. It’s good for everybody.

Sally: Very true, and it seems to me that we all need play now more than ever, especially given the past couple of years!

Laura: Families have gone through trauma on a large scale over the last two years. And I think there’s a really important moment right now where, as a country, we have the opportunity to say we know what is important for our children’s well-being and for their recovery.

Lynneth: Play allows children to deal with uncertainty. So what it allows children to do is to pivot, to adapt, to follow different paths, depending on what’s happening right in front of them. So it’s an iterative process. And those skills that are developed over time are the building blocks of those coping mechanisms that are important when children are exposed to uncertain situations, like a pandemic, et cetera. And the interesting thing is that this is also true for adults.

Laura: Some of the most impacted families and children in the pandemic were our youngest children, so pre-academic years, children 0 to 4 or 5 years old, whose parents and caregivers were essential workers, and who tended to also be in our lower socioeconomic strata. Those families and children lost access to most of their learning and care supports and were very isolated in their homes. So many of us were, but you think about a restaurant or service worker with a two-year-old and what that first year of the pandemic looked like. Virtual learning doesn’t work for a three-year-old.

One of the innovations that we saw, in the children’s museum world in particular, was the development of learning kits—very simple sets of materials, tangible materials, that were focused around fun and playful activities. Quite often, they were just small prompts to elicit pretend play and guided play between adult and child.

What we heard from hundreds and thousands of parents was that they wanted these kits. They needed materials to engage their children away from screen time and in ways that were meaningful and that gave the parents confidence and power to engage their children in something joyful in a time of incredible stress. Hundreds of thousands of these kits have been disseminated by hundreds of libraries and museums. And the need is still there, and the want is still there. And so I think that tells us something about how families feel like play is a critical part of their toolkit, their resilience toolkit.

Sally: Thank you for those thoughts; they’re so important. We’ve talked a lot about the connection between resilience and play as it relates to learning. I’m wondering, though, are there also connections between play and other kinds of development? For example, we’ve been thinking a lot about health and social-emotional skills..

Lynneth: Something that is important to understand about the connections between play and all sorts of developmental outcomes for children is that not every single play experience leads to all the outcomes. So what do I mean? That there are certain types of play that are particularly supportive of health outcomes, for example. So you might think about more physically active play that might have children practicing both fine and gross motor skills or games that might have them be, again, physically active, may help reduce stress, which is also associated to biological responses to stress that can be harmful to the body.

On the other hand, if you think about social-emotional skills, dramatic play, pretend play, storytelling are types of play that can be associated with outcomes that are about understanding emotions, knowing how to name emotions, knowing how to respond to others and their emotions, regulating how to interact with others in a positive way.

So it’s not that children should only be engaging with object play and building and learning mathematical skills or that they should only be engaged in dramatic play and developing language and social-emotional skills. But that, actually, it’s sort of the toolbox of opportunities for children to engage in different types of playful interactions with peers, with friends, but also adults, as we’ve heard from the other panelists.

Laura: I really would like to “yes, and” what Lynneth said about the different kinds of play. Especially as you’re thinking about yourself as a parent or an educator or a policymaker, there’s often wanting the answer of, what kind of play is the best? And so I think emphasizing the notion that all kinds of play is the best is so important.

And also acknowledging why different communities are going to take different approaches, because the needs are going to be different. The affordances, what’s available, what matters is going to be different from family to family, community to community. And that’s a kind of diversity and flexibility I think it’s important for us to also embrace.

Lynneth: A question we often hear is, should this be free play or guided play? Which one is the most beneficial? And I think going along with this idea of all kinds of play for different types of outcomes is the idea that free play, children being able to play uninterrupted, being able to focus, being able to set up their own challenges and figure out problem-solving strategies is incredibly important for children.

And, as we’ve also discussed in the podcast, that the interaction with others—so the added support, the added scaffolding from educators, from parents, from other adults in children’s lives—can also help expand the types of opportunities that children have to learn and to develop skills through their play. So it’s important to know that adults helping to shape play is not necessarily a negative thing.

And it’s always in relationship to what is the interaction, how are we making these interactions with children the most valuable to both allow them to take risks and build autonomy and independence while also feeling supported in their environment?

Andres: I absolutely love this conversation about different kinds of play. And I really appreciated something that Laura said, which is that in each community, this might look different. And I think that’s the beauty in this idea of designing with the people who are going to be, at the end, using the space.

And so, for example, in our work in Santa Ana, a huge theme that came through from all of our families is this idea of transmission of culture intergenerationally. You know, whether it’s their language or their culture or their customs or their childhood games, they feel like their kids are not always getting their full experience of their community.

That might not actually be a top priority for every community. But I think that’s why if you design with the people who are going to be in the space, it’s so powerful. And you end up tapping into these really valuable ideas that are really going to motivate people to use these play spaces and create the kind of rich learning that we really want to see between kids and families.

Lynneth: I love what Andres and Laura have shared about working with communities. When I think about involving communities and creating playful experiences for children, there’s three questions that I like to think about. One is, what is working here? What’s already good? And what’s most meaningful?

Both Andres and Laura have shared examples of this. How do we work with communities to say, when we think about play, we don’t want to impose an already packaged program or set of activities. What we want to learn is, what’s already working for you? What’s already meaningful for you? And how does this continue to celebrate your history, your family relationships, community relationships, and the values that you have for the children in your community? So I really, really appreciate this conversation.

Sally: Thank you all so much, this was honestly such a treat – I love hearing all of your perspectives. So thank you!

Musical interlude

Sally: So next up, we have an expert on one really important kind of setting that’s all too often overlooked: humanitarian settings for refugees. There are millions of children in these settings worldwide and they need playful experiences as much as any child. Well, fortunately, there are some very committed people working on just that, and today I’m delighted to have a chance to speak with one of them. Her name is Erum Mariam and she’s with the BRAC Institute of Educational Development. I’m so looking forward to our conversation today, Erum.

Erum Mariam: Thank you, Sally. Looking forward to this conversation with you today.

Sally: So I know that you and the BRAC Institute, as well as your partners from Sesame Workshop and other organizations, have done a lot of work bringing play to humanitarian or refugee settings. Could you tell me a little bit more about what you mean by humanitarian settings?

Erum: Sure. I’ll be speaking from my experience of the Rohingya context today. Rohingya started coming in in 2017. There were thousands and thousands of Rohingya who were coming over from Myanmar and coming to Bangladesh to a place named Cox’s Bazaar. It’s the largest refugee camp in the world, and with about almost a million people.

So I will be talking about people who have been displaced from their own country. And in this case, it’s really very, very sad because they came away after the genocide in Myanmar. And there were women with infants and toddlers. They came with the most essential belongings, their families. And then they went into shelters, which were absolutely very temporary, with bamboo and then plastic sheets on top. And then after that, they moved more into what looked like housing. But these houses are of two, three rooms and made of bamboo as well as sheets. And that’s the humanitarian setting.

Sally: Wow. Could you give me a sense of how many children in particular are in this kind of setting worldwide, and maybe give us a glimpse into what that situation might look like for a child in particular?

Erum: I think, worldwide, the amount of displaced population is somewhere around 82 million. And out of that, believe it or not, it’s thought that about 42% are children. That’s around 34 million children we are talking about. It’s a really big number of children.

And what it’s like for children, I mean, one day, I saw this, I observed this, and it has really stayed with me. That there was a child who was about two years old, and she was with the mother. And the mother was given some—they were getting relief materials, and the mother got biscuits. And I saw that the mother took a piece of stone and the packet, and she was crushing the biscuits. As she crushed the biscuits, and it became powder, and she took the powder, and she was feeding the child. And then she was taking some for herself. Because you know, there were days that they wouldn’t get meals. And so even in the extremely difficult situation, I saw that mothers and parents tried their best for the children.

After that, when I observed that they got some kind of housing, we could see parents trying so hard to get a sense of normalcy, to give a sense of normalcy to their children in a very, very difficult situation. So I would see moms and dads getting water, moms cooking, dads getting bamboo to make the house stronger, parents drying their chilis and other things on the rooftop. And so just to give that sense of normalcy to everyday life in a very, very difficult situation.

Sally: I can imagine in these moments, where people are struggling to have access to food and water, that play might be something that’s lost. And in some cases, rightfully so, right? You need to make sure you’re treating these more immediate needs. Could you tell us a little bit more about why play should still be considered important in these settings?

Erum: Sure. Play does have this power of creating a very nurturing environment. And play of course has so much to do with relationships, because when children play, there is a relationship there. There is a caregiver or even their older siblings also in that space. When there are these situations of real deprivation, of so much of trauma, and if we can have these situations where there is nurturing and there is stimulation, I think that’s really fantastic for the children, that there are these opportunities for child development.

Sally: Erum, I love that you highlighted that responsive relationship with an adult or sibling. I think that’s really critical in terms of developing resilience. Could you give me an example of how these playful approaches might be integrated into these settings?

Erum: Yes, absolutely. In 2017, when we were there in the camp, and one day we were at a center. It was a child-friendly space, and the children were there. And we went in and we said, what do you want to show us? Show us anything that you really want to show and you’re proud of. And the children all got up and they were chanting a rhyme.

And believe it or not, Sally, when the children were chanting, we found that community members, they came and they surrounded the center. And they surrounded the center because with the chanting and with the children clapping and chanting, there was a connection with the community.

So we started exploring the Rohingya culture. We asked the children, what did you do when you were in Myanmar? And they showed us the most fascinating physical play. We asked the children, what do you like drawing? And they showed us motifs which were different. Children even as young as age two were able to hold the crayon. And they had really good fine motor skills. And so they were showing us the motifs of art.

We explored, we were exploring with the caregivers. We asked what is it that they had that belongs to the Rohingya culture. They showed us designs of cloth that they used to have in every household that would hang under the ceiling. The caregivers, the community members, they told us stories which were very much about the Rohingya culture and history.

As we developed this content, we spoke to child therapists. And the child therapists, they told us that, don’t you see what you have done. What you have done is you’ve been working on learning through play, but what you have really done here is healing through play.

And so they said that the two elements that you have been able to bring out is you have given so much emphasis on the children’s voices that they could say—they could tell you that this is what we did, this is what we like, this is what we play, and things like that. And the second was that we respected the Rohingya culture. And the Rohingya have beautiful play. And their play is really about coordination and balance. And they were bringing that to us and to the world.

Sally: Incredible. I really loved it when you were talking about both respect for the culture and how they play, as well as respect for children as autonomous and humans that have their own beliefs and ideas and creative thinking, too. I think that’s a really powerful mix. I’m wondering if you could tell us a little bit more about how this pandemic that we’re experiencing has affected your work with the Rohingya?

Erum: Once there was the lockdown and there was restricted mobility, parents of course had to step up. And that meant that every child’s home had to be, had to have an environment which was so very stimulating for the child.

So every week we would call the mother for 20 minutes. For the first 10 minutes, we would speak about her mental health issues. Was she having any kind of difficulty? How were the days? Is there anything that she wanted to speak to us about? And the next 10 minutes was about the playful approaches with the child. And so the child and the mom and the facilitator who was calling on the phone. And so this was, the next 10 minutes was about the chanting, the rhymes that the children love doing, and also some physical play that would be possible under those circumstances.

This was something that was totally emerged from COVID. And what we have found is when we looked at all the data and the results of the 20-minute phone call, we found that this has shown so much of improvement in the children’s communication and language, in children’s social-emotional development and cognitive development. So those are results that we’re extremely excited about. And so we look forward to much more.

Sally: That’s thrilling. And I feel like this thread that’s gone throughout this interview is around listening and how important that’s been for you and your organization, and how that’s meant that the resources you provide are so much more targeted. And that’s beautiful.

I have one last question for you. The needs for international refugees seem really huge and daunting. And we were wondering if you could share a little bit more around how might listeners of the podcast take action, or any feelings you have around hope that you’d like us to end on.

Erum: Yeah. My experiences with working with the refugees have shown that those who are displaced, their experiences are so hard. And so they live under such harsh realities. But what I have found is that their spirit is so—they have so much resilience. And there’s so much spirit for them to go on.

Because at the end of the day, we go back to our lives. But the people who are living in these conditions, they go on, and they find normalcy. They find aspirations. They find dreams. They find—under the most difficult of conditions. So the best we can do is just keep on supporting. Whatever opportunity we get. Whenever there’s a chance for any kind of resources, contribute there. So any opportunity to be there to amplify the cause and be a part of the solutions for the humanitarian settings.

Sally: Thank you so much for your time, Erum, I really enjoyed our conversation. And for listeners, we’ll post resources and information relating to the support for children in humanitarian settings on our website, which is developingchild.harvard.edu. When we come back, we’ll wrap up with a pediatrician’s important prescription for parents.

Musical interlude

Sally: And we’re back! After so much emphasis on what societies and communities can do, we wanted to close with something really practical that everyone could do. Joining us on today’s podcast, we have Dr. Michael Yogman who’s a pediatrician and faculty at Harvard Medical School and Cambridge Hospital. It’s so nice to talk to you today, Dr. Yogman.

Michael Yogman: Thank you so much for inviting me.

Sally: One thing I didn’t say in my introduction is that you are actually the founder and driver of an initiative of the American Academy of Pediatrics; it’s called Prescription for Play. The idea is to encourage pediatricians to actively prescribe play for children to support their healthy development, and then to give them some tools and resources for the kinds of playful interactions they might suggest to parents. Could you tell me a little bit more about what the Prescription for Play initiative is, and where did it come from?

Michael: I spent about six years as chairman of the board of the Boston Children’s Museum. I was also chairing a committee of the American Academy of Pediatrics and had agreed to write a clinical report on play in early childhood. It occurred to me that pediatricians often considered play frivolous, parents often considered play frivolous. And there had been an increasing movement about taking the focus on learning standards, and third grade, and literacy, and moving that kind of No Child Left Behind testing standard back into preschool and early child care. And I interviewed a teacher who was weeping because her director said that she should remove the blocks from her child care center. And I said, you know what? That’s nuts!

It started a notion that we could point out to pediatricians that just like any other medicine, they could write a “prescription for play” at all well visits, and that it would convey a message that play was not frivolous, that it was brain-building. We realized the role that play could play in promoting safe, stable, nurturing relationships, which were critical to resilience. And pediatricians could play an important role in incentivizing parents to value play.

I think the pandemic and its ensuing stresses, this child mental health emergency that we’re now seeing, never has it been more important for kids to be able to play. The notion that we’re going to make up for the learning loss through remote learning, by hammering kids with more stressful academic pressure is only compounding the stresses of child mental health. Play has a really important role in buffering the stress that is really preventive.

Sally: Do you have any sense of how many pediatricians are participating in this?

Michael: So it’s an uphill battle. I think just as I think we really were making headway, lo and behold, the pandemic hit. Pediatricians are very supportive of this concept. I think that any changes have been a little bit put on the back burner as they’ve just tried to get kids immunized, move away from virtual visits toward in-person visits. And I think we’ll get back to an emphasis on play. So I think it’s been picked up actually in hospitals in Denmark, and in Salt Lake City, and by the LEGO Foundation. I’ve gotten lots of inquiries on trying to transform pediatric waiting rooms, hospital waiting rooms to really promulgate a lot of these ideas. And part of the purpose is to enable parents to realize the value in observing what their kids are doing during play rather than sitting on their iPhones during the waiting room.

Sally: It’s exciting to hear, and I can only imagine how frustrating that was to feel like you were getting traction and then have this pandemic hit.

Michael: Unbelievable.

Sally: So could you give our listeners three ideas or maybe three tips that represent how pediatricians might guide parents to support healthy child development through play?

Michael: I think that acknowledging when really young infants have that brief period of quiet alertness and they’re cooing, to realize those are meaningful moments, and parents want to be responsive and engaged. Even if it’s brief. It’s important. So that’s number one. When they coo and you coo back at them, they’re really learning about turn-taking. That’s an important skill for the pragmatics of language development, which evolves later on.

Number two, the power of letting kids explore. There’s some wonderful research by Alison Gopnik that if parents were too pushy, you gave them a toy with multiple aspects of it, if parents were too pushy at demonstrating all the things, the kids weren’t interested. If you let the children explore it on their own, they did much more active exploration and were much more joyful about discovering things on their own.

And the third one is just to emphasize the importance of reading, and singing, and letting kids even play. You don’t need to buy expensive toys, playing with wooden spoons and plastic Tupperware that are just around the house. Since parents are using those objects, kids are really excited to pretend that they’re adults and exploring those objects just as the adults are using them.

Sally: It’s funny, they’re all ready to grow up and turn into adults, and here we are as adults sometimes wishing we could be kids again, right?

Michael: Exactly. And I think for parents to, the final advice is as adults, I love George Bernard Shaw’s quote: “We don’t stop playing because we grow old, we grow old because we stop playing.” Probably a good note to end on.

Sally: Perfect. I really have enjoyed talking with you.

Musical interlude

Sally: So that concludes our look at how play builds resilience and what we can do to support it. I’d like to thank all of our guests, those conversations were so much fun, I really learned so much on today’s episode. And thank you for sharing your personal experiences and your stories. I’m your host, Sally Pfitzer, and we hope you’ll join us next time!

The Brain Architects is a product of the Center on the Developing Child at Harvard University. Harold Shawn of Levelsoundz Productions was our audio editor for this episode and Lauren Osgood was our production assistant. Our music is “Brain Power” by Mela from freemusicarchive.org. You can find much more on the science of child development at developingchild.harvard.edu, where we’ll post any resources that were discussed in this episode. We’re also on Twitter (@HarvardCenter), Facebook (@centerdevelopingchild), Instagram (@developingchildharvard), and LinkedIn (Center on the Developing Child at Harvard University).

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