Since the publication of the American Academy of Pediatrics (AAP) Clinical Reports on the importance of play in 2007, 1, 2 newer research has provided additional evidence of the critical importance of play in facilitating parent engagement promoting safe, stable, and nurturing relationships encouraging the development of numerous competencies, including executive functioning skills and improving life course trajectories. At a time when early childhood programs are pressured to add more didactic components and less playful learning, pediatricians can play an important role in emphasizing the role of a balanced curriculum that includes the importance of playful learning for the promotion of healthy child development. This clinical report provides pediatric providers with the information they need to promote the benefits of play and and to write a prescription for play at well visits to complement reach out and read. The mutual joy and shared communication and attunement (harmonious serve and return interactions) that parents and children can experience during play regulate the body’s stress response. When play and safe, stable, nurturing relationships are missing in a child’s life, toxic stress can disrupt the development of executive function and the learning of prosocial behavior in the presence of childhood adversity, play becomes even more important. Play is not frivolous: it enhances brain structure and function and promotes executive function (ie, the process of learning, rather than the content), which allow us to pursue goals and ignore distractions. Furthermore, play supports the formation of the safe, stable, and nurturing relationships with all caregivers that children need to thrive. Research demonstrates that developmentally appropriate play with parents and peers is a singular opportunity to promote the social-emotional, cognitive, language, and self-regulation skills that build executive function and a prosocial brain. Children need to develop a variety of skill sets to optimize their development and manage toxic stress.
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