A new prescription for Health and Wellbeing
By Julia Whitaker, Health Play Specialist
As the leaves fall and 2016 draws to a close, we read that an ever-increasing number of our children are being identified as having some sort of mental health problem . Our 3 and 4 year olds are labelled with ‘conduct disorder’ and the vocabulary of childhood now commonly includes references to ‘stress’, ‘anxiety’, and ‘depression’. We witness mental health services under strain with long waits for an appointment with a child mental health professional  and a growth in the prescribing of psychiatric drugs for children – including an 8% increase in prescriptions of stimulant medication to treat so-called ‘hyperactivity disorders’ .
Our children deserve better – not better labels, better drugs or more therapeutic interventions – but a better prescription: a Prescription for Play.
OUR CHILDREN NEED TO MOVE:
From before birth, children are driven to move: to stretch and flex, to turn and twist, to curl and unfurl. The transition through the motor milestones – from rolling to crawling to standing, walking and running; from reaching, grasping, pointing to holding a pencil – is a meaningful sequence of skill development and practice. Children need time to grow into their bodies, to practise physical movement skills and to know the pleasure in doing so. This wonderful, universal sequence of growth and change does not reach an abrupt conclusion at age 4 or 5, when the child starts school, but continues until the age of 7 and beyond. (The process of physical maturation is actually not completed until early adulthood).
When we interrupt this natural process of physical development with a premature introduction to the unnatural demands of the classroom (‘sit down’, ‘don’t fidget’, ‘no climbing’), we create both physical and psychological stress in our children by expecting them to curb their natural instincts. When they fidget or ‘wander’, crawl under the table or climb on top of the chairs, our children remind us that they need to move – and we need to pay attention to what they are telling us.
An extended play-based curriculum which is not only permissive but encouraging of active, physical play supports the natural process of motor development. Our children need opportunities to discover and practise their physical capabilities – with direct benefits for their mental and physical health.
Physical play is associated with improved concentration levels, more pro-social behaviour (such as kindness and conflict resolution) and with children feeling that they are liked by their peers and that they have enough friends. Children who engage in lots of active play show lower levels of anxiety and depression, are happier with their appearance, and report higher levels of self-esteem, happiness and satisfaction with their lives .
The enjoyment of physical activity is also associated with happiness and lower levels of worry and reinforces positive habits with lifelong benefits for health and wellbeing.
OUR CHILDREN NEED TO BREATHE:
Children need lots of active play and there is a wealth of evidence to support the view that this physical play is of greatest benefit to mental wellbeing when it takes place in natural green-space, out of doors . Outdoor play serves both preventive and protective functions and it has been shown, for example, that going for a walk in the fresh air can be as effective as medication in reducing some of the symptoms of ADHD. .
Breathing properly is one of the simplest, most accessible ways of improving our physical and mental health. When children play outdoors, they breathe deeply using their full lung capacity, boosting oxygen uptake, increasing energy levels and improving mental clarity, whilst promoting feelings of calmness and wellbeing.
However, by the time they start school at 5, many children have replaced the slow, deep breathing of infancy with the shorter, shallower breathing typically associated with the ‘fight or flight’ stress response. The stress response is important because it helps to protect children from danger but when it becomes a habitual reaction to the challenges of everyday life – hyper-stimulation, performance anxiety, frustrated impulses – it results in the early presentation of symptoms of stress, depression and anxiety – symptoms which endure into adolescence and beyond .
Some schools are recognising the impact of increased stress on mental wellbeing by introducing yoga or mindfulness classes designed to teach children deep-breathing techniques . Whilst these special measures are commendable, young children don’t really need to be taught to breathe . . . Outdoor play as part of a balanced kindergarten curriculum up to the age of 7 allows children to find a natural rhythm of lively and less-lively activity through their own intuitive motivation and their developing capacity for self-regulation.
OUR CHILDREN NEED TO MAKE MISTAKES . . .
School is about ‘getting it right’ – earning the tick, the star, the smiley face, the ‘Well Done!’ sticker. But learning is about something else altogether. Learning is about trying things out, about experimentation and being curious about possibilities – whilst making lots of mistakes along the way.
The young child is engaged in a continuous process of creative experimentation as they learn about the world and their place in it. Whether they are tossing things out of the high chair, upturning the tomato pasta, or expanding their vocabulary of ‘rude words’, they are learning important lessons about cause-and-effect, consequential action and reciprocity. Young children embrace possibilities with little regard for ‘right or wrong’ but soon discover that ‘making mistakes’ has negative consequences. With the start of school and its demands for logic, reason, and ‘getting it right’, the process of creative mistake-making is prematurely suspended. The ‘achievers’ are the children who quickly learn to conform to the rules-of-the-game through a realisation that there is a right answer, a right way of doing things. The ‘under-achievers’ are the children who wilfully hang-on to their experimental approach until they too are obliged to surrender to an externally imposed set of expectations. The tragedy is that the abandonment of experimentation is accompanied by a reduction in creativity, curiosity and a belief in infinite possibilities. Once children start worrying about making mistakes, they become less likely to take risks, less playful and spontaneous – resulting in what is recognized as the ‘Fourth-Grade Slump’  mid-way through their primary education.
It is the fear of making mistakes and of ‘getting it wrong’ which leads to the fear of failure responsible for many of the mental health problems that emerge in later childhood and adolescence. When the drive to avoid failure overrides the drive for success, our children and young people sabotage their own life chances, as self-esteem is gradually undermined by a lack of ambition and diminished self-belief .
A play-based kindergarten curriculum up to the age of 7 extends the period of creative ‘mistake-making’ allowing our children to explore possibilities free from externally imposed expectations and limitations to their creativity. It was Einstein who said, “Play is the highest form of research” and research is about ‘finding-out’ as opposed to ‘getting it right’. By celebrating the natural curiosity and creative experimentation of childhood, we foster robust, resilient children who retain a belief in infinite possibilities and their potential for innovation, flexibility and self-discovery.
OUR CHILDREN NEED TO PLAY:
There will always be some children whose individual characteristics and personal circumstances make them more vulnerable than most to psychological difficulties. These children certainly need ready access to mental health professionals and services that can address their particular needs.
However, all our children need a ‘Prescription for Play’ until at least the age of 7. The evidence for the link between play and positive mental health is irrefutable. One study has shown that play may actually cause children to become emotionally well: “Children demonstrate increased emotional well-being when they perceive an activity as play rather than not play… play can be seen as an observable behaviour but also as a mental state.” 
When children are given the time and space to explore the world through play – to discover their physical capacities, to find their innate rhythm, to experiment and create – they develop the confidence and resilience to embrace life’s challenges and stand the best chance of going on to live happy, purposeful lives.
 Faculty of Public Health and Natural England (2010) Great Outdoors: How Our Natural Health Service Uses Green Space To Improve Wellbeing: Briefing Statement, London: Faculty of Public Health and Natural England.
 Torrance, E. P. (1968) A longitudinal examination of the fourth grade slump in creativity. Gifted Child Quarterly, Vol 12(4), 195-199.
 Martin, A. (2010) Building Classroom Success: Eliminating Academic Fear and Failure. A&C Black.
 Howard J. and McInnes K. (2013) The impact of children’s perception of an activity as play rather than not play on emotional well-being. Child Care Health Dev. 39(5): 737-42.