Allowing young children to play with their friends must be prioritised as soon as possible when lockdown is eased

Dr Kathryn Lester
Senior Lecturer in Developmental Psychology, University of Sussex, on behalf of the Play First editorial panel: Dr Kathryn Lester and Professor Sam Cartwright-Hatton (University of Sussex) and Professor Helen Dodd (University of Reading)

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While the Covid-19 pandemic has posed a lower risk of physical health problems for children, it has transformed the social lives of children more rapidly than anyone could have imagined.

Sixty percent of children worldwide, approximately 1.4 billion children, are currently living under partial or full lockdown conditions (UNICEF, 2020). It has now been two months since most British children last played in-person with a friend.

Emotional Wellbeing

Recent data, collected in the first few weeks of lockdown, showed that two-thirds of parents already perceived their child to be feeling lonely (Dodd, H. F. Personal communication, April 2020). This reflects an increase of approximately 50% compared to normal levels (Office for National Statistics, 2018). Interim data from the Co-Space study (Waite, P. et al, 2020), which focuses on how families are coping with lockdown, showed that over half of parents are concerned about their child’s emotional wellbeing. Twenty percent of parents felt they would benefit from support for managing their child’s behaviour, with this rising to 40% of parents who felt they would benefit from support for managing their child’s emotions. These rates were even higher for parents of children with special educational needs.

These challenges to children’s mental health are backed up by a recent rapid systematic review, which concluded that loneliness and social isolation adversely affect children’s short- and long-term mental health (Loades, M. E. et al). Importantly, the duration of loneliness, rather than its intensity, most strongly predicted poorer outcomes. Given these facts, it seems very likely that children’s emotional health is suffering in lockdown, and for many this suffering will continue longer term. Poor emotional health in childhood is linked to not only long-term mental and physical health difficulties (Essau, C.A. et al, 2014; Maughan, B., & Collishaw, S., 2015;) but also poor educational (Jaycox, L.H. et al, 2009; McLeod, J.D., & Kaiser. K., 2004) and occupational outcomes (Knapp, M. et al, 2011). These negative impacts disproportionately affect children from disadvantaged backgrounds (Collishaw, S, et al, 2019; Royal College of Paediatrics and Child Health, 2017), thereby contributing to growing concerns that the lockdown will exacerbate existing health and social inequalities.

The Importance of Play

Play is so essential for children’s wellbeing that The United Nations Convention on the Rights of the Child, Article 31, defines play as a fundamental right. However, the importance of play for children’s wellbeing is still all too easily overlooked, and sadly even more so in the midst of a global pandemic. For social and emotional wellbeing, children need to engage in all types of play (Hughes, B., 2006). Although some children will be spending more time playing during lockdown, either alone or with parents or siblings, children across the UK currently have a play deficit because they are deprived of the chance to play with peers. Playing with peers has a very significant impact on children’s social and emotional development (Goldstein, J., 2012). Without it, children can feel lonely and isolated.

Play is especially beneficial when children are feeling anxious or stressed (Fearn, M., & Howard, J., 2012).  In highly stressful situations, and where children have been deprived of play opportunities (e.g. war zones, in hospital, in orphanages), there is evidence that reintroducing opportunities to play with other children is therapeutic (Brown, F., & Webb, S. 2005; Feldman, D., 2019; Koukourikis, K. et al., 2015; Potasz, C. et al., 2013).  Play helps children to work through emotions, to make sense of things they find hard to understand, and it supports their coping and emotional resilience (Lester, S., & Russell, W., 2008), and so it is a significant concern that the opportunity to play with peers has been absent from so many children’s lives.

Play First Recommendations

Given this evidence, we have recently written to Government ministers urging them to prioritise children’s social and emotional wellbeing in all decisions relating to the easing of lockdown and the re-opening of schools.

In our recommendations, we ask that, once it is safe to do so, the loosening of restrictions should be done in a way that provides all children with the opportunity to play with peers. Outside of school we suggest that children should be allowed to play with their friends as soon as possible, even if gatherings of children are very small, must be held outdoors, or are initially restricted in frequency.

Within schools, a traditional break-time may not be possible while social distancing remains necessary, but with a little creativity, we hope that all children can have frequent opportunities to play with their friends each day. Children could go out to play in small groups on a rota system throughout the day, and games, such as ‘shadow tag’ could be encouraged, that are fun for children while meeting the challenges of playtime when social distancing. As soon as it is possible to do so without increasing physical risks, children should be allowed to play with their peers without social distancing. Without the need to socially distance, children will be able to play freely. Free play where children choose what they want to do, and how they want to play is especially beneficial for children’s physical and mental wellbeing (Brussoni, M. et al, 2015; Lester, S., & Russell, W. 2008).

We recommend that playing and learning outdoors should be encouraged where school facilities allow and given the likely reduction in risk of infection outdoors. Outdoor play, in particular, is linked to improved physical health as well as social and emotional health (Tremblay, M.S. et al, 2015), and there is a wealth of evidence demonstrating the effectiveness of outdoor learning approaches (Bilton, H., 2010).

Children cannot learn effectively when they are struggling emotionally. In the coming weeks and months as schools reopen, it is important that schools are given the time, resources and clear guidance to focus on emotional wellbeing and to encourage play as a priority, rather than academic progress. However, we understand many education staff and parents will be worried about the risks posed to children by allowing them to play with one another as well as concerns about academic progress. To address these concerns, we recommend the widespread dissemination of public health messages communicating the social and emotional benefits of play with peers, alongside clear guidance on any objective risks to children’s physical health.

There will be lots of variation in children’s experiences of lockdown and in their anxieties about returning to school. For many children returning to school after a long period of time at home will be difficult and upsetting. Some children will need more support with this transition than others, such as children who are experiencing grief, children with special educational needs, and children with existing mental health problems. Where necessary, families and education staff should work together to develop individual plans for transitioning children back to school.

Concluding Remarks

Our Play First recommendations can be read in full

We hope that when policy decisions are made over the coming weeks and months, children’s need to play with their peers is prioritised and their social and emotional needs are at the forefront of all decision-making.

Conflict of Interest Statement: No conflicts declared

Acknowledgements:

Kathryn Lester receives funding from the British Academy, The Kavli Trust and Jacobs Foundation

Sam Cartwright-Hatton receives funding from The Kavli Trust and has previously received funding from MRC, ESRC and NIHR.

Helen Dodd receives funding from a UKRI Future Leaders Fellowship.

References

Cartwright-Hatton, S., Dodd, H. F. and Lester, K. J. (2020). Play First: Supporting Children’s Social and Emotional Wellbeing During and After Lockdown. Available online

Bilton, H. (2010). Outdoor learning in the early years: Management and Innovation. Routledge.

Brown, F., and Webb, S., (2005). Children without play. Journal of Education, 35 (1), 139-158.

Brussoni, M., Gibbons, R., Gray, C., Ishikawa, T., Sandseter, E. B. H., Bienenstock, A., … and Tremblay, M. S., (2015). What is the relationship between risky outdoor play and health in children? A systematic review. Int J Environ Res Public Health, 12(6): 6423-6454. doi: 10.3390/ijerph120606423

Collishaw, S., Furzer, E., Thapar, A. K.,Sellers, R., (2019).  Brief report: a comparison of child mental health inequalities in three UK population cohorts. Eur Child Adolesc Psychiatry, 28: 1547–1549. doi:10.1007/s00787-019-01305-9

Dodd, H.F. (2020). Personal communication. Data collected April 2020 as part of UKRI Future Leaders Fellowship Ref: MR/T041897/1

Essau, C.A., Lewinsohn, P. M., Olaya, B., and Seeley, J. R., (2014). Anxiety disorders in adolescents and psychosocial outcomes at age 30. Journal of Affective Disorders, 163:125-132. doi:10.1016/j.jad.2013.12.033

Fearn, M., and Howard, J. (2012). Play as a resource for children facing adversity: An exploration of indicative case studies. Children & Society , 26 (6), 456-468. doi: 10.1111/j.1099-0860.2011.00357.x

Feldman, D., (2019). Children’s Play in the Shadow of War. American Journal of Play , 11 (3), 288-307. Available online

Goldstein, J. (2012). Play in children’s development, health and wellbeing. Toy Industries Europe. Available online

Hughes, B., (2006). Play Types. Speculations and Possibilities. London: The London Centre for Playwork Education and Training.

Jaycox, L.H., Stein, B. D., Paddock, S., Miles, J. N. V., Chandra, A., Meredith, L. S., Tanielian, T., Hickey, S., & Burnam, M. A., (2009) Impact of Teen Depression on Academic, Social, and Physical Functioning. Pediatrics, 124 (4): e596-e605. doi:10.1542/peds.2008-3348 [PubMed Abstract]

Knapp, M., King, D., Healey, A., and Thomas, C., (2011). Economic Outcomes in Adulthood and Their Associations With Antisocial Conduct, Attention Deficit and Anxiety Problems in Childhood. J Ment Health Policy Econ, 14(3): 137-147. [PubMed Abstract]

Koukourikis, K., Tzeha, L., Pantelidou, P., and Tsaloglidou, A. (2015). The importance of play during hospitalization of children. Mater Sociomed, 27(6): 438-441. doi: 10.5455/msm.2015.27.438-441

Lester, S., and Russell, W., (2008). Play for a Change. National Children’s Bureau. Available online

Loades, M. E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., Shafran, R., ….and Crawley, E. Rapid Systematic Review: The impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. JAACAP Available online

Maughan, B., and Collishaw, S., (2015). Development and psychopathology: A life course perspective. In A. Thapar, D.S. Pine, J.F. Leckman, S. Scott, M.J. Snowling, & E.A. Taylor (Eds.), Rutter’s child and adolescent psychiatry (pp. 5–16). Chichester, UK: John Wiley & Sons.

McLeod, J.D., and Kaiser. K., (2004). Childhood Emotional and Behavioral Problems and Educational Attainment. American Sociological Review, 69 (5): 636-658. doi:10.1177/000312240406900502

Office for National Statistics, (2018). Loneliness in children and young people [Dataset].

Potasz, C., De Varela, M. J. V., De Carvalho, L. C., Fernandes Do Prado, L. F. and Fernandes Do Prado, G. (2013). Effect of play activities on hospitalized children’s stress: a randomized clinical trial. Scandinavian Journal of Occupational Therapy, 20: 71-79. doi: 10.3109/11038128.2012.729087

Royal College of Paediatrics and Child Health, (2017). State of Child Health. Report 2017. RCPCH, London. Available online

Tremblay, M. S., Gray, C., Babcock, S., Barnes, J., Bradstreet, C. C., Carr, D., … and Brussoni, M., (2015). Position statement on active outdoor play. International J Environ Res Public Health, 12(6): 6475-6505. doi: 10.3390/ijerph120606475

UNICEF, (2020). Don’t let children be the hidden victims of COVID-19 pandemic. Available online

Waite, P., Patalay, P., Moltrecht, B., McElroy, E., and Creswell, C. (2020). Report 02: Covid-19 worries, parent/carer stress and support needs, by child special educational needs and parent/carer work status Results from the first 5000 participants. Available online

Discussion

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An excellent article. Thank you. This is so very important.

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Thankyou for this article – I agree whole-heartedly with your argument for putting play at the top of the return to school agenda and actions. It is essential for children’s emotional well-being.

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Very interesting article – I note you comment on education staff and parents being worried about distancing and infection – the children themselves are paranoid about it (both of my children have been very stressed in partic my younger child has been very troubled ranging from worry and not sleeping through to hysteria about death and us, his parents dying). Are there any strategies for dealing with that and any fake news children have absorbed? Even if we are very careful at home with the news, they still hear and are aware. This means that they don’t want to play and physically back off.

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