Picture of Sarah Currie

Sarah Currie is a medical copy editor on CMAJ

The opposite of play is not work. It’s depression. — Brian Sutton-Smith

A little nonsense now and then is cherished by the wisest men.― Roald Dahl, Charlie & the Great Glass Elevator

Recess Rules

What happens when we play? What changes do we notice in our bodies? When we play a game with others, how do we experience those players? What physical or physiological responses to the actions or emotions involved do we notice? What is play? According to Jill  Vialet, author of the book ‘Recess Rules‘, play is like pornography: you know it when you see it. The dictionary definition includes words like “aimless” and “frivolous.” Bernard Suits described playing a game as a voluntary attempt to overcome unnecessary obstacles. But we shouldn’t be so dismissive of play and its benefits and rewards.

People who play are more trusting; they are better self-regulators and can resolve conflict more effectively. Groups who play together have healthier interactions. In schools involved in a randomized controlled trial in which play was thoughtfully and mindfully introduced in day-to-day activity, children felt safer (not just on the playground), teachers recovered instructional time, kids were more cooperative and, even though bullying wasn’t specifically targeted by the intervention, teachers rated bullying as being 43% lower than in the schools where play was not prioritized. Play gives us the skills to become engaged citizens.

Despite all of these positive qualities, society remains ambivalent to the necessity of play. Play should not be so easy to dismiss. Play matters. Play reminds us that people matter. It allows us to see one another and to truly be seen.

Life, Liberty and the Pursuit of Independence

When do we achieve independence? With our first job? During our first solo-flight in the family car? On our first day of kindergarten?

Cole Galloway believes that independence starts with our first movements that impact the world around us. With the baby who realizes that if she knocks her sippy cup off the table, daddy will reach down and pick it up — every time. Independence is born in that first attempt at play. So how do we foster independence in children with special needs that limit their mobility, children who need assistance to play? And how do we democratize mobility to ensure that it remains an attainable human right when pediatric power chairs can cost upwards of USD25 000?

Galloway’s team at the University of Delaware provides affordable assistive and rehabilitative technology to children with limited mobility using inspiration from the local toy store. By adapting motorized ride-on toys that retail for about a hundred dollars, Go Baby Go! gives children with special needs the opportunity to benefit from the play so many of us take for granted. Their perspective of the world literally changes when they are able to navigate it on their own.

Adult play

While it’s hard to argue against the value of child’s play, adults can be more reticent when it comes to letting their hair down. However, Carla Pugh, Surgeon and Haptic educator, and Kayt Sukel, Science writer, see a place for play in a grown-up world.

As a child, Pugh’s play largely involved exploring how things were made and how she could fix them. It seemed the natural evolution of such an interest would be a career in surgery. However, early on, Pugh could see a disconnect between the way she was taught and assessed, mainly through pen and paper tests like board certification exams, and what she actually had to do in the operating room. In a profession that relies so much on haptics, the art and science of touch, why was her education based more on reading about what to do with her hands than on practising how to use them effectively? Inspired by the instant replays and years’ worth of data and metrics available to athletes trying to master their craft, Pugh developed simulation technology for medical and surgical education. Her training tools use sensors to measure and characterize the sense of touch and provide instant feedback to trainees and teachers.

Pugh’s devices allow surgeons to take risks during play — to make mistakes — for which their patients won’t pay the price. Kayt Sukel argues that it isn’t just doctors and patients who benefit from doing so. She proposes that risks no longer be categorized as “stupid” or “ill-advised.” Rather, she encourages us all to be risk-takers, defining risk simply as a decision with an uncertain outcome. And what in this life is certain, death and taxes aside?

The Free-Range Kids movement encourages risk-taking in children as learning opportunities, and Sukel states that there is science to back up their philosophy. The mesocortical limbic circuitry, which connects our reptilian “I want what I want, and I want it right now!” brain with our more rational “Now, let’s just think about this for a second” prefrontal cortex, is a dopaminergic pathway involved in assessing risk. When we take a risk that results in our receiving an unexpected reward, we get a jolt of dopamine that helps us remember our choice the next time we’re faced with a similar decision. And the lifelong plasticity of the brain means that old dogs can, in fact, learn new tricks — adults can benefit from risk, too.

So make time for play in your day. Tag! You’re it!