Play-It’s more important than you think!

As pediatricians, we frequently receive updates regarding topics of interest that the Academy of Pediatrics finds important for us to be aware of. Recently, a new clinical report from the American Academy of Pediatrics caught my attention. They are recommending that doctors write a “PRESCRIPTION FOR PLAY!”.

Yes, a prescription to play. It sounds so simple. Yet, from 1981 to 1997, children’s playtime decreased by 25 %. Children ages 3 to 11 have lost 12Β  hours per week of free time due to academic pressures and organized after-school activities. The pressures felt from parents to keep up with the daily-changing electronic games and digital devices is real. Kids whose parents cannot afford the expensive digital toys may feel left out and kids whose parents CAN afford them, think that allowing their kids unlimited access to these objects is healthy and promotes learning. New games and apps come in the guise of claiming to help your child learn his or her ABC’s, math skills and or other didactic academic skills. Yet, studies show that the truth is actually that the opposite of this is true. Children’s creativity and play is actually improved with inexpensive objects that are found in any household…boxes, spoons, balls, puzzles, crayons, boxes, pots and pans, etc.

The importance of play, it seems, has been lost. Sometimes play is viewed as frivolous or a waste of time. Parents are spending a small fortune and endless hours in a child’s life in organized sports and/or activities. The competition in the academic world is real. Parent’s want their children to be the best and this sometimes comes with the loss of free play. Yet the studies show that play actually leads to changes in the brain in the molecular, cellular and behavioral levels. It is believed that play can have lasting changes in the brain that help to improve execute functioning and help in processing social interaction. Executive functioning is the process of learning rather that the actual content.Β  It has been shown to help children with improved self-regulation and self-control, better problem solving skills, filtering of distracting details, and mental flexibility.Β In fact, countries that offer more free play see greater academic success among children as they mature.Β  It has even been shown that children have lower levels of cortisol (which indicate lower stress levels) when involved in active play. This is especially important for children dealing with significant toxic stress and adversity in their daily lives, but is also important for decreasing anxiety as well. In fact, countries that offer more free play see greater academic success among children as they mature.

So what can we do? What can we as parents do to help change this? The recommendations are clear. Encourage free play in your day to day life with your children. You do not necessarily need extra time to play. Incorporate play in your day to day life. Engage your children in helping at home with chores, which can in turn result in role playing or fun games. Let your child lead with their creativity. If your child gets a new toy resist the temptation to show them how to use it. Let them try to figure it our for themselves. They may actually teach you something you had not even thought about! Make free play a priority instead of viewing it as a waste of time. Relax and enjoy in watching your child run around yelling “I am a pirate” or “let’s play school”…Free play, without constant supervision, helps children come together. It often brings children from diverse backgrounds together as the make up rules to a game, role-play and learn empathy. Through play,Β  children learn what its like to lose andΒ  they are encouraged to come up with strategies to improve their outcomes in up-coming challenges. These interaction help to evolve independent thinking and creativity. Some of my happiest moments as a mom, was watching my kids build a fort and create their own stories and/or games. It makes me smile just to think about it.

It is up to us as parents to bring free play back into the lives of our children. Our world is changing and our children need the skills necessary to compete in the 21st Century world. We need them to be creative, innovative and problem-solvers. These are the very skills that free-play encourages through the development of executive functioning.

Stop and look around you. Take a long hard look at your child’s life and what his/her daily activities involve. Perhaps you have been feeling over scheduled and stressed with parenting and “keeping up with the jonses”. Play with your kids. Act silly sometimes and laugh. Enjoy games you played as a child and help your child discover their interpretation of the world around them, free fromΒ  your interpretation. The truth is that free play will not only help your child but you as well.


Below are age-specific recommendations :

  1. 2-3 months-Β  Respond to your infants emergence of a social smile by smiling in response. It helps an infant learn the effects of their behaviors. (making a parent smile when they smile).
  2. 4-6 months- Encourage games of peek-a-boo, laughing, and encourage your infant to discover new objects on their own. Instead of teaching an infant how to use a toy, watch them discover it!
  3. 9 months- At nine months is when babies begin to develop separation anxiety and stranger anxiety. It is a time when infants begin to learn self-regulation as they begin to use their parents for social refrencing. Your baby is looking at you for guidance. Make sure your facial expressions are encouraging instead of fearful as your baby begins exploring the world.
  4. 12 months- At this age, infants really begin to lay the foundation of the development of social skills/interactions. They love the feeling of accomplishment and true joy as they take their first steps or say a new word. Encourage your child taking those baby steps in self-discovery. Again, remember that your facial expression is what your baby is looking for.
  5. 2 year olds- Everyone talks about the “terrible twos”. I believe that the reason this is a belief is that this is a difficult time for a toddler. It is a time of emerging independence and they undertand usually a lot more than they are able to communicate. This leads to frustration and tantrums. Try to provide your child with some independence while staying close by providing words of encouragement when they fail or fall. Resist the temptation to scoop them up when they fall. Watch to see what they do and how they begin to problem solve.
  6. 3 year olds- By 3 years of age, most children have begun to communicate more effectively and can understandΒ  cause and effect. This is when it is critically important to model behavior for your child. Help your child deal with emotionally challenging situations. Guide and lead but do not be so quick to offer solutions. Let them come up with their own ways and help them learn why some solutions may be better than others. Encourage drawing, coloring and creating. Sit back and discuss how wonderful that their elephant is purple and flies, just because… Encourage creativity and take them to the park, beach or outside with no agenda.
  7. 4-6 year olds-Β By 4-6 years of age, most children have started some form of formal teaching in an academic setting. If possible, try to select programs that prioritize free play and recess in these early years. If your income is limiting take the time when possible to find local parks or community centers where your child can simply just play…
  8. 7-9 year olds- By 7-9 years of age, many parents are focusing their child’s talents on one sport or another form of specific after-school activity. Many children this age spend sometimes 10-12 hours a week practicing and developing a skill. The pressures to be the best are beginning to become real and many parents with lower means begin to feel that their children are not able to keep up with their more “economically-advantaged” peers. The increase in the use of electronic devices increases significantly in this age group. Yet, studies show that active play for 1 hour per day, allowed kids in this age group to think more creatively and multi-task. These kids were also found to improved social-emotional skills that later are found to correlate with improved academic and economic success. Third grade prosocial behaviors correlated with eighth grade reading and math better than with third grade math and reading levels. So, set up play dates at the park. Set up no-electronic times in your child’s schedule and let them be “bored”. Boredom sparks creativity and taps into their imagination. Do not over-schedule them.
  9. 10 and beyond-Β  After the age of 10, most kids are playing electronic games and or watching more TV and videos than interacting in free play. Make a point to go outside (with no electronics) whenever possible. Find activities in your community that encourage free play. Play decreases stress, fatigue, injury and depression. In fact, adult success in later life can be related to the experience of childhood play that cultivated creativity, problem solving, teamwork, flexibility and innovations.
  10. Parents- Β The benefits of play for parents are too many toΒ  list. If your child asks you to play, do it. Enjoy the joy in your child’s face when he/she discovers the world. Go back to childhood, when life was simple, days were long and troubles were few. Create a bond with your child that will only strenghten with time, and have fun doing it!

Elizabeth Vainder, M.D., F.A.A.P





The Road to Independence and Self-Confidence

May 29, 2018

Did you know that according the the National Institute of Mental Health in 2016, 2.2 million adolescents aged 12-17 suffered from a major depressive episode with severe impairment? (Severe impairment is defined by DSM IV criteria as at least 2 weeks of symptoms reflecting change of functioning such as sleep, eating, energy, concentration, self-image, increased thoughts of death and suicide) This is 9% of the U.S. population ages 12-17 (Almost 1:10 teens)! Among adolescents aged 13-18, 31.9% were found to have some sort of anxiety disorder. This is heart-breaking and very worrisome. This study was done 2 years ago, and I imagine with the recent school shootings and all other political and global conflicts that these numbers are significantly higher today.

These numbers are frightening to say the least. So, what as parents can we do? Stress management and coping skills begin in infancy. A baby cries, a parent responds. A toddler falls, the parent responds. A child is made fun of in school, the parent responds. A teen fails a test in school, the parent responds. It is how we respond that can determine how well our children will fare.

One of the most difficult parts of parenting is the balance between providing our children with support and encouragement while at the same time “helping” them when they fail. It seems the knee-jerk reaction is to put your super cape on and help make things right in your child’s world. I mean, you are a super parent right? Well, not so fast. These “saving” mechanisms can actally do more harm than good and can result in feelings of low self esteem, anxiety and possibly depression down the road. Remember the ultimate goal as a parent is to help a child develop into an independent, self-sufficient, well-rounded, and happy adult (no pressure)!

I believe there are at least three components to dealing with stress in all stages of a child’s life that are imperative. 1. Listening to your child (regardless of age-this includes verbal and non-verbal communication) 2. Validation of their feelings and concerns 3. Strategies to help your child effectively resolve the stress/problem on their own.

Stress of course is very different for a 2 year old that didn’t get the toy he wanted and the 15 year old that is failing in school. However, when a child is going through the stress it can feel debilitating and overwhelming regardless of age. Each age brings with it an opportunity as a parent to use these three techniques when helping deal with stress. It is extremely important not to dismiss what can seem trivial in a small child. The parent-child trust and relationship begins early on.

Take the time to listen to your small child, validate their feelings and concerns and guide them in finding constructive ways to deal with the “problem”. If he/she decides that a temper tantrum is the most effective way, then let them have their tantrum. Do not try to reason with a two year old having a tantrum. It is the equivalent of an adult that has just “lost it”. Once the tantrum is over, this is your opportunity to approach your child, perhaps give them a hug and give them the opportunity to express themselves when they have calmed down. This is sending a message to your child that it’s okay to feel upset or disappointed, you will be there to provide unconditional love, and that the tantrum really didn’t solve anything. Then, together with your child explore helpful ways to resolve the problem or disappointment. Pay attention also to the ways that you respond to conflict or problems in your life. Are you having adult tantrums? Do you sometimes just “lose it”? Your child is watching.

In adolescence, the problems are different of course but using these three techniques can at least help get your started with helping your child navigate this new world that brings with it so much change and uncertainty. It is a period of insecurity and doubt. Even the “coolest” of kids worry about what others will think of them or what they look like (sometimes even more!). That is the irony of it all. Most adolescents worry about very similar things but communicate very little. So, when your child is faced with a problem in school or socially, stop and remember these three skills. Take the time to listen to your teen ( I mean really listen-without judgement and without thinking about what you are going to say next), validate their feelings (yes, sometimes it just “sucks” and sometimes it’s not fair) and finally help them come up with ways that they can make the situation better. If they are too upset to think, encourage them to “take a day” to relax and re-visit their emotions. We all know that when we calm down we can think more clearly and react more productively that when we simply just react to a situation.

The key is to find productive ways of dealing with stress that work for your child. Encourage them to exercise, meditate, go for a walk, read, run, journal…there are many options. Just resist the temptation to jump in and make the situation “right” for your child. Don’t speak for them but instead help them find their voice. Don’t fight their battles, but give them the confidence to defend themselves. In the end they will be adults; strong, independent adults willing to stand up for themselves.

Elizabeth Vainder, M.D., F.A.A.P


May 8, 2018

I think my tendency to worry grew 100 fold when I became a parent. There are so many decisions to make as a parent and the internet provides an endless display of options from diapers, lotions, soaps, clothes, schools, shoes, etc….You understand what I mean. It is exhausting and time consuming. It literally will eat up hours in your day as you try to peruse the many options. I believe this is why so many parents join online groups…to find out what other people try so they can narrow down their choices…In the end I have learned several lessons with respect to worry.

Worry doesn’t make anything happen. Worry is exhausting…it disrupts my sleep. Worry does not make problems disappear and it is the synonym of inaction. I do believe however that worry can serve a great purpose if you reflect on the cause of the worry.

It is important to write down your thoughts on why you have a particular worry and get to the core of your concerns. Do not get caught up on thought loops taking you no where. Clear your mind and try to focus on what you want as your end result and write a plan on how to get there. When a thought enters your mind reminding you to worry, acknowledge it as a thought and move on. Do not dwell on those thoughts/worries.

It’s funny because when you write down a plan and take action (ie read, visit schools, ask other parents, etc…) suddenly the worry tends to become smaller. I encourage you to write a plan with detailed steps and check each one off along the way. Remember that finding out that you do not want something is just as helpful as finding what you truly want.

In the end, so much time is wasted on worrying about insignificant things. Many of which you will not remember even thinking about when your reflect on your journey through parenthood. Try to keep your life simple. Choose 2-3 options after doing some research and move forward. Free your mind from worry and enjoy truly living.

Elizabeth Vainder, M.D.. F.A.A.P

The Why


The Why

March 6, 2018

I am a board certified pediatrician. I decided to write this blog not as your doctor but as your friend. I am also a mom, so I know where you are coming from. I have been in practice for 17 years and have learned so much from my children and my patients. This site is a casual site to share what I have learned. This is not intended for medical advice or consultations. I have just grown and learned so much in these last few years, that I wanted to share it with all of you. I am a mother, a wife, a daughter, a sister, a friend, etc. but I am also ME and I want to share with all of you the importance of not forgetting YOU. I hope you enjoy my posts. They are intended to remind you about important moments and topics that come up while parenting. Parenting is a beautiful but sometimes frustrating and frightening journey. I want to remind you that you are not alone. Many patients come in with the same concerns and worries regardless of ethnicity, culture or background. I have found this so interesting. If we really stop to listen to each other we will realize we are more similar than we think. I hope you enjoy my blog. Join me every Tuesday for a new topic!

-Elizabeth Vainder, M.D., F.A.A.P