Dr. Kenneth Ginsburg, a paediatrician at Children's Hospital of Philadelphia, wrote the American Academy of Pediatrics clinical report arguing that play is essential to healthy brain development, and that modern family life is quietly squeezing it out. This article looks at what his prescription means for the under-5 in your house.
Kenneth Ginsburg is a paediatrician at Children's Hospital of Philadelphia and the author of the American Academy of Pediatrics clinical report on play: the document in which one of the world's most influential medical bodies set out, formally and for its own members, why play matters to a child's development and what doctors should do about its disappearance.
That authorship is the reason he belongs in this library. Plenty of voices argue for play; most of them are speaking to parents. Ginsburg was writing for physicians, in a peer-reviewed clinical report carried in Pediatrics, the AAP's own journal. A clinical report is not an opinion column. It is guidance intended to shape what paediatricians say in the consulting room, alongside their advice on sleep, feeding and immunisation. When play appears in that company, it has been moved from the category of nice-to-have into the category of health behaviour. That reframing, more than any single finding, is Ginsburg's contribution.
The report's central claim is direct: play is essential to healthy brain development. Not decorative, not a reward for finishing the important things, but one of the mechanisms through which the important things happen. Through play, children build the cognitive, physical, social and emotional capacities that everything later rests on. The report also makes a point that still surprises parents: play is recognised by the United Nations High Commission for Human Rights as a fundamental right of every child. A right, in the same breath as shelter and education. Rights are not granted to pastimes. They are granted to things a child cannot do without.
The second half of the argument is the warning, and it is the half that has aged most sharply. Writing in the 2007 Pediatrics report, Ginsburg described the forces squeezing play out of childhood: schedules packed with adult-organised activity, academic pressure reaching further and further down the age range, and passive entertainment filling whatever gaps remain. None of these forces is malicious. Each is usually driven by love, by parents trying to give a child every advantage. But their combined effect is that the unstructured hours in which a child invents, negotiates, builds and imagines are treated as empty space, and empty space in a modern family calendar gets filled.
The source
Ginsburg (2007), The Importance of Play in Promoting Healthy Child Development, Pediatrics · Read the original
The prescription follows from the diagnosis. If play is a health behaviour and the pressures eroding it are structural, then good intentions are not protection enough. Unstructured time has to be defended as deliberately as any other health behaviour: planned for, guarded, and treated as non-negotiable when the week gets busy. A family would not let a packed diary routinely cancel a toddler's sleep. Ginsburg's report asks why play should be any easier to cancel.
For the parent of a child under five, the practical reading starts with a reassurance. The report's villain is not any single activity. Swimming lessons are not the enemy; neither is a nursery phonics song nor a Saturday cartoon. The enemy is the pattern: a week in which every block of time is either scheduled, instructional or screened, leaving no hour in which the child is simply free to play. Under-5s are at a peculiar risk here, because their time is almost entirely arranged by adults. A nine year old can carve out free play in the cracks of the day. A three year old gets exactly the childhood the calendar allows.
So the work is not to add another enrichment. It is to subtract, or rather to protect. Choose a window in the day, the same way you chose a bedtime, and let nothing ordinary move it. In that window the child leads, the toys are open-ended, the adult is nearby but off duty as instructor, and there is no screen doing the imagining on the child's behalf.
Honesty about the evidence matters too. A clinical report of this kind synthesises a wide literature; it does not prove that one protected hour produces one measurable outcome, and no one can promise that a child with more free play will hit any particular milestone sooner. What the report supports is a direction of travel, backed by a major medical body: development is served by generous unstructured play, and harmed at the margin by its disappearance. That is grounds for confidence, not for a new anxiety. If anything, Ginsburg's framing should lift pressure off parents, because it says the developmental heavy lifting happens in the cheapest, simplest hour of the week.
Treat the family calendar as a health document. It already is one, if you read it that way: it records when the child sleeps, when meals happen, when the dentist is booked. Ginsburg's report effectively asks for one more entry. Write the play hour in. Not an activity, not a class, just a block that says nothing happens here, and defend it the way you defend bedtime: politely, firmly, against all comers.
Then watch what the protected hour actually looks like. Four o'clock, kitchen floor. The basket comes out and a two year old lifts a beech block and feels the cool weight of it settle into her palm. A tower goes up, wobbles, and comes down with a clatter that would worry no one who understood what was being learned. An older brother lines up dominoes on the tiles, that small ivory click as each one is placed, and the held breath before the run is tipped. Nobody is teaching. Nobody is performing. The hour has no output, and that is precisely its value. A well-made wooden toy earns its place in this hour because it has no script of its own: it waits for the child's idea, and it survives being part of a thousand of them.
When the weather allows, the protected hour walks outside, because the report's logic does not stop at the back door. A lawn with a set of garden games on it, the thud of a bean bag, the slow arc of a quoit, a skittle going over to a cheer, is unstructured time wearing its summer clothes: child-led, sociable, gloriously unproductive. Jaques London has been equipping this kind of hour since 1795, longer than paediatrics has existed as a speciality, and the company that invented croquet in 1851 has never needed a clinical report to believe that an afternoon of free play is one of the most serious things a child does. It is simply pleasant that the doctors now agree.
The original document is short, readable and freely worth your time: The Importance of Play in Promoting Healthy Child Development, published in Pediatrics in 2007. On this site, the wider case continues in why real play matters, the practical guidance in reducing screen time for toddlers, and the closely related argument in why boredom is good for children.
The report does not issue a daily dose, and be wary of anyone who does. The useful test is the shape of the week, not a stopwatch: does your child have generous, regular, protected stretches in which nothing is scheduled and no screen is running? For most under-5s the honest answer used to be yes by default. The point of treating play like bedtime is to make it yes by design instead.
No, and the report does not say so. Structured activities bring real benefits: skills, friendships, confidence. The concern is displacement, a timetable so full that organised activity crowds out free play entirely. A sensible reading for an under-5 is one or two chosen activities, held inside a week that still has more free play in it than scheduled enrichment. If the calendar fills, the play hour is the last thing to give, not the first.
Not in the sense the report means. Ginsburg names passive entertainment as one of the pressures squeezing play out, not one of play's forms. The defining features of developmental play are that the child drives it, invents within it and works at it. Watching is none of those things. That does not make an episode of television a crime; it makes it a different category, and the protected hour should be kept for the real thing.
It is an expected sign, and a temporary one. A child used to ready-made entertainment has to warm up the muscles that invent their own. The first protected hours may involve complaint. Hold steady, keep a few open-ended things within reach, blocks, dominoes, a bean bag and a target, and let the boredom do its work. The grumbling phase is usually short, and what follows it is the play the report was written to protect.
Britain's oldest toy maker. Every toy open-ended, wooden, and built for exactly the kind of play the research recommends.