SEASON 2:
EPISODE 3The Power of Play

As Canada continues to deal with effects of Covid-19, concerns over the critical importance of the early years and the impacts on kids are growing. In this episode you’ll hear from researchers specializing in children’s mental health and development, each who will share unique insights on the status of children and family’s mental health throughout the pandemic. Specifically, you’ll learn about a growing area of research that is proving to be a critical support for children and youth during this difficult time: the power of play. 


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Mission: Healthy People & Health Care Systems

Dr. Alexa Bagnell 0:06

Research in Youth Mental Health is critical. Youth are 25% of our population, but they're 100% of our future. So we need to invest in them in all areas.

Dr. Michelle Stone 0:20

And without frequent quality play experiences, children's mental health, their social emotional health, their physical health, all of those developmental milestones are going to be compromised.

Rhys Waters 0:32

As Canada continues to deal with the effects of COVID-19, concerns over the critical importance of the early years, and the impacts on kids are growing. For children, the pandemic has presented a unique set of challenges to the development and mental health. Public health measures have interrupted children's ability to socialize during important developmental stages, causing worry over potential generational scarring for years to come. Welcome to Beyond Research, a podcast brought to you by Research Nova Scotia. In this episode, you'll hear from researchers specializing in children's mental health and development, each who will share unique insights on the status of Children and Families mental health throughout the pandemic. Specifically, you'll learn about a growing area of research that is proven to be a critical support for children and youth during this difficult time, the power of play.

Dr. Alexa Bagnell 1:38

Intervening for children and youth early and in terms of mental health is probably one of the most effective ways we can help with mental health in our population. Because you know, often mental illnesses or even mental health struggles happen in the early years, we know that three quarters of mental illnesses will start before someone's 24. So the earlier we can get to someone and help them, the better they're going to do and the less milestones they're going to miss.

Rhys Waters 2:13

This is Dr. Alexa Bagnell, Chief of Psychiatry at the IWK Health Center, a pediatric hospital in Halifax, Nova Scotia, and Professor of Psychiatry at Dalhousie University. In her role at the IWK Alexa has had a unique first hand view of the impacts COVID-19 has had on youth and children's mental health and well being.

Dr. Alexa Bagnell 2:38

Since the onset of the pandemic at the IWK, we've been monitoring our data pretty closely, because we didn't know what to expect to be truthful, when the pandemic had, I think all of us were a bit in shock even and we didn't see a huge increase in admissions at that time. In fact, if anything, there was a slight decrease, but not not dramatic. So we followed that through the course of this year and was staying relatively stable into the fall, which we didn't fully expect. We thought it might increase in the fall with back to school, but it was close to what the past five years have looked like in terms of back to school. And then in November, December, we started to see an increase in emergency department presentations and crisis calls. The demands on our outpatient appointment started to increase. And that really continued into the spring. You know, we also aren't fully sure of all the reasons for that. But I think all of us can understand pandemic fatigue, the stress and that it was going on longer than I think many of us had expected. And so people do well for a period of time and showed a lot of resilience. But for some it was getting longer and harder. And there was more stresses with school an uncertainty. So we saw an increase in that, that trend has continued.

Rhys Waters 3:51

It's important to note that in November 2020, Nova Scotia was entering its second wave of the virus, and its capital city and surrounding metropolitan area went into another lockdown. Though Alexa wasn't surprised when the increase in emergency department visits and crisis calls occurred at this time, there was something unexpected appeared in the data.

Dr. Alexa Bagnell 4:13

What's interesting is that our admissions have not changed. So if you compare people needing to come into hospital, which would be our children and adolescents who would be the most ill, that hasn't changed through this year compared to previous years. Why do we think that people were presenting more to the emergency department, more distress in the in the population? And why didn't the admissions rate increase in a corresponding way? And we really looked at the data and it seems that people are more in crisis, so more distress, but not actually an increase in mental illness. So more crisis presentations, and those kids and families need support. But they don't necessarily need hospitalization.

Rhys Waters 5:03

Alexa and her team cannot provide a definitive explanation for the spike in visits not translated in admissions, as they're still collecting and analyzing data. But they do have some pretty good theories.

Dr. Alexa Bagnell 5:15

You know, most kids, in a regular year we'll be going to school doing extracurricular activities, seeing their friends, having a pretty regular routine in their day, not as much time to think about other things, because they have a lot of things they have to think about in school, outside of school, getting to and from school. And so their routine is pretty stable, and they have things that they use to cope. And so, in terms of managing stress and things they have their ready made tools, and everyone finds their own in terms of how to cope with the different stresses in their life. With the pandemic, a lot of those coping mechanisms were gone, from public health reasons due to the virus, and that left people with some, you know, some increased stress and maybe anxiety and other things where they didn't feel that they could cope as well.

Rhys Waters 6:07

According to Alexa, this understanding that kids were struggling to cope with the dramatic changes in their routine was an integral reason behind the provinces push to keep kids in school as much as possible.

Dr. Alexa Bagnell 6:19

So during the pandemic, we knew that the best place for kids to be would be in school in terms of their mental health. But we're always balancing that with the public health recommendations of where in the pandemic we are, what's the risk for kids and their families and kids coming back in terms of the virus. And as soon as we were able to, in our province, I think we really worked towards having kids back in school. And there's a lot of reasons why that's so important for their mental health.

Rhys Waters 6:48

As someone with school aged kids, when I think about their education in school, I immediately start to think about the stuff they're learning from their actual teacher, the kind of books they're reading, the tests they're taking, but of course, there is so much more to it than just that, as an actual point out school offers an environment for many learning opportunities that go well beyond the teachers lesson plan.

Dr. Alexa Bagnell 7:09

So social is sometimes challenging for some kids, but it's important. So there's the positives of being around your friends, but there's also the social emotional development that happens by being around your peers and navigating that and having those experiences on a day to day basis. And that is really important for our neurodevelopment, our mental health. And the loss of that over time is really hard on kids and some kids like they lose skills. So some kids that kind of comes naturally and they stop it and then they come back and it's not a big deal. But for some, it's you know, the social part is challenging, and they can lose skills, being out of that environment. And then that makes them feel more isolated, and it can negatively impact their mental health, so we knew that part was really important too. And, you know, social also creates really positive neurochemical release in our brain, not to get into the neuro chemicals, but it really is a mood enhancer. And so we also know that those activities, being around friends, being in the school, are all sort of boosters to our mood. Whereas sitting in a rooms in front of a screen all day with no contact or just family checking in on you is not the same and you don't get the same boost to your mood.

Rhys Waters 8:22

Though critical for the healthy development of all children and youth, Alexa notes that the social and physical support provided by school and extracurricular settings plays an especially important role in supporting kids who are considered at risk or in more vulnerable circumstances.

Dr. Alexa Bagnell 8:40

The pandemic has not impacted everyone equally. And in many ways, it's actually shown much more the disparities in our province in terms of access, support, financial racial, it really has, I think, annunciated that is not an even playing field. And so we see kids who have different needs that might not be able to be addressed at home, because they need some specific supports like within the school and then not being able to access those in the same way. Although I think schools did try very hard, they were very limited by what they were able to provide during the pandemic in terms of in-person services. So getting back to school was huge for those kids, especially kids who have developmental needs that really at home for a busy family or a single parent are pretty hard to put in place. And also, you know, parents were trying often to work, to teach, to look after kids and that is, you know, one of those jobs is huge, trying to put all those together with your own stress and then possibly financial stress. It made it made it really challenging for some families. And then we have this idea that everyone has some sort of quiet space in their house. Well, that isn't the reality for many families and kids. So if they're all sharing the same space and then trying to do all things together, and then the stress level in in a house can be really difficult. And then we also assume that homes are always the safe place. And sometimes school is a safe place for kids. So there are a lot of factors that I think we knew about before the pandemic, but really came to the forefront during the pandemic as an unequal playing field for for kids,

Rhys Waters 10:34

Gen C's reduction in access to supports and the obvious unequal playing field described by Alexa has been noted by organizations around the world. UNICEF has reported that every key measure of childhood progress has gone backwards, with reported increases in the number of children who were isolated, anxious, and living in poverty, and a notable decrease in children's access to learning environments, socialization, essential services, health, nutrition and protection. As we move forward in our collective recovery, continued research in the area of early childhood development will be imperative.

Dr. Alexa Bagnell 11:11

Research in Youth Mental Health is critical. I can stop right there, post pandemic is going to be even more important in terms of really understanding what's been going on but and I do have to quote Jennifer Gillivan, who's the CEO of the IWK Foundation, because she said this, and I'm sure other people have said it, but she said it so well. And she said, you know, youth are 25% of our population, but they're 100% of our future. So we need to invest in them in all areas.

Rhys Waters 11:45

Though there is no singular solution to the problem. Research in a specific area of early childhood development is showing promise in its ability to support children and youth through this difficult time. It's an area that our education system and communities can invest in, and families can incorporate into their routines with little or no cost, play.

Dr. Michelle Stone 12:07

When we look at the literature, too... There's a lot of literature talking about how play is essential to children's health and development. So while some people will recognize that play could be frivolous or not as important as other aspects. In terms of the early years, it's actually probably the most central important thing that children really need to develop optimally. And it's been described as kind of the business of childhood too. So children need play to kind of figure out how to make sense of the world and to understand themselves and, you know, to learn how to work with others, and negotiate and plan and problem solve and challenge themselves and all of those things are going to be critical to their ability to develop optimally.

Rhys Waters 12:48

This is Dr. Michelle Stone, an associate professor of Kinesiology at Dalhousie University, Her research focuses on enhancing children's opportunities for physical activity, physical literacy, and active play.

Dr. Michelle Stone 13:02

So physical literacy is it can be a term that can be kind of a mouthful and hard for people to understand. But there's, there's different components of it. So, you know, one has to do with a child's physical competence. So their fundamental movement skills like their, you know, walking and running and hopping and balancing and throwing and jumping and all the different ways that they can move their own body. So that's the physical competence side of it. And then we have the confidence side of it too. So a child's confidence in their own abilities, and their motivation to engage in different activities in a variety of different environments. The last domain is kind of their knowledge and understanding of the value of physical activity for a healthy lifestyle. So you know, if you think about outdoor play, if you give children opportunities to play in a way that they self direct their play, they're going to move their bodies in different ways. So it gives them a chance to develop those movement skills and the fiscal competence side of things. They start to gain confidence because their skills are improving, and they're succeeding in situations and because of their confidence and self efficacy, they can be more motivated to kind of play and move outdoors in a variety of environments. And then over time, they start to understand the benefits like that knowledge and understanding of the value of activity. So all of that really kind of encompasses physical literacy. And it's not something that just happens at one point, like it's all it's it's continuous throughout the lifespan.

Rhys Waters 14:58

According to Michelle a child's ability To develop physical literacy is very much linked to their mental health, especially during the early years of development.

Dr. Michelle Stone 15:08

You know, when kids are allowed opportunities to play in the early years, you know, they, they are able to have opportunities to be creative, and problem solve and invent and create an experiment and challenge themselves and learn from failure and be resilient and all those things, right. And so I think, when you have those opportunities, you are able, as I said, to learn a little bit more about yourself, learn how to work with others, you develop empathy, and learn how to self regulate, control your emotions, those are all things that are going to help support a child's mental health. And so if we continue those experiences throughout the early years, then you're going to you're develop, you're developing those milestones, or developing the capacity to kind of deal with stressful situations or deal with challenges or know how to recover from failure, right, or know how to solve problems and, you know, negotiate or work with others, all those are going to help support better mental health outcomes.

Rhys Waters 16:16

Even before the pandemic, there was a term coined in Michelle's line of work that was becoming top of mind. But it's even more of a concern now, play deprivation, referring to the decline in rates of play and physical activity among kids.

Dr. Michelle Stone 16:31

And I think what we're seeing now is really the negative effects of play deprivation over time, with outdoor play advocates like myself, trying to get this, you know, awareness of play back into our community. So that heightened understanding of just why it's so important and how we need to kind of change our systems and settings to really reintegrate play back into children's lives and give it the attention and the significance that it deserves. I mean, I think there's been concerns for a long, long time now. The decline in playing over the last couple of generations has led to an increase or is aligned with an increase in mental health issues like anxiety, depression, lack of resilience, and so on, in which children are played deprived, and they don't have the opportunity to gain these skills, then we see children not being sure of themselves doubting themselves, and so they could be anxious, or it could lead to depression, or, you know, they're not having opportunities to kind of figure things out on their own and direct their own experiences. And so they don't have that self confidence. And they're not able to learn how to deal with failure. And so you know, that that resilience, that ability to bounce back suffers. So that's what I found to be most really fascinating and interesting was reading like these connections between play deprivation over time, and just the whole host of, you know, challenges that we're seeing and in ongoing generations, particularly around mental health now,

Rhys Waters 18:17

For experts, concerns over low levels of physical activity and play experienced by children have only become heightened since the onslaught of the pandemic, sparking multiple studies, analyzing the impact of lockdown on kids and their physical activity. One such study was led by Michelle's colleague, Dr. Sarah Moore, of Dalhousie University.

Dr. Michelle Stone 18:38

ParticipACTION, funded some research where parents across the country were asked to fill out various questionnaires that got it the 24 hour movement guidelines. And so, you know, Sarah and her colleagues asked parents on, you know, were children meeting the activity recommendations, for example? And there's different recommendations based on different ages? How much time are they spending outdoors, what factors actually facilitated outdoor time are presented barriers to outdoor time and so she did find that even though we were pretty dire in terms of the amount of children meeting 24 hour movement guidelines before the pandemic, it had declined. And she sends down a follow up paper to explore what's happened six months later. And the levels are pretty much stable, I believe. So they're still down from what they were pre pandemic. So it's showing us that, you know, as a result of the pandemic and all the pressures and the restrictions, particularly in the beginning that we saw on outdoor play spaces with playgrounds being shut down and just, you know, not having opportunities for families are having opportunities to allow their children to access safe play spaces. That would have obviously impacted their movement behaviors.

Rhys Waters 19:55

As part her work to address play deprivation and get kids active, pre and post pandemic, Michelle has been investigating more accessible methods of integrating play into children's lives. One commonly known as loose parts play, and is exactly what it sounds like children playing with random parts of whatever they can get their hands on.

Dr. Michelle Stone 20:16

We had heard a little bit about how these parts these kind of, you know, materials with no fixed purpose could support aspects of fiscal literacy development. But there was really no research on the topic. So we didn't no one really, very few people understand the term loose parts, but we said well, it's the way we always used to play. Like, we just gather up stuff in our neighborhood and put it together and play with it in creative ways. And so when we show them examples, they're like, okay, yeah, we have tires, we have rope or buckets or whatever, we can donate those. And they just immediately got it because they would, you know, really such valuable experiences that they had out in the outdoors independent, playing with materials, they found in nature, just things that were scattered around and and it's it's inclusive, right, and so that's another thing you know, it's it's very accessible, it's inclusive, at least part can be anything that you imagine it to be, right. So anything that doesn't have a fixed purpose, and it can be natural materials, or it can be manufactured materials. And so the main thing is just trying to get a diversity of materials into a space.

Rhys Waters 21:24

Before the pandemic, Michelle and her team led a community event in Halifax as part of her summer of play project, a knowledge sharing strategy aimed at increasing awareness of the benefits of outdoor loose parts play to children's physical literacy and overall health. Involvement and reception from the community, including local businesses was overwhelmingly positive.

Dr. Michelle Stone 21:46

So we had a lot of local businesses donate a lot of materials for that day. And so we had cardboard boxes, we had tire rope, twine, duct tape, scissors, buckets, balls, wooden planks, and wooden pallets, milk crates, tree cookies, bike tires, and tubes, hula hoops, frisbees, kitchen items, you name it, like anything that you could think of under the sun was there. And these kids created these incredible forts and just use their imagination in so many ways. And we really did see the value of the loose parts play to children's fiscal literacy, which was kind of our central kind of goal, you know, with this project. So, yeah, pretty incredible events.

Rhys Waters 22:30

Michelle has since been focused on integrating loose parts play into other community settings, such as the home childcare centers, before and after school settings, and hopefully, eventually schools post pandemic. So far, her research is added to a growing body of evidence stated that child directed play has benefits for children's development in key areas, such as numeracy and spatial recognition, fine motor skills, language and word knowledge, cognitive skills and memory, and social and emotional learning.

Dr. Michelle Stone 23:03

So we've seen amazing examples from our play project where the children have been brought out of their shell, maybe they were those quiet children who found it hard to kind of play with others, they didn't feel like they were invited into the play. And through these parts, they were able to work with others and develop relationships. We even heard examples, and this was really cool finding was that it supported language development in children who were English wasn't their first language. And so parents were actually saying, as a result of the loose parts play, my child's coming home and their English has improved. Because, again, they're being brought into play with other children, and they're having to learn how to communicate, you know, to contribute to that play experience. So it's just it's fascinating when you see it, and you hear what can actually come out of loose parts play and, you know, we were able to see that, from the educators perspective, when we asked some questions around, did outdoor loose parts play, facilitate aspects of fiscal literacy or other health and development they talked about? Yes, it helped children learn movement skills, or they develop confidence or competence are more motivated to play or so we see we saw from this qualitative data that there was a real value tied our loose parts play in supporting movement skills and other aspects of fiscal literacy, and then just health in general. So we've got some really strong data out of that project. We've got you know, some lessons learned on what went well with the project and what didn't, that we're trying to take. You know, keep mindful of and integrate into our our new project. But I suspect that we are going to see, you know, similar benefits in school aged children in youth.

Rhys Waters 24:54

Support and children's mental health and well being as we collectively recover from the COVID-19 pandemic will be a complex journey, requiring the participation of families, our school system, healthcare system, policymakers and entire communities. We need experts like Dr. Alexa Bagnall and Dr. Michelle Stone, who have dedicated their time and energy to not only the research, but the ways in which the results can be integrated into an impact society so we can make better decisions tomorrow. Looking ahead, though, there is cause for concern for kids, both doctors are optimistic about the resilience of the younger generations.

Dr. Michelle Stone 25:36

And I do think kids are pretty resilient, and they will find ways to play how they want to play in the environment that they're in. And they tend to bounce back pretty quickly, I think, not to say we shouldn't be mindful of their mental health and how it's been compromised. But I've seen a lot of real resilience from kids and their ability to kind of process the pandemic and adhere to restrictions and rules and just kind of go with it.

Dr. Alexa Bagnell 26:08

So one of the things I've been most impressed by, in the pandemic is, you know, our populations resiliency, but particularly our, our kids. So children and teens that we work with, and their ability to rise to some challenges, some difficulties, problem, solve, get supports, you know, I am in awe sometimes, and it's pretty inspiring. And I think our kids coming from this will not only be more grateful and have gratitude about some of the things that maybe we took a bit for granted before, but they're also going to be more resilient. Because this was a big challenge that faced our whole world, that they will not be the kid who's not going to remember it, there won't be an adult that will remember it either. And it changes us and it also gives us confidence, like, well, wasn't, wasn't as bad as the pandemic or nothing could be as bad you know, some of that kind of talk but also just knowing and confident that you face something pretty big before. So this one, maybe it looks a little smaller in comparison to maybe some of the other challenges you've had to face in the last year. So those kind of resiliency things you know, knowing you've got the skills and coping tools it's not that you don't have adversity it's that you know, or have confidence that you can actually cope with it. That's the stuff that we want to build in kids and I you know, would I wish this on anyone would ever want to go through this again, no, but there will be some good things that come from it in terms of our own inner abilities to cope with stuff like that adversity when it hits us.

Rhys Waters 27:50

Thank you for listening to Beyond Research brought to you by Research Nova Scotia. For more information, visit researchns.ca. My name is Rhys Waters, and we'll see you next time.

Transcribed by https://otter.ai

Featured Guests:

Dr. Alexa Bagnell is the Chief of Psychiatry at the IWK Health Centre, a pediatric hospital in Halifax, Nova Scotia, and a Professor of Psychiatry at Dalhousie University.

Dr. Michelle Stone is an Assistant Professor of Kinesiology in the School of Health and Human Performance at Dalhousie University, and lead researcher for Play Outside Nova Scotia.