World Health Organization’s Guidelines on Play and Sleep:
Froebel, Montessori and Piaget Would Concur
Link to the report summary → http://bit.ly/2V2C2JT
Download the entire report as a free PDF → https://apps.who.int/iris/handle/10665/311664
Last week the WHO (World Health Organization) released a set of guidelines for physical activity, sedentary behavior and sleep for children under 5 years-of-age.
Many saw this report as another condemnation of using screens with young children. Not so fast.
A closer reading of the document reveals that it is really an edict on the importance of active learning in the early years. Students of child development understand that this important message is hardly new. In fact, it is nicely grounded in child development theory. Here are the recommendations:
“Quality sedentary time spent in interactive non-screen-based activities with a caregiver, such as reading, storytelling, singing and puzzles, is very important for child development.
• Infants (less than 1 year) should not be restrained for more than 1 hour at a time (e.g., in prams/strollers, high chairs, or strapped on a caregiver’s back). Screen time is not recommended. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.
• Children 1–2 years of age should not be restrained for more than 1 hour at a time (e.g., in prams/strollers, high chairs, or strapped on a caregiver’s back) or sit for extended periods of time. For 1-year olds, sedentary screen time (such as watching TV or videos, playing computer games) is not recommended. For those aged 2 years, sedentary screen time should be no more than 1 hour; less is better. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.
• Children 3–4 years of age should not be restrained for more than 1 hour at a time (e.g., in prams/strollers) or sit for extended periods of time. Sedentary screen time should be no more than 1 hour; less is better. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.”
The WHO labeled these guidelines as “strong recommendations, with very low quality evidence.” That means there’s little or no research to back up these ideas. But they are not new. Child Psychologist Jean Piaget helped educators understand that children construct knowledge through active exploration of their world. He called these early stages of growth “concrete operations” for a reason. Maria Montessori understood the liberating power of freedom of movement, and discouraged the use of learning settings which minimized child control.
It’s obvious that children need to sit less and play more. But some of the guidelines could be better defined. What exactly is “play,” and should “screen time” be associated with being confined in a children’s straight jacket (aka a car seat)? It’s easy to say “let children move around” but not in a moving car during a cross country trip to see Grandma.
I like list the authors and advisors, who, not surprisingly are strong in medical training. I also like the research focus which considers the credible research evidence behind these recommendations. Every one of the recommendations is labeled as a “strong recommendations with very low quality evidence.” My guess as a researcher is that the foundation pillars of the recommendations are too shaky. “Screen time” is a fuzzy variable full of confounds — and the human child and family is highly variable across cultures, and this can weaken research.
Another word in the report that I was happy to see is “watching” and “sedentary” as in “sedentary screen time.” But — as with many of these types of idealistic white papers, the cluster of mostly medical authors could have done a better job being specific with these loaded words, so that the news media would not misinterpret the conclusions as a condemnation of screen time.
RESEARCH GAPS
Attention doctoral students. The report states that there is a continuing need for high-quality studies, in particular that:
1. examine the entire 24-hour day and physical
activity, sedentary behaviors and sleep duration
in young children;
2. establish standardized procedures and
objective measurement to enable comparison
between studies;
3. study a broader range of health indicators, including additional indicators of motor, cognitive and
psychosocial development and the long-term
effects of early interventions;
4. provide a cost-effectiveness analysis of interventions to improve physical activity, sedentary behaviors and sleep duration in young children;
5. examine the impact of screen-based activities
compared with interactive sedentary activities
such as storytelling on health indicators;
6. explore the developmentally appropriate dose and
intensity of physical activity in young children;
7. examine the relationship between sleep duration
and motor development, growth and harms
or injuries;
8. consider confounders such as diet;
9. consider the particular needs of children with
disabilities and how guidelines can be adapted
to meet their needs
10. examine the key factors that enable dissemination, adaptation, activation, implementation and uptake of the guidelines.
References: WHO guidelines on physical activity, sedentary behaviors and sleep for children under 5 years of age. Geneva: World Health Organization; 2019.
