About My Two Hats

Thoughts on everything from parenting to policy from pediatrician/mom, Dr. Heidi Roman.

The Magic of Imagination and Its Importance for Kids

calvin-hobbes-dinosaur-005There is a lion roaring outside our patio. A squirrel is under the bed. And, the trains and dinosaurs at our house are having some very cool conversations and adventures. Our son’s imagination has fully arrived. An amazing development- the emergence of imaginary play is certainly magical to witness as a parent, but it also serves important functions for kids.

Emergence of Imagination
A child’s imagination typically emerges between two and five years of age. Closely linked with expressive language, these two skills often take-off together. Imagination is a marker of cognitive growth. Its presence depends on “symbolic function”, the ability to pretend that one object is another thing entirely.

Function of Imagination
A child’s imagination can serve many important functions. Imaginary play is a way for children to solidify their understanding of the world around them and set events to memory. Children use imaginary play to work through feelings of uncertainty, fear, and anxiety. Parents can learn a lot about what kids are thinking or worrying about by observing their child’s imaginary play. Children also often engage in cooperative imaginary play with other kids and learn from each other’s imagination.

Types of Imaginary Play
There are different types of imaginary play. Kids can play out scenarios- using toys or other props they repeat episodes that occurred on the playground or at school, trying out different ways to respond. They might role play, especially with other kids, pretending to be a teacher or police officer. This allows them to try on roles that are beyond what they can do in real life. Finally, kids may have imaginary friends.

Parents often ask about these activities in clinic and worry, especially about imaginary friends, that they may be unhealthy in some way. On the contrary, imagination is a very healthy development and in no way interferes with a child’s ability to understand the “real world”. Developmental pediatricians Suzanne Dixon and Martin Stein say this of imaginary friends,

     “Imaginary friends are very useful to young people. These friends can be the scapegoats for misdeeds, a comforter after discipline, or even a jolly companion for a long afternoon or a dark night. These valuable people come and go depending upon the situation. Too careful a scrutiny of them or even too much attention to them by adults makes them disappear because they don’t survive in the hard light of reality. They should be prized and respected as being the product of a creative, adaptive, and developing person. No evidence shows them to be harmful, indications of pathology or unmet needs, or cause for concern.”

Parents’ Role in Supporting Imagination
So, instead of worrying about imaginary play, parents should embrace and support it. Allow kids to direct imaginary play. Parents involvement in play can increase the complexity of play scenarios, but parents should not take over or ignore signs that their child might prefer to play on their own for a while. If a child asks, set a place at the table for their imaginary friend or invite them along to the park.

Does Imagination Disappear?
If imagination is so important, why does it seem to diminish over time for all but the most creative among us? My own ability to imagine up a story or new world seems far weaker than it used to be. Or is it?

Early developmental psychologists such as Jean Piaget argued that pretend or fantasy play was simply part of a particular stage in cognitive development that we naturally outgrow as we learn to differentiate between fantasy and reality. However, some current scholars have a different view. Harvard Professor Paul Harris, author of “The Work of the Imagination”, said this in a 2002 interview,

“. . suppose we think of pretend play and fantasy as something that’s quite characteristic of young children—it makes them playful and endearing but doesn’t really contribute to their later cognitive development and by adulthood it has in some sense disappeared. I tried to argue that this is wrong. Human beings have a gift for fantasy, which shows itself at a very early age and then continues to make all sorts of contributions to our intellectual and emotional life throughout the lifespan.

To give you some examples, imagination helps us to make causal judgments about how things might have turned out differently. If something goes wrong in life, then we ask ourselves where we went wrong. The imagination allows us to engage in thinking about alternatives in this prosaic form.

In making moral judgments we also think about alternatives. We look at something that has happened and we ask how it could have been done better or differently. And again we are exercising our imagination.

And then a third domain is simply language comprehension. There is a great deal of work showing that when adults listen to a narrative they build in their mind’s eye, so to speak, a mental image or a model of the situation that is being described and of the events that unfold. And it’s that mental model that they retain over a long period of time rather than the particular words. The ability to construct such models in the imagination is, in my view, something that emerges from these very early capacities that children show to engage in pretend play and to think about a time and place that is removed from their current situation.

So, depending on how you define the imagination, you can either see it as disappearing or waning during childhood or you can see it the way I do, as persisting throughout life.”

How do you see your child using their imagination? Are you using yours?

References:
Encounters with Children: Pediatric Behavior and Development by Suzanne D. Dixon, MD, MPH and Martin T. Stein, MD
Touchpoints by T. Berry Brazelton, MD

Time For Games: Why Playing Games Is Great For Kids

photoI grew up in a game-playing family. A love for playing cards and board games seems to be embedded in our DNA. Lazy summer afternoons were spent laughing over a game of Scattergories or Balderdash with cousins. I learned the ins and outs of Hearts, Canasta, and the “Dice Game” from grandparents, aunts, and uncles. In my immediate family we have a years-long Euchre rivalry (kids currently besting parents, if memory serves).  So, it is with quite a bit of joy and a nod to my game loving relatives that I’ve realized that my newly minted 3 year old really likes games.

As it turns out, games are good for him as well. Continue reading

What To Tell Kids When Bad Things Happen

This has been a very tough week. Scary and sad, for so many reasons. Terrible events are very upsetting for everyone. But these events, and subsequent media coverage, are particularly difficult for kids to process. Here are some of the best articles I’ve found regarding how to talk with children about tragedies. We’ve had all too frequent need of them lately. Continue reading

Kids In The Car: Essential Safety Tips

Many parents clearly remember that first car ride home with their newborn. I certainly do. Car seat buckles double and triple checked. Driving slowly, cautiously out of the parking lot. The weight of our new precious cargo heavy on our minds.

As time passes that anxiety fades a bit but still, three years later, I often have jolts of the weight of it. To sit behind the wheel of a car brings great responsibility, made even heavier when a child is riding with you. There are a number of things we can do as parent-drivers to make the ride safer for kids. Continue reading

A Few Thoughts on “Modern Parenthood”

The Pew Research Center‘s report entitled, “Modern Parenthood” recently came through my twitter feed. Amidst so much recent talk about women and our professional lives and “balance”, I loved reading this treasure trove of data about how moms and dads are spending our time, how that has changed over the last few decades, and how we feel about it. First, let me say that if you’re not following Pew’s work (including that of the fabulous Susannah Fox) you really must check it out. Here are a few things that stood out for me. Continue reading

Open For Comment: The Risks and Rewards of Writing in an Open Space

I recently co-authored an op-ed on gun violence that was picked up by The Huffington Post. As topics go, this is about as controversial as a pediatrician can get. Anticipating strong feelings on all sides of the issue, I was forced to really look at my feelings about writing in open spaces and exposing myself to criticism. This is an interesting vulnerability for a physician. Ever trying to avoid mistakes and often trained to steer clear of controversy, we avoid a public role as a rule. But, recent reflection has made me realize how much my perspective on all of this has shifted and been clarified over the last few years. Continue reading

When Your Child Is Afraid

Going to the doctor is a scary thing for a lot of kids. Whether it’s due to being in an unfamiliar place, having someone poke and prod you, or the intuition that shots are coming, I see kids deal with fear and anxiety every day. Parents respond in many different ways, almost always with the goal of diffusing the situation, but with varying degrees of success. Here are a few tips for helping your child when they are feeling afraid, whether at the doctor’s office or in other life situations. Continue reading

Atopic Dermatitis in Children: Information and Resources for Parents

eczemaAtopic dermatitis (also called eczema) is right up there with diaper rash as one of the most common skin conditions I see in clinic. This post will answer some of the most common questions parents have about atopic dermatitis (AD), as well as describe the types of treatment your child’s health care provider may recommend. As with all topics, please consult with your child’s physician if you have specific questions about your child. Continue reading

It Is The System, Not The Patient, That Is Difficult

As a pediatrician at a busy county clinic with close proximity to pediatric specialists, I care for a significant number of children with special health care needs. Instead of colds and ear infections (though there are those too), my days are often filled thinking about gastrostomy tubes, tracheostomies, and ventriculo-peritoneal shunts. I sign orders for specialty formulas and nebulizer machines. Many of my patients have thick charts and diagnoses like hypoxic-ischemic encephalopathy, chronic renal failure, and achondroplasia. And, I wouldn’t have it any other way. These kids and their families have taught me more than I can possibly put into writing. About medicine. About life.

But, all too often these families are labeled “difficult”. Continue reading