CLINICAL REPORT
Guidance for the Clinician in Rendering Pediatric Care
SelectingAleeya Healey, MD, FAAP,a, b Alan Appropriate Mendelsohn, MD, FAAP,a,c COUNCIL ON ToysEARLY CHILDHOOD for Young Children in the Digital Era Play is essential to optimal child development because it contributes to the abstract cognitive, physical, social, and emotional well-being of children and youth. It also offers an ideal and significant opportunity for parents and other caregivers to engage fully with children using toys as an instrument of play and interaction. The evolution of societal perceptions of toys from children s aNew York University Langone Health, New York City, New York; ’ bBernard and Millie Duker Children’s Hospital at Albany Medical playthings to critical facilitators of early brain and child development has Center, Albany, New York; and cBellevue Hospital Center, New York City, challenged caregivers in deciding which toys are most appropriate for New York their children. This clinical report strives to provide pediatric health care Drs Healey and Mendelsohn conducted a thorough literature review on all topics, integrated the most up-to-date data, and synthesized providers with evidence-based information that can be used to support this evidence to create an original authorship with cited references of recommendations for the use of toys in promoting optimal child caregivers as they choose toys for their children. The report highlights the development; and all authors approved the final manuscript as broad definition of a toy; consideration of potential benefits and possible submitted. harmful effects of toy choices on child development; and the promotion This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have of positive caregiving and development when toys are used to engage filed conflict of interest statements with the American Academy caregivers in play-based interactions with their children that are rich in of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of language, pretending, problem-solving, and creativity. The report aims Pediatrics has neither solicited nor accepted any commercial to address the evolving replacement of more traditional toys with digital involvement in the development of the content of this publication. media based virtual toys and the lack of evidence for similar benefits in Clinical reports from the American Academy of Pediatrics benefit from – “ ” expertise and resources of liaisons and internal (AAP) and external child development. Furthermore, this report briefly addresses the role of reviewers. However, clinical reports from the American Academy of Pediatrics may not reflect the views of the liaisons or the organizations toys in advertising and/or incentive programs and aims to bring awareness or government agencies that they represent. regarding safety and health hazards associated with toy availability and The guidance in this report does not indicate an exclusive course of accessibility in public settings, including some health care settings. treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.
All clinical reports from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time. RATIONALE FOR CLINICAL REPORT DOI: https://doi.org/10.1542/peds.2018-3348
Address correspondence to Alan Mendelsohn, MD, FAAP. E-mail: alm5@ nyu.edu The last 20 years have brought a shift in parental and societal perception ’ PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). of toys, with parents and other caregivers increasingly likely to view Copyright © 2019 by the American Academy of Pediatrics toys as being important1,2 for children s development, self-regulation, and executive functioning. A number of interrelated underlying factors have contributed to this shift, including: (1) increased recognition of To cite: Healey A, Mendelsohn A, AAP COUNCIL ON EARLY early brain and child development as critical to educational success; (2) CHILDHOOD. Selecting Appropriate Toys for Young Children increased recognition of early experiences in the home and in child care in the Digital Era. Pediatrics. 2019;143(1):e20183348 “ ” 3 settings as facilitating early brain and child development ; (3) increased marketing of so-called educational toys as critical for enhancing early Downloaded from www.aappublications.org/news by guest on September 26, 2021 PEDIATRICS Volume 143, number 1, January 2019:e20183348 FROM THE AMERICAN ACADEMY OF PEDIATRICS experiences; (4) the perception supported by the large body of toys (eg, lights and sounds emanating (perhaps misperception) of toy research documenting the role of from a robot) detract from social play rather than interaction with play in fostering development across engagement that might otherwise ’ caregivers around toys as important all domains (including cognitive, take place through facial expressions, for the child s development, inclusive language, social-emotional, and gestures, and vocalizations and 3 – 1,4, 19 of self-regulation ; and (5) increasing physical). Although the concept that may be important for social “ ” 24,25 sophistication of digital media based of play has not changed over time, development. virtual toys replacing physical what constitutes a toy at the time Over the past 2 decades, a number of toys and often incorrectly perceived of this report is substantially core elements of traditional toys have by caregivers4,5 as having educational different than what20 it was during the been adapted to electronic (virtual) benefit. previous century. This difference versions, such as laptops, tablets, is attributable in part to the Although high-quality toys facilitate phones, other mobile devices, and proliferation of electronic, sensory- child development when they lead – stand-alone electronic game devices, stimulating noise and light toys to the engagement of caregivers in and to toys that substitute for and digital media based platforms play-based interactions that are rich human interaction (eg, toy bear that with child-oriented software and 2,5 in language, pretending, problem- 1,21 can read a story aloud). In many mobile applications that can be solving, reciprocity, cooperation, and cases, these have been integrated 4 perceived by parents as necessary creativity (and potentially for older with new elements not previously 1 for developmental progress despite children in solitary play ), many of available within traditional toys, the lack of supporting evidence and, the claims advertised for toys are such as sensory-stimulating toys perhaps most importantly, with not based on scientific evidence. (especially for infants, for whom the potential for the disruption of Additionally, there has been 22 the strong visual engagement and caregiver-child interactions. increasing recognition of potential neurodevelopmental consequences2 for harm in the context of exposure are not presently known ). This to electronic media, environmental Traditional (physical) toys can be blurring of the line between toxins, and safety hazards. In categorized in a variety of ways: (1) physical and virtual toys has greatly particular, electronic media have symbolic and/or pretend (eg, dolls, complicated caregiver decision- been associated with displacement action figures, cars, cooking and/ making when selecting toys, or feeding implements, etc); (2) fine of play-based caregiver-child– especially because mobile device interactions and reductions in motor, adaptive, and/or manipulative applications for children have 6 10 (eg, blocks, shapes, puzzles, trains, cognitive and/or language proliferated1,21 at an extraordinary 11 etc); (3) art (eg, clay and coloring); and gross motor activities, with 7 pace. As a result, pediatric health implications for child development (4) language and/or concepts (eg, care providers have an important 11 card games, toy letters, and board and health outcomes (eg, obesity). role in providing guidance for 21 ’ games); and (5) gross motor and/or selecting appropriate applications This clinical report addresses the physical (eg, large toy cars, 23 and toys. pediatric health care providers role ’ tricycles, and push and pull toys). TOYS AND CHILD DEVELOPMENT in advising caregivers about toys in High-quality toys in each of these the context of changes in caregivers categories can facilitate caregiver- General Considerations perceptions of toys and the evolution child interactions, peer play, and the of what now constitutes a toy. It growth of imagination. It should be complements existing policy from emphasized that high-quality toys Toys are important in early child the American Academy4 12, of13 Pediatrics need not be expensive. For example, development in relation to their related to 14play, media, 15, 16 school toy blocks, in addition to household facilitation of cognitive development, readiness, 17 toxic stress,18 injury objects, can be interesting for a child language interactions, symbolic prevention,4 toxicology, and to examine and explore, especially and pretend play, problem-solving, poverty. if the child observes adults using social interactions, and physical AN EVOLVING DEFINITION OF TOYS them. Unfortunately, many caregivers activity, with increasing importance
believe that expensive electronic as children move1 from infancy into toys (eg, sensory-stimulating toddlerhood. Pretending through In this report, a toy is defined as an noise and light toys for infants and toy characters (eg, dolls, animals, ’ object (whether made, purchased, toddlers) and tablet-based toys are and figures) and associated toy ’ or found in nature) intended for essential for their2 children s healthy objects (eg, food, utensils, cars, children s play. Developmentally, development ; however, evidence planes, and buildings) can promote the importance of toys is strongly suggests that core elements of such the use of words and narratives to Downloaded from www.aappublications.org/news by guest on September 26, 2021 2 FROM THE AMERICAN ACADEMY OF PEDIATRICS imitate, describe, and cope with demonstrating the development of provide children with the interaction actual circumstances and feelings. spatial awareness. and parental engagement that are Such imaginative play ultimately criticalAppropriateness for the healthy of Toys development for Children. facilitates language development, Notably, data in support of a With Special Needs self-regulation, symbolic thinking, 26 developmental role for toys primarily and social-emotional development. “ ” come from studies of activities in 3 Problem-solving through play with which children play with caregivers 4,27, 29 Children with developmental delays the traditional favorites, such as rather than alone. In particular, or disabilities may face a variety of blocks and puzzles, can support toys that are most likely to facilitate difficulties or obstacles in their play fine motor skills and language and development are those that are most because of factors such as intellectual cognitive development and predicts enjoyably and productively used limitations or physical restrictions. both spatial and early mathematics for play together with an engaged 27,28 One of the greatest difficulties is skills. The use of toys in physical caregiver, because in such contexts when the play itself becomes atypical activity (such as playing with balls) play with toys is likely to include “ ” in nature. For example, they may has the potential to facilitate gross rich language experiences, reciprocal 15,16 play with objects repetitively (eg, motor development together with ( serve and return ) verbal stacking blocks in the same way over self-regulation and peer interaction interactions, and scaffolding. Toys and over again but not constructing because of the negotiations regarding can play an especially important role “ ” anything per se) or nonfunctionally rules that typically take place. The in the promotion of learning and (eg, tapping a toy phone on the floor aforementioned are only a few discovery in guided play, in which versus talking into it) or engage examples of skill development children take the lead, but caregivers with toys at a significantly different associated with toy play. Play with support their exploration in the 1,30 developmental level than that of caregivers is most likely necessary to context of learning goals. The idea peers of a similar age (eg, 3 toddlers support skill development. However, that play with toys is enriched by use are having their toy dinosaurs chase solitary play can also have a role with a caregiver is consistent with one another, whereas a fourth is (especially for older children, for the many studies of early childhood ’ standing aside chewing on the whom exploration and play with documenting that learning takes toy dinosaur s tail). Furthermore, toys on their own time and pace can place optimally in the context of ’ atypical behaviors among children foster their independent creativity, serve-and-return conversations that 31 with disabilities may themselves investigation, and assimilation build on the child s focus (and are 1 disrupt social interactions in addition skills ). analogous to shared book reading). to the play itself. These differences In general, toys that facilitate ’ in developmental capacities are In general, the best toys are those imaginative play and problem- 3 exhibited across domains, and in that match children s developmental solving are most likely to enable such turn, how children play with their skills and abilities and further engagement by caregivers, whereas toys may limit their ability to learn encourage the development of toys that are electronically based and develop maximally from parent- new skills. Developmentally (whether traditional or media based) 10,32 child and peer play opportunities. advanced toys can be appropriate are less likely to do so. Therefore, too, especially when caregivers when pediatric health care providers The choice of toys may be especially scaffold (eg, setting up a storyline advise parents and caregivers, it is complex for children with special ’ for pretending together or providing important to stress that toys can needs given that recommendations ’ support for the child s learning of serve an important but supportive on packaging are usually based “ ” a new skill) children in their play. role in enhancing a child s social on age and not developmental Some toys have the ability to grow development in addition to other capacities. For instance, caregivers with the child, in that they can be domains, such as language, primarily of children with special needs may used differently as children advance through engaging caregivers3 in be more likely to choose functional developmentally. For example, an responsive interactions and toys (eg, toys that are easily activated ’ 18-month-old child might try to pretend play. The pace of life in and often33 respond with lights and use blocks functionally (eg, stack today s society provides limited time sounds) over symbolic toys that them), whereas a 2-year-old might available to many caregivers, and encourage pretend play, creativity, use the same blocks to engage in solitary play with toys should not and interactions34 (eg, toy animal sophisticated symbolic play (eg, by be a substitute for caregiver-child farm). Thus, caregivers of children feeding the doll with1 a block that interactions during play or other with special needs may benefit represents a bottle ) or use the contexts, such as reading aloud. from additional guidance from same blocks to construct a bridge, Electronic toys by themselves will not specialty therapists (eg, speech, Downloaded from www.aappublications.org/news by guest on September 26, 2021 PEDIATRICS Volume 143, number 1, January 2019 3 occupational, or physical therapists) to enhance early development by device; this has more than doubled in choosing which toys, activities, and promoting caregivers and children when compared4,11, 32 with data collected interactions are most appropriate for to play together with toys. These in 2011. More recent data the developmental age of their child efforts are especially important for presented in 2015 suggests that to ensure continued growth and skill children growing up in poverty, for 96.9% of children have used mobile mastery. whom there is both reduced access devices, and most started47 using them to developmentally appropriate before 1 year of age. For young Adaptations of toys to accommodate toys and barriers to caregiver-child children, the increase in screen time, a motor, visual, or other disability can 4,14, 15 interaction. Such initiatives which has evolved over the past be important for children with special complement existing programs decade, has taken place in association needs. This can be accomplished seeking to enhance early literacy with a decrease in play, including by combining easy access with 35 within the pediatric medical home both active play and play with multisensory feedback, such as light 40 11 ’ (eg, Reach Out and Read ). Efforts toys. This is especially significant and sound when a toy is powered on. to promote play with toys have for young children s development Examples of adaptations in design taken place across diverse platforms, because screen time directly include Velcro strips to help a child 36 including in (1) preschools (eg, Tools interferes with both play activities hold a toy, adding a piece of foam 41 48 of the Mind ), (2) home visiting (eg, and parent-child interactions, and around a marker or paintbrush to Parent-Child Home Program and even educational media is typically make the art utensil easier to hold for 42 Play and Learning Strategies ), (3) watched without caregiver a child with an inability to grasp the 29 11,21,48 37 public health (eg, Building Blocks input. Furthermore, virtual toys utensil independently, and the use of 43 and Blocktivities ), and (4) pediatric (ie, screen games and/or applications) a larger push button to activate a toy primary care (eg, Video Interaction are increasingly designed to emulate for a child with fine motor difficulties 29 Project ), to name a few. Findings and even replace physical toys. who cannot easily manipulate a small 35 from these programs strongly This potentially increases known switch. Technology has played suggest that toys are most likely to risks of electronic media exposure, a particularly important role in facilitate developmental advances such as the promotion of aggressive supporting the use of toys, and it is 3 49 50 in the context of interactions behavior and obesity. The anticipated that the role of technology with and support by caregivers potential for these risks is especially in addressing developmental (including scaffolding and guided great in the context of violence interventions will increase over time play rather than as a result of the toy portrayed as humorous or justified, with the guidance of research. As with 31 itself ), early childhood educators, which can reinforce aggressive children who are typically developing, 44’ and other providers. Pediatric behavior and desensitize children children with special needs maximally 51 health care providers knowledge to violence and its consequences. benefit from play with toys in the and awareness of these programs Although it has been suggested that context of caregiver interaction. can inform anticipatory guidance there may be learning benefits in Toys can be used as a mode of to parents, provide opportunities association46,52, 53 with interactive incentive in the context of early for integration within the medical media, there is presently no intervention services and physical home enhancement, and function evidence to suggest that possible therapy more generally. For example, as potential sources of referral benefits of interactive media match therapists often use toys to stimulate depending on availability within those of active, creative, hands-on, the use of a nondominant hand by the communities they serve. and pretend play4, 9with more placing the toy on that side of the Furthermore, the selection of toys traditional toys. In particular, body. Alternatively, using a toy as a offered to children should reflect the children need to use their hands to reward may help elicit verbalizations diverse and multicultural world we explore and manipulate to strengthen in a child with a language disability. ’ live in (ie, selecting dolls of various those areas in the brain associated Novel or preferred toys can be held ethnicities in the pediatric office with spatial and mathematical 45 54,55 ’ near an adult s face to encourage waiting area). learning. Recent investigations eye contact for a child38,39 with autism ELECTRONIC MEDIA EXPOSURE AND have revealed that during children s Toysspectrum and thedisorder. Promotion of PLAY WITH TOYS play with electronic toys, there Parenting, Positive Caregiving, and were fewer adult words, fewer Child Development conversational turns, fewer parental A 2013 study revealed that 38% of responses, and fewer productions of
US children younger than 2 years11, 46and content-specific words than during There has been a broad range of 80% of 2 to 4 year-old children play with traditional toys or books. scientific- and policy-based efforts have used a mobile electronic media Children, themselves vocalized Downloaded from www.aappublications.org/news by guest on September 26, 2021 4 FROM THE AMERICAN ACADEMY OF PEDIATRICS less during play with 8electronic federal (Federal Communications with gastrointestinal hemorrhage60 toys than with books. Newer Commission and Federal Trade and death when ingested. The smartphone applications are focused Commission) and local levels have US Consumer Product Safety on addressing the lack of social and sought and continue to develop Commission (CPSC) Web site (www. physical interactivity; however, long- regulations to guide and reduce such cpsc.gov/ ) contains information term risk and benefit studies are suggestive content in advertisements. regarding toy safety and can be a necessary to determine their56 actual One example is the US toy ordinance resource for pediatric17,64 providers impact and sustainability. It is ironic piloted in Santa Clara County, and caregivers. Two CPSC that at a time when psychologists California, which prohibited the initiatives of particular relevance are and other developmental scientists distribution of toys and other SaferProducts (www.saferproducts . are recognizing the role of the incentives to children in conjunction gov/), which allows anyone to report body in learning, toys for children with meals, foods, or beverages that safety concerns, and the Recalls. are becoming increasingly57 do not meet minimal nutritional gov Web site (www.recalls .gov), two-dimensional. criteria. This ordinance, in turn, which provides information about positively influenced the marketing safety recalls. In addition to physical ADVERTISING AND TOYS ’ of healthful menu items with the safety characteristics, close attention toy incentive, and children then should be paid to a toy s contact with requested their parents to purchase harmful substances that may be used A great deal of marketing in both the healthier meal options. The trial to treat its materials (eg, arsenic used traditional and new media is used period provided data revealing the to treat some wood products, lead to encourage caregivers to view ’ Caring for Our Children, Third effects of marketing through toy paint, or chemicals such as bisphenol technologically driven toys as critical Edition18 incentives on children s food choices A ). for development. Such marketing and, furthermore, the effects of their , includes detailed information has led to increasing exposure by 65 requests on the parental purchase regarding potential hazards. children to enrichment videos, 62 of the meal. The initiative was TOYS AND THE OUTPATIENT PEDIATRIC computer programs, specialized “ ” later expanded to similar changes SETTING books with voice-recorded reading, in a number of major US cities (San and developmental toys beginning 4,58 Francisco and New York City). in early infancy. It is important Toys provided in the waiting to note that claims for such toys on TOY SAFETY CONSIDERATIONS – rooms of pediatric offices and packaging and advertising are largely 59 61 other medical settings can serve unsubstantiated by credible as a model for caregivers and studies, and thus, it is important for Government regulations, improved thereby aid in their decision- pediatric health care providers to safety standards for the manufacture making about toys. Such toys can aid caregivers in deciphering such and use of toys, and product testing also help reduce child anxiety advertisements. have made most toys safe when used regarding visits and procedures. Toys are also used extensively as appropriately for recommended However, toys in pediatric settings a mechanism for marketing. For ages and stages of development. also have the potential to become a example, there has been a trend over However, just because a product is vehicle for transmitting viruses and the past decade of coupling food on the market does not mean that other pathogens among pediatric consumption with a toy incentive. it is safe. In determining toy safety, patients. Clear, easy-to-follow Many fast food restaurants offer a the characteristics of the toy should recommendations for the use and toy incentive with particular meal be considered as well as how the cleaning of toys in the pediatric office purchases (many of which are energy toy might be used or abused and have been made– by the Centers for dense and nutrient poor) to increase the amount of supervision or help Disease Control66 69 and Prevention sales; such incentives are thought needed for safe play. In a recent and others. For example, the to have 62contributed to childhood example of potential dangers, sanitization of toys can be safely obesity. Promotions and incentives ingestion of high-powered magnetic accomplished by washing with soap are an especially important objects (eg, rare earth magnets and water and then disinfecting by consideration for children younger and strong permanent magnets) using a freshly prepared solution than 8 years, who are unaware that sometimes used in toys resulted63 (1:100 dilution of household bleach; promotions and advertisements are in significant child morbidity. soak for at least 2 minutes) or by – actually designed to persuade them Button batteries are ubiquitous using an Environmental Protection ’ to have their59 caregivers buy specific as energy sources in electronic Agency registered sanitizing solution products. Recent initiatives at the toys and have been associated (according to the manufacturer s Downloaded from www.aappublications.org/news by guest on September 26, 2021 PEDIATRICS Volume 143, number 1, January 2019 5 – instructions) and66 68then rinsing they may be viewed as models for 6. Although pediatric health care and air drying. Toys should toys that are appropriate for the providers can make toys available be cleaned between uses to avoid67 home. in their offices, those who do the transfer of infectious agents. so should choose toys that are ’ 4. Pediatric health care Also, caregivers can be given the easily and routinely cleaned. providers may choose to give option to bring their child s own When possible, each time a toy parents information about toys for office visits to minimize has been in contact with saliva or developmentally appropriate toys, the sharing and transmission of other bodily fluids, it should be which are those that promote infectious disease. Although some sanitized. language-rich caregiver-child available toys are marketed as interactions, pretend play, 7. Displaying notices in the office incorporating antibacterial agents physically active play, problem- about product recalls of toys is in their construction, it is important solving, and creativity. Lists important to inform parents of to note that such construction “ ” of appropriate toys can be product dangers. is currently unproven to be 66 found through many resources, antibacterial. Further guidance 8. Take available opportunities to Caring For Our Children, including books, pamphlets of cleaning and disinfecting toys can counsel caregivers regarding Third Edition from organizations such as Zero be found in dangers associated with high- 65 to Three, and instruments for . Although adequate powered magnet toys as well assessment of the provision infection control measures may seem as button batteries that are of toys in the home. Pediatric daunting, recommendations tend to ubiquitous in electronic toys. health care providers can also be straightforward to implement and ADVICE FOR PARENTS AND recommend books that provide should not be considered a barrier CAREGIVERS guidance about interacting with to the use of toys in the outpatient children, including in the context setting. of toy play to encourage language CONSIDERATIONS FOR PEDIATRIC 1. Recognize that one of the most development (see Resources). HEALTH CARE PROVIDERS IN THE important purposes of play OFFICE SETTING 5. If pediatric health care providers with toys throughout childhood, make toys available in the office, and especially in infancy, is not they may consider whether they educational at all but rather 1. Advice regarding toys and/or play are safe for all children of all to facilitate warm, supportive with toys can be offered together ages according to the following interactions and relationships. with guidance in 5 related areas: ⚬recommendations:⚬ 2. Scientific studies supporting social-emotional development do not provide small toys or toys a developmental role for toys through social interactions, ’ ’ with easily dislodged parts that primarily come from studies literacy promotion, block and fit in an infant s or toddler s of activities in which children puzzle play in relation to science ⚬⚬mouth; play with caregivers rather than and/or math and spatial skills, alone. The most educational toy imaginative and creative play in do not provide toys with loose is one that fosters interactions relation to make-believe and/or ⚬⚬string, rope, ribbons, or cord; between caregivers and children free play, and electronic media in supportive, unconditional exposure. do not provide toys with sharp ⚬⚬edges; play. 2. Pediatric health care providers 3. Provide children with safe, can advise parents and do not provide toys that make affordable toys that are caregivers regarding toys that are ⚬⚬loud or shrill noises; developmentally appropriate. appropriate for young children provide only toys made of Include toys that promote in terms of stage of development, ⚬⚬nontoxic materials; learning and growth in all areas learning opportunities, and of development. Choose toys safety. For families for whom the always store toys safely and that are not overstimulating literacy level of the caregivers is of ⚬⚬avoid toy chests with lids; and and encourage children to concern, handouts with example be extremely cautious of toys use their imaginations. Social- toy pictures may be created by the with button batteries; ensure emotional and cognitive skills practitioner. that they are not accessible to are developed and enhanced as 3. If toys are available for children in children so that they cannot be children use play to work out waiting and examination rooms, accidentally ingested. real-life problems (see Zero to Downloaded from www.aappublications.org/news by guest on September 26, 2021 6 FROM THE AMERICAN ACADEMY OF PEDIATRICS Three: Tips for Choosing Toys caregiver interaction is essential toys-play-for-children- with- for Toddlers in Resources). to minimizing adverse media disabilities-resource-list/ ), and effects on the young mind. 4. Make a thoughtful selection 2. How We Play! A Guidebook for of toys and remember that a 10. Seek out toys that encourage Parents and Early Intervention good toy does not have to be the child to be both mentally Professionals. Birth through trendy or expensive. Indeed, and physically active. Two (https://eric.ed .gov/? id= sometimes the simplest toys may RESOURCES • ED447660). be the best, in that they provide • For information regarding the opportunities for children to promotion of physical activity, refer use their imagination to create For information on toy safety to the ’following resources: the toy use, not the other way concerns or questions, refer to around. Choose toys that will the US ConsumerCaring for Product Our Children, Safety 1. Let s Move (https://letsmove. grow with the child, foster ThirdCommission Edition Web site (www.cpsc . obamawhitehouse.archives .gov/ interactions with caregivers, gov) and get-active), and encourage exploration and • ’ . 2. National Resource Center for problem-solving, and spark the For questions or concerns Health and Safety in Child Care child s imagination’ . regarding infection control and Early Education (http:// 5. Use children s books to develop guidelines, refer to Centers for nrckids.org/ index.cfm/ products/ ideas for pretending together Disease Control and Prevention LEADvideos11/ AUTHORSmotion- moments1/). while playing with toys; use of •guidelines (http://www.cdc .gov) . the library should be routine Aleeya Healey, MD, FAAP For guidance in identifying for all parents regardless of Alan Mendelsohn, MD, FAAP appropriate toys for young children, socioeconomic status. A list of refer to the following“ resources: COUNCIL ON EARLY CHILDHOOD EXECUTIVE community library locations for ” COMMITTEE, 2017–2018 the office should be considered. 1. Zero to Three, Tips for Choosing Toys for Toddlers (https:// Jill M. Sells, MD, FAAP, Chairperson 6. Keep in mind that toys are not www.zerotothree .org/ resources/ Sherri L. Alderman, MD, MPH, IMH-E, FAAP a substitute for warm, loving, 1076-tips- for-choosing- toys- for- Andrew Hashikawa, MD, MPH, FAAP dependable relationships. Use toddlers); Alan Mendelsohn, MD, FAAP toys to enhance interactions ’ Terri McFadden, MD, FAAP between the caregiver and child 2. The National Association for the Dipesh Navsaria, MD, MPH, MSILS, FAAP rather than to direct children s Education for Young Children Georgina Peacock, MD, MPH, FAAP play. (NAEYC) (http://www.naeyc .org/ Seth Scholer, MD, MPH, FAAP ’ ecp/resources/goodtoys); and 7. Seek the pediatric health Jennifer Takagishi, MD, FAAP care provider s advice in 3. StimQ (http://www.med .nyu . Douglas Vanderbilt, MD, MS, FAAP P. Gail Williams, MD, FAAP distinguishing between safe and edu/pediatrics/developmental/ research/belle- project/stimq- unsafe toys (see Resources). FORMER COMMITTEE MEMBERS • cognitive-home-environment) . 8. Be aware of the potential for Marian Earls, MD, MTS, FAAP toys to promote race- or gender- For suggestions on how caregivers Elaine Donoghue, MD, FAAP based stereotypes. can use toys, play, and other activities to encourage language development, 9. Limit video game and computer CONSULTANTS refer to the following Web sites: game use. Total screen time, Kathy Hirsh-Pasek, PhD including television and 1. Too Small to Fail (http://toosmall. Roberta Golinkoff, PhD computer use, should be less org/), and LIAISONS than 1 hour per day for children 2. Bridging the Word Gap (http:// 2 years or older and avoided in • bwgresnet.ku .edu/ ). Lynette Fraga, PhD – Child Care Aware children 18 to 24 months of age. Katiana Garagozlo, MD – AAP Section on Pediatric Children younger than 5 years For a resource list of suggestions Trainees should play with computer or on toys, play, and recreation for Dina Lieser, MD, FAAP – Maternal and Child Health Bureau video games only if they are children with disabilities, refer to the Rebecca Parlakian, MA, Ed Zero to Three developmentally appropriate, following Web sites: – Alecia Stephenson and Lucy Recio – National and they should be accompanied 1. The Northwest Access Association for the Education of Young Children by the parent or caregiver. The Fund Web site (http:// use of media together with washingtonaccessfund .org/ Downloaded from www.aappublications.org/news by guest on September 26, 2021 PEDIATRICS Volume 143, number 1, January 2019 7 FORMER LIAISONS Laurel Hoffmann, MD – AAP Section on Medical Students, Residents, and Fellows in Training ABBREVIATION David Willis, MD, FAAP – (Formerly with the Maternal and Child Health Bureau) STAFF Barbary Sargent, PNP – National Association of Pediatric Nurse Practitioners Charlotte O. Zia, MPH, CHES CPSC: Consumer Product Safety Commission
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
FUNDING: No external funding.
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
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Downloaded from www.aappublications.org/news by guest on September 26, 2021 10 FROM THE AMERICAN ACADEMY OF PEDIATRICS Selecting Appropriate Toys for Young Children in the Digital Era Aleeya Healey, Alan Mendelsohn and COUNCIL ON EARLY CHILDHOOD Pediatrics originally published online December 3, 2018;
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Downloaded from www.aappublications.org/news by guest on September 26, 2021 Selecting Appropriate Toys for Young Children in the Digital Era Aleeya Healey, Alan Mendelsohn and COUNCIL ON EARLY CHILDHOOD Pediatrics originally published online December 3, 2018;
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