By Blakely M. Rice
Manager of Child Life & Creative Arts Therapy
Across cultures, abilities, and experiences, children use play to make sense of the world, express what they cannot yet say, and maintain a sense of control in unfamiliar environments.
For these reasons it is crucial to acknowledge play as a form of communication. Therefore, recognizing and responding to play as a child’s primary language is no longer a nice way to build rapport but it is a clinical competency. Just as healthcare providers are responsible for using interpreters to communicate with a patient who speaks another language, we carry a responsibility to understand and engage with children through play. For our child life specialists and the broader care team—honoring this form of communication is essential to delivering truly safe, effective, and developmentally appropriate care, especially in the most complex medical moments.
Research has made it clear that play is not a reward children receive once the hard work of treatment is done. It is a critical part of the treatment. Children given play-based preparation before procedures demonstrate lower heart rate and blood pressure, reduced distress behaviors, and faster recovery times. Those who engage in play between and after interventions show greater cooperation with clinical staff, require less sedation, and report less fear. These are not incidental findings — they reflect something fundamental about how children heal.
To understand why play matters so deeply, we have to look beyond the brain to the body as a whole. Research from the National Scientific Council on the Developing Child at Harvard University shows that a child’s brain, immune, cardiovascular, and metabolic systems are tightly interconnected, responding to stress as a unified network. When a child perceives a threat, that network activates. Their heart rate rises, inflammatory responses mobilize, and cortisol courses through the body in short bursts, followed by a return to calm. This stress response can be adaptive, but when stress is intense, prolonged, or unrelieved—as it often is during a new diagnosis, repeated procedures, or extended hospitalization—it creates a biological burden known as allostatic overload, where the body’s protective systems begin to cause harm. This is precisely where play becomes essential. Play is one of the most effective ways to interrupt and regulate this stress response in real time. Whether a child is rehearsing a procedure with a doll, expressing their experience through art, or immersing themselves in imaginative play, these moments are not a distraction from care, but they are an integral part of it. Play provides measurable physiological relief, helping stabilize stress systems, while also building the coping skills and sense of agency that support long-term resilience. In this way, play sits alongside the science, not separate from it: a direct, accessible mechanism through which children’s bodies and minds are supported in healing.
The developmental stakes are equally high. Children who are hospitalized for extended periods are at risk of falling behind not only academically, but physically, socially, and emotionally. Play preserves developmental momentum when a child's world has been reduced to a hospital room. It supports gross and fine motor development, language, executive function, and social-emotional growth in ways that no other single intervention can replicate across all domains simultaneously. It keeps children connected to who they are outside of their illness or injury and allows them a safe and effective way to cope and problem solve.
Our certified child life specialists work each day to create an environment and opportunities where play can do this work. We utilize multiple strategies, including normalizing play and activities that restore familiarity and routine, medical play that builds mastery and reduces the fear of the unknown, and therapeutic play that gives children a language for experiences words alone cannot hold. We are also fortunate to extend this work through meaningful partnerships. Organizations like Project Sunshine allow us the opportunity to grow our reach in carrying out this mission. Project Sunshine brings trained volunteers directly to our patients' bedsides and playrooms, delivering connection, joy, and play-based programming that amplifies everything our teams are working toward. At Komansky, this partnership and the work being done through our programs are not supplemental — they are integral to our wholistic patient and family-centered care model.
A child who is playing is not just passing time. Their stress systems are quieting, their immune systems are being protected, and the biological foundations of lifelong health are being reinforced. That is the work we do every day at Komansky, and it’s why we believe, without reservation, that play is medicine.
Ready to help us spread the healing power of PLAY? Join us during the month of June for our Summer Solstice Play-A-Thon. You can sign up your team today and make this the longest—and most meaningful—day of play yet.