The American Psychiatric Association classifies Attention Deficit Hyperactivity Disorder (ADHD) as comprising two major symptoms: poor sustained attention, impulsiveness and hyperactivity. The three subtypes of the disorder include: predominantly inattentive, predominantly hyperactive-impulsive, and combined types (DSM-IV). These behavioral deficits arise early on in childhood, usually before the age of seven, and continue over the child’s development. ADHD occurs in approximately 3-7% of the population, with boys being overrepresented 3:1. The disorder persists into adolescence in 50-80% of cases and into adulthood in at least 30-50% of these same cases. Treatments for ADHD typically include counseling, behavioral management techniques and psychoactive medications (Barkley, 1997).

Play behaviors are very important for the development of the young mammalian brain. Besides modeling social interactions, play behaviors also facilitate the maturation of the prefrontal cortex’s inhibitory skills. Because the prefrontal cortex is not completely online at birth, young children are incapable of impulse control or emotional regulation, typically until the age of two or three years. The more children engage in social play, the sooner and more completely they will develop frontal lobe regulatory functions. Poor behavioral inhibition is the central deficit in ADHD, which points to a cognitive deficit in the prefrontal lobes. It is possible that many of these play deprived children go on to be diagnosed with Attention Deficit Hyperactivity Disorder.

Ironically, psychostimulants that are commonly prescribed to children diagnosed with ADHD have been shown in animal models to reduce playfulness (Panksepp, 2007), which may be what that these children actually need. These medicines are also ineffective methods of promoting long-term learning and retention of material and thus should not be seen as a long term solution.

Whether or not there is a correlation between children being deprived of active, social play and later developing ADHD is yet to be clinically shown. However, “play-therapy in ADHD-type rats effectively reduced some impulse control problems later in life” (Panksepp, 2002). Based on existing animal models, more research is needed in this area as it applies to human children.

Given the difficulty of measuring the evolutionary benefits of play, there are many secondary benefits that can be observed and measured, particularly when they are absent. Throughout every stage of neurological development, play seems to strongly influence healthy growth. In infants, social and solitary play are important in developing secure attachment to the primary caregiver. In toddlers and preschoolers, play becomes the basis for social connections made amongst peers. In adolescents, active play facilitates dominance hierarchies and allows for practice in controlling aggressive impulses.

Play as a therapeutic intervention has been used for centuries, the benefits of which have recently begun to be evaluated empirically. One promising area is when working with children diagnosed with Attention Deficit Hyperactive Disorder. As this disorder is characterized by impulsiveness, hyperactivity and poor impulse control, it would make sense to see these symptoms in children who did not have access to a healthy amount of active play, and had not fully developed their prefrontal cortices. There is much more research that needs to be done in this area, but anecdotal evidence suggests that play therapy is a promising alternative to potentially harmful psychostimulants.

References

Barkley, R.A., (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. American Psychological Association. 121: 65-94.

Burghardt G.M., (2005). The Genesis of Animal Play: Testing the Limits. Cambridge, Massachusetts: MIT Press. 500 p.

Cordoni, G. & Palagi, E., (2011). Ontogenetic trajectories of chimpanzee social play: Similarities with humans. PLoS ONE 6(11): e27344.doi:10.1371/journal.pone.0027344

Freud, S. (1955). Little Hans. Standard Edition of the complete psychological works of Sigmund Freud, 10, 3-152.

Jennings, S. (2010). Neuro-Dramatic-Play and attachment. The British Journal of Play Therapy. 6:35-50.

Newman, J.D. & Harris, J.C., (2009). The Scientific contributions of Paul D. MacLean(1913-2007). The Journal of Nervous and Mental Disease. 197: 3-5. DOI: 10.1097/NMD.0b013e31818ec5d9

Panksepp, J., (2007). Can PLAY diminish ADHD and facilitate the construction of the social brain? Journal of the Canadian Academy of Child and Adolescent Psychiatry. 16(2): 57-66.

Potegal, M. and Einon, D. (1989), Aggressive behaviors in adult rats deprived of playfighting experience as juveniles. Dev. Psychobiol., 22: 159–172. doi: 10.1002/dev.420220206

Van den Berg, C. L., Hol, T., Van Ree, J. M., Spruijt, B. M., Everts, H. and Koolhaas, J. M. (1999), Play is indispensable for an adequate development of coping with social challenges in the rat. Dev. Psychobiol., 34: 129–138. doi: 10.1002/(SICI)1098-2302(199903)34:2

VanFleet, R. & Faa-Thompson, T., (2010). The Case for using animal-assisted play therapy. The British Journal of Play Therapy. 6:4-18.