Mexico tells early learners: You need to play more.

Suri Amaizani Gonzalez Peña meets with a physical therapist at the Federico Gómez Children’s Hospital in Mexico City in August. Suri, 5, is part of a pilot program in public health centers and preschools across Mexico that ‘prescribes’ play to improve early childhood development.

Whitney Eulich

January 8, 2019

Suri Amaizani Gonzalez Peña is trying to make her Lego brick “talk.” She knocks it lightly on the tabletop, giggling, and whispers “azul” (blue).

Two physical therapists and her mother, sitting at the same small, circular table, encourage her to try again – but louder.

“What color is that block? I can’t hear it!” cheers physical therapist Magdalena Ferrusquia, knocking her own red brick on the wooden table, announcing the color. 

Why We Wrote This

Mexico’s experiment with prescribing songs and games for young children to improve their development is prompting discussion around the question “What is the role of play in education?”

Suri, age 5, who has a speech delay and trouble walking on her own, tilts her head to the side shyly and smiles. She tries again.

This is one of a series of exercises “prescribed” by Suri’s doctor. It’s a prescription to play, and last fall more than 60,000 children at early childhood centers in 13 states in Mexico started receiving a similar regimen of activities to encourage learning. The team behind the experiment – a collaboration between the health and education sectors and civil society – hopes that tapping into Mexico’s robust educational infrastructure, and focusing on training educators and empowering parents, will have long-term effects on development and educational opportunities here.

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“We realized a lot of parents don’t know what to do [with their young children] and we wanted to strengthen their capacities,” says Dr. Antonio Rizzoli, who teamed up with the Lego Foundation in Mexico to launch the play prescription program beyond his private practice. “We have different threats [to learning and development] in the 21st century, and the most important thing is to promote love, interaction, and social engagement. There’s no other way to do that than through play.”

Early childhood development – and education – has received more international attention in recent years. Between the ages 0 and 3, experts say fundamental building blocks are laid for future learning and development. But a 2014 study released by Mexico’s leading education-advocacy group, Mexicanos Primero, served as a wake-up call for policymakers and families here. The report, titled “The Invisibles,” found that a large swath of children in Mexico are essentially overlooked by lawmakers and excluded from education or early childhood development opportunities in their key developmental years, whether because of poverty or the maze of bureaucracy involved in social security systems. 

Encouraging play 

The prescription approach is being piloted with pediatricians in a handful of states for Mexicans who are in the conditional-cash-transfer program known as Prospera, which requires medical visits for children. Each prescription, a small pamphlet, encourages parents and adults to interact with children in a way that promotes early childhood development via language and motor skills. They’re also being used as a training tool for educators within the department for child and family services.

Jesus Rodriguez, 2, holds onto the hand of his mother Maria Fernandez, in a play area of La Raza Medical Center, in Mexico City, June 26, 2012. Play is not typically part of education in Mexico, but advocates are working to teach parents and educators about its benefits for young children.
Esteban Felix/AP

Preschool is mandatory at the age of 3 in Mexico, but the country has traditionally put very little emphasis or value around the idea of play. 

There are “hidden curriculums” that come from the home on how one is supposed to educate children, says Robert G. Myers, director of projects at Toward a Democratic Culture (ACUDE), a nongovernmental organization that focuses on education and children’s rights in Mexico. “Obedience is still a very important trait Mexican families believe kids should have: Adults should be listened to; kids are talked at and told what to do,” Dr. Myers says. “There’s lots of love. That’s important,” he adds, despite the often rote relationship between educator and child.   

“I think we’re on the edge of change” when it comes to early childhood development in Mexico, Myers says. “The discourse is changing, but the practice hasn’t yet,” he says, pointing to a deadly fire at a preschool in 2009 that killed nearly 50 children as a central reason for the more recent lags. There’s often a bigger emphasis now on health and safety – hairnets on cafeteria workers and clearly marked fire exits – than child development in early childhood centers and preschools, he says.

The lack of play between adults and young children – or a misunderstanding of what play means, relying instead on screen time – translates to many children missing out on a critical window for development, experts say. Mexicans have some of the longest work days in the world, limiting the amount of time parents have to play and interact with their children. Others want to help their children, but don’t know where to begin, or how.

Tools for adults 

Back at Suri’s doctor’s appointment, mother Laura Brenda Peña Camacho says they are three prescriptions in and so far the approach has been life-changing for her as a parent.

“I wanted to help my daughter, but I didn’t know how,” Ms. Peña says. They live in Mexico state, and travel over an hour to get to the National Children’s Hospital Federico Gómez for their monthly consultations. “I have a better understanding about what’s going on with Suri, but I can also use the tools we’re learning for her back home with my other children. I feel like she’s advancing, but so am I.” 

Some activities in the prescriptions involve Lego bricks (which are gifted to families participating in the program), but most rely on singing songs, engaging parts of the body, or using common household items.

“Most of the things we do are things parents already know or have access to, we’re just helping them to organize activities and make play more intentional,” says Ms. Ferrusquia, the physical therapist. “Even something as simple as a metro ride to come to our offices can be turned into a developmental game – asking questions about colors or sounds the child is observing,” she says.

The importance of play is increasingly touted by medical professionals. “Parents have moved to devaluing play and thinking that it’s frivolous,” says Michael Yogman, a Boston-based pediatrician and researcher who co-wrote an article on play prescriptions in the journal Pediatrics published in August. 

In addition, there’s a misconception among some families in Mexico that children don’t begin to learn until they can speak, researchers say, creating missed opportunities for development in the first two years.

The benefits of play include “enhancing brain function, 21st-century skills like executive function, problem-solving, and collaborative play, and a chance in a guilt-free way for parents and children to engage and enhance their relationship,” Dr. Yogman says. 

A focus on quality

During a pilot program in Puebla state, researchers found that of the 300 students involved, 70 percent showed improvement in their development within the first six months – particularly with language and communication. 

“Our value add doesn’t come from infrastructure or building schools. What we are good at is adding quality,” says Diego Adame, former director of the Lego Foundation in Mexico, on why they got involved in this project. “Mexico has a lot of infrastructure, lots of government resources, and good access to education. But it has a big, big quality problem.”

Mexico is also home to one of Lego’s largest factories, in the northern city of Monterrey. Mr. Adame says launching in Mexico was a way of directly giving back to the nearly 3,000 Lego factory employees and other citizens. For families involved in the play prescription program, each month when they graduate to the next prescription, they are gifted a few new Lego blocks, something Adame and Rizzoli see as an added incentive for participants.

Meyers says he’s interested in seeing the results of the play prescriptions and particularly the training of educators in using play in the classroom. But he thinks it might take more than a few training sessions for preschool and early education professionals to really implement the spirit of the idea.

“In the centers where we observe, something like playing with blocks is still kind of restricted and it’s slotted into something like, ‘Now we are going to learn’ instead of something that’s truly about play,” Meyers says.

Still, he says, he’s not entirely without hope. “This is part of a long process that I think has to occur in changing mind-sets and experiences of the people in charge of early childhood education.”