Pretend Play in Toddlerhood Predicts Fewer Behavioral Problems in Later Childhood, Longitudinal Study Shows

The research, published in *Early Childhood Education Journal* and titled “Longitudinal Evidence of the Relationship Between Pretend Play and Mental Health in the Early Years,” analyzed 1,426 Australian children enrolled in daycare or child-minder settings. Participants were followed at three developmental stages: ages 2-3 (pretend-play assessment), 4-5 (emotional-regulation survey), and 6-7 (mental-health evaluation). Educators rated pretend-play ability using three items that captured solitary imagination, object substitution, and peer role-play. Mental health at ages 4-5 and 6-7 was measured with the Strengths and Difficulties Questionnaire (SDQ), yielding internalizing (anxiety, depression, withdrawal) and externalizing (aggression, hyperactivity, rule-breaking) scores.

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Higher pretend-play ability at ages 2-3 was statistically associated with lower SDQ internalizing and externalizing scores at ages 4-5 and 6-7. The relationship was strongest in educator-reported outcomes and remained significant after controlling for family socioeconomic status, maternal mental health, child vocabulary, and attachment security. Caregiver reports also showed a modest but significant link at age 6-7.

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The investigators hypothesized that emotional regulation at ages 4-5 would mediate the pretend-play–mental-health link. Analyses revealed no evidence that emotional-regulation scores explained the later reductions in behavioral problems, contrary to the team’s expectations. This suggests that other developmental processes, such as embodied cognition, may underlie the observed association.

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• Observational Design: The study cannot establish causality; it only indicates a statistical association.

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• Measurement Scope: Pretend play was captured by three educator-rated questions, potentially overlooking nuanced aspects of imagination.

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• Sample Bias: Inclusion was limited to children already attending formal childcare, excluding families unable to afford such services and possibly reducing generalizability to disadvantaged groups.

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• Reverse Causality: It remains plausible that children with inherently better mental health are more inclined toward pretend play, a direction not tested in the analysis.

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• Unexplored Mechanisms: The lack of mediation by emotional regulation leaves the underlying pathways unclear.

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• The authors emphasize that pretend play appears to have a “unique role” in early development, distinct from language ability and socioeconomic background.

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• They note that the persistence of the association across multiple ages strengthens confidence in the finding.

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• The team recommends incorporating direct observational methods and structured play tasks in future research to address measurement limitations.

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• “The team wanted to focus on whether creative processes are important for mental health and wellbeing for young children.” — Fotini Vasilopoulos, Matilda Centre for Research in Mental Health and Substance Use & CREATE Centre, University of Sydney

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• “Pretend play is the precursor to the performing arts and is also like ‘the secret language of a child’ so looking at pretend play was a natural fit.” — Fotini Vasilopoulos

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• “Pretend play is important for the wellbeing of young children.” — Fotini Vasilopoulos

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• “Play for play sake (not with a learning goal in mind) is also important.” — Fotini Vasilopoulos

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• “The next step is to show this through a randomized control trial.” — Fotini Vasilopoulos

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The research group has completed a pilot program aimed at enhancing pretend-play quality in early-childhood settings and is preparing a follow-up paper reporting preliminary benefits. They plan to design a randomized controlled trial to test causality and to explore embodied-cognition mechanisms using neuroimaging and more comprehensive play assessments.

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