Recent research shows that young children who demonstrate greater ability in pretend play tend to experience fewer emotional and behavioral difficulties when they enter elementary school. Published in early childhood education journalthis study provides evidence that encouraging imaginative play early in life may support improved long-term mental health. The findings highlight the potential benefits of simple childhood activities for psychological well-being.
The authors of the new study sought to explore the long-term mental health benefits of pretend play for children in the general population. Because young children’s cognitive and social skills are still rapidly developing, identifying mental health concerns in young children often requires observing their behavior during play. Previous research suggests that pretend play can help children express emotions and cope with anxiety.
Based on these initial findings, the authors wanted to see whether the ability to engage in pretend play in early childhood predicted improved mental health in early childhood and beyond. “The team wanted to focus on whether creative processes are important for young children’s mental health and well-being,” said Photini Vasilopoulos, a researcher at the Matilda Center for Research in Mental Health and Substance Use and the University of Sydney’s CREATE Center.
“Pretend play is a precursor to the performing arts and a kind of ‘child’s secret language,’ so it was natural to look at pretend play,” Vasilopoulos said.
Longitudinal studies that track these benefits over several years are rare. Most previous studies have focused on small groups of children in laboratory settings or focused on short-term interventions. The researchers aimed to test whether emotion regulation could explain the relationship between play and mental health over time.
Emotion regulation refers to a child’s ability to manage and respond to their emotions in different situations. This is a fundamental skill for good mental health and develops rapidly during the preschool years. Scientists hypothesized that children who engage in complex pretend play may be better able to regulate their emotions and have fewer problem behaviors.
To answer these questions, the authors analyzed data from a large-scale ongoing project called the Australian Children’s Longitudinal Study. They focused on a specific sample of 1,426 children who regularly attend daycare centers or child care providers. The researchers followed these children across three different developmental stages: ages 2 to 3, ages 4 to 5, and ages 6 to 7.
At ages 2 to 3, early childhood educators assessed children’s pretend play abilities. Educators answered three specific questions about the extent to which each child engaged in imaginative activities. These activities included simple pretend play such as pretending to feed a stuffed animal or doll.
The evaluation also included alternatives such as using towels as blankets and turning cardboard boxes into homes. Finally, educators assessed children on peer pretend play. This included using materials to role-play in costumes and play house with other children.
Scientists have described several external factors that can affect a child’s development. These factors include the family’s socio-economic status, which is a combination of income, education, and occupational status. They also controlled for the mother’s mental health, the child’s vocabulary and grammar skills, and the child’s attachment security with the parent.
To measure emotion regulation at ages 4 and 5, parents completed a temperament survey. The study assessed how easily children became distraught and how difficult they were to comfort. A higher score on this scale indicates a lower level of emotional regulation, which means that the child is highly reactive to stress.
Children’s mental health was assessed by both educators and primary caregivers at ages 4 to 5 and 6 to 7 years. They used a widely recognized behavioral screening tool called the Strengths and Difficulties Questionnaire. Children often behave differently at home than at school, so collecting data from both parents and teachers gave us a more complete picture.
This questionnaire measures internalizing problems, which refer to internalized conflicts such as anxiety, depression, and social withdrawal. It also measures externalizing problems, which are external problems such as aggressive behavior, hyperactivity, and rule-breaking. Higher scores on these sections indicate greater mental health problems, and lower scores indicate better psychological adjustment.
The researchers found that higher pretend play skills at ages 2 to 3 predicted fewer internalizing and externalizing problems later in life. This positive association was primarily observed with mental health assessments provided by early educators. This connection became evident when the children were 4 to 5 years old and persisted into 6 to 7 years of age.
Primary caregivers also reported a small but significant association between early pretend play and fewer behavioral problems when children were 6 to 7 years old. The fact that this relationship held even after controlling for family background and language skills suggests that play has a unique role in development.
Vasilopoulos highlighted the main lessons for the public. “Pretend play is important for young children’s health,” Vasilopoulos told SciPost. “It’s also important to play for fun (rather than with a learning goal in mind).”
Interestingly, researchers found that emotional regulation did not act as a bridge between early pretend play and later mental health. The data did not provide evidence that emotional regulation at ages 4 to 5 explains the positive outcomes seen at ages 6 to 7.
This particular finding was unexpected for the research team. Vasilopoulos said the team was surprised that “emotional regulation did not mediate the relationship between pretend play ability and mental health outcomes.”
Because emotion regulation was not a relevant factor, the authors suggest that other unknown developmental processes may be at play. They point to a concept called somatic cognition as a possible explanation. This theory suggests that thoughts are deeply tied to the physical movements of the body and interactions with objects.
During pretend play, children use motor skills to simulate actions, even if the objects are imaginary. These physics simulations support higher-level thinking goals such as improvisation, finding solutions, and solving problems. Previous brain imaging studies suggest that these physical simulations activate specific motor areas in the brain. Scientists note that these same brain regions also appear to play a role in attention and anxiety disorders.
Readers should note that this study is observational. In other words, we cannot prove that pretend play directly leads to improved mental health. This only suggests a statistical association between the two factors.
“This study shows that there is a relationship between pretend play ability and mental health,” Vasilopoulos said. “The next step is to demonstrate this through a randomized controlled trial.”
One limitation of the study is that pretend play was measured using only three questions answered by educators. This simple method may not fully capture the complexity of a child’s imagination.
The study also focused only on children already enrolled in formal childcare programs. This requirement can exclude children from very disadvantaged backgrounds whose families cannot afford regular childcare. As a result, the findings may not fully apply to all segments of the population.
Furthermore, the researchers did not test whether the relationship worked in the opposite direction. It’s still possible that children with inherently good mental health and fewer behavioral problems simply choose to engage in more pretend play. Since the data is based on surveys and questionnaires, there is always room for different interpretations of children’s behavior.
Future research should use more diverse methods to measure pretend play. Rather than relying solely on educator surveys, the authors suggest incorporating direct observations by researchers or using structured play tasks. Scientists also recommend investigating situational factors that may influence play, such as daily screen time limits and different types of educational environments.
The research team is already taking action based on these findings. “We have completed a pilot program to support the quality of pretend play in early childhood and understand its impact on self-regulation and emotional and behavioral difficulties,” Vasilopoulos said. “We plan to publish a paper soon, but we have seen preliminary signs of promise.”
Photini Vasilopoulos, Lucinda Gromit, Sasha Bailey, Louise Birel, Iloise Dumontaille, Gil Francis, Eliza Oliver, Olivia Karaolis, Robin Ewing, Michael Anderson, Marie Teesson, Emma L. Barrett.
