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Can Children with Autism Pretend Play?

Although children with autism face difficulties in generating pretend play acts spontaneously during free play, they do have the ability and capacity to engage in and understand pretend play, such as when there are instructions to pretend.


Pretend play happens when children engage in pretence and imagination during play. Examples of children engaging in pretend play include animating dolls, having pretend tea parties, feeding teddy bears, using a banana as a telephone, and dressing up as pirates and pretending the box is a ship. This form of play starts to emerge at about 12 to 18 months of age and it emerges by the age of 3 where typically developing children can independently and spontaneously engage in pretend play.

In contrast to typically developing peers, pretend play is often delayed in children with autism where they tend to engage in fewer acts of pretend play spontaneously or that there is a lack of pretend qualities during play. In addition, children with autism engage in “more intense, repetitive interactions with objects” and hence the quality of pretend play in children with autism tends to be “limited, sterile, and ritualised.” Pretend play is important for children as it is associated with social and cognitive development and the development of social, language, and communication skills. Exercising one’s imagination during pretend play may also contribute to planning and problem-solving skills.

Skills Needed for Pretend Play

Why is it that children with autism face difficulties with pretend play compared to typically developing children? Several theories have been used to hypothesise the reasons behind the delays or differences that children with autism show in pretend play. Researchers have also studied several skills to test if they play a role in the development of pretend play. Here I present some of the factors that have supporting evidence to show that they may contribute to the difficulties that children with autism have with pretend play.

Lack of Joint Attention Skills

Joint attention behaviours include the gesture of pointing to highlight, share, or to show interest in an object, as well as using alternating eye contact to check if others are attending to the same object or event as them (i.e., coordinated joint attention). Pretend play and joint attention are likely to influence one another: joint attention skills are needed to engage in play and pretend play also contributes to the development of joint attention. A longitudinal study has shown that joint attention skills are crucial in the development of pretend play for both typically developing and developmentally delayed children. Thus, the lack of joint attention skills in children with autism may have interfered with the development of pretend play.

Deficits in Generativity

Children with autism may experience difficulties producing pretend play due to generativity problems, such as difficulties in generating new ideas and actions that are needed during pretend play. During free play periods, they are less likely than typically developing children to engage in acts of pretend play spontaneously. However, this does not mean that they do not have the ability to engage in pretend play. Studies that provide instructions for children to pretend find that children with autism do have the ability to engage in pretend play. Thus, the reduction in the production of pretence during play lies in the difficulty with generating ideas or self-initiated actions for children with autism.

Additionally, some researchers have hypothesised that the difficulties or delays that children with autism face with pretend play may be due to the lack of imitation skills. However, studies have found that imitation skills are unrelated to the development of pretend play. Other researchers have hypothesised that the deficits in meta-representational skills may interfere with pretend play development for children with autism. A lack of meta-representational skills means that children with autism may have difficulties in “representing how another represents the world,” which also indicates the global inability to engage in pretend play. Contrary to the meta-representational deficit explanation, children are able to produce pretend play under certain circumstances, such as when there are prompts for children to engage in pretend play. Hence, research evidence shows that the lack of meta-representational skills does not explain the deficits in pretend play for children with autism.


In conclusion, although there may be delays or differences in the development of pretend play among children with autism, children with autism have the abilities to engage in pretend play as shown by studies that find that children with autism engage in pretend play acts similar to typically developing children when they receive instructions or prompts to perform.

While pretend play is associated with certain developmental skills and outcomes, there is a lack of supporting evidence on whether pretend play has a causal influence on later developmental outcomes in children. Moreover, it might be the case of equifinality, where pretend play acts as a by-product that contributes to later developmental outcomes. Hence, more research is needed to establish a greater understanding of the importance of pretend play in contributing to later developmental outcomes.

Written by Sylvia.


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