The importance of pretend play in child development: an occupational therapy perspective

Play is a complex behaviour and is defined as being more internally than externally motivated, transcending reality as well as reflecting reality, controlled by the player, involving more attention to process than product, safe, usually fun, unpredictable, pleasurable and spontaneous and involving non-obligatory active engagement (Bundy 1997, Stewart et al 1991). Pretend play, which occurs between the ages of 18 months and 6 years, reflects these qualities of play. Using the World Health Organization's classification of body functions and structures, activities and participation (ICIDH-2, WHO 1999), this paper outlines the skills that are essential for pretend play ability and asserts that if there are any impairments in these skills the child experiences a reduced ability to pretend play. This leads to possible participation restrictions in the child's life, such as difficulties in fulfilling usual social roles. Cognitive, social and emotional skills are presented as having the biggest impact on pretend play development, while the motor and sensorimotor skills that enable the child to manipulate objects in the environment are presented as being of secondary importance. Two models are offered which illustrate the importance of pretend play to child development and the sequence of play development. The paper concludes by recommending that occupational therapists address and reduce the participation restrictions that some children experience in learning and social situations by enabling a child to increase activity in pretend play.