Summary: Toddlers who display strong pretend-play skills are far less likely to have emotional and behavioural problems when they reach primary school. A major longitudinal study of more than 1,400 Australian children identified a consistent link between early imaginative play and better mental health outcomes later in childhood.
The research indicates that pretend play is more than simple entertainment: it appears to be a core developmental activity that supports long-term emotional wellbeing. These associations remained after accounting for family socioeconomic status, the mother’s mental health, language ability, and the security of the child’s relationship with caregivers.
Key Facts
- Predictive power: Children rated higher in pretend play at ages two and three showed fewer emotional and behavioural difficulties between ages four and seven.
- Not explained by emotional regulation alone: Contrary to expectations, emotional regulation did not account for the link, suggesting other developmental mechanisms are at work.
- Brain-body connection: The study’s authors highlight embodied cognition as a possible factor—pretend play may engage motor and sensorimotor brain networks that influence attention, anxiety, and resilience.
- Cultural shift concerns: Researchers warn that increasing screen time and more rigid, structured schedules may be reducing opportunities for the free, imaginative play that supports healthy development.
Source: University of Sydney
Overview
A new interdisciplinary study led by Dr Fotini Vasilopoulos at the Matilda Centre for Research in Mental Health and Substance Use and the CREATE Centre examined links between early pretend play and later mental health in a representative Australian sample. Using data from the Longitudinal Study of Australian Children, the team tracked more than 1,400 children born in 2004 and followed their development across early childhood.
Educators assessed the children’s pretend-play abilities when they were two and three years old. Mental health outcomes were then measured using parent and educator reports when the children were aged four to five and again at six to seven. The association between early pretend play and fewer later difficulties persisted after controlling for known predictors such as attachment to the main caregiver, family socioeconomic position, maternal mental health and child language skills.
Pretend play and mental health: what the study found
Pretend play involves acting out imagined scenarios—using everyday objects as props, assigning roles, and creating stories. While often dismissed as mere fun, this study suggests pretend play supports developmental processes that protect mental health. Children who showed stronger pretend-play skills early on had lower rates of both internalising (anxiety, withdrawal) and externalising (aggression, disruptive behaviour) problems in early school years.
The findings shift attention to the very early years, when foundational skills develop rapidly and before many children enter formal schooling. Prevention efforts that focus only on later childhood or adolescence may miss this important window.
Why this matters for families, educators and policymakers
Because the study used a large, population-based sample, its results are relevant for families, early childhood educators and policy makers seeking scalable strategies to support child mental health. The researchers note a worrying trend: children today often have fewer opportunities for unstructured, imaginative play because of increased screen exposure and more scheduled activities. Restoring time and space for child-led pretend play could be a simple, low-cost way to support emotional development at scale.
Mechanisms: emotional regulation and embodied cognition
Surprisingly, the researchers found that emotional regulation did not mediate the relationship between early pretend play and later mental health. This suggests other, less well-understood mechanisms are involved. The team proposes embodied cognition as one promising avenue: pretend play engages the body and motor systems in ways that may shape attention, arousal and anxiety regulation, thereby contributing to resilience.
Practical tips to encourage child-led pretend play
The study offers concrete, evidence-informed suggestions for nurturing pretend play at home and in early learning settings:
- Allow play to unfold: Avoid turning play into a teaching moment. If a child mislabels an object or makes an error during play, prioritize the flow of imagination over correction.
- Follow the child’s lead: Join play by waiting for the child to “serve” first. Respond and build on their cues rather than introducing your own agenda.
- Use observations, not instructions: Describe what you see or wonder aloud about what might happen next, rather than giving directives.
- Participate inside the play: If you join, ask the child what role you should play or offer to be a gentle, low-power character—someone who supports the child’s imaginative choices.
“Pretend play doesn’t need to be elaborate,” noted Dr Vasilopoulos. “Simple, child-led involvement from adults can help develop the pretend-play skills that our study links to better mental health outcomes later in childhood.”
Key Questions Answered
Q: What counts as pretend play for toddlers?
A: Pretend play is when a child creates imagined situations—using a block as a phone, feeding a stuffed animal, or acting as a doctor. The defining feature is assigning new meanings to objects and roles.
Q: If my child doesn’t pretend much, will they develop mental health problems?
A: No. The study shows an association, not a certainty. Pretend play is a skill that can be nurtured; gentle, child-led play with an adult can strengthen imaginative abilities.
Q: Should I correct my child’s mistakes during play?
A: Generally no. Correcting facts during play can interrupt imaginative flow. Letting a child’s symbolic choices stand supports their creative and cognitive development.
Editorial Notes
- This article was edited by a Neuroscience News editor.
- The journal paper was reviewed in full by our editorial team.
- Additional contextual information was provided by staff to aid reader understanding.
About this research
Author: Emily Fraser
Source: University of Sydney
Contact: Emily Fraser, University of Sydney
Image Credit: Neuroscience News
Original research: Longitudinal Evidence of the Relationship Between Pretend Play and Mental Health in the Early Years. Authors include Fotini Vasilopoulos, Lucinda Grummitt, Sasha Bailey and colleagues. Published in Early Childhood Education Journal. DOI: 10.1007/s10643-026-02150-7. Open access.
Abstract (summary)
This longitudinal study used data from the Longitudinal Study of Australian Children (N = 1,426) to examine links between pretend play at ages two to three and mental health outcomes at ages four to five and six to seven. Pretend-play ability predicted fewer internalising and externalising difficulties, even after adjusting for attachment to the main carer and other known predictors. Emotional regulation did not mediate this relationship, indicating other mechanisms may be responsible. The findings suggest that early childhood practices and high-quality preschool experiences that foster pretend play could reduce the prevalence of mental health difficulties as children enter primary school.