A review of research into pretend play in autism.

Gilbert (2003) pulled together every paper on pretend play in autism. The goal was to see if autistic kids really lack pretend skills and what helps them show those skills.

The review covered many ages and many study designs. It looked at free play, structured tasks, and how testers asked the questions.

Autistic children do show clear pretend-play deficits when they must start the play on their own. The gap shrinks when an adult gives prompts or asks the child to show understanding instead of creating new play.

Structure matters. Comprehension tasks and adult help let the same kids look far more competent.

Irvin et al. (1998) saw the same toddlers years earlier. They also found atypical play, but noted some symbolic acts still appeared. Christopher’s wider view confirms the deficit yet shows it softens under support.

Hobson et al. (2009) went deeper. They agreed autistic kids can do the motions, but added the play lacks creativity, fun, and self-awareness. The 2003 review set the stage; the 2009 study colored in the details.

Watson et al. (2007) and Gutierrez et al. (2016) took the next step. Once the deficit was clear, they tested fixes. Both used video modeling and got better play scores, proving the gap can be narrowed with ABA tools.

Do not write “no pretend skills” in your report. Instead, write “needs structure to show pretend skills.” Start sessions with a quick model or scripted prompt. Use comprehension checks—ask “What’s the doll doing?”—before you ask the child to invent a story. These small shifts turn silent kids into players.