Cognitive underpinnings of pretend play in autism.
Pretend-play delays in autistic preschoolers stem more from theory-of-mind gaps than from executive-function weaknesses.
01Research in Context
What this study did
The team watched autistic preschoolers play. They scored how well the kids pretended.
They also gave two quick tests. One checked theory-of-mind skills. The other checked executive function.
The goal was to see which test better predicted pretend-play delays.
What they found
Autistic children showed clear pretend-play delays compared to peers.
Theory-of-mind scores predicted these delays. Executive-function scores did not.
How this fits with other research
Jarrold et al. (1994) saw no group difference when kids only had to watch simple pretend acts. Rutherford et al. (2003) shows the gap grows when kids must create their own play. The two studies used different tasks, so both can be true.
Dall et al. (1997) found autistic kids could copy one pretend action but fell apart on multi-step scripts. The new data say the breakdown is rooted in theory-of-mind, not general planning trouble.
Shawler et al. (2021) later proved that brief pretend-play lessons can boost imagination in older autistic children. This supports the idea that the delay is movable, not fixed.
Why it matters
When a child struggles to feed a doll or sail a toy boat, look first at perspective-taking, not at working-memory or shift skills. Target theory-of-mind with simple social stories, role-reversal games, and thought-bubble activities. These moves may unlock pretend play faster than broad executive-function drills.
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02At a glance
03Original abstract
This article examines the cognitive underpinnings of spontaneous and prompted pretend play in 28 young children with autism, 24 children with other developmental disorders, and 26 typical children. The article compares theories that consider either theory of mind (ToM) or executive function (EF) to be causally important deficits in the development of pretend play in autism and important factors in pretend play. Each of these two theories posits a cognitive precursor to pretense, which would need to be present in typical development, and the absence of which could explain pretend play deficits in children with developmental disabilities such as autism. We tested which of these theories better predicts a child's production of pretend play. Children with autism were significantly delayed on pretend play scores. They also had significant deficits in our ToM measure, but not our EF measures. Regression analyses suggested a role for our measure of generativity, one of the EF measures.
Journal of autism and developmental disorders, 2003 · doi:10.1023/a:1024406601334