Research into mother-child pretend play and the impact of mental health

Pretend play is a fun way to bond with your under five, and whether you’re running a café together, putting on a puppet show or hunting for pixies, these collaborative, make-believe moments have far-reaching benefits.

There’s evidence that pretend play has a positive effect on children’s developmental outcomes, and parent-child pretend play is an important way for littlies to learn the skills and behaviours that will stand them in good stead as they grow.

That said, pretend play isn’t always easy for all parents. It takes a certain level of creativity and enthusiasm to play in this way, and new research from the University of Cambridge shows that mental health challenges experienced by mums can reduce pretend play interactions between mother and child.

Today, we look at the benefits of pretend play, and explore this research to see the effect that maternal anxiety or depression can have on this kind of play.

Why is pretend play so important?

The University of Cambridge researchers focused on pretend play when investigating the impact of mental health on mother-child play and child development, because this type of play helps children develop key social and emotional skills.

Bright Horizons explains that pretend play is important for child development because it:

• Teaches children about themselves and the world, e.g., their likes/dislikes, interests, abilities and observations
• Helps them work out ‘confusing, scary, or new life issues,’ e.g., going to the doctor
• Develops children’s advanced thinking skills, communication and social skills, e.g., negotiating skills, perspective-taking, planning and delay of gratification
• Develops children’s social and emotional intelligence, e.g., when they learn to ‘read’ social cues, control emotions and take turns, and
• Provides opportunities for children to combine their knowledge and skills, e.g. pretending to run a supermarket incorporates literacy, numeracy and interpersonal skills.

Children can engage in pretend play with their grown-ups and peers; and the University of Cambridge researchers explain that if these essential social and emotional skills are less well-developed, children might experience difficulties as they get older (e.g., when trying to make friends or settle into big school) and, ‘This can, in turn, impact further on behavioural development.’

What did the pretend play research involve?

To explore the impact of maternal anxiety and depression on parent-child pretend play, the researchers worked with families of children aged between 24- and 36-months-old.

Sixty mum-toddler pairs were involved, and the toddlers were chosen because their routine health assessments suggested that they might be vulnerable to developing behavioural problems.

To see how the different pairs played, the mums were given a bag of toys (including things like a toy picnic set and puppets) and asked to play with their toddler, ‘As they normally would.’

These play sessions were recorded as five-minute videos, which were then split into five-second clips. The researchers then analysed all 3,600 clips and documented the times when mums and toddlers both engaged in pretend play (e.g., when they pretended to eat picnic food, or created make-believe characters using the puppets).

As well as videoing the mother-child play, the researchers also asked families to answer some questionnaires at the start of the research, and two years later, to measure:

• Each mum’s depression level, on a scale of zero to 27
• Each mum’s anxiety level, on a scale of zero to 21, and
• Each child’s behaviour problems, using a Child Behaviour Checklist.

What did the research find?

As a result of all this visual and written information-gathering, the researchers found that:

• Mums with lower anxiety levels were more likely to engage in pretend play with their children than mums with higher anxiety levels.

Although higher maternal anxiety was linked with less pretend play by mums, it’s interesting to know that the researchers didn’t find a similar association amongst mums with depression.

• Higher levels of maternal depression did have an effect on children’s pretend play, however the research found that children engaged in more make-believe play if their mother had lower levels of depression or anxiety.

In percentage terms, children whose mums had moderate anxiety (measuring 10 to 14 on the zero to 21 scale), ‘Typically engaged in imaginative pretend play for around 10% less time than those of mothers with no anxiety issues.’ 

What this means is that if two mums engaged in pretend play as often as each other, but one mum had higher anxiety or depression, their child would, ‘Tend to engage in less pretend play.’

More research is needed to explain exactly why this is, but the researchers suggest that maternal depression and anxiety may reduce children’s pretend play because parents grappling with mental health challenges:

• Might be less likely to notice or correctly interpret their little one’s pretend play signals,
• Have trouble coming up with pretend play ideas, or
• Feel too negative to join in.

• The research also suggests that a mum’s pretend play might help to reduce the risk of behavioural problems in her child.

Two years after the mother-toddler play sessions, the researchers found ‘some limited evidence’ that behavioural problems were less common in the children whose mums engaged in more pretend play when they were two- or three-years-old.

They say this suggests that, ‘Pretend play may be a protective factor preventing the development of behavioural problems in children.’

What’s the wrap-up of this research?

It’s vital that parents with depression or anxiety receive the support they need, and this research suggests that families impacted by maternal anxiety and depression could benefit from interventions that support mums to engage in pretend play with their children and help to reduce the risk of adverse outcomes for youngsters.

Supporting mums’ mental health promises to strengthen their role as a ‘protective playmate,’ and this research reminds us to take the time to engage in pretend play with our toddlers, preschoolers and young schoolchildren.

Researcher, Dr Zhen Rao explains that, ‘Parents are usually [our] child’s first play partners, so [we] fulfil an essential role, through pretend play, in helping children to learn skills like how to communicate, control their emotions, and co-operate with others.’

At home, prop boxes, play kitchens, puppets, dolls, and made-up stories and games can all inspire make-believe moments, and we wish your family well as you engage in pretend play together.

Key references

University of Cambridge

Bright Horizons