Longitudinal Evidence of the Relationship Between Pretend Play and Mental Health in the Early Years

Abstract Empirical evidence suggests that pretend play can help children manage anxiety. Few longitudinal studies have explored the benefits of pretend play on the mental health outcomes of children in the general population. The current study explored longitudinal associations between pretend play at age 2–3 years old and mental health outcomes at age 4–5 and 6–7 using data from the Longitudinal Study of Australian Children, which included children born in 2004 ( N = 1,426). We also examined whether emotion regulation mediated this relationship. Children’s mental health was measured using the Strengths and Difficulties Questionnaire completed by primary caregivers and educators. Higher pretend play ability at age 2–3 was associated with fewer internalising and externalising problems, even after controlling for attachment to main carer and other known predictors. Emotional regulation was not a significant mediator, suggesting that other unexplored factors may have mediated this relationship. These findings suggest that pedagogical practices and high-quality preschool experiences that support the development of pretend play ability could contribute to reducing children’s mental health difficulties into primary school.