Investigating parent-child pretend play in early school-aged children referred for symptoms of emerging mental health difficulties

Sheehan, Catherine 2026. Investigating parent-child pretend play in early school-aged children referred for symptoms of emerging mental health difficulties. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

This thesis focused on pretend play in early school-aged children exhibiting emerging mental health difficulties, as they played with a parent. This was investigated in the context of children referred to Cardiff University’s Neurodevelopment Assessment Unit. In Chapter 1, key definitions and theoretical perspectives pertaining to pretend play were reviewed. This informed the development of an observational coding scheme in Chapter 2, designed to capture individual pretence (enacting, storytelling, and negotiating) and non-pretence (organising) behaviours during play, whilst aligning with how these behaviours have been coded across previous frameworks. Findings showed that parents and children organised the play more than they pretended, but when pretending, children emerged as enactors and parents as negotiators. Individual child differences were investigated, and parent-child play behaviours were associated with each other. Chapter 3 assessed associations between children’s mental health difficulties and individual pretence behaviours. Parent engagement in pretend play was not associated with parents’ symptoms of anxiety or depression, but children with greater symptoms of depression engaged in fewer negotiating behaviours after controlling for covariates. At a bivariate level, children with greater hyperactivity difficulties engaged in more enacting behaviours. Chapter 4 presented a characterisation of the thematic content of the observed pretence, finding that parent and child themes were associated with each other. Aggressive themes were the least common theme, but when children engaged in aggressive pretence, this was positively associated with children’s peer difficulties. Children with more symptoms of depression engaged in fewer caring themes. Chapter 5 probed these associations further by assessing if children’s emotion regulation skills explained any further variance in children’s pretend themes, beyond that explained by child mental health difficulties. Although some prior work had linked children’s emotion regulation capacities to children’s affective pretend content, the current study found no evidence to support an association. ii Chapter 6 discussed evidence from this thesis that suggested parent-child pretend play was a meaningful interactional context, while also considering how methodological choices may have influenced findings and the conclusions drawn. This chapter also discussed how findings broaden the inclusivity of current understanding of pretend play by examining an overlooked group of children, and how subclinical mental health difficulties relate to children’s play behaviours. It also provided support for the need to measure pretend play at a fine-grained level and highlighted a continued role for parents as play partners of early school-aged children.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Psychology
Date of First Compliant Deposit:	7 September 2026
Last Modified:	08 Sep 2026 08:48
URI:	https://orca.cardiff.ac.uk/id/eprint/189427

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