Pretend play at 3

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DS will be 4 at the end of the year. I've noticed that his pretend play doesn't appear to be as well developed as some of his peers - this is mainly just from what I've seen in parks etc, but also compared with one or two friends' children.

He has no problems playing pretend of basic, every day scenarios eg will make pretend food in his kitchen, pretend to go to the shop, pretend to give his baby doll milk or take it for a walk in its pushchair (he has a baby sibling). He also pretends objects are something else (he does this well/a lot). He'll wiggle on the floor and say I'm a snake! Or occasionally say there's a monster or something.

But that's as far as it goes. The peer children I've seen seem to play pretend much more elaborately eg make a huge game of it. DS' pretend play is always short lived.

The main thing he does when playing - and I mean up to 80-90% of the time - is drive vehicles around or pretend he is on a vehicle (eg ship at the park) and make the relevant sound effects. Over and over again. There is the odd bit of standard narration eg "land ahoy" if he's on a pretend boat, but it's mainly the sound effects.

Is this typical? I don't think it is, but I don't want to seem fussy...

What are your 3-4 year olds' pretend play like?

My DS was like this at 3-4 and still is at 5 years old. He prefers vehicles, or construction-type activities. At that age, he pkayed a lot with his train track. He will sometimes do role play, e.g. get the doctors set out, but he never makes up any kind of story or scenario. Instead he will ask what hurts, then use every tool in the set to "examine" me, e.g. use the stethoscope etc, then he puts a bandage on and that is it. He wouldn't think to ask how I hurt myself, for example.

Like your DS, he makes a lot of vehicle noises when he is playing with vehicles, with the odd bit of humming/singing or the odd few words, but I can never make out a scenario or story. He used to be really into Paw Patrol and would play with the vehicles and their characters, but nothing more than pushing them around making the vehicle noises, or maybe setting up the story that he has already heard on tv. He is quite good at pretending objects are something else, e.g. make a birthday cake out of playdough and stick some candles in it.

I am now planning to request a referral for ASD assessment, because DS has some other potential ASD traits too, e.g. difficulty reading social situations and making friends, repetitive play, obsessions with one tv show at a time, and currently an obsession with maths. If it was just the lack of imaginative play, I wouldn't worry, but combined with the other things it does suggest there could be something underlying I think. I'm not meaning to worry you - they are all individuals and if the lack of imaginative play is the only thing worrying you then this probably isn't relevant to you.

Wow, my DS sounds identical in terms of his play! And yes, ASD is a worry to me. There is a referral in process, but it'll be a long time before he's seen. It was made based on some very minor things, but as you say, all put together, it can indicate an issue.

What's your DS like in terms of sharing interest? I keep reading how key that is, and my DS has/does definitely shares interest - pointed to share interest at 13 months, still always says look mummy an xyz whenever he sees something.

I'd be really interested to hear more about your DS as he sounds so similar to mine.

He does share things with me often, so I haven't been concerned about that. I can't remember exactly when he started pointing, it may have been around 14 months or so. I remember being concerned at the time about it and mentioned it to the HV at his 1 year check, but a couple of months later he started doing it.

I guess the other thing I would say about DS in terms of play, is that he very much likes to be in control. He's rarely open to me suggesting something, and if he wants me to play with him, he insists on leading it. I think this makes it difficult when playing with peers, and is probably one of the reasons he struggled socially in reception. I think he often excluded himself rather than compromise with his peers on what or how to play.

We have been thinking about the ASD assessment for some time now, but we have been back and forth on it a lot because his social issues could also be due to immaturity, particularly because he is August-born. I will say that he has improved over the year and definitely made some strides in terms of forming relationships in summer term.

Alongside the ASD assessment, I'm now trying to think now of better ways to support him, as this is probably the most important thing really whether he is diagnosed or not. He is quite bright and is unlikely to get any additional support at school. The main issue is really with social skills, although I suspect the lack of imagination will probably make writing more difficult. But on the plus side, he is very good at maths!

Yes I've heard about the control element being linked to ASD. My DS isn't like that so much, in fact he's always looking for me or DH to play with him and is happy to be led. So I don't know how he would be with peers if they were taking the lead, I'm more concerned about the fact that his limited imagination would mean he can't contribute all that much to the game and so gets left out, or would leave himself out on purpose.

My DS has only just started nursery school so we have another year before he starts reception. I don't think he needs any support currently either, as he doesn't seem to struggle particularly and isn't rigid with routines etc.

Good to hear your DS is good at maths! I hope mine is too as it's definitely a good strength to have. My DS is very interested in how things work, so he has more "imagination" in that area I guess...

Forgot to ask, what repetitive play have you noticed from your DS?

This is a very interesting topic, but also a difficult one. One thing to remember is that ASD is a social communication disorder, not a social disorder (autistic children can be very socially motivated) or a repetitive disorder (we all have repetitive behaviors) or any other type of disorder. The problem with some of the stereotypical and repetitive behaviors linked to ASD is that typically developing children will also do them (as some of them like spinning/crashing/jumping are very fun to do) and hence if in isolation tend to not be concerning. To diagnose ASD clinicians will first need to see significant deficits in social communication before they even look at any other behaviors. Things like wanting to play alone, or not wanting to play with other children because they do not do what he wants them to do (to some extent) would not be classified as deficits in social communication - much of this can be linked to just personality or temperament. Wanting to play with other children and make friends but not being able to because they are unable to understand the social cues or unwritten rules required to form friendships is what they would be looking for. An example of this would be a child not being able to read the facial expressions (happy/sad/annoyed/etc) of other children to see how they react to their actions (be positive or negative) as that is what they will use to learn how to compromise/sympathies in order to make friends (they will start to understand that certain facial expressions, like a peer getting annoyed, will require them to either compromise or potentially loose a friend), i.e. what works and what does not. If these types of behaviors are present they would expand their criteria and start looking at repetitive behavior, imaginative play, etc. A simple test that they perform (and you can perform) is to show them photos of children and adult faces (happy, crying, worried, surprised, etc) and ask them how are they feeling, the results can be interesting.

If ASD is present normally the best time to 'see it' is between 18M-36M because after 3YR old they become much more aware of what other people do and begin to mask and conform to what is required, before 3YR old they are in their 'pure form' and do not mask/hide, i.e. what you see is what they are. Typically between 18M-36M the most important signs are those linked to social communication, so lack of pointing to share interests, weak social referencing, poor eye contact for communicative purposes, not seeking praise, not showing you items of interest, etc. If a regression occurs (also refered to the onset of autism) where they loose skills, it tends to happen around 18-24M, after 3YR it is very very rare.

Thanks Aladdinmum.

My DS would ace any test looking at pictures of people being happy/sad etc. He knows when I'm cross just from my face, even if I'm not frowning.

I think social cues are so much more than just facial expressions though. A reasonably bright child will know someone is happy if they're smiling.

No issues were picked up with my DS before he turned 3 because he hadn't been in a pre-school environment much until he reached 2.8. He went to private nursery one day a week and no issues were ever flagged there, but I imagine at 2-3 nursery workers would expect parallel play and not expect children to be overly socially sophisticated with their peers. I think often issues only become apparent as the child gets older, sadly, and is obviously different to their peers. The only thing that ever could be said about my DS at age 2-3 was that he played (and still does) with vehicles a lot, always at eye level. But he's not the only little boy I know who does this, so it never concerned me.

I don't know about my DS, obviously, otherwise I wouldn't have posted this! But I do feel that he's most likely on the spectrum somewhere.

Indeed, they do say that most communication (even between adults) is non verbal, so reading facial expressions is just one of many social cues. However, I do agree that some cues like facial expressions can be learned by those on the higher functioning side of the spectrum, they are able to learn/mask and come up with coping strategies to 'fit in' but as they get older and the social demands intensify these coping strategies can start to break down.

It is the right thing to get him assessed if you have worries about his development, specially as it sounds ever so subtle (normally ASD is not subtle). One thing to keep in mind is that, if he is somewhere on the spectrum, then it would have been there from an early age where we would not have had any coping strategies, and while he did not have to (or be expected to) communicate/interact much with with his peers at nursery he would have had to communicate with you hundreds of times a day to both meet his needs and share enjoyment with you. ASD, if had been there, would have interfered (at some level) with every one of those attempts to socially communicate with you.

He's never had any issues communicating his interests or wants, from an early age anyway. He seems to play well superficially with peers eg in softplay, the park. It's the more sophisticated elements of relationships and friendships that I fear he'll struggle with. We shall see though. Some days I'm certain he is on the spectrum, others in certain he's not.