Patterns of play in early childhood shed much light on how a child’s brain is processing information in the environment. Children by 18-20 months of age begin to engage in imaginative or ‘make-believe’ play activities. They will make a toy airplane fly through the air or pretend to drink from a small cup. They understand the use of most common items around the house and will use them in a purposeful manner, such as sweeping with a toy broom.
Once a child is using most objects appropriately, they will begin to sequence out play tasks involving 2-3 steps that are related to each other. They will pretend to feed a doll, pat it, and then lay it down to sleep. Or they may pretend to prepare play food, put it on a plate, and then serve it to someone in the family. The child is typically flexible and creative in their play and having others join in is usually welcomed. Atypical patterns of play that are often cause for concern include lining up objects on a surface, gathering small toys that are unrelated into piles for no clear reason, or only paying attention to the moving parts of toys, such as watching the wheels of a car. Sometimes children will insist on holding small toys in their hands, even while playing with a different toy. Or they will demonstrate patterns of play that are inflexible or rigid, such as only stacking blocks with the letters facing a certain way, or a particular order of items that cannot be interrupted.
Children may become distressed or upset when others attempt to show them a different way to play with their toys. They may become easily frustrated and knock all their blocks off the table or begin throwing toys. Obsessions with particular toys and not showing an interest in a wide range of playthings may also be a sign that a comprehensive assessment is needed. Make-believe play is an important sign of brain development that inserts itself naturally into a child’s play. If you have any concerns about your child’s patterns of play around 18 months of age, do not wait to have a comprehensive developmental assessment from a licensed psychologist, along with early autism testing.