Which statement about pretend or imaginative play in children with autism spectrum disorder is accurate?

• A. They routinely engage in elaborate pretend play
• B. They do not engage in pretend or imaginative play
• C. They only pretend play with caregivers
• D. They have advanced abstract play

Answer: (B)

Pretend or imaginative play relies on symbolic thinking and social interaction. In many children with autism spectrum disorder, there is a notable difficulty with engaging in symbolic or pretend play. They often show limited or absent make-believe activities, sticking to more literal, repetitive, or sensorimotor play rather than creating roles, stories, or imagined scenarios. This pattern reflects challenges with symbolic representation and social reciprocity, which are common features of ASD.

That’s why the statement that they do not engage in pretend or imaginative play best fits typical presentations. These children may show delayed onset of pretend play or rely on very simple, concrete forms of play, rather than elaborate or abstract imagination.

The other ideas—that they routinely engage in elaborate pretend play, that they only pretend with caregivers, or that they have advanced abstract play—do not align with the common ASD profile, where pretend play tends to be diminished or atypical rather than advanced or universally caregiver-specific.