The Relation Between Pretend Play and the Development of Self-regulation: A systematic Review
University of Amsterdam Elizabeth Wynberg
10742557
Assessor: A. van den Akker Date: 29/1/2017 Word count: 5652
Table of contents
Abstract ...3
The relation between pretend play and the development of self-regulation...4
Method ...6
Results...7
The relation between pretend play and emotion regulation...7
The relation between pretend play and behavioral regulation...10
Discussion ...16
References...20
Abstract
This systematic review assesses the relation between pretend play and the development self-regulation in children (age range: 2-10 years), by reviewing previous empirical research. Most im-portantly, results revealed that pretend play showed a significant relation to both emotional and be-havioral self-regulation. A factor that proved to be of particular importance, was the theme of the pretend play session. Furthermore, regarding the relation between pretend play and behavioral regu-lation, it was important that it concerned social pretend play; considering that having play partners means having to negotiate and adhere to rules. The importance of pretend play should not be under-estimated; children should receive sufficient opportunities for developing certain self-regulatory skills in situations that pretend play can facilitate.
The Relation Between Pretend Play and the Development of Self-regulation Play is the work of the child.
–Maria Montessori, The absorbent mind, 1949.
Within Western society, the focus keeps shifting more towards the achievement of academic success regarding the development of young children (McWayne, Fantuzzo, & McDermott, 2004; Nicolopoulou, de Sá, Ilgaz, & Brockmeyer, 2009). This causes the acquisition of academic skills to start at increasingly younger ages (e.g. head start & Voor-schoolse Educatie), even though results on the effectiveness of early education programs are ambiguous (Fukkink, Jilink, & Oostdam, 2015). Moreover, these programs cut into time that children could use for play, an activity that can be regarded as vital to their development (Bodrova, Germeroth, & Leong, 2013; Göncü & Gaskins, 2012; Vygotsky, 1967). One type of play, specific to the human species, is regarded as the most important learning activity for children during the pre-school period, namely pretend play (Galyer & Evans, 2001; Gómez, 2008; Van Reet, 2015).
Pretend play refers to playing in an “as if” mode and requires a high level of cognitive de-velopment, distinctive to the human species (Bergen, 2002). This type of play can be referred to by different terms: imaginative play, make-believe play, fantasy play, symbolic play, or socio-dramatic play. Several criteria serve to specify what constitutes pretend play: acting out familiar activities without the necessary materials or relevant social context, substituting objects or gestures for one another, acting out situations to an unusual outcome, treating inanimate objects as animate, or per-forming an activity usually done by someone else (Fein, 1981). Pretend play is accompanied by interactive social dialogue and negotiation and it often involves role playing, the use of scripts, and improvisation (Bergen, 2002).
One major play theorist, Vygotsky, referred to pretend play as the activity that embodies the child's relationship to social reality (Vygotsky, 1967). Children need to develop understanding of a uniquely complex social environment, and in order to function within this environment, self-regulation is vitally important (Vygotsky, 1967). Developing self-self-regulation is an intricate part of
the socialization process of children in their early developmental years (Hammond, Bibok, & Carpendale, 2010). During these years, babies shift from total regulation by parents to gradually regulating themselves more as toddlers, and this gradual process continues throughout their child-hood (Bernier, Carlson, & Whipple, 2010). The start of this development occurs during the same time-period as that of engagement in pretend play.
Self-regulation refers to a child’s abilities to function according to everyday norms and to follow the customs of his or her surroundings (Crafa, 2015). It requires a child to become aware of his or her own actions, thoughts, and feelings in relation to those of others as well as requires the ability to act according to societal, family or other social values, in the absence of an external moni-tor (Crafa, 2015). Self-regulation is a multidimensional construct that encompasses both emotional and behavioral components. The emotional component is referred to as emotional regulation; multi-ple skills including monitoring, evaluating and regulating one’s emotional experience and the ex-pression of these emotions (Galyer & Evans, 2001; Hoffmann & Russ, 2012). The behavioral com-ponent consists of different forms of regulating one’s behavior (e.g. inhibitory control, or inhibit-ing/delaying a response).
While children engage in pretend play, they develop and practice self-regulatory skills. Dur-ing pretend play, they need to create and plan the play scenario’s, discuss and negotiate rules, and agree upon the direction of play together (Hoffmann & Russ, 2012). The play scenarios give chil-dren the opportunity to experience different characters, roles within society, emotions, and activities involving high levels of emotional arousal, to subsequently learn about their own emotions and be-havior (Galyer & Evans, 2001). Moreover, they learn that in order to play with others, a certain amount of regulation of their behavior and emotions is necessary (Cemore & Herwig, 2005; Hoff-mann & Russ, 2012). Children develop this capacity for emotion and behavioral regulation, mainly by creating and following their own rules (Vygotsky, 1978; Galyer & Evans, 2001).
Additionally, when determining what role an object should fulfill in the pretend play situation, chil-dren notice they are no longer bound by the present reality, but have control over the pretend
situa-tion by focusing on internal ideas and regulating their impulses (Savina, 2014). These
self-regulatory skills emerge, are practiced and developed, and are necessary for a successful socializa-tion into society (Hoffmann & Russ, 2012).
Investigating the association between pretend play and self-regulation can facilitate a better understanding of this relationship as well as assess the importance of play and self-regulation in a child’s development. Therefore, by examining previous scientific research, this systematic review will attempt to assess the relation between pretend play and the development self-regulation in chil-dren (age range: 2-10 years). Self-regulation can be divided into two separate constructs, emotional regulation and behavioral regulation. Therefore, this thesis is divided into two subsections; the first question assesses the relation between pretend play and emotion regulation. Secondly, the relation between pretend play and behavioral regulation will be discussed. The thesis will close with an overall discussion.
Method
This systematic review was conducted according to the Preferred Reporting Items for Sys-tematic Reviews and Meta-Analyses (PRISMA) (Moher, Liberati, Tetzlaff, & Altman, 2009). The literature search was conducted through the search engines ERIC and PsycINFO. The following search terms were entered; terms for pretend play included (pretend play* or make-believe play* or fantasy play* or socio-dramatic play* or symbolic play*), this was either combined with terms for self-regulation (self-regulat* or self-control*), terms regarding behavioral regulation (behavior reg-ulat* or inhibitory control or inhibition or delay of gratification), cognitive regulation (cognitive regulat* or executive function*), and lastly with terms for emotion regulation (emotion regulat* or affect control*).
In order to be eligible for this systematic review, articles had to be written in English and published in a peer reviewed journal, between 2000 and 2016. Only empirical articles concerning original data on the relation between pretend play and self-regulation were included. One important
exclusion criterion pertained to studies regarding autism. Autism is a very broad and intricate con-struct that is beyond the scope of this systematic review to include and discuss.
The search of all terms on the two search engines initially produces eighty-five articles, and an additional three were identified through the reference list of already included articles. After four-teen duplicates were removed, another eleven where excluded given the preset criteria. By reading the abstracts, and the full articles when necessary, it was determined whether the article was rele-vant, provided that the study concerned the relation between pretend play and self-regulation and adhered to all other inclusion and exclusion criteria. Of the remaining sixty-three studies, a total of twenty studies were finally included in the systematic review, (see Figure 1).
All included studies were conducted in the United states of America and the samples used are predominantly Caucasian children unless otherwise noted. Regarding the family background, the studies are spread from lower to upper-class, with most studies pertaining to mainly middle-class. The total number of participants, of all studies assessed in this systematic review, is 1459 children (49.4% girls), ages 3 to 10 years and 528 self-regulatory events.
Results
This systematic review assesses the relation between pretend play and self-regulation. Self-regulation is divided into two separate constructs, discussed separately in this section. Firstly, the results regarding the relation between pretend play and emotional regulation will be assessed, after which the relation pretend play and behavioral regulation will be discussed.
The relation between pretend play and emotion regulation
Six studies pertained to the relation between pretend play and emotion regulation (Galyer & Evans, 2001; Gilpin, Brown, & Pierucci, 2015; Hoffmann & Russ, 2012; Lindsey & Colwell, 2013; Moore & Russ, 2008; Whitebread, Coltman, Jameson, & Lander, 2009). The studies included in this systematic review most frequently used the emotion regulation checklist (ERC), which is a par-ent report questionnaire that rates the frequency of behaviors relevant to developmpar-entally
appropri-ate displays of emotion (Galyer & Evans, 2001; Hoffmann & Russ 2012; Gilpin et al., 2015; Moore & Russ, 2008).
Pretend play can either be reality based or fantasy based, this distinction was assessed by three studies (Gilpin et al., 2015; Lindsey & Colwell, 2013; Moore & Russ, 2008). Gilpin et al. (2015) assessed the level of fantasy orientation during pretend play and measured the emotion regu-lation of 103 preschool children with the ERC. A significant positive reregu-lation was found between fantasy orientation and emotion regulation. Further, results showed that the level of fantasy in the pretend play sessions of children explained 24% of the variance in their emotion regulation, con-trolled for other variables such as age, theory of mind, or language abilities. These findings suggest that children who are more fantasy oriented demonstrated better emotion regulation skills. Lindsey and Colwell (2013), on the other hand, conducted a 2-year longitudinal study (N = 122) and com-pared fantasy play to socio-dramatic play. In socio-dramatic play children take on an existing per-sona or social role, and consequently, it is more reality based (Lindsey & Colwell, 2013). Both types of pretend play together explained 22% of the variance in emotion regulation, controlled for the variables gender, age, and emotion regulation at time 1. But when assessed separately, the re-sults showed that only socio-dramatic play, not fantasy play, was found to be a significant predictor for emotion regulation for both genders. However, the results gained from a longitudinal study by Moore and Russ (2008), did not corroborate either one of the previously mentioned results. In this 2- to 8-month follow-up of a play intervention study, 45 predominantly African-American children were randomly assigned into three groups, the imaginative play group (where high fantasy was en-couraged), an affect play group (where the expression of emotions was enen-couraged), and a control group. The imaginative play group did show higher scores on showing positive affect during play, but the three groups did not differ regarding any of the outcome variables including emotion regula-tion (Moore & Russ, 2008).
The Affect in Play Scale (APS) was used by two studies (Hoffmann & Russ, 2012; Moore & Russ, 2008), to distinguish and examine different variables of pretend play (the level of
imagina-tion, organizaimagina-tion, comfort, frequency of positive/negative affect, and variety of affect). This dis-tinction can give more insight into which variables are important to the relationship of pretend play and emotion regulation (measured by the ERC in both studies). Hoffmann and Russ (2012) found that all the variables measured by the APS showed a moderate correlation to emotion regulation, in their sample of sixty-one girls. Thus, a relation was found between each of the variables and the rating parents gave their children on emotion regulation. Moore and Russ (2008), also assessed these different variables through the APS. In this study, only the frequency of affect was positively correlated to the total score on the ERC, suggesting that frequent emotional expression during pre-tend play relates to better emotion regulation.
Other variables, not measured by the APS, can also be considered, such as the quantity or quality of pretend play and the level of adult involvement. Taking these factors into account Galyer and Evans (2001) found that in a sample of 51 preschool children, both the quantity and quality of pretend play showed a positive relation to emotion regulation. However, quantity, namely the amount of time a child spend engaged in pretend play, showed a stronger relationship with emotion regulation, than quality, measured by the number of objects used and the ideational transformations children made during pretend play. Also, results showed that parents who engage in pretend play with their children also rated their children higher on the emotion regulation scale (Galyer & Evans, 2001). Contrary to these results regarding parental involvement, the only study that assessed both pretend play and emotion regulation through observations (N = 528 self-regulatory events), found that when adult involvement increased in pretend play, the rate of emotion regulation behaviors decreased (Whitebread et al., 2009).
In conclusion, regarding the relation between pretend play and emotion regulation, the re-sults are inconsistent concerning the distinction between fantasy based play or reality based play. Assessing only the level of fantasy in pretend play, higher levels of fantasy correlated with higher scores on emotion regulation (Gilpin et al., 2015), but when fantasy play was compared to reality based play (socio-dramatic play), only reality based play was significant as a predictor for emotion
regulation (Lindsey & Colwell, 2013). Further, no difference was found when a fantasy play group was compared to an affect play group (Moore & Russ, 2008). As for the different variables regard-ing pretend play, both quantity of time engaged in pretend play and quantity of positive affect showed during pretend play, correlated significantly to emotion regulation (Moore & Russ, 2008; Galyer & Evans, 2001). Lastly, results were ambiguous regarding adult-involvement, whereas one study showed that emotion regulation increased as adult involvement increased, findings from an-other study revealed the exact opposite (Galyer & Evans, 2001; Whitebread et al., 2009).
The relation between pretend play and behavioral regulation.
Fifteen studies assessed the relation between pretend play and behavioral regulation (often referred to as inhibition or inhibitory control), of which three studies applied an intervention to in-crease the amount of pretend play (Albertson & Shore, 2009; Carlson, White, & Davis-Unger, 2014; Cemore & Herwig, 2005; Diamond, Barnett, Thomas, & Munro, 2007; Dunn & Hughes, 2001; Elias & Berk, 2002; Kelly, Hammond, Dissanayake, & Ihsen, 2011; Li, Hestenes, & Wang, 2016; Nader-Grosbois & Vieillevoye, 2012; Nicolopoulou et al., 2009; Nicolopoulou, Cortina, Il-gaz, Cates, & de Sá, 2015; Thibodeau, Gilpin, Brown, & Meyer, 2016; Van Reet, 2015; Vieillevoye & Nader-Grosbois, 2008; Whitebread, et al., 2009). One intervention is the storytelling/story-acting practice (STSA). This practice allows a child to dictate a made-up story of their own to their teach-er, after which they get to enact the story with some of their classmates (Nicolopoulou et al., 2009; Nicolopoulou et al., 2015). Another intervention that is used to promote pretend play, is tools of the mind. This is an intervention that targets the development of specific executive functions (inhibitory control, working memory, and cognitive flexibility) by using 40 different activities, of which 18 involve dramatic play (Diamond et al., 2007).
Two studies, that used the STSA intervention, conducted an experimental pre- post-test de-sign study, across a 2-year span, and found a de-significant improvement in self-regulation
(Nicolopoulou et al., 2009; Nicolopoulou et al., 2015). Both studies measured self-regulation through observations of inhibition. The randomized control trial (N = 149, n = 81 experimental and
n = 68 control) conducted by Nicolopoulou et al. (2015), reported a medium to large effect size re-garding the improvement of self-regulation for the experimental group. Further, results showed that the experimental group improved more in their pretend abilities as well, with a small to medium effect size (Nicolopoulou et al., 2015). Nicolopoulou et al. (2009) found that the intervention signif-icantly improved self-regulation, and followed up their experimental study (N = 147, n = 81 exper-imental and n = 66 control), by singling out one case for their case study. The single case study, concerned a girl that experienced problems with self-regulation. Results showed that her score on self-regulation increased from 1 at pre-test to 9 points at post-test (Nicolopoulou et al., 2009).
In the interest of assessing the relation between pretend play and inhibition in specific, inhi-bition can be assessed through several different executive functions tasks. (Diamond et al., 2007; Dunn & Hughes, 2001; Kelly et al., 2011). A randomized control trial (N = 147), using tools of the mind as an intervention, measured inhibition and cognitive flexibility through the Dots and Flankers task (Diamond et al., 2007). The Dots task requires the inhibition of a tendency to respond, and the Flankers task requires inhibiting your attention to focus elsewhere and flexibility to switch your focus. Results indicated that the experimental group that took part in the tools of the mind interven-tion outperformed the control group with a score of 75% correct on the Dots task and 84% correct on the Flankers task, this was twice as good as the control group (Diamond et al., 2007). Although it is important to keep in mind that tools of the mind also includes activities that promote private speech, memory, and attention. Therefore, the findings can not be attributed solely to dramatic play. Nevertheless, similar results were found in the study (N = 20) conducted by Kelly et al. (2011). Us-ing the Sun-Moon Stroop task, which requires a child to inhibit a previously learned response, Kelly et al. found a significant correlation between symbolic play and inhibition. Contrary to these results, Dunn and Hughes (2001), using a two-year longitudinal design (N = 80, n = 40 hard to manage children and n = 40 children as control group), found no significant correlations between pretend play turns and inhibition. In this study inhibition was measured with a marble-retrieval game, where children had to inhibit their response to immediately reach for the marble and with the Tower of
London task, where children needed to think about their solution prior to beginning, seeing as they only had a limited number of moves.
Regarding the measurement of pretend play in relation to inhibition, several factor can be distinguished, such as types of play and level of fantasy, as well as themes within the pretend play session (Dunn & Hughes, 2001; Kelly et al., 2011; Thibodeau et al., 2016). To assess symbolic play, Kelly et al. (2011) used observations of spontaneous symbolic play and the Test of Pretend Play (ToPP). The ToPP distinguishes between three kinds of pretend play; object substitution, giv-ing properties to an object or a person, and reference to a absent object or person. All types of play showed a significant correlation to inhibition, but no significant differences were found between them (Kelly et al., 2011). Furthermore, Thibodeau et al. (2016) tried to address the causality of the relationship between fantasy orientation in pretend play and inhibitory control by using a pre- and post-test RCT design. The children (N = 110) were appointed to one of three conditions of play in-terventions (fantastical pretend-play, non-imaginative play, or control). Because of the study design it was possible to show that a higher level of fantasy play can increase the amount of pretense dur-ing play, compared to non-imaginative play. Though ultimately, the scores on inhibition, controlled for the pre-score on inhibition, did not show a significant difference between the three different conditions (Thibodeau et al., 2016). However, the previously mentioned study by Dunn and Hughes (2001) differentiated between the different themes in pretend play, and found that this affected the relationship with inhibition. For pretend play, observations were used distinguishing between 5 themes; domestic, monsters, violence, fairytale/magic, and sex. The violent themes were more fre-quent for boys and even more so in the hard to manage group. In the combined sample, the propor-tion of violent themed pretend play was significantly negatively correlated with the score on the inhibition task that was used (Dunn & Hughes, 2001). Meaning that the more frequently a violent themed pretend play episode occurred, the poorer the performance on inhibition tasks was for both groups. The themes of the pretend play episode could possibly explain the difference found in the relationship between pretend play and inhibition across different studies.
Inhibition can be further delineated, into conflict inhibitory control (inhibiting a response in favor of an atypical/conflicting response) and delay inhibitory control (delaying a response). Two studies assessed the relation of pretend play to either one or both delineations (Cemore & Herwig, 2005; Carlson et al., 2014). First, Cemore and Herwig (2005) assessed the relation between pretend play and the ability to delay a response. This study found support for the notion that engaging chil-dren in fantasy play can help increase self-delaying behavior, when measured through a delay of gratification task (Cemore & Herwig, 2005). In this study (N = 39 children who had not yet attend-ed kindergarten), a significant relation between pretend play at home and delay of gratification was found (Cemore & Herwig, 2005). Additionally, Carlson et al. (2014) looked at the unique contribu-tion of pretense to both conflict- and delay inhibitory control. In this study (N = 104) both delay- and conflict inhibitory control were assessed in relation to two pretend tasks, pretend-actions and pretend-reality. These two pretend tasks were designed to tap and measure pretense representation, with pretend-actions requiring a more complex developmental level of pretense. Results showed that pretend-reality predicted conflict inhibitory control scores, whereas pretend-actions predicted delay inhibitory control (Carlson et al., 2014).
The relation between both delay- and conflict inhibitory control and pretend play/pretense was further assessed in the opposite direction by three studies (Albertson & Shore, 2009; Carlson et al., 2014; Van Reet, 2015). In one of the two randomized experiments (N = 36) conducted by Van Reet (2015), delay inhibitory control was compared to conflict inhibitory control. Results showed that the conflict inhibitory control group scored significantly higher on pretense than the delay in-hibitory control group, with a medium to large effect size (Van Reet, 2015). In another randomized experiment (N = 56) Van Reet further assessed the specific role of conflict inhibitory control in its relation to pretense. Children were randomly assigned to one of three conditions, a conflict inhibito-ry control task first, a neutral task first, or a pretense measurement first. The children who partici-pated in the conflict inhibitory condition previous to the pretense measurement, scored significantly higher on pretense abilities, with a moderate to strong effect size. Suggesting that engaging in
con-flict inhibitory control can improve children’s subsequent pretending abilities (Van Reet, 2015). This finding was supported by the results found in the studies by Carlson et al. (2014) and Albert-son and Shore (2009). This latter study (N = 32) used the True and Pretend Identities task, which tests the processing and memory abilities during reality and pretense. Results showed that conflict inhibitory control is important for processing and remembering during pretense or pretend play (Al-bertson & Shore, 2009). The higher the score on the conflict inhibitory control tasks the better the child memorized both the true and pretense identity. These results together corroborate the notion that not only can pretend play help the development of inhibitory control but that inhibitory control, especially conflict inhibitory control, can enhance the pretend play, this way creating a vicious cir-cle.
The relation between pretend play and behavior regulation can further be assessed by obser-vations within natural settings, where children engage in spontaneous pretend play (Elias & Berk, 2002; Li et al., 2016; Whitebread et al., 2009). The observational study conducted by Whitebread et al. (2009) found that self-regulatory behavior occurred most frequently when playing with other children and thus having to establish and follow rules. The study by Cemore and Herwig (2005) also showed that for the children who were already attending kindergarten, solitary pretend play was not associated with delay of gratification, suggesting that having partners in the play situation is crucial to the relation (Cemore & Herwig, 2005). These results were corroborated by a cross-sectional study (Li et al., 2016), where the play behaviors of 26 preschool children were recorded, through time sampling. In this study, different types of pretend play were discerned, concrete pre-tend play, abstract prepre-tend play and social prepre-tend play. Social prepre-tend play showed a moderate positive correlation to behavioral regulation, as measured by a sub-scale of 10 items, such as await-ing your turn and compromisawait-ing. In contrast, abstract pretend play and concrete pretend play, were not significantly associated with behavioral regulation (Li et al., 2016). The results of a 5-month longitudinal study (N = 53) conducted by Elias and Berk (2002) were also in accordance with the above-mentioned results. Through observations, the frequency and persistence of complex
socio-dramatic play was found to be significantly moderately associated with the self-regulation score at time 2 controlled for the score at time 1. Self-regulation was measured by looking at the amount of self-regulating behaviors children showed during clean-up time. In contrast, frequency of solitary dramatic play was significantly negatively correlated with self-regulation (Elias & Berk, 2002). This result suggests that there is a negative relation between the time a child plays by him/herself and the amount of behavior regulation they showed during clean-up time.
In dyadic play situations, matched on mental age, two studies compared typically develop-ing children (TD) with children that had intellectual disabilities (ID) (Nader-Grosbois &
Vieillevoye, 2012; Vieillevoye & Nader-Grosbois, 2008). In both studies, using the same sample (N = 80, n = 40 TD children and n = 40 ID children), pretend play was assessed using the ToPP and an observational coding grid was used to measure 7 categories of self-regulation (identification of ob-jective, planning or exploration of means, joint attention, request, self-attention, self-motivation, and self-evaluation). In the study of Vieillevoye and Nader-Grosbois (2008), no differences were found in the amount of pretend play between the two groups, but the ID group had a lower score on overall regulation. For both groups, strong correlations between pretend play and overall regulation were found. However, the TD group showed positive correlations to all specific self-regulatory categories. Whereas, the ID group only showed significant correlations to identification of objective, joint attention, and self-motivation (Vieillevoye & Nader-Grosbois, 2008). Further-more, in order to assess whether a structured situation could lead to more favorable results than a less structured situation, requiring a child to demonstrate more creativity, Nader-Grosbois and Vieillevoye (2012) assessed pretend play in two separate situations. These were the structured ‘Itin-erary’ situation and the unstructured ‘Creativity’ situation. High positive correlations were found between dyadic pretend play in both situations and overall self-regulation for both the ID and TD group. In addition, the structured ‘Itinerary’ situation elicited higher levels of symbolic behavior and the use of more self-regulatory strategies in both the TD and ID group (Nader-Grosbois & Vieillevoye, 2012).
In conclusion, all included studies confirmed that pretend play, as initiated through interven-tions, tapped into through pretense tasks, or assessed as spontaneous and naturally occurring, showed a significant relation to behavioral regulation. No significant differences were found be-tween different types of pretend play in their relation to behavior regulation (Kelly et al., 2011; Thibodeau et al., 2016). Concerning the theme of the pretend play session, the results showed that the more violent themed the play session, the poorer the performance on inhibitory tasks (Dunn & Hughes, 2001). Observational studies showed that the relationship between pretend play and behav-ioral regulation was strongest when it concerned social pretend play, whereas, solitary pretend play was correlated with poorer self-regulation (Elias & Berk, 2002; Li et al., 2016; Whitebread et al., 2009). Further, results revealed that more complex pretend play was only a significant predictor for delay inhibitory control (Cemore & Herwig, 2005; Carlson et al., 2014). However, conflict inhibito-ry control improved pretense abilities (Van Reet, 2015; Albertson & Shore, 2009). Most important-ly, these findings showed that the relationship between pretend play and inhibition can presumably be regarded as circular, both enhancing each other’s development (Van Reet, 2015; Carlson et al., 2014; Albertson & Shore, 2009). Lastly, the relation was confirmed to apply to both ID and TD children but was stronger when the pretend play was structured (Nader-Grosbois & Vieillevoye, 2012; Vieillevoye & Nader-Grosbois, 2008).
Discussion
In this systematic review the most recent and relevant studies are assessed with the purpose of giving insight into the relation between pretend play and self-regulation. The relation between pretend play and self-regulation is well documented and confirmed by all the studies included in this review. What factors are important to this relationship and how the relation is sustained, are further explored.
First, for both emotional and behavioral regulation, the findings are inconsistent regarding the distinction between types of pretend play. A higher level of fantasy during pretend play might improve the pretense, but it does not necessarily improve inhibition or emotion regulation
(Thibodeau et al., 2016; Lindsey & Colwell, 2013). These inconsistent findings regarding the level of fantasy might be explained by looking at the theme of fantasy-based play, as the findings from Dunn and Hughes (2001) revealed that the level of violence in pretend play sessions can impact this relation. Further distinctions within pretend play did not show significant differences to either type of regulation, only structured play, compared to unstructured play, was found to significantly en-hance the use of self-regulatory strategies (Nader-Grosbois & Vieillevoye, 2012; Vieillevoye & Nader-Grosbois, 2008).
Secondly, several factors are shown to be of importance when assessing the relation be-tween pretend play and emotional regulation, in particular. The more time children spent engaged in pretend play and the more they expressed positive emotions during play, the higher they scored on emotion regulation (Moore & Russ, 2008; Galyer & Evans, 2001). Regarding adult-involvement, the findings were ambiguous (Galyer & Evans, 2001; Whitebread et al., 2009). However, only two studies assessed adult-involvement, and these studies did not specify what this exactly entailed. Adult-involvement can be beneficial when it helps facilitating or structuring the play session with-out creating an external regulator for the children, causing self-regulation skills to be less practiced by the children (Whitebread et al., 2009). This balance of structuring without creating too much adult-involvement, is what the interventions, STSA and tools of the mind, successfully aim for (Nicolopoulou et al., 2009; Diamond et al., 2007).
Lastly, regarding behavioral regulation, research showed that the presence of other children in pretend play is crucial for the subsequent development of inhibition, as well as that this relation can be regarded as circular (Elias & Berk, 2002; Li et al., 2016; Whitebread et al., 2009; Van Reet, 2015; Albertson & Shore, 2009). Social pretend play, meaning there is a play partner, requires more rules. These rules need to be created, negotiated and followed, which can explain why this type of pretend play, strengthens the relation between pretend play and behavior regulation (Elias & Berk, 2002). Further, the circularity of this relation can be understood when inhibition is delineated into conflict inhibitory control (Van Reet, 2015; Albertson & Shore, 2009). Because there is a difference
between what happens in reality, versus what can happen during pretend play, children practice conflict inhibitory control. Likewise, the more the child develops conflict inhibitory control, the better they can pretend in return.
The findings of this current systematic review support expectations based on the play theory presented by Vygotsky (1967). This theory presumes that self-regulation is attained and practiced through pretend play as this creates a ‘zone of proximal development’ for the children. The zone of proximal development refers to trying and practicing skills, in different situations, that are just above the level of current capabilities, and consequently, evolving to higher levels of these capabili-ties (Bodrova et al., 2013). This theory explains the importance of having an accurate level of adult-involvement, suggesting that adults should be involved to the point where they can help create a zone of proximal development, and no further. Also, this theory emphasizes the importance of rules, and pretend play will always contain rules, but even more so when played in social context with a play partner/peer, resulting in better self-regulatory skills (Vygotsky, 1978).
Interestingly, the development of self-regulation occurs parallel to the increasing ability to understand one’s own mind and the mind of others, commonly referred to as Theory of Mind (ToM) (Korucu, Selcuk, & Harma, 2016). The development of ToM is an important milestone in a child’s development and is needed in order to be able to construct a further understanding of the social world (Korucu et al., 2016). Research has shown that the two domains of self-regulation and ToM are highly correlated, but there has been a lot of debate regarding the nature of this relation (Hammond, Bibok, & Carpendale, 2010). Nevertheless, pretend play is believed to have a relation to both self-regulation and ToM (Bergen, 2002). In light of this current systematic review, it could be suggested that during pretend play these two processes possibly enhance each other’s develop-ment. Therefore, this could be an interesting avenue for future research.
A main limitation of this systematic review can be ascribed to the fact that only one of the included articles assessed the relation between both behavioral and emotional regulation, in three separate studies (Whitebread et al., 2009). Unfortunately, this article did not provide the actual data
on which they based the results for the experimental studies that assessed behavior regulation, mak-ing inferences and comparisons difficult. In order to say more about the unique relation between pretend play and the two types of self-regulation, and how these two relations interact, more empir-ical research is necessary that include, assess and compare both behavioral and emotional regulation in relation to pretend play. Additionally, seeing as the theme of pretend play, the level of adult in-volvement and the structuring of pretend play matter to its relation with self-regulation, these fac-tors should be taking into account in future research, for the sake further explaining the nature of this relation.
Another limitation is the lack of empirical studies including a diverse ethnic sample. This has implication for the generalizability of the findings to children of all ethnic backgrounds. Seeing as within our society ethnic backgrounds are becoming more diverse and integrated, using diverse ethnic samples in research is becoming more paramount as well (Awad, Patall, Rackley, & Reilly, 2016). Therefore, future research should include samples with diverse the ethnic background for the purpose of improving the generalizability as well as assessing whether ethnic background can ac-count for any differences in the results.
In conclusion, the importance of pretend play, especially non-violent themed social pretend play, should not be underestimated; society should make sure children receive opportunities for developing certain self-regulatory skills that accompany situations that come about while playing. Self-regulation, both as behavioral and emotional regulation, is often identified as important for the development of cognitive processing and independent learning behavior, both of these being essen-tial for academic motivation and subsequently for academic success (Blair & Razza, 2007; Grazi-ano, Reavis, Keane, & Calkins, 2007; Nader-Grosbois & Vieillevoye, 2012).
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Figure 1. Flowchart of study selection process. Records identified through
data-base searching (n=85) Inc lude d E lig ib ilit y Id en ti fi ca ti o
n Additional records identified
through other sources (n=3)
Records after duplicates removed (n=74)
Full-text articles as-sessed for eligibility
(n=63)
Full-text articles exclud-ed, after reading
ab-stracts (n=43)
Studies included in sys-tematic review (n=20)
Full-text articles exclud-ed, according to the
cri-teria, Autism or review (n=11)
