Autistic children with imaginary friends have better social skills, just like neurotypical children

By guest author Dan Carney

Imaginative, or "pretend", play in childhood is important. It offers opportunities for social interaction as well as the chance to learn how to understand social signals and the minds of others. A common form of pretend play is the creation of an imaginary friend, and research with neurotypical children has found that children with imaginary friends tend to show better understanding of the mental and emotional states of others, greater focus on the mental states of friends, and superior communication skills.

Autism has been associated with deficits in both pretend play and social skills. But Paige Davis and colleagues have previously found that although autistic children are less inclined to create imaginary friends, when they do create them, they are similar to those of neurotypical children in terms of their social attributions (e.g. mental states, personality traits), reported function (e.g. social, comfort) and gender. Now, Davis and her team have examined whether autistic children who have imaginary friends also experience the social benefits seen among neurotypical children.

For the new study, published in Autism, the team recruited 124 parents of autistic children aged between 5 and 12, with measures administered online. The parents answered up to three questions regarding their child's imaginary friend – whether they had one, and – if so – at what age had they created them, as well as why they thought they had done so.

They then rated their children's communication skills, social skills, and social understanding, using established scales. For communication, parents rated the frequency of certain aspects of their child's language use (e.g. "Produces utterances that sound babyish because they are just 2 or 3 words long, such as 'me got ball' instead of 'I've got a ball'.") The social understanding scale examined the children's Theory of Mind – the ability to represent and understand others' mental states. Subscales looked at children's understanding of others' beliefs, perceptions, and emotions, with parents again indicating how frequently their children behaved in certain ways (e.g. "Talks about people's mistaken beliefs"). Finally, to measure social skills, parents answered questions on their children's friendships, and rated their social interaction skills (e.g. "how well does your child start conversations with others?").  

The team found that autistic children with imaginary friends scored higher than those without imaginary friends on both social measures. On the social understanding scale, they scored higher on understanding others' emotions and beliefs (although no difference was found on understanding others' perceptions). With regard to social skills, children with imaginary friends were reported to be more interested in making friends and spending time with peers. These differences were present regardless of children's communication ability. Surprisingly, almost 50% of parents reported their child having an imaginary friend. This is higher than the proportion (16%) in Davis and colleagues' previous study, although the authors point out that the children in the new study were older.

These results offer interesting preliminary evidence that the link between imaginary friends and improved social competence observed in neurotypical children is also present in autistic children. The results also suggest that Theory of Mind is not a "single" skill that is impaired in autistic children – as has been claimed in the past – but something involving different areas which may vary in relation to pretend play behaviour. More generally, the findings suggest that imaginary friends represent an intriguing new way to examine the relationships between pretend play and social profiles in autism.

However, it's important to acknowledge some limitations. Firstly, the direction of any causal relationship is not established: it's not clear whether having an imaginary friend leads to better social skills, whether more socially skilled children are more likely to create imaginary friends, or even whether another as-yet-unidentified variable may be involved. This is important for future research to address, especially as these relationships may differ in autistic children relative to neurotypical children. Secondly, relying solely on parental reports, something the authors did due to COVID-19 restrictions, is not ideal. Children's perspectives are lost, and parents may have forgotten, or not be aware of, their imaginary friends. The authors also mention other factors that should be examined in future research. These include whether autistic children have different kinds of imaginary friend and how this may relate to social skills, as well as how children's imaginary friend behaviour is affected by being in an autism-specific environment, something which has been shown to decrease feelings of social isolation.

About the author

Dr. Dan Carney is a UK academic psychologist specialising in developmental disorders. He undertook his post-doctoral research fellowship at London South Bank University, and his published work has examined cognition, memory, and inner speech processes in Williams syndrome and Down syndrome, as well as savant skills in autism.