Early Start Denver Model – Pretend Play


Provide targeted, naturalistic therapy during pretend play using the Early Start Denver Model (ESDM). This model was specifically designed to help children with Autism Spectrum Disorder (ASD) and other neurodevelopmental disorders engage, connect, learn, communicate and play!

Materials Required

  1. Toys that can be utilised to create pretend play routines such as dolls house, dolls, teddy bears, animals etc.
  2. A variety of resources to support the pretend play routine e.g. bottles, blankets, pillows, food (real or pretend).
  3. Containers with lids that your child needs assistance to open.
  4. Toys or resources that your child needs assistance to operate e.g. dressing a doll in clothes.


Prepare additional resources for you to use whilst imitating your child.

Method (or Ideas)

  1. Offer up a few choices of materials that could be used to create a pretend play routine (e.g. dolls, animals, teddy bears) and see where your child lands. Join your child here, sitting near/opposite and comment with interest. Back up if your child shows signs of fussing.
  2. Narrate/describe your child’s actions. Commenting on how your child is playing with the materials e.g. patting, feeding, rocking. Remember to speak in single words. Continue to praise and describe and don’t worry about touching materials or teaching, yet. The goal is to slowly increase your involvement without challenging the child.
  3. Slowly start to involve yourself in your child’s play by offering materials such as blankets, food, bottle etc. Only touch materials not yet claimed by your child. The goal is to hand them over when the child is facing you and watching your handling of the materials, although eye contact from the child to receive the material is not yet necessary.
  4. Next, offer help. When your child is not looking, put things in containers they need help to open, or show new toys the child needs support to operate. Be sure to give the item right back as soon as you have helped. The goal is for the child to see you being helpful with the materials.
  5. Begin to imitate your child, pick up the same materials and create the same movements, using single words to express the actions. The goal is to capture your child’s eye contact, both on your handling of the material and to your face, and to find your child’s smile in the game.
  6. For every three times you imitate your child, give your child a choice related to the play. E.g. Wash or Feed? (i.e. wash the baby or feed the baby. Holding a washcloth and a piece of food up near your face can support this choice). Don’t worry about eye contact yet. The goal is for the child to become more active in decision-making and to increase the length of the activity.
  7. For every three times you offer your child a choice, ask your child to do something in the play e.g. burp the baby. Whatever it is, make sure there is a fun reward following compliance e.g. a loud pretend burp. Remember that the consequence has to be worth the effort. The goal is for the child to become more active in play and to take turns following your ideas in play.
  8. For every 3 times you provide a fun reward, have the child respond to your teaching opportunity using a non-verbal behaviour. This could be a gesture, body movement, or eye contact. It has to be directed towards you and relate somehow to this activity. Remember to accept attempts and reward. The goal is to have the child use an intentional behaviour in response to your antecedent, followed by the rewarding consequence. E.g. you might pat your baby on the back slowly opening your mouth wider and wider, with lots of excited affect and pause waiting for your child to cue you to continue, reward this non-verbal behaviour by immediately providing an exaggerated burp with lots of affect.

Facilitation Tips – What To Say


  • Use the ‘one up’ rule with your language: if your child is not speaking yet, use only 1 word. If they are using single words, use 2 words etc.
  • Comment on how your child is using materials e.g. rocking, patting, feeding,
  • Use sound effects and lots of affect to find your child’s smile e.g. exaggerated yawning, snoring, burping, hiccups, sneezes

Extend the Experience

Employ the Early Start Denver Model in other aspects of your daily routine and play such as during mealtimes, nappy changes and bath time

You can learn more about the Early Start Denver Model, including information about upcoming training courses for parents, carers and professionals, working with and caring for, children with ASD

WHO Guidelines for Physical Activity & Sedentary Behaviour

This experience can become more physically active by engaging in play while standing which allows more opportunity for movement.

Early Years Learning Framework


  1. Children become strong in their social and emotional wellbeing
  2. Children interact verbally and non-verbally with others for a range of purposes
  3. Children feel safe, secure, and supported.


Principle 4: Respect for diversity. Children are born belonging to a culture, which is not only influenced by traditional practices, heritage and ancestral knowledge, but also by the experiences, values and beliefs of individual families and communities. Respecting diversity means within the curriculum valuing and reflecting the practices, values and beliefs of families.


Practice: Intentional teaching. Intentional teaching is deliberate, purposeful and thoughtful. They use strategies such as modelling and demonstrating, open questioning, speculating, explaining, engaging in shared thinking and problem solving to extend children’s thinking and learning.

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