I love so many things about being a pediatrician. Listening to children share creative stories that involve real and make-believe friends, for example, makes every day unique and entertaining. Conversations with my younger patients are as likely to involve comments like, "Look how much you've grown since your last visit!" as, "I did not realize that you have a new pet dinosaur!"
Children love sharing details about their imaginary pals. Understandably, though, parents are often concerned about how "normal" imaginary friendships are, and whether they may signal any mental health issues.
Rest assured, most imaginary friendships during childhood are considered normal. In fact, they can help children practice interacting with others and their environment. But looking out for a few red flags can help identify when it may be time to talk to your pediatrician about your concerns.
Social-emotional development in children
Children learn to interact with the world around them shortly after birth.
In infants, this may start with making eye contact with a parent while feeding. They may get quiet when you speak to them or, at some point, start to return your
smile with one of their own. They begin to piece together the world around them, and how different behaviors help them interact with it.
By around age 2, children love to play alongside other kids. They may especially like to reenact activities they may see adults doing, like talking on the phone or vacuuming. Their imagination blossoms, often sparking an interest in playing dress up and acting out everyday social interactions with toy figures and puppets.
By 3 years of age, children link their imagination and cooperative play skills together. They often create stories with richly detailed scenes involving playmates, family members, pets, and imaginary friends.
At age 4 or 5, a child's growing imagination and creativity can blur lines between their real and invented worlds. At this age, even kid friendly cartoons and stories can cause nightmares, since everything "feels so real" to them.
As children mature and gain more social skills, they slowly move away from their imaginary world that provided comfort and familiarity as they learn about the real one.
Why do children have imaginary friends?
Having imaginary friendships does not mean that your child is lonely or does not have "real" friends. Children often use imaginary friendships as a safe haven to try out their social skills, group dynamics and communication strategies. It often helps them see their world from other perspectives and gain empathy. By creating an imaginary friend, they have to understand the perspective of others in the scenarios they are acting out.
Imaginary friendships should be comforting and controllable. Children can usually make their imaginary friends "go away" when they are "done playing."
When should I be concerned about my child's imaginary friendships?
In general, imaginary friendships are a normal part of social development and will fade away over time. It is important to discuss any concerns you have with your pediatrician, particularly if:
You have other developmental concerns about your child, especially involving speech, talking patterns, or social interactions.
The imaginary friends never "go away" or are "always talking."
Imaginary friends are threatening or encouraging your child to use violence--towards themselves or others.
You notice sudden changes in your child's social interactions, personal hygiene practices, speech patterns, or concentration ability.
There is a strong family history of mental illness, especially in close relatives.
Remember
Young children have such rich imaginary lives, and they are so generous in sharing them with you. Enjoy this special stage in their development, but don't hesitate to talk with your child's doctor whenever you have concerns about their physical or mental health.
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