Psychometric properties of the child-initiated pretend play assessment for children with attention-deficit hyperactivity disorder

Background: Play is a core childhood occupation crucial for cognitive and social development. Children with attention-deficit hyperactivity disorder (ADHD) frequently face pretend play difficulties; however, evidence on standardized play assessments’ psychometric properties for them remains limited. This preliminary study aimed to evaluate the psychometric properties of the Child-Initiated Pretend Play Assessment (ChIPPA) in children with ADHD and compare their performance to typically developing (TD) peers. Method: This cross-sectional study, conducted in Iran, evaluated 30 children with ADHD and 29 TD peers aged 4–8 years using the ChIPPA. For test–retest reliability, children with ADHD were reassessed after 2 weeks. Data were analyzed via descriptive statistics, independent t -tests, and intraclass correlation coefficients (ICC). Results: Children with ADHD scored significantly lower in number of object substitutions (NOS) and percentage of elaborate pretend play actions (PEPA) than TD peers ( p < 0.001). Conversely, number of imitated actions (NIA) scores were significantly higher in the ADHD group ( p < 0.001). Test–retest reliability was good-to-excellent for PEPA and NOS (ICC ⩾0.80) and moderate for NIA (ICC = 0.60–0.70). Conclusion: Children with ADHD exhibited significantly lower pretend play competence than TD peers. While these preliminary results support the ChIPPA’s reliability for assessing play in this population, due to the small sample size, this cannot be considered a full validation study.