What is a common sign that may prompt concern for developmental delay in early childhood?

• A. Absence of pretend or fantasy play by 3-1/2 years
• B. Excessive sleepiness
• C. Early potty training
• D. Strong interest in books

Answer: (A)

Noting a lack of pretend or fantasy play by about 3½ years is an important sign because this kind of play shows a child’s emerging symbolic thinking, imagination, and social interaction. By this age, most children engage in make-believe—using objects to represent other things and acting out scenarios with others. When pretend play is absent or limited, it can point to developmental delays in cognitive, language, or social areas and should be explored further.

Other options don’t typically signal developmental delay in the same way. Excessive sleepiness can arise from sleep or medical issues rather than a milestone delay. Early potty training isn’t a standard marker of delay, and a strong interest in books is usually a positive sign of early literacy development rather than a delay.