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Objective: To empirically test whether systematic examination of emotions and themes in children's play can provide useful information about childhood problems.

Method: Using the MacArthur Story-Stem Battery and coding system, distress and destructive themes (aggression, personal injury, and atypical negative responses) were coded from the play of 51 children at ages 3, 4, and 5 years, in a low-risk, nonclinical volunteer sample. To measure behavior problems, both parents completed the Child Behavior Checklist at all ages, and teachers completed the Teacher's Report Form when the children reached 5 years of age.

Results: Both distress and destructive themes in the play of 4- and 5-year-olds were found to correlate with externalizing behavior problems as rated by parents and teachers.

Conclusions: Children who display more distress during play at 4 and 5 years of age and who demonstrate destructive themes at 4 and 5 years of age appear to have more externalizing behavior problems, as rated by their parents and teachers. These results provide empirical support for the use of play as an assessment tool in young children. The findings suggest approaches to and limitations of play interpretation.

Copyright 1996 (C) American Academy of Child and Adolescent Psychiatry