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Parents of toddlers and preschoolers often ask me if it is all right for their child to be speaking to imaginary friends. I won’t usually answer until Dr. Check-Up, my imaginary pediatrician friend, gives me the advice I need to answer their question. Fortunately, he has, so here are my responses.

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How common are imaginary friends?

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Imaginary friends are a normal part of a child’s development, rearing up when a child is 2 1/2 to 3 and hanging around until age 6. More than two-thirds of children will have an imaginary friend at some time, and about a third will have one by age 7. They can have names, personalities and may even be taking up space in your child’s bed, so you need to be careful or you may sit on them.

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Imaginary friends as a tool

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First, be aware that having an invisible friend is not a sign of loneliness, poor social skills or other serious problems. In fact, having one may be a wonderful way to stimulate creativity and imagination. They can also help children figure out the difference between right and wrong when they are not quite ready to assume complete responsibility for their actions.

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Imaginary friends as a feeling

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Imaginary friends can also give insight into what your child is feeling. This could be something as simple as comforting their invisible friend who is about to get a shot before they themselves go to the doctor. On the other hand, don’t let your child’s invisible friend be your child’s only companion. Additionally, don’t let them shift the blame all the time to the friend.

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My best advice

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So what do I recommend if your child develops or has an imaginary friend? My best advice is to let them have one without much interference in order to cultivate their imagination. Let your child take the lead, and play along if asked to do so, similar to playing other pretend games with your child.

The good news is that imaginary friends will go away as your child gets a better handle on what is fantasy and what is reality. As they meet other real friends at school, the imaginary ones just disappear.

In addition, by giving your child adequate attention each day and stimulating their creativity through games, art and play with other children, children will find they don’t have to resort to imaginary friends to use their imagination.

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When to worry about an imaginary friend

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When should you worry about an imaginary friend? If your child won’t play with anyone else or seems very withdrawn from interacting with other real people, then talk to your child’s health care professional. Though it’s rare, counseling may be needed.

Hopefully you’ll find tips like these to be more helpful than you can imagine when it comes to dealing with your child’s and maybe even your own imaginary friends.

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Lewis First, MD, is chief of pediatrics at the University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch “First with Kids” weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at www.UVMHealth.org/MedCenterFirstWithKids.