The effect of suggesting themes for pretending to messy tactile play was tested with eight participants with sensory sensitivity (determined through the Sensory Profile, compared to controls. Engagement in messy play was measured in two conditions: one with themes for pretending suggested and one without. Measurements included both the duration of play and participant behaviors via the Child Behavior Rating Scale. For the children with sensory sensitivity, applying meaning through pretending yielded improvement in the initiation of messy play providing support for the use of this occupation-based approach.