Kids’ mental health (ages 0–12)

In the first year, babies form bonds of love and trust with their parents and others. The way parents cuddle, hold and play with their baby sets the base for how they relate to people later on.

Experts call the everyday back-and-forth “serve and return”. A baby babbles, points or cries, and an adult answers with a look, words or a hug. Like a game of tennis, each exchange helps build the brain’s connections for language, social skills and emotional well-being.

Simple ways to connect

• Answer their sounds by repeating them and adding words
• Cuddle and hold them often
• Play when they are alert and relaxed, and stop when they seem tired or fussy
• Read to them
• Sing and play music
• Talk to them through the day. Your voice calms them.

Toddlers grow fast and can get upset or overwhelmed easily. Their language is still limited, so they mostly “talk” through behavior. They want independence, yet find being apart from their caregivers hard. Tantrums are common and a normal part of growing.

What helps

• Add words to theirs: if they say “baba”, say “Yes, that’s your bottle”
• Let them help with dressing and feeding themselves
• Name their feelings: “You’re mad that playtime is over”
• Notice and respond to the behavior you want more than you punish what you don’t
• Tell or show them what to do instead, and keep any time-outs very brief

Preschoolers become more independent and start to focus more on adults and children outside the family. Playing with other children helps shape their personality and teaches sharing and friendship.

What helps

• Be clear and consistent with discipline. When you say “no”, follow with what they should do instead.
• Give a few simple choices: what to wear, or which snack
• Let them help with simple chores
• Stay nearby during play to coach sharing and solving conflicts without hitting
• Teach that anger passes, and can be shown without hurting anyone
• Walk them through the steps to solve a problem when they are upset

In the school years, friendships help children learn to understand and connect with others. Self-esteem grows too, and it plays a big part in motivation, schoolwork, friendships and bouncing back from setbacks.

What helps

• Praise effort, not only results
• Give chores they can master. Finishing tasks builds confidence.
• Help them feel they belong: with friends, classmates or a team
• Listen when they talk about classmates, and help them solve their own problems
• Welcome their friends at home
• Help them name their own feelings, then think about how a friend feels

The single most important thing for a child’s self-esteem is an adult who shows them respect and acceptance.

Early adolescence starts around age 10. Puberty begins, usually a year or two earlier for girls than boys. Thinking is often black-and-white, and tweens can feel very self-conscious and judged by peers. They want more privacy and may push limits or react strongly to rules.

Children are often most open to peer pressure between about ages 11 and 15. Friends can also be a strong positive influence.

What helps

• Explain body changes before they happen, and reassure them it is normal
• Start talks early about friendships, relationships, consent and substances
• Set clear, reasonable limits, and give more freedom as they show responsibility
• Point out their strengths and celebrate successes
• Give them face-saving ways to say no, like “My parents won’t let me”

All children have fears, sad days and hard behavior sometimes. It becomes more of a concern when it is unusual for their age, lasts a long time, or is severe.

Signs it may be time to talk to someone

• Fears or worries are so frequent or strong that they get in the way of school, home or play
• They don’t outgrow fears that are typical for a younger age
• Sadness or irritability is constant or extreme
• Behavior is much bigger, or goes on much longer, than for other kids their age
• They lose interest in things they used to enjoy

Anger is a normal feeling. It becomes a problem when it gets out of control or turns aggressive. The reason is not always obvious, so it helps to work it out together.

What may be behind it

• Body and hormone changes during puberty
• Family arguments or changes at home
• Friendship problems or bullying
• Pressure from schoolwork or tests
• Stress or worry they can’t name

What helps

• Make it clear “the anger is the problem, not you”
• Help them spot early body signs: fast heartbeat, clenched fists, tight jaw
• Practice calm-down tools together: counting to 10, walking away, slow breathing
• Encourage active play or exercise to release tension
• Praise every effort to stay calm, no matter how small

Some pushback is a healthy part of growing up. Children are learning to think for themselves. But constant arguing, refusing all requests, and blaming others may be a sign that something deeper is going on.

What may be behind it

• A parent or caregiver who is struggling too
• Harsh or inconsistent rules at home
• Learning problems that make school feel impossible
• Seeing or living through violence or neglect
• Stress, worry or low mood

What helps

• Clear, calm and consistent rules
• Notice and praise good moments, often
• Pick your battles: be firm on safety, flexible on small things
• Spend relaxed one-on-one time together

Every child says “no” sometimes. But some children are angry, touchy and argumentative most of the time, for months on end. They lose their temper often, argue with adults, refuse rules, blame others, and may try to annoy people or get back at them. Professionals sometimes call this pattern oppositional defiant disorder (ODD).

It usually starts before about age 8, and no later than about age 12. Children tend to show it most with the people they know best, like parents, a regular caregiver or a teacher. What sets it apart from ordinary pushback is how often it happens, how long it lasts, and how much it gets in the way of home, school and friendships.

What can feed it

• A parent who is struggling with low mood, substance use or ADHD
• Being rejected by other kids
• Harsh, unpredictable or inconsistent discipline
• Living with conflict, violence or a lot of instability
• Ongoing stress, trauma or neglect
• Other difficulties going on underneath, like ADHD, worry or learning problems

What helps most

• Parent training: a therapist coaches parents in praise, rewards, clear and calm consequences, and better communication. This is the main treatment, and many families see progress within the first few months.
• Therapy for the child to practice handling anger, solving problems and seeing how their actions affect others
• Family therapy to agree on consistent rules and lower the conflict at home
• A behavior plan at school, so home and school pull in the same direction

Everyday tips for parents

• Catch them being good, and say so out loud: “Thanks for coming in when I asked.”
• Give clear, short instructions, one at a time
• Use calm, predictable consequences rather than shouting or harsh punishment
• Keep the same rules at home and at school as much as you can
• Find small daily moments of fun together that have nothing to do with rules

Many children improve, especially with early, steady support, and things often ease with age. Some go on to have more serious behavior problems, but most do not. Because these children can also be at higher risk of worry and low mood, it helps to keep an eye on their feelings, not just their behavior.

Some young people show a repeated pattern of hurting others or breaking serious rules. This can include bullying or fighting, cruelty to animals, damaging property or setting fires, stealing, lying, breaking into places, running away or skipping school. Professionals sometimes call this conduct disorder. It most often starts in the pre-teen and teen years.

In the U.S., it is thought to affect roughly 2% to 10% of children and teens, and it is more common in boys. It often first shows up around ages 10 to 12 in boys and 14 to 16 in girls. These young people are more likely to get hurt, to struggle with friendships, and to face low mood, worry and substance use.

What can raise the risk

• A parent with substance use or mental health struggles
• Brain injury, or an impulsive temperament that runs in families
• Harsh or inconsistent parenting, or a lot of conflict at home
• Living with violence, neglect or abuse
• Poverty, unsafe neighborhoods and easy access to drugs

What helps

• Parent training in consistent discipline and rewarding positive behavior
• Family- and school-focused therapy, so everyone works together
• Anger management skills for the young person
• Individual therapy to build problem-solving, conflict skills and the strength to resist negative peer pressure
• Structured community or school programs, for some young people

Why early help matters: problems that start before age 10 tend to be harder to turn around, and school can slip a lot. For most young people, this kind of behavior settles by early adulthood. How things go depends a great deal on how early help starts.

All children have tantrums and grumpy days. But some children seem irritable or angry most of the day, nearly every day, and have frequent, intense outbursts that are much bigger than the trigger. It happens at home, at school and with friends, and it keeps going at an age when most kids have outgrown tantrums. Professionals sometimes call this pattern disruptive mood dysregulation disorder (DMDD).

How it differs from ordinary tantrums

• Ordinary tantrums come and go. Afterwards, the child usually bounces back to their normal mood.
• With this pattern, the bad mood stays between outbursts too.
• The outbursts happen often, and are out of proportion to what set them off.
• It shows up in many places, not just at home.
• It gets in the way of school, friendships, family life and activities like team sports.

What helps

• Parent training: a therapist coaches parents in calm, consistent ways to respond to behavior
• Therapy that teaches the child skills to notice, name and calm big feelings, and to cope when they get too intense
• Help for parents to stay calm and look after themselves during long outbursts
• School support: a plan for calming down in class, like a short break to splash water on their face, which can be written into a 504 plan or IEP

Children with this pattern are more likely to struggle with worry and low mood later on, so getting help early matters. Experts say these children are very capable of change once they learn to manage their feelings.

Anxiety in children can show up as fear or worry, but also as irritability or anger. Some anxious children hide their worries, so it can be easy to miss.

Signs you might see

• Avoiding places, people or activities
• Headaches or stomachaches
• Irritability or angry outbursts
• Seeming tired a lot
• Trouble sleeping
• Worrying out loud, or asking for reassurance again and again

Children are more likely to develop anxiety after trauma or stress, bullying or rejection, or when a parent has anxiety or low mood. In the U.S., experts recommend checking for anxiety at checkups from age 8.

What helps

• A visit with your child’s doctor or a mental health professional
• Therapy that teaches coping skills step by step, like CBT
• Family involvement. For young children, parents taking part is key.
• Including the school, when worry shows up there

Low mood in children can look like ongoing sadness, hopelessness or irritability. Some children don’t seem sad at all. Instead, it can look like misbehavior or a lack of motivation.

Signs to notice

• Changes in eating, sleep or energy
• Feeling worthless or guilty
• Hurting themselves on purpose
• Losing interest in things they used to enjoy
• Ongoing sadness, hopelessness or irritability
• Trouble concentrating

Babies and toddlers often cry when a parent leaves. That is a normal stage, and most children grow out of it by about age 3. For some children, though, the fear of being apart from a parent or caregiver stays strong, or comes back later. It can be much bigger than the situation calls for, and it can get in the way of school, sleep and friendships.

What it can look like

• Getting very upset before or during time apart
• Nightmares about being separated
• Not wanting to sleep alone, or to be alone in another room
• Refusing to go to school, sleepovers or camp
• Stomachaches, headaches or feeling sick around goodbyes
• Worrying that something bad will happen to a parent, or that they’ll get lost
• Older children may explain their fears in detail, or feel very homesick on trips

It is the most common anxiety difficulty in children under 12, affecting about 4 in 100. It can follow a loss, a divorce, a move or a change of school, and it can run in families. The good news: children who get help, especially early, tend to do well and become more independent.

What helps

• Keep goodbyes short, warm and the same each time. Long, worried goodbyes can make it harder.
• Tell them clearly when you’ll be back, and keep your word
• Practice small separations first, then build up
• Praise each brave step
• Reassure them that you are there for them, even when they can’t see you
• Ask your child’s doctor or school about easing transitions
• Therapy that teaches coping skills step by step (like CBT) and family therapy can help a lot

Some children talk easily at home, but can’t speak in certain places, most often at school or around people they don’t know well. This is called selective mutism. It is a form of anxiety. The child is frozen by fear: they are unable to speak, not refusing to speak.

What it can look like

• Not speaking even to familiar adults when other people are around
• Seeming “frozen” or shut down in social situations
• Talking freely at home, but silent at school or with strangers
• Using nods, pointing and facial expressions instead of words

It usually starts around age 3 or 4, but is often noticed later, when school begins. It is easy to brush off as shyness. But the longer it goes without help, the harder it can be to overcome.

What helps

• Never pressure, bribe or punish a child to make them talk
• Behavioral therapy with small, gentle steps: speaking in new places, with new people, a little at a time
• Praise brave talking specifically: “Great job telling us you want juice!”
• Try not to answer for them. Wait about five seconds to give them a chance.
• Practice in real places, like the classroom or a shop
• Work with the school. A child may qualify for support through a 504 plan or IEP.

Shyness is common. Most shy children do well with friends and in groups once they get past a first period of adjusting. Children who still struggle after that time deserve a closer look and more support.

What helps

• Coach them not to pull away when a conflict comes up
• Gently guide them into social situations where they can succeed
• Give them time to get through the first adjusting period
• Help them warm up to other children
• Model and practice skills like sharing, asking for help, saying sorry and handling rejection

It is worth a closer look if shyness becomes disabling, if your child keeps avoiding social settings, or if they are left out and spend most of their time alone. The longer avoidance goes on, the harder it can be to change, so a child mental health professional can help.

School refusal (also called school avoidance) is when a child is so anxious or upset about school that they can’t go, or keep trying to come home. It isn’t about laziness or defiance. It is usually a sign that something at school or inside them feels too hard.

Signs you might see

• Begging to stay home or asking to leave early
• Crying, tantrums or arguments before school
• Headaches, stomachaches, nausea or dizziness, mostly on school days and gone on weekends
• Lots of visits to the school nurse
• Missing many days

Common causes

• Bullying, friendship problems or worry about fitting in
• Coming back after a long break or an illness
• Fear of failing, or perfectionism
• Fears about safety at school
• Learning difficulties, grade worries or a test coming up
• Stress at home: divorce, a move, money worries
• Worry about using school bathrooms
• Online bullying after school hours

What helps

• Start with a doctor’s visit to rule out a physical illness
• Ask specific questions: “What’s the hardest part of the day?”
• Keep mornings predictable, and be calm and firm
• Praise each brave step: getting dressed, walking to the gate
• Keep days at home boring, without extra screen time or treats
• Work with teachers and the counselor on a plan, like a check-in adult or a quiet space

The longer a child stays home, the harder it usually is to go back. If symptoms are severe, a gradual return can help: one class, then half a day, then full days.

Dyslexia makes it hard to connect letters with sounds, sound out words and rhyme. It is the most common learning disability, making up at least 80% of them.

What can help

• Audiobooks alongside printed books
• Extra time on tests
• Reading for fun together, without pressure
• Specialized reading teaching from trained teachers

Children with dysgraphia may have messy handwriting, struggle with spelling, or find it very hard to get their ideas onto paper. They are often wrongly seen as sloppy or lazy.

What can help

• Answering out loud instead of in writing
• Breaking writing tasks into smaller steps
• Getting class notes from the teacher or a note-taker
• Typing instead of handwriting

Dyscalculia makes numbers, counting, math facts and math ideas hard to grasp. Without support, children can start to feel anxious about math and doubt themselves.

What can help

• Extra time and step-by-step instructions
• Practicing math in everyday life, like cooking and shopping
• Using a calculator or number chart where allowed
• Using real objects to show numbers

When a child keeps struggling while classmates seem to find things easy, they can feel frustrated, embarrassed and “stupid”. Learning disabilities are linked with lower self-esteem and a higher risk of anxiety and low mood. Steady support from family, teachers and friends helps a lot.

Ways to build confidence

• Explain that their brain learns differently, not worse
• Celebrate effort and progress, not just grades
• Help them find what they are good at: art, sport, music, building, caring for others
• Watch for self-critical comments and avoiding schoolwork
• Get mental health support if they seem very low or worried

In the U.S., the Individuals with Disabilities Education Act (IDEA) gives eligible children the right to a free and appropriate education. An Individualized Education Program (IEP) is a formal plan with specialized teaching, support services and measurable goals that are reviewed every year.

How to start

1. Ask the school for an evaluation in writing. Be specific and include dates and examples.
2. The school evaluates your child. Schools must evaluate children ages 3 to 21 who may have a disability that affects learning.
3. If your child qualifies, a team meeting is held to write the IEP.
4. Take your time. You don’t have to sign at the meeting.
5. Check progress reports, and ask for a review meeting if something isn’t working.

A 504 plan is for students with a physical or mental condition that greatly limits a major life activity, like concentrating, reading or communicating. It focuses on accommodations: changes that remove barriers to learning, without special teaching. Some children who don’t qualify for an IEP can still get a 504 plan.

Examples of accommodations

• A seat near the teacher
• Breaks during the day
• Extra time on tests
• Shorter assignments
• Unlimited bathroom access

Children rarely learn friendship skills without some support and good examples. Clubs, sports and activities help them meet kids with the same interests.

Ideas

• Arrange playdates, starting around ages 2 to 3
• Encourage clubs, teams, arts or volunteering
• Help them think about a friend’s feelings before acting
• Model listening and talking things through rather than fighting
• Watch for a best-friend pair that leaves others out, or where one child feels burdened
• Welcome friends at home, and keep family time a priority too

Self-esteem plays a central role in a child’s motivation, schoolwork, friendships and ability to bounce back. Feeling accepted in a group, like friends, classmates or a team, matters a lot. Without it, children can feel rejected and lonely.

Signs of low self-esteem

• Avoiding a task or challenge without even trying
• Becoming bossy or rigid, or blaming others
• Being very sensitive to what others think
• Pulling away from friends
• Quitting at the first sign of frustration
• Saying things like “I never do anything right”

What builds it

• Chores and tasks they can master, and a say in decisions
• Fun, non-competitive one-on-one time together
• Praise for effort, not only results
• Respect and acceptance from at least one adult: “I believe in you”
• Shielding them from adult problems and family conflict
• Telling them you love them, with no conditions

Building self-esteem can take months or years. If your child isn’t responding, talk with their pediatrician about extra support.

Bullying is unwanted, aggressive behavior where there is a real or perceived power imbalance, and it happens again and again, or is likely to. It can be physical, verbal, social (like leaving someone out or spreading rumors) or online. Many children don’t tell adults. They may feel ashamed, scared it will get worse, or worried they won’t be believed.

You might notice

• Changes in sleep or eating
• Fewer friends, or avoiding social events
• Not wanting to go to school, or certain places
• Saying harsh things about themselves
• Seeming upset after using a phone, tablet or game
• Torn clothes, lost belongings or unexplained injuries

Your first job is to make your child feel safe telling you. Reassure them it is not their fault and that you will work through it together. Bullying can lead to low mood, anxiety, sleep problems and lower grades, so it is worth acting on.

Steps to take

1. Listen calmly and thank them for telling you.
2. Ask what happened, how it started and who is involved.
3. Write down dates, times and what happened. Save screenshots.
4. Report it to the school. Many states require schools to deal with bullying, including cyberbullying.
5. If there are threats of violence or a possible crime, contact the police.
6. Check in often, and get counseling support if your child is struggling.

Bystanders can become “upstanders” by speaking up, interrupting or getting help. Online, they can refuse to like, share or comment on hurtful posts.

Safe ways to help

• Be kind to the person being bullied: sit with them, check in
• Don’t laugh or join in
• Send a private, supportive message, if it feels safe
• Tell a trusted adult

Young people who bully others are at higher risk of problems later, including substance use, school problems and violence. Those who both bully and are bullied face the most serious effects. They need help too.

What helps

• Stay calm, and make it clear bullying is not OK
• Find out what is behind it: stress, being bullied, wanting to fit in
• Help them understand how the other person feels
• Set clear consequences, and follow through
• Model kindness and respect at home
• Ask the school counselor for support

Students who feel that adults and peers at school care about them are less likely to have poor mental health, use substances or experience violence. They are also more likely to attend school and graduate, and the benefits can last into adulthood.

Ways to help

• Get to know their teacher, and share your child’s strengths
• Encourage one club, team or activity they enjoy
• Go to school events when you can
• Ask about the good parts of the day, not only problems

Screens can crowd out play, moving, exploring outside, reading and conversation, which build the brain and social skills young children need for school. Handing over a device every time a child is upset also misses chances to learn to manage big feelings.

Pediatricians suggest

• Avoid open access to tablets and phones
• Keep screens to regular times of day, plus long trips
• Set aside time every day for play, reading or being outside
• Turn off autoplay and make a playlist of good-quality videos
• Watch together and talk about what you see

Instead of one time limit for every child, the American Academy of Pediatrics suggests thinking about five C’s.

• Child: what draws my child to this, and how does it affect them?
• Content: what are they watching or playing? Is it violent, mean, unrealistic or full of ads?
• Calm: can they calm down and fall asleep without a screen?
• Crowding out: what is screen time replacing, like sleep, play, family time or outdoors?
• Communication: are we talking about media early and often?

Pediatricians suggest watching for

• Being preoccupied with gaming, and sad, irritable or anxious when it’s taken away
• Gaming instead of homework, sleep, exercise or time with family and friends
• Losing interest in activities they used to enjoy
• Lying about how much time they spend
• Using games to escape a bad mood
• Wanting more and more time, and not being able to cut down

Boys are more likely to develop unhealthy gaming habits. Children dealing with low mood, anxiety, shyness or aggression, or who have ADHD, may be more vulnerable.

• Check that gaming isn’t crowding out homework, exercise or sleep
• Check what games and apps get downloaded, and talk about hidden ads and data collection
• Keep gaming in shared rooms when you can
• Keep phones and gaming devices out of bedrooms at night
• Play together sometimes; it helps you understand the game and set limits
• Use a timer so the end of play isn’t a surprise

Many games let players talk by voice or text with people they don’t know. That can mean bullying, strangers asking personal questions, or pressure to meet in person.

What helps

• Agree on who your child can play with
• Explain why never to share personal details or meet someone from a game
• For younger kids, choose games with little or no chat, and turn off voice chat
• Show them how to block, mute and report
• Tell them to come to you if a stranger contacts them or something feels wrong
• Use private worlds or invite links, and set spending limits

The American Academy of Pediatrics suggests a Family Media Plan: rules for screens that fit your family’s routines and values, made together and reviewed as kids grow.

Ideas to include

• Check privacy settings and talk about ads and influencers
• Make room for offline fun: reading, play, hobbies, time outdoors
• One screen at a time
• Screen-free zones: the dinner table, homework time and bedtime
• Turn off autoplay and notifications
• Use parental controls for time limits and downloads, where helpful

1. Pick a calm moment, not mid-game.
2. Ask what they love about it, and listen.
3. Share what you’ve noticed, without blame.
4. Agree on a plan together and write it down.
5. Change the setup: devices out of bedrooms, device-free meals and car rides.
6. Offer real alternatives, including time with you.
7. Expect pushback at first, and stay steady and kind.

Children may hide problems because they fear losing their devices. Respond supportively when they tell you something went wrong online, so they keep coming to you.

Start by saying what you’ve noticed, without guessing or labeling. Then listen more than you talk. Children open up more when they don’t feel judged or interrogated.

Try saying

• “I’ve noticed you seem down lately. I’m here if you want to talk.”
• “That sounds really hard. Thank you for telling me.”
• “You’re not in trouble. I just want to understand.”
• “What would help right now?”
• “We’ll figure this out together.”
• “I love you, no matter what.”

In a hard moment, it’s natural to want to fix things fast, or to say the worry is “nothing”. But brushing feelings aside can teach a child not to tell you next time.

Try to avoid

• “You’re just being dramatic.” or “It’s just a phase.”
• “What do you have to be upset about?”
• “When I was your age…” (at least at first)
• “You’re a bad kid.” Name the behavior, not the child.
• Comparing them to a sibling or a friend
• Shouting, threats or sarcasm in the middle of a meltdown

Pediatricians suggest “emotion coaching”. Acknowledge your child’s feeling, help them name it, let them know it makes sense, and meet the need underneath: comfort for sadness, safety for fear, and kindness with clear limits for anger.

Calming skills to practice together

• Box breathing: slow, even breaths in, hold, out, hold
• Imagining a calm, peaceful place
• Relaxing the muscles, one part of the body at a time

Clear, calm and consistent rules, plenty of praise for good moments, and relaxed time together are some of the most helpful things parents can offer. These are also the core of the parent training that professionals use for behavior problems.

Everyday ideas

• Keep regular sleep, meal and homework routines
• Spend short one-on-one time most days, doing what they choose, with phones away
• Praise effort and kindness, specifically and often
• Agree on a few important rules, and follow through calmly
• Make home a place their friends are welcome
• Look after their body too: movement, time outdoors, good food and sleep

Early help works best when it fits the child and the family. A good first step is the child’s doctor, who can look for physical causes and refer you to a mental health professional. The school may also check for learning problems that can sit behind behavior.

Ways to make it easier

• Explain to your child that seeing a counselor is like seeing a coach for feelings
• Let older children have a say in who they see
• Ask how parents will be involved, and what you can practice at home
• Share what you see at home with the school, and ask what they see
• Give it time. Progress often comes in small steps.

Supporting a struggling child is exhausting and can bring up guilt, fear and even grief. How you cope shapes how your child copes. Getting support for yourself is part of helping them.

Ideas

• Join a parent support group, in person or online
• Let go of the idea of the “perfect parent”. Good enough, and showing up, is what children need.
• Notice your own stress signals, and use your own calm-down tools
• Take short breaks, and share the load with other trusted adults
• Talk to a friend, partner, relative or your own therapist