I’m worried about my preschooler (0–5 years old)

From birth to age 5, a child’s brain and body are going through enormous changes. This rapid development means that almost every day can bring something new in how they behave, communicate, learn, and move. Some of these changes may seem triumphant (first steps!) while others can be trying (the “terrible twos”). During this time, you may begin to have concerns about your child’s emerging mental health — including their social, emotional, and behavioral development. Mental health concerns are more common than you may realize, even in the early childhood years. Your child is:

• Moving through phases of shyness and separation anxiety to interest in others, especially children
• Evolving ways to deal with frustration, from crying to tantrums to the beginnings of problem-solving
• Increased independence as skills grow and your child can do — or try to do — more things on their own
• Defiance, as they test their growing independence — and you
• Evolving awareness of danger, real or imagined, and expression of fears
• Improving abilities to play and get along with others

What can I do?

During this period of incredible change, you’re building the foundation for your child’s future development. It’s an ideal time to start supporting their mental fitness. Some of the steps you can take include:

• Playing with, talking and listening to, and interacting with your child
• Ensuring that basic needs are met — healthy foods, adequate sleep, time for play
• Providing consistency with routines and rules
• Responding to unwanted behaviors quickly, calmly, clearly, and consistently; don’t plead or negotiate
• When your child gets upset, helping them learn to problem-solve once they are calmer

When should I worry?

The “milestone” charts for this period of a child’s life are long, and no child hits every mark. Just as some children develop faster physically than others, there are also differences in their social, emotional, and behavioral development timetables. In general, these are some causes for concern:

• Tantrums that persist and get more intense, in more places for longer times
• Defiant behavior that persists, is unsafe, and/or disrupts family, preschool, or other people or settings
• Persistent underreaction to everyday things
• Persistent overreaction to everyday things
• Worries that are persistent, out of proportion, or interfere with everyday life
• Hyperactivity that is aggressive toward others, unsafe, or continuous
• Sadness that is persistent or out of proportion to the cause