Does My Child Need Therapy?

As children progress in their growth and development, it is not uncommon for your child to experience emotional and behavioral challenges that may seem concerning and leave you wondering, is this normal?

The information below is only a guide and should not replace medical advice- each child is different and may have their own track of development.

 
  • Emotional Development

    • Is often silly and enjoys laughing

    • Experiences a wide range of emotions with intensity

    • Identifies own and other’s feelings

    • Shows concern by offering hugs or comfort

    • Struggles to regulate emotions when tired, stressed, or experiences changes in routine

    • Throws fewer temper tantrums than at 2 ½

    3 ½

    • Expresses emotions more intensely

    • Cries, whines, or has more difficulty separating from parents

    • Is very determined and strong -willed

    • May have imaginary friends

    • Seems sensitive and becomes upset easily

    • Can be inflexible; responds negatively to changes in schedule

    Normal Challenges at 3

    • Frequent potty training accidents when engaged in play, or withholding to avoid missing out on activities

    • Masturbating in private or in public

    • Enjoying being naked and frequently taking off their clothes

    • Asking questions about genitalia and where babies come from with body parts

    • Wanting to wear costumes or pretending to be a fictional character or animal

    Normal Challenges at 3 ½

    • Biting nails, picking nose, sucking thumb, or chewing on clothes to self-soothe

    • Excessively blinking or developing facial tics

    • Refusing to be cooperative or flexible

    • Whining and complaining

    When to Seek Help

    • Your child’s behavior or abilities seem significantly different from those of other children his or her age

    • Your child demonstrates extreme separation anxiety, or withdrawals from friends or play

    • You need parenting support to address concerns or issues related to discipline

    • Your child experiences a significant change or traumatic experience, including loss, disruption of the home or family environment, abuse, or a medical emergency

    • You frequently feel disconnected and stressed in your relationship with your child

    • Your child has extreme temper tantrums or lacks self-control

    • Your child has significant difficulties sleeping or toilet training

  • Emotional Development

    • Often reacts strongly, with intense feeling of happiness, silliness, anger, and sadness

    • Needs adult help to find words to express needs, instead of reacting physically

    • Can be aggressive and bossy

    • Loves and hates many things

    • Has a growing sense of humor, and enjoys laughter and silliness

    • Learns from modeling; needs chances to practice new behavior

    • May throw temper tantrums

    4 ½

    • Is often fearful or anxious

    • May have frequent nightmares

    • May develop phobias

    • Can stay on-task for long periods of time yet still not long

    • Is dramatic

    Normal Challenges at 4

    • Aggressive behavior including hitting, kicking, and throwing temper tantrums when angry

    • Lying when in trouble

    • Frequent nightmares stemming from new feelings or experiences

    • Imaginary friends

    • Fascination with their own bodies and masturbation

    • Fascination with going to the bathroom and using “potty” words or name-calling

    • Constant motion and noise

    Normal Challenges at 4 ½

    • Seeming “at odds” with environment

    • Frequent fears

    • Fears developing into phobias (typical for this age)

    • Fears regarding what is real and what is not

    • Inconsistency, making them hard to predict

    When to Seek Help

    • Your child’s behaviors or abilities seem significantly different from from those of other children his or her age

    • You child experiences severe or prolonged anxiety or sadness

    • Your child experiences excessive phobias that interfere with daily functioning

    • You need parenting support to address concerns or issues related to discipline

    • You child experiences a significant change or traumatic experience, including loss, disruption in the home or family environment, abuse, or a medical emergency

    • You frequently feel disconnected and stressed in your relationship with your child

    • Your child demonstrates highly aggressive behavior behaviors towards you and others

    • Your child shows little interest in play or playing with others

  • Emotional Development

    • Is calm and confident in his or her own abilities

    • Feels safe with consistent guidelines and routine

    • Is positive and optimistic about self and life

    • Is quieter and at times more withdrawn

    • Avoids overstimulation

    • Is able to express feelings verbally

    • Demonstrates more self-control and less impulsivity

    • Becomes more independent and gains a sense of competence

    5 ½

    • Is still eager to do activities, but less motivated to please than earlier in the year

    • Displays extremes in behaviors, both positive and negative

    • May seem overly demanding and disobedient

    • Experiences intense rage and fluctuations in emotions

    • May bite nails, pull hair, or cry to relieve anxiety

    • Is indecisive

    • Is hesitant and insecure

    Normal Challenges at 5

    • Frequent nightmares, and often waking up screaming and crying

    • Enjoying watching television and playing on the computer and needing limits on screentime

    • Sometimes too obedient and should be protected from overly dominating or aggressive playmates

    • Lying to avoid punishment

    • Stealing items from other people

    Normal Challenges at 5 ½

    • Opposition to adults and peers

    • Complaining frequently

    • Becoming easily overwhelmed with choices

    • Tattling

    When to Seek Help

    • Your child’s behaviors or abilities seem significantly different from from those of other children his or her age

    • You child experiences severe or prolonged anxiety or sadness

    • Your child does not show interest in developing friendships or playing with friends

    • Your child has problems in school or another academic environment

    • Your child displays extreme disobedience or defiance

    • Your child has frequent accidents or difficulties toileting during the day

    • You need parenting support to address concerns or issues related to discipline

    • You child experiences a significant change or traumatic experience, including loss, disruption in the home or family environment, abuse, or a medical emergency

    • You frequently feel disconnected and stressed in your relationship with your child

    • Your child demonstrates highly aggressive behaviors towards you and others

    • You are having difficulty deciding whether your child is ready for kindergarten

  • Emotional Development

    • Is highly sensitive to criticism and correction

    • Is more emotionally volatile under stress, or when hungry and tired

    • Is gaining a greater sense of competence and mastery

    • Is more aware of other’s needs and feelings

    • Is proud of accomplishments

    6 ½

    • Is calmer and more easygoing

    • Is likable and affectionate

    • Has a good sense of humor

    • Likes to try new things

    Normal Challenges at 6

    • Fear at bedtime and needing a nightlight or security object

    • Bedwetting or accidents during times of high stress

    • Lying, which is quite normal for this age, but stressful for parents and adults

    • Poor sportsmanship in games

    • Defiance of and arguments with parents as the child tries to gain more independence

    • More anxiety and fears at bedtime, and needing extra reassurance and comfort

    • High sensitivity to criticism and correction, to which perceived judgment or failure they may respond with intense emotion

    Normal Challenges at 6 ½

    • Extreme sensitivity to criticism

    • High levels of anxiety

    • Performance anxiety

    • A tendency to lie to win or to get out of trouble

    When to Seek Help

    • Your child’s behaviors or abilities seem significantly different from from those of other children his or her age

    • You need parenting support to address concerns or issues related to discipline

    • You child experiences a significant change or traumatic experience, including loss, disruption in the home or family environment, abuse, or a medical emergency

    • You frequently feel disconnected and stressed in your relationship with your child

    • Your child demonstrates highly aggressive behaviors towards you and others

    • Your child becomes highly discouraged when, or, avoids, learning new skills or knowledge

    • Your child shows little interest in interacting with others or making friends

    • Your child shows little interest in play or physical activities

    • Your child is struggling to read or has significant difficulty in school

  • Emotional Development

    • Is often more withdrawn and quieter

    • Experiences large shifts in mood, and is more sensitive and serious in general

    • May seem moody and sad without cause

    • Tends to worry about serious things, such as wars, illness, natural disasters, and money

    • Is more introspective and self-reflective

    • May blame others for wrongdoing and has difficulty admitting failure

    • Cries easily, but often hides his or her tears to avoid embarrassment

    • Is easily disappointed and clings to his or her own plans

    • Works had to control his or her temper, voice, thoughts, and body, and often feels fatigued

    • Likes to observe others

    • Develops great empathy for others and is highly sensitive to other’s feelings

    Normal Challenges at 7

    • Seeming more withdrawn, quieter, and sadder in general (but this does not necessarily mean that they are depressed or struggling)

    • Worrying more about death, the loss of loved ones, natural disasters, getting good grades, making friends, and other concerns

    • Perfectionistic tendencies and repeating a task or assignment multiple times to meet their own high standards

    • Sensitivity to rejection and failure, and interpreting bad experiences or mishaps as rejection and responding dramatically

    When to Seek Help

    • Your child’s behaviors or abilities seem significantly different from from those of other children his or her age

    • You become discouraged by your child’s attitude or behaviors

    • Your child becomes excessively withdrawn

    • Your child is aggressive and engages or welcomes conflict with you or others

    • Your child cries excessively or displays extreme agitation

    • Your child has no or few friends or does not socialize with peers

    • You need parenting support to address concerns or issues related to discipline

    • You child experiences a significant change or traumatic experience, including loss, disruption in the home or family environment, abuse, or a medical emergency

    • You frequently feel disconnected and stressed in your relationship with your child

  • Emotional Development

    • Is outgoing and sociable, with bouts of rudeness and being demanding

    • Is sensitive and tends to be dramatic

    • Is able to understand and interpret others emotions

    • Is able to regulate his or her own emotions

    • Is self-critical and self-competitive

    • Experiences more fear and anxiety, but refrains sharing those fears with adults

    Normal Challenges at 8

    • High levels of activity and energy, and a need for physical activity that adults may find surprising

    • Increased focus and concern about peer relationships and acceptance

    • Testing rules and limits as they become more independent

    • Excessive self-criticism

    When to Seek Help

    • Your child’s behaviors or abilities seem significantly different from from those of other children his or her age

    • Your child wets the bed or has difficulty sleeping

    • Your child behaves impulsively, lies, or steals frequently

    • Your child experiences intense anxiety regarding his or her performance

    • Your child experiences intense anxiety when separated from his or her parents

    • Your child has difficulty making friends, withdraws from peers, or is overly sensitive to peer pressure

    • You child experiences a significant change or traumatic experience, including loss, disruption in the home or family environment, abuse, or a medical emergency

    • You frequently feel disconnected and stressed in your relationship with your child

    • Your child is struggling in school or failing subjects

  • Emotional Development

    • Tends to worry or become anxious

    • Gets feelings hurt easily

    • Is determined, motivated, and independent

    • Is more mature and generally calmer

    • Is persistent and sometimes impatient

    • Is able to take the perspective of others and understand other’s thoughts and feelings

    • Follows rules and is eager to gain approval from teachers, parents, or peers

    • Is generally self-confident and dependable

    • Is able to communicate and express is or her feelings with others

    • Has strong and intense internal world and emotional experiences

    • Tends to be perfectionistic

    Normal Challenges at 9

    • Struggling with taking tests and becoming more anxious about academic performance

    • Excessive perfectionism

    • Excessive worries

    • Competitiveness with others

    • Self-Criticism

    • Sensitivity and avoidance of situations in which they believe they will fail

    When to Seek Help

    • Your child’s behavior or abilities seem significantly different from those of other children his or her age

    • Your child’s worries interfere with his or her daily functioning

    • Your child withdraws from interaction or competition because of fear of failure

    • Your child is overwhelmed by social interactions or has difficulty developing friendships

    • Your child experiences severe or prolonged anxiety or sadness

    • You need parenting support to address concerns or issues related to discipline

    • Your child experiences a significant change or traumatic experience, including loss, disruption in the home or family environment, abuse, or a medical emergency

    • You frequently feel disconnected and stressed in your relationship with your child

    • Your child demonstrates aggressive behavior toward you or others

  • Emotional Development

    • Is relatively calm

    • Is typically flexible and easygoing

    • Is comfortable in his or her environment

    • Needs to be perceived as “good”

    • Has a strong sense of right and wrong

    • Demonstrates self-confidence

    • Is drawn to activities in which he or she feels competent

    • Uses cognitive skills to regulate emotions

    • Can become angry quickly, but will calm equally quickly

    • Prefers his or her environment to be organized and predictable

    Normal Challenges at 10

    • Excessive concern with belonging to the group

    • Choosing peer values over family values

    • Desire to spend substantial time with peers

    • Spending time and energy on maneuvering through social interactions

    When to Seek Help

    If your child has no friends, dislikes school, or displays emotional and social difficulties. Additionally, if your child does not express a sense of belonging in a recognized group, this might be an area of concern. At the age of 10, children also need to experience a sense of mastery or competence; thus if they are struggling with finding areas of competence, they might need help.

Help for Your Child Starts Here