Key points
- Sadness, worry, irritability and trouble sitting still are common in childhood and are often a normal part of growing up.
- What matters most is how long a change lasts, how upsetting it is and whether it gets in the way of daily life.
- Signs can look different in younger children than in older children and teens.
- Talking with your child, their doctor and their teacher is a good first step.
- Any talk of self-harm or unsafe behavior needs help right away, not a wait-and-see approach.
A phase, or something more
Every child feels sad, anxious, irritable or angry sometimes. Many find it hard to sit still, pay attention or get along with others now and then. The National Institute of Mental Health (NIMH) says that in most cases these are typical developmental phases. Symptoms also change as a child grows, so what you see at eight may look quite different at fourteen.
Three questions help sort a phase from a pattern. Has it lasted for weeks or longer? Is it causing distress for your child or your family? Is it getting in the way at school, at home or with friends? NIMH suggests considering help when the answer is yes. The Centers for Disease Control and Prevention (CDC) describes the same idea: a concern becomes a possible mental health condition when symptoms are severe, persistent and interfere with school, home or play.
You do not need to be sure before you ask. A list like the ones below cannot tell you what is going on with your child. It can help you decide whether it is time to talk with someone who can.
Signs in younger children
In school-age children, feelings often come out through behavior and the body instead of words. NIMH and the American Academy of Child and Adolescent Psychiatry (AACAP) list signs such as these:
- Frequent tantrums, or being irritable much of the time
- Often seeming fearful or worried, including regularly refusing to go to school, go to sleep or join activities that are usual for their age
- Frequent stomachaches or headaches with no known medical cause
- Being in constant motion and unable to sit quietly, except during activities they enjoy
- Sleeping too much or too little, frequent nightmares or seeming sleepy during the day
- Little interest in playing with other children, or difficulty making friends
- Struggling at school or a recent drop in grades
- Repeating actions or checking things many times out of fear that something bad may happen
Signs in older children and teens
As children get older, the signs tend to look more like withdrawal or a change in habits. The same sources describe signs like these:
- Losing interest in things they used to enjoy, or having low energy
- Marked changes in sleeping or eating habits
- Spending more and more time alone and avoiding friends or family
- Strong worries that get in the way of daily life, such as at school or with friends
- A marked decline in school performance, or great difficulty concentrating
- Frequent outbursts of anger, or severe mood swings
- Dieting or exercising excessively, or an intense fear of gaining weight
- Harming themselves, or taking part in risky or destructive behavior
When to act right away
Some signs should not wait. NIMH says to seek help immediately if your child's behavior is unsafe, or if your child talks about wanting to hurt themselves or someone else. Threats of self-harm are on AACAP's lists for both younger and older children.
If your child is in crisis or talking about suicide or self-harm, call or text 988, or call 911 if there is immediate danger. Locascio Wellness does not provide emergency services. Our crisis resources page lists more options.
First steps for parents
Parents are usually the first to notice that something has changed. You do not have to work out the cause alone.
- Talk with your childAACAP suggests starting by gently and openly talking with your child about how they feel. Pick a calm moment, ask simple questions and listen more than you speak.
- Ask the adults who know themCheck in with your child's teacher and their doctor. They can tell you what they see, and a doctor can look for medical causes of things like stomachaches or poor sleep.
- Look at the basicsThe CDC notes that regular physical activity, enough sleep for their age, healthful food and strong relationships with family and friends support a child's mental health.
- Ask for a referralIf the concern continues, or other people in your child's life are worried too, ask for a referral to a mental health professional who works with children.
How child counseling by video works
Counseling for children is not a small version of adult therapy. According to NIMH, psychotherapy for children often includes the parent, involves practicing skills at home or at school, and includes ways to measure progress over time. Family counseling can also help everyone understand how a child's struggles affect relationships at home.
In an online session, your child meets with a therapist by secure video from a familiar place, such as their bedroom or the kitchen table. They need a phone, tablet or computer, a steady internet connection and a private spot. A parent usually helps with setup, stays nearby and often joins for part of the conversation.
NIMH suggests a few questions to ask any provider: whether the approach is supported by research, how parents are involved, whether there is practice between sessions and how progress will be tracked.
How we can help
Locascio Wellness offers child therapy by secure video for children from age 7, along with teen therapy and family therapy. All sessions are online, and your child must be physically in Pennsylvania, West Virginia or Arizona during each session. We match your family with a therapist licensed where you live who works with your child's age group.
You can start with a free 15-minute consultation on our booking page. It is a chance to describe what you are seeing and ask questions before deciding anything. Our insurance and fees page explains coverage, or you can ask us to verify your benefits.
If your child is younger than 7, their doctor is the right place to start. Whatever their age, noticing and asking is a strong thing to do, and many families find that the right support helps things feel lighter at home.
Common questions
How do I know if my child's behavior is just a phase?
Look at how long it has lasted, how distressing it is and whether it gets in the way of daily life. The National Institute of Mental Health suggests considering help when a behavior or emotion lasts for weeks or longer, causes distress for your child or family, or interferes with school, home or friendships. A professional can help you sort out what is typical for your child's age.
Who should I talk to first if I am worried about my child?
Start with your child, in a calm and open way. Then talk with the adults who know them well, such as a teacher and their doctor. If the problem continues or others are worried too, ask for a referral to a mental health professional who works with children. You can also book a free consultation with us to talk it through.
What age does my child need to be for online counseling with you?
The youngest clients we see are 7 years old. Our team also works with teens, adults and families. Which therapist sees which ages varies, so we match your child with a therapist who works with their age group and is licensed in your state. For a child younger than 7, your child's doctor can point you toward the right support.
Will I be involved in my child's counseling?
Usually, yes. The National Institute of Mental Health notes that psychotherapy for children often includes parent involvement and practicing skills at home or school. How much you take part depends on your child's age and needs. It is a good question to raise at a consultation, along with how progress will be measured.
Sources
Published by Locascio Wellness. Published October 13, 2026. Clinically reviewed by Anthony Locascio, PsyD, LPC. This page is general information, not medical advice or a diagnosis.