Children

Behavior and Emotions in Children

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A father crouching to comfort an upset young child

Written and reviewed by the DrSensory Editorial Team · Sources: American Psychiatric Association (DSM-5-TR), American Academy of Child & Adolescent Psychiatry · How we write and who reviews it · Last updated August 27, 2026

Behavioral and emotional conditions in children include anxiety disorders, mood conditions, and patterns of behavior that persistently interfere with home, school, or friendships. They are common, they are diagnosable, and they can be treated⁠1,2 — but they can be misread first as defiance, attitude, or poor parenting. The most useful reframe is that behavior is communication: a child who refuses, melts down, or withdraws is usually telling you something they can’t say directly. Behavior problems also often come with difficulties that aren’t behavioral at all, including sensory difficulty, learning and language differences, poor sleep, and anxiety,⁠3,4,5,6 which is why assessment should look wider than the behavior itself.

Behavior is communication

The single most useful idea on this page.

A child who won’t go into school, screams at homework, or hits a sibling is doing something. The question worth asking isn’t “how do I stop this,” but “what is this for.”

Common answers: the demand is beyond what they can currently manage · the environment is intolerable · they can’t express what’s wrong in words · something is frightening them · they’ve learned this works when nothing else does.

None of those responds to consequences alone.

Conditions covered here

Anxiety

Generalized anxiety disorderSocial anxietySelective mutismObsessive-compulsive disorder

Mood

Bipolar disorderChildhood depressionMood disorders in childrenDisruptive mood dysregulation disorderPersistent depressive disorder

Behavior

Oppositional defiant disorderConduct disorderMoving from hitting to words

What frequently sits underneath

Behavioral presentations often come with non-behavioral difficulties, which is why an evaluation screens for them.⁠4

Sensory difficulty. Children who are over-responsive to touch and sound have more emotional and behavioral problems,⁠3 and a child who melts down at the end of every school day may have spent their capacity tolerating the environment. → Sensory over-responsivity

Undiagnosed learning differences. Refusing homework is a rational response to work you can’t do. → Learning and thinking

Communication difficulty. A child who can’t explain what’s wrong has fewer options. → Speech and language

Sleep. Poor sleep in children can show up as overactivity, trouble paying attention, misbehavior, anger and mood swings rather than as obvious tiredness.⁠5 → Sleep regressions · Mouth breathing and disrupted sleep

Anxiety. Can show up as irritability and anger in children, not only as visible worry.⁠6

ADHD and autism, both of which involve emotional regulation differences.⁠7,8 → ADHD · Autism

Ask what’s driving the behavior before treating the behavior.

How these conditions are diagnosed

Who — a child psychiatrist, psychologist, or pediatrician with mental health training, using the American Psychiatric Association’s diagnostic manual (DSM).⁠2,9

What’s involved — a mental health and medical history, standardized rating scales from parents and teachers, direct assessment, and observation.⁠4,9 Diagnosis rests on how long difficulties have persisted, how many settings they appear in, and how much they interfere: for ADHD, symptoms must last at least six months, show up in two or more settings, and get in the way of daily life.⁠9

What’s ruled out — medical causes, sleep problems, learning and language differences, and the effects of stress or trauma.⁠4,9

One thing worth knowing: several of these conditions look similar in a young child and separate as they develop. In one study that followed children from age 3, preschool anxiety was linked to depression by early adolescence, and preschool ADHD to later disruptive behavior.⁠10 An early diagnosis may be revised, and that isn’t a mistake — it’s how developmental assessment works.

What helps with behavior and emotions in children

Behavioral parent training has strong evidence for oppositional and disruptive behavior, and it’s typically first-line for younger children. It teaches strategies rather than treating the child directly.⁠4,11,12

Cognitive behavioral therapy is well supported for anxiety in children and adolescents,⁠13 and it is also used for depression, particularly in older children.⁠6

School support — accommodations and behavior plans. → IEPs and 504 plans

Environmental change, which is frequently overlooked. Reducing the demand or the sensory load sometimes resolves what looked like a behavioral problem.

Medication, where indicated. For ADHD in school-age children, guidelines pair it with behavioral treatment rather than using it instead,⁠4 and for anxiety, both CBT and SSRI medication are well supported.⁠13

When to seek help sooner

Contact your child’s doctor promptly if:

  • Your child talks about wanting to die, or about hurting themselves
  • There has been a marked change in mood, behavior, or functioning
  • Your child is not eating, sleeping, or going to school
  • Behavior is putting your child or others at risk

If you believe your child is in immediate danger, call 911 or go to an emergency department.

In the US, the 988 Suicide & Crisis Lifeline is available 24 hours a day by calling or texting 988.⁠14

What frequently sits underneath the behavior, and where to read about it.

Sensory over-responsivity

An environment that is genuinely too much looks like refusal from the outside.

Learn more →

ADHD

Impulsivity and trouble regulating emotions are part of the picture for many children.

Learn more →

Autism

Big emotional reactions and communication difficulty can both look like behavior problems.

Learn more →

Learning differences

Work that is genuinely too hard is refused, and the refusal gets the attention.

Learn more →

Frequently Asked Questions

Is this behavior, or is something else going on?
Frequently both. Behavior is communication, and it commonly comes with difficulties that aren’t behavioral — sensory difficulty, learning differences, poor sleep, or anxiety.⁠3,4,5,6 Assessment should look wider than the behavior itself.
Is my child’s behavior my fault?
Not in the way the question usually means. Many factors play a role in these conditions, including biology, temperament and stressful experiences.⁠6,12 Harsh or inconsistent parenting can add to the risk of behavior problems,⁠12 but behavioral parent training is offered because it’s effective, not because parents are the problem.⁠11
Will my child grow out of it?
Some difficulties ease with development, and others persist: in one long-term study, preschoolers with a diagnosis were more than twice as likely to have one later.⁠10 These conditions can be treated and managed.⁠2 Persistent difficulty across multiple settings, affecting daily life, is worth assessing rather than waiting out.
Who should we see?
Start with your pediatrician, who can assess, rule out medical causes, and refer. A child psychiatrist or psychologist carries out the fuller assessment.⁠4,9
Does my child need medication?
It depends on the condition, the severity, and the age. Behavioral and psychological therapies are typically first-line for younger children, with medication considered alongside where indicated.⁠4,12
What if the school says it’s a behavior problem?
Worth asking what they’ve tried and what happens immediately before the behavior. Patterns tied to specific lessons, times of day, or environments usually point to a cause rather than a character trait.

More on this topic

Sources

  1. Centers for Disease Control and Prevention. Data and Statistics on Children’s Mental Health. In US data from 2023–2024, 11% of children aged 3 to 17 had current, diagnosed anxiety, 8% a behavior disorder and 4% depression. Checked October 6, 2026.
  2. Centers for Disease Control and Prevention. About Children’s Mental Health. “Childhood mental health conditions can be treated and managed”; health care and mental health professionals diagnose them using the American Psychiatric Association’s Diagnostic and Statistical Manual. Checked October 6, 2026.
  3. Ben-Sasson A, Carter AS, Briggs-Gowan MJ. Sensory over-responsivity in elementary school: prevalence and social-emotional correlates. Journal of Abnormal Child Psychology. 2009;37(5):705–716. doi:10.1007/s10802-008-9295-8 (PMID 19153827). In 925 children aged 7 to 11, those with elevated over-responsivity to touch and sound had more internalizing, externalizing and dysregulation problems.
  4. Wolraich ML, Hagan JF, Allan C, et al. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2019;144(4):e20192528. doi:10.1542/peds.2019-2528 (PMID 31570648).
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    American Academy of Pediatrics guideline: diagnosis draws on a parent interview, examining and observing the child, and rating scales from parents and teachers; clinicians rule out other causes and screen for anxiety, depression, learning and language disorders and sleep apnea, referring on when needed; parent training in behavior management is first-line for preschoolers, and school-age children get medication along with behavioral treatment.
  5. National Heart, Lung, and Blood Institute. Sleep Deprivation and Deficiency: How Sleep Affects Your Health. “Children who are sleep deficient might be overly active and have problems paying attention. They also might misbehave”, and “may feel angry and impulsive, have mood swings”. Checked October 6, 2026.
  6. Centers for Disease Control and Prevention. Anxiety and Depression in Children. “Anxiety may present as fear or worry but can also make children irritable and angry”; many factors play a role, including biology, temperament, trauma and stress; cognitive-behavioral therapy “is used to treat anxiety or depression, particularly in older children.” Checked October 6, 2026.
  7. Shaw P, Stringaris A, Nigg J, Leibenluft E. Emotion dysregulation in attention deficit hyperactivity disorder. American Journal of Psychiatry. 2014;171(3):276–293. doi:10.1176/appi.ajp.2013.13070966 (PMID 24480998). Emotion dysregulation “is prevalent in ADHD throughout the lifespan and is a major contributor to impairment.”
  8. Mazefsky CA, Herrington J, Siegel M, et al. The role of emotion regulation in autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry. 2013;52(7):679–688. doi:10.1016/j.jaac.2013.05.006 (PMID 23800481). Autism “is associated with amplified emotional responses and poor emotional control.”
  9. National Institute of Mental Health. Attention-Deficit/Hyperactivity Disorder: What You Need to Know. Checked October 6, 2026.
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    Primary care providers diagnose or refer to a mental health professional; the evaluation covers mental health and medical history and uses standardized rating scales; symptoms must last at least 6 months, appear in two or more settings and interfere with functioning; stress, sleep disorders, anxiety, depression and physical conditions “can cause similar symptoms.”
  10. Finsaas MC, Bufferd SJ, Dougherty LR, Carlson GA, Klein DN. Preschool psychiatric disorders: homotypic and heterotypic continuity through middle childhood and early adolescence. Psychological Medicine. 2018;48(13):2159–2168. doi:10.1017/s0033291717003646 (PMID 29335030).
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    559 children followed from age 3: preschoolers with a diagnosis were over twice as likely to have one later; preschool anxiety was linked to early adolescent depression and preschool ADHD to later disruptive behavior disorders.
  11. Kaminski JW, Claussen AH. Evidence Base Update for Psychosocial Treatments for Disruptive Behaviors in Children. Journal of Clinical Child and Adolescent Psychology. 2017;46(4):477–499. doi:10.1080/15374416.2017.1310044 (PMID 28459280). For children 12 and under, group parent behavior therapy and individual parent behavior therapy with child participation are well-established treatments for disruptive behavior.
  12. Centers for Disease Control and Prevention. Behavior or Conduct Problems in Children. “For younger children, the treatment with the strongest evidence is behavior therapy training for parents”; many biological and social factors play a role, and risk is greater with “harsh or inconsistent parenting.” Checked October 6, 2026.
  13. Walter HJ, Bukstein OG, Abright AR, et al. Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders. Journal of the American Academy of Child and Adolescent Psychiatry. 2020;59(10):1107–1124. doi:10.1016/j.jaac.2020.05.005 (PMID 32439401).
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    American Academy of Child and Adolescent Psychiatry guideline: CBT and SSRI medication both have “considerable empirical support as safe and effective short-term treatments for anxiety in children and adolescents.”
  14. Substance Abuse and Mental Health Services Administration. 988 Suicide & Crisis Lifeline. “988 offers 24/7 judgment-free support”; text, call or chat 988. Checked October 6, 2026.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your child. If you’re concerned about your child’s mental health, speak to a qualified professional.