Emotional Development and Regulation in Children

What are emotions, and why do they matter for children?

Emotions are the feelings, such as joy, fear, anger and sadness, that shape how a child reacts and how they connect with other people. Harvard’s Center on the Developing Child calls the ability to regulate one’s own emotions key for later learning, mental health and relationships.⁠¹¹

Its scientific council describes the core of emotional development as a set of skills: reading other people’s emotions, managing strong feelings and how they come out, regulating behavior, developing empathy, and building relationships.⁠¹¹

The long-term evidence is striking. A 2020 meta-analysis of 150 studies, with 215,212 participants, found that self-regulation in childhood predicted later achievement, relationships, mental health and healthy living, and a study that followed 1,000 children to age 32 linked childhood self-control to adult health, finances and offending.⁠^4,12

What is emotional regulation in children?

Emotional regulation is the ability to manage feelings so they do not take over: noticing an emotion, naming it, calming the body and choosing what to do next. A US Department of Health and Human Services (HHS) brief defines self-regulation as managing thoughts and feelings so a person can act on their goals.⁠¹

It does not mean hiding feelings. The Harvard council describes the skill as managing strong emotions and their expression in a constructive way, and a review of family research links punitive responses to children’s emotions with children learning to avoid feelings rather than understand and express them.⁠^3,11

• Noticing

  Recognizing what you feel, sometimes first as a body signal, such as a racing heart.

• Naming

  Putting the feeling into words; HHS advises adults to label emotions for toddlers.⁠¹

• Managing

  Calming down and choosing a response, a skill children practice with adult coaching first.⁠¹

Self-regulation is the wider skill, covering attention and behavior as well as feelings; HHS describes it developing through a child’s interactions with caregivers such as parents, teachers and coaches.⁠¹

What emotions do babies and children feel?

Babies show basic emotions early: by 9 months most show several facial expressions, such as happy, sad, angry and surprised, according to the CDC’s milestone checklists.⁠¹³

More complex, self-conscious emotions follow: embarrassment, guilt, shame and pride. A 2026 review describes them as central to managing relationships and suggests they may appear earlier than once thought, within the first months and years of life.⁠¹⁴

Feelings wordsWords to help kids express feelingsEmotional fluency

Emotional development by age: what is typical from birth to the teen years?

Emotional development follows a broad path: babies rely on adults to calm them, toddlers feel more than they can manage, preschoolers learn words and calming strategies, school-age children gain control, and teenagers keep maturing into adulthood.⁠^1,2

The CDC milestones below are skills that at least 75% of children show by each age, so a single missing one is not a diagnosis. Social-emotional milestones also have the least research behind their ages.⁠¹⁶

Emotional development in babies (birth to 12 months)

By 2 months most babies calm down when spoken to or picked up and smile when you smile at them; by 6 months they laugh and know familiar people; by 9 months they are often shy, clingy or fearful around strangers and react when you leave.⁠¹³

At this age, regulation happens almost entirely through adults: HHS describes babies as needing caregivers who read their cues and soothe them when they are distressed.⁠¹

Your babyBaby development: the first year

Emotional development in toddlers (1 to 3 years)

Toddlers have strong feelings and few tools. HHS notes that their emotions far outweigh their emerging skills, and the American Academy of Pediatrics (AAP) calls the quick swings of a 2-year-old just part of growing up.⁠^1,17

By 18 months most explore but check you are close by, and by 2 years they notice when others are upset and look at your face to see how to react to something new.⁠¹³

Your toddlerToddler development: one to three

Emotional development in preschoolers (3 to 5 years)

By 3 most children calm down within 10 minutes after a parent leaves, by 4 they comfort a friend who is hurt or sad, and by 5 they follow rules and take turns in games.⁠¹³

Tantrums tend to ease after age 3, though they do not disappear, and HHS suggests teaching calming strategies and offering a calm-down space at this age.⁠^1,15

Your preschoolerPreschool development

Emotional development in school-age children (6 to 12 years)

In elementary school, HHS says, children gain more control over their attention, emotions and behavior, and adults shift to prompting and coaching coping skills.⁠¹

Most manage well: in national US data for 2023 to 2024, 72% of children aged 6 to 17 usually or always stayed calm and in control when faced with a challenge.⁠¹⁸

School yearsSchool-age development

Emotional development in teenagers

The teenage brain is still being built: the National Institute of Mental Health (NIMH) says it finishes maturing in the mid-to-late 20s, that teens may respond to stress differently than adults, and that most go on to become healthy adults.⁠²

Strong feelings are common, and so is real distress: in 2023, 40% of US high school students reported persistent sadness or hopelessness in the past year.⁠¹⁸

TeensThe teen yearsDBT for emotional regulation

How do children learn to regulate their emotions?

Children learn emotional regulation mostly from the adults around them. A 2007 review of family research describes three routes: watching and copying how adults handle feelings, the way parents respond to a child’s emotions, and the emotional climate of the home.⁠³

1. Watching. Children learn by observation, modeling and checking adults’ reactions.⁠³
2. Being coached. How parents respond to and talk about a child’s feelings shapes regulation.⁠³
3. Feeling safe. Warm relationships and predictable routines make regulation manageable.⁠^1,3

Children differ too. The same review discusses how a child’s own temperament, including how strongly they react to negative events, affects regulation, and how parents’ mental health affects what they can teach.⁠³

The need for adult support shrinks with age but never disappears: HHS describes co-regulation as support that remains important from infancy into young adulthood.⁠¹

What is co-regulation, and how do you do it?

Co-regulation is the support a calm, caring adult gives a child to manage feelings, by staying steady, structuring the situation and coaching skills. HHS describes it as an interactive process of support within caring relationships, across the whole of childhood.⁠¹

• A warm, responsive relationship

  Showing care, reading your child’s cues and comforting them under stress.⁠¹

• A structured environment

  Predictable routines and clear expectations, with stress kept to a level your child can handle.⁠¹

• Teaching and coaching

  Modeling skills, explaining them, practicing them and prompting them in the moment.⁠¹

• Your own calm first

  A calm adult response keeps a child’s feelings from escalating and models the skill.⁠¹

In practice, co-regulation can be as simple as kneeling down, speaking slowly, breathing with your child and waiting until they are calm enough to talk.

It asks a lot of adults, and HHS acknowledges that caregivers may need support from family, friends or professionals to build their own coping and calm-down skills.⁠¹

How can you help a child name and manage their feelings?

Help a child name and manage feelings by noticing the emotion, putting it into words, accepting the feeling, and then solving the problem together. Researchers call this emotion coaching.⁠³

What is emotion coaching?

Emotion coaching, described by John Gottman and colleagues, means being aware of the child’s emotion, seeing it as a chance to connect or teach, helping the child label it, empathizing with it, and helping them problem-solve.⁠³

It has been tested. In a randomized trial of the Tuning in to Kids program with 216 parents of 4- and 5-year-olds, parents coached emotions more and dismissed them less, children’s emotional knowledge improved, and parents and teachers reported fewer behavior problems.⁠⁶

Understanding emotions goes with getting along: a meta-analysis found small to medium-sized links between children’s emotion knowledge, their social competence and fewer behavior problems.⁠¹⁹

1. Notice it early. Catch the feeling while it is small, before it becomes a storm.⁠³
2. Name it. “You look really frustrated that the tower fell.”⁠³
3. Accept the feeling. “That makes sense. You worked hard on it.”⁠³
4. Hold the line on behavior. Feelings are fine; hitting is not. The AAP advises not ignoring hitting, kicking, biting or throwing.⁠¹⁵
5. Solve it together. “Do you want to build it again, or take a break first?”⁠³

What should you say when your child is upset?

• “I can see you are really angry.”
• “It is hard to stop when you are having fun.”
• “I am right here. We can take some deep breaths together.”
• “You can be mad, and I will not let you hit. You can stomp your feet instead.”

Brushing a feeling aside (“You’re fine,” “Stop crying”) gives a child no help with it. Research links punitive or negative responses to children’s emotions with children learning to avoid feelings rather than understand and express them, and the trial above reduced dismissive responses.⁠^3,6

Words for feelingsFrom hitting to words

What calming strategies help children with big emotions?

Calming a child starts with the adult staying calm, then simple tools such as slow breathing and a calm-down space, and meeting basic needs like sleep and food.⁠^1,20

• Breathing and self-talk. HHS suggests modeling deep breathing for preschoolers and coaching self-talk and relaxation for school-age children.⁠¹
• A calm-down space. HHS recommends an external structure for calming down, including a calm-down space and materials.⁠¹
• Sleep. Children who are short on sleep may feel angry and impulsive, have mood swings or feel sad, the National Heart, Lung, and Blood Institute notes.⁠²⁰
• Hunger and tiredness. The AAP suggests carrying a snack and protecting naps when tantrums peak with hunger or fatigue.⁠¹⁵

Mindfulness helps a little. A meta-analysis of 33 randomized trials with 3,666 children and adolescents found small benefits, and against active comparison groups only for mindfulness, depression and anxiety or stress.⁠²¹

Should you use a phone or tablet to calm a child down?

Occasionally it is understandable, but not as the main tool. In a study of 422 families with children aged 3 to 5, frequent use of devices to calm a child was followed by more emotional reactivity in boys, and the authors suggest it may crowd out chances to learn regulation strategies.⁠⁷

Calm-down helpCalm-down cornersWhat drains a child’s emotional tank

Tantrums, meltdowns and big emotions: what is normal?

Tantrums are a normal part of development. The AAP says they happen most between ages 1 and 3 and tend to get better after 3, and in a study of 1,490 preschoolers, 83.7% had tantrums sometimes while only 8.6% had them daily.⁠^5,15

What separated concerning tantrums from ordinary ones in that study was their character: the worrying ones were unpredictable, prolonged or destructive, while milder ones reflected frustration in expected situations.⁠⁵

Meltdowns call for a different response from tantrums. Our guide to meltdowns and tantrums covers how to tell them apart and what helps in the moment.

Physical punishment makes regulation harder, not easier: the AAP advises against spanking, saying it often increases aggression and anger in children instead of teaching self-control.⁠²³

How do sensory processing differences affect a child’s emotions?

Children who are strongly bothered by noise, touch, light or crowds are more likely to struggle with anxiety and big emotions. In a study of 917 children aged 2 to 5, 43% of preschoolers with sensory over-responsivity also had an impairing anxiety disorder.⁠⁸

The link ran forward in time: sensory over-responsivity in the preschool years predicted more anxiety at age 6, and that anxiety was in turn linked to irritability and sleep problems.⁠⁸

If your child’s hardest moments follow noisy, busy or crowded settings, DrSensory’s guides to sensory processing, interoception (sensing the body’s inner signals) and telling sensory issues from anxiety can help you look at the sensory side.

Sensory helpHow to calm sensory overload

How do ADHD and autism affect emotional regulation?

Many children with ADHD or autism find emotional regulation harder. A 2014 review in the American Journal of Psychiatry concluded that emotion dysregulation is prevalent in ADHD throughout life and is a major contributor to impairment.⁠²⁴

In autism, researchers describe amplified emotional responses and poor emotional control, and they suggest poor regulation may be part of autism itself rather than always a separate problem.⁠²⁵

DrSensory’s guides to ADHD in children, autism and mood swings in neurodivergent kids cover strategies for each.

How do a parent’s own emotions affect a child’s?

A parent’s own emotions are one of a child’s main teachers. Children learn regulation by watching adults, and the emotional climate of the home and parents’ mental health both shape it.⁠³

You do not have to be perfect. The AAP suggests that after losing your temper, you wait to cool down, apologize to your child and explain how you will handle it next time, which also shows how to repair a mistake.⁠²³

If your own stress, low mood or anxiety makes calm responses hard, getting support is part of helping your child; HHS notes that caregivers may need help to build their own calm-down skills.⁠¹

When are a child’s emotions a reason to see a doctor?

Talk to your child’s doctor when emotional or behavior changes last weeks or months and get in the way of daily life at home, at school or with friends. That is the line NIMH draws between a phase and a problem worth discussing.⁠⁹

• Frequent tantrums or constant irritability

  NIMH lists frequent tantrums or intense irritability much of the time among signs in younger children.⁠⁹

• Fear or worry that does not fade

  Often seeming fearful or worried is another sign NIMH lists.⁠⁹

• Lost interest and low energy

  In older children, losing interest in things they used to enjoy.⁠⁹

• Withdrawn or always sad

  The AAP advises calling the pediatrician if a toddler seems very withdrawn or perpetually sad.⁠¹⁷

Emotional and behavior conditions are common. In 2023 to 2024, 11% of US children aged 3 to 17 had diagnosed anxiety, 4% depression and 8% a behavior disorder, and Harvard’s council warns that even very young children can have serious mental health problems.⁠^11,18

Is it anxiety, depression or DMDD?

Help usually starts with talking to the child’s doctor, and for DMDD NIMH describes treatment that adapts forms of psychotherapy for children and teaches parents behavior management skills. The behavior and emotions guide and mood disorders in children cover the other conditions.⁠^9,28

Do social-emotional learning programs at school help?

Yes, on average. A meta-analysis of 213 school social and emotional learning (SEL) programs, involving 270,034 students from kindergarten through high school, found better social and emotional skills and behavior, and an 11-percentile-point gain in achievement.⁠³⁰

SEL programs teach the same skills this page describes, recognizing and managing emotions and getting along with others, in the classroom, so it is worth asking your child’s school what it uses.⁠³⁰

Who can help with a child’s emotional regulation?

Start with your child’s pediatrician or family doctor; NIMH suggests asking them when you are unsure where to go for help. Depending on the picture, they may refer you to a child psychologist, a psychiatrist or an occupational therapist.⁠⁹

• Pediatrician or family doctor

  The first stop for any lasting emotional or behavior change.⁠⁹

• Psychologist or psychiatrist

  Diagnoses and treats emotional conditions; for DMDD, NIMH describes adapted psychotherapy plus behavior management skills for parents.⁠²⁸

• Occupational therapist

  Works on everyday skills, including social-emotional development in young children.⁠³¹

• Parenting programs

  Emotion-coaching programs such as Tuning in to Kids have trial evidence.⁠⁶

DrSensory’s guide to occupational therapy explains what an OT does, and the therapist directory lists clinics near you.

Related guides on DrSensory

• Behavior and emotions

  Anxiety, mood and behavior conditions in children, and what helps.

• Meltdown or tantrum?

  How to tell them apart and respond in the moment.

• DMDD

  Severe irritability and outbursts: signs and treatment.

• Sensory processing

  When the senses make everyday life harder.

• Developmental milestones

  Every CDC checklist from 2 months to 5 years.

• A child’s emotional tank

  What drains it and what refills it.

Sources

1. Office of Planning, Research and Evaluation, Administration for Children and Families (US Department of Health and Human Services). Co-regulation from birth through young adulthood: a practice brief. Checked October 22, 2026.
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   Based on work by the Duke Center for Child and Family Policy. Self-regulation is “the act of managing thoughts and feelings”, and “self-regulation develops through interaction with caregivers such as parents, teachers, coaches”; co-regulation is “an interactive process of regulatory support that can occur within the context of caring relationships across the lifespan”. Three kinds of support: “Provide a warm, responsive relationship”, “Structure the environment”, and “Teach and coach self-regulation skills through modeling, instruction, opportunities for practice”. Toddlers “continue to have strong emotions that far outweigh these emerging skills”; for toddlers, “Label emotions”; for preschoolers, “Provide external structure for calming down, including a calm-down space and materials”; “In elementary school, children gain more control over their attention, emotions, and behavior.” For school-age children, “Prompt and coach coping skills and calm-down strategies”. “When a caregiver responds calmly to a child, youth, or young adult, it helps to keep the young person’s feelings from escalating and also models regulation skills.” “Caregivers may need support, practice, and coaching from friends/family or professionals to build their own coping and calm-down skills”
2. National Institute of Mental Health. The teen brain: 7 things to know. Revised 2023. “The brain finishes developing and maturing in the mid-to-late 20s.” “Because the teen brain is still developing, teens may respond to stress differently than adults.” “most teens go on to become healthy adults”. Checked October 22, 2026.
3. Morris AS, Silk JS, Steinberg L, Myers SS, Robinson LR. The role of the family context in the development of emotion regulation. Social Development. 2007;16(2):361–388. doi:10.1111/j.1467-9507.2007.00389.x (PMID 19756175). Checked October 22, 2026.
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   “children learn about ER through observational learning, modeling and social referencing”; emotion coaching parents “are aware of the child’s emotion; they see the child’s emotion as an opportunity for intimacy or teaching; they help the child to verbally label his/her own emotions; they empathize with or validate the child’s emotion; and they help the child to problem-solve”; punitive responses “teach children to avoid rather than to understand and appropriately express negative emotions such as sadness and anger”.
4. Robson DA, Allen MS, Howard SJ. Self-regulation in childhood as a predictor of future outcomes: a meta-analytic review. Psychological Bulletin. 2020;146(4):324–354. doi:10.1037/bul0000227 (PMID 31904248). Checked October 22, 2026.
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   “A comprehensive literature search identified 150 studies that met inclusion criteria (745 effect sizes; total n = 215,212).” “self-regulation in childhood can predict achievement, interpersonal behaviors, mental health, and healthy living in later life”.
5. Wakschlag LS, Choi SW, Carter AS, et al. Defining the developmental parameters of temper loss in early childhood: implications for developmental psychopathology. Journal of Child Psychology and Psychiatry. 2012;53(11):1099–1108. doi:10.1111/j.1469-7610.2012.02595.x (PMID 22928674). Checked October 22, 2026.
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   1,490 preschoolers: “Nearly all (83.7%) preschoolers had tantrums sometimes but only 8.6% had daily tantrums.” “clinically concerning problem indicators were unpredictable, prolonged, and/or destructive”.
6. Havighurst SS, Wilson KR, Harley AE, Prior MR, Kehoe C. Tuning in to Kids: improving emotion socialization practices in parents of preschool children; findings from a community trial. Journal of Child Psychology and Psychiatry. 2010;51(12):1342–1350. doi:10.1111/j.1469-7610.2010.02303.x (PMID 20735794). Checked October 22, 2026.
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   216 parents of children aged 4 to 5, randomized: “increases in emotion coaching, and decreases in emotionally dismissive beliefs and behaviors”; “Child emotional knowledge improved, and reductions in child behavior problems were reported by parents and teachers.”
7. Radesky JS, Kaciroti N, Weeks HM, Schaller A, Miller AL. Longitudinal associations between use of mobile devices for calming and emotional reactivity and executive functioning in children aged 3 to 5 years. JAMA Pediatrics. 2023;177(1):62–70. doi:10.1001/jamapediatrics.2022.4793 (PMID 36508199). Checked October 22, 2026.
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   422 parents of children aged 3 to 5: “Among the boys, the use of devices to calm at T2 was associated with higher emotional reactivity at T3”; “the frequent use of mobile devices for calming young children may displace their opportunities for learning emotion-regulation strategies over time”.
8. Carpenter KLH, Baranek GT, Copeland WE, et al. Sensory over-responsivity: an early risk factor for anxiety and behavioral challenges in young children. Journal of Abnormal Child Psychology. 2019;47(6):1075–1088. doi:10.1007/s10802-018-0502-y (PMID 30569253). Checked October 22, 2026.
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   Community sample of 917 children aged 2 to 5, 191 followed at 6: “Forty three percent of preschool children with sensory over-responsivity also had a concurrent impairing anxiety disorder.” “Preschool sensory over-responsivity symptoms significantly and positively predicted anxiety symptoms at age six.”
9. National Institute of Mental Health. Child and adolescent mental health. Checked October 22, 2026.
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   If symptoms “last weeks or months, and if these issues interfere with the child’s daily life at home and at school, or with friends, you should contact a health professional”. Signs in younger children include “Have frequent tantrums or are intensely irritable much of the time” and “Often seem fearful or worried”; in older children “Have lost interest in things that they used to enjoy”, “Engage in self-harm behaviors (such as cutting or burning their skin)” and “Have thoughts of suicide”. “If you are unsure where to go for help, ask your pediatrician or family doctor”
10. 988 Suicide & Crisis Lifeline. 988 Lifeline. “The 988 Lifeline is available 24/7/365. Your conversations are free and confidential.” Checked October 22, 2026.
11. National Scientific Council on the Developing Child. Children’s emotional development is built into the architecture of their brains (Working Paper No. 2). Center on the Developing Child, Harvard University; 2004. Checked October 22, 2026.
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    “The ability to regulate one’s own emotions and manage successful interactions with other people is key for later academic performance, mental health, and social relationships.” Core features include the ability “to accurately read and comprehend emotional states in others, to manage strong emotions and their expression in a constructive manner, to regulate one’s own behavior, to develop empathy for others, and to establish and sustain relationships”; “Young children are capable of surprisingly deep and intense feelings of sadness”; “Science does not support the claim that infants and toddlers are too young to have serious mental-health problems.”
12. Moffitt TE, Arseneault L, Belsky D, et al. A gradient of childhood self-control predicts health, wealth, and public safety. Proceedings of the National Academy of Sciences. 2011;108(7):2693–2698. doi:10.1073/pnas.1010076108 (PMID 21262822). Checked October 22, 2026.
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    “Following a cohort of 1,000 children from birth to the age of 32 y, we show that childhood self-control predicts physical health, substance dependence, personal finances, and criminal offending outcomes”.
13. Centers for Disease Control and Prevention. Learn the Signs. Act Early. Milestone checklists: 2 months, 6 months, 9 months, 18 months, 2 years, 3 years, 4 years, 5 years. Read from Internet Archive copies of September 27 to October 16, 2026. Checked October 22, 2026.
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    Social and emotional milestones include “Calms down when spoken to or picked up” (2 months), “Laughs” (6 months), “Is shy, clingy, or fearful around strangers” and “Shows several facial expressions, like happy, sad, angry, and surprised” (9 months), “Moves away from you, but looks to make sure you are close by” (18 months), “Notices when others are hurt or upset, like pausing or looking sad when someone is crying” (2 years), “Calms down within 10 minutes after you leave her, like at a childcare drop off” (3 years), “Comforts others who are hurt or sad, like hugging a crying friend” (4 years) and “Follows rules or takes turns when playing games with other children” (5 years).
14. Nikolić M, Hepach R. The expression of self-conscious emotions and their motivational and communicative function in early development. Philosophical Transactions of the Royal Society B. 2026;381(1959):20250134. doi:10.1098/rstb.2025.0134 (PMID 42779424). Checked October 22, 2026.
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    “Self-conscious emotions, such as embarrassment, guilt, shame and pride, play a central role in managing reputation and interpersonal relationships.” They “may be observed earlier than previously thought-within the first months and years of life”.
15. Swanson WS; American Academy of Pediatrics (HealthyChildren.org). Temper tantrums. Last updated April 21, 2021. “Tantrums are a normal part of development. They happen most between ages 1 and 3 years”; “Tantrums do tend to get better after the age of 3.” “Do not ignore behaviors like hitting, kicking, biting, or throwing.” Checked October 22, 2026.
16. Zubler JM, Wiggins LD, Macias MM, et al. Evidence-informed milestones for developmental surveillance tools. Pediatrics. 2022;149(3):e2021052138. doi:10.1542/peds.2021-052138 (PMID 35132439). Checklists use “milestones most children (≥75%) would be expected to achieve”; “Social-emotional and cognitive milestones had the least normative data.” Checked October 22, 2026.
17. American Academy of Pediatrics (HealthyChildren.org). Emotional development: 2 year olds. Last updated September 1, 2022. “These mood swings, however, are just part of growing up.” Consult your pediatrician “if your child seems very passive or withdrawn, perpetually sad, or highly demanding and unsatisfied most of the time”. Checked October 22, 2026.
18. Centers for Disease Control and Prevention. Data and statistics on children’s mental health. Read from the Internet Archive copy of October 10, 2026. Checked October 22, 2026.
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    2023–2024 data: “83% usually or always bounce back quickly when things do not go their way” (ages 6 months to 5 years); “72% usually or always stay calm and in control when faced with a challenge” (ages 6 to 17); “11% of children ages 3-17 had current, diagnosed anxiety”; “4% of children ages 3-17 had current, diagnosed depression”; “8% of children ages 3-17 had current, diagnosed behavior disorders”; among high school students in 2023, “40% reported persistent feelings of sadness or hopelessness in the past year”.
19. Trentacosta CJ, Fine SE. Emotion knowledge, social competence, and behavior problems in childhood and adolescence: a meta-analytic review. Social Development. 2010;19(1):1–29. doi:10.1111/j.1467-9507.2009.00543.x (PMID 21072259). “Emotion knowledge demonstrated small to medium-sized relations with each correlate” (social competence, internalizing and externalizing problems). Checked October 22, 2026.
20. National Heart, Lung, and Blood Institute. How sleep affects your health. “Sleep-deficient children may feel angry and impulsive, have mood swings, feel sad or depressed, or lack motivation.” Checked October 22, 2026.
21. Dunning DL, Griffiths K, Kuyken W, et al. Research review: the effects of mindfulness-based interventions on cognition and mental health in children and adolescents; a meta-analysis of randomized controlled trials. Journal of Child Psychology and Psychiatry. 2019;60(3):244–258. doi:10.1111/jcpp.12980 (PMID 30345511). Checked October 22, 2026.
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    “Thirty-three independent studies including 3,666 children and adolescents”; “small effect sizes”; against active controls, “significant benefits of an MBI were restricted to the outcomes of Mindfulness (d = .42), Depression (d = .47) and Anxiety/Stress (d = .18) only”.
22. National Institute of Mental Health. Disruptive mood dysregulation disorder: the basics. NIH Publication No. 23-MH-8119, revised 2023. Checked October 22, 2026.
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    “Severe temper outbursts (verbal or behavioral), on average, 3 or more times per week”; “Chronically irritable or angry mood most of the day, nearly every day”; “Trouble functioning due to irritability in more than one place”. “All children can become irritable sometimes.” Severe irritability means outbursts “out of proportion to the situation at hand”.
23. American Academy of Pediatrics (HealthyChildren.org). What’s the best way to discipline my child?. Last updated November 5, 2018. Checked October 22, 2026.
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    “The AAP advises that parents and caregivers should not spank or hit children. Instead of teaching responsibility and self-control, spanking often increases aggression and anger in children.” “If you feel you have made a real mistake in the heat of the moment, wait to cool down, apologize to your child, and explain how you will handle the situation in the future.”
24. 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”. Checked October 22, 2026.
25. 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 spectrum disorder (ASD) is associated with amplified emotional responses and poor emotional control”; “poor ER may be inherent in ASD”. Checked October 22, 2026.
26. National Institute of Mental Health. Anxiety disorders. Last reviewed December 2024. “anxiety disorders involve more than occasional worry or fear. For people with these disorders, anxiety does not go away, is felt in many situations, and can get worse over time.” Checked October 22, 2026.
27. National Institute of Mental Health. Teen depression: more than just moodiness. Checked October 22, 2026.
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    “If you have been feeling sad most of the time for a few weeks or longer and you’re not able to concentrate or do the things you used to enjoy, talk to a trusted adult about depression.” Questions include “Do you get easily frustrated, irritable, or angry?” and “Do you find yourself withdrawing from friends and family?”
28. National Institute of Mental Health. Disruptive mood dysregulation disorder (DMDD). Last reviewed December 2024. “In life-threatening situations, call 911.” Treatments “include adapting specific forms of psychotherapy for children with DMDD and teaching behavior management skills to parents”. Checked October 22, 2026.
29. National Institute of Mental Health. Warning signs of suicide. Revised 2025. Checked October 22, 2026.
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    Signs include talking about “Wanting to die”, feeling “Empty, hopeless, trapped, or having no reason to live”, “Withdrawing from friends, saying goodbye, giving away important items, or making a will” and “Displaying extreme mood swings”; “get help as soon as possible, particularly if the behavior is new or has increased recently”.
30. Durlak JA, Weissberg RP, Dymnicki AB, Taylor RD, Schellinger KB. The impact of enhancing students’ social and emotional learning: a meta-analysis of school-based universal interventions. Child Development. 2011;82(1):405–432. doi:10.1111/j.1467-8624.2010.01564.x (PMID 21291449). “213 school-based, universal social and emotional learning (SEL) programs involving 270,034 kindergarten through high school students”; “an 11-percentile-point gain in achievement”. Checked October 22, 2026.
31. Clark GF, Kingsley KL. Occupational therapy practice guidelines for early childhood: birth–5 years. American Journal of Occupational Therapy. 2020;74(3):7403397010p1. doi:10.5014/ajot.2020.743001 (PMID 32365324). “A variety of interventions within the domain of occupational therapy were found to support the development of cognitive, social-emotional, motor, and self-care skills.” Checked October 22, 2026.
32. Choi H, Cha Y, McCullough ME, Coles NA, Oishi S. A meta-analysis of the effectiveness of gratitude interventions on well-being across cultures. Proceedings of the National Academy of Sciences. 2025;122(28):e2425193122. doi:10.1073/pnas.2425193122 (PMID 40627390). Checked October 22, 2026.
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    “Using data from 145 papers, 163 samples, 727 effect sizes, and 24,804 participants from 28 countries, we found that gratitude interventions led to small overall increases in well-being”.

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