Little kids,
big feelings

Children's mental
and emotional health

_{^{A GUIDE TO THE PRIMARY YEARS}}_{^{| MENTAL & EMOTIONAL HEALTH}}

Children's mental and emotional health

Between the ages of 4 and 11, children’s emotional ‘climate’ can be pretty stormy. They’re learning to manage friendships, cope with challenges and handle brand new feelings, as well as going through lots of biological changes connected to their physical growth.

These biological changes during childhood can also significantly influence mental health¹ – it’s a lot for someone who’s only just working out how their mind works. So, it’s normal for them to struggle at times.

But when do worries tip over from a ‘normal’ blip to a real concern? Here’s our quick guide to what’s normal – and when and how to get help.

Children’s mental health in the primary school years

• Age 4 – 7: Concerns around changes to routine and separation anxiety.

• Age 7 – 11: Concerns become more complex as they start navigating friendships and comparing themselves to peers.

In 2023, in a poll of 2,370 children and young people aged 8-25, around 20% of 8-16 year olds had a probable mental health disorder.²

_{^{1. Can childhood experiences influence later mental health –}}_{^{My Patient Advice}}
_{^{2. Mental Health of Children and Young People in England, 2023 –}}_{^{NHS England}}

_{^{A GUIDE TO THE PRIMARY YEARS}}_^|_{^{MENTAL & EMOTIONAL HEALTH}}_{^{| SIGNS OF ANXIETY OR LOW MOOD}}

What are the signs of anxiety or low mood?

Children may struggle to explain what they’re feeling, so may not say they feel ‘anxious’. Instead, there may be telltale signs:

tummy aches
sleep changes like night terrors, or difficulty falling or staying asleep
separation anxiety
anger or tantrums
longer or more frequent episodes of crying
bedwetting
changes in appetite and eating patterns.

As well as these general signs, look out for:

Anxiety	Low mood
Avoiding certain situations, such as group gatherings. Catastrophising – always expecting the very worst. For example, ‘I made a mistake so now they’ll expel me from school.’ Difficulty concentrating.	Being irritable, as well as simply sad. Withdrawing from things they usually like doing. Making hopeless statements such as ‘What’s the point’ or ‘Things won’t get better’.

_{^{A GUIDE TO THE PRIMARY YEARS}}_^|_{^{MENTAL & EMOTIONAL HEALTH}}_{^{| RESILIENCE}}

How can I help my child build resilience
and self-esteem?

Resilience is about knowing you can get through challenges. Children build resilience through practice, persistence and support, not by avoiding problems altogether.

As a parent, you can nurture resilience by:

Letting them struggle a little
It’s tempting to swoop in and fix things, but learning to deal with small setbacks helps build resilience. Instead of fixing the problem yourself, support them to find their own solution.

Praising effort
Praise effort, not just achievement – even when they fail. This teaches them that effort and persistence matter more than getting it right first time.

Showing them how to cope through your own behaviour
Children learn to regulate their emotions by watching others. You could try saying ‘This is hard, but I’m going to keep trying’. This creates an environment where your child feels safe to fail. There is a lot of pressure to ‘get it right’ and to be ‘perfect’, but by demonstrating how we learn from any mistakes can help shift the pressure.

_{^{A GUIDE TO THE PRIMARY YEARS}}_^|_{^{MENTAL & EMOTIONAL HEALTH}}_{^{| NAVIGATING CHANGE}}

How can I help my child navigate change?

You’ve probably noticed that your child feels safe when things are predictable, and that change can trigger big feelings and behaviours.

Changes take many forms. Some are obviously significant – a new school, divorce, a family bereavement or the arrival of a new sibling. Others may seem small to adults – such as changing desks in the classroom. But for a primary age child, sometimes even the smallest shift can be unsettling.

By learning how to navigate change from an early age and finding out what helps, we can use these skills throughout life, as change is inevitable. You’re, therefore, helping your child create positive building blocks for their future.

Prepare in advance if you can
Talk through and visualise what’s coming. If the change involves moving house or school, see if you can visit beforehand.

Keep some things the same (where possible)
Stick to the same bedtime, mealtime and family routines – such as a regular movie night – to keep a sense of stability.

Don’t dismiss worries
However small the worry seems to you, it’s very real to them and can’t be wished away. Reassure them that you recognise it’s hard. Try to listen to the worry without jumping in with answers. The key is to be validating and not dismissive.

Where you can, involve them in decision making
Give them something to control – choosing paint for a new bedroom, or the best route to a new school.

Look for other support
There are lots of books that can help with these changes – often tailored to the exact type of change.

Six books that can help with
big feelings

The Colour Monster – Anna Llenas – helps children identify emotions.
Ruby’s Worry – Tom Percival – helps open communication about worry.
The Huge Bag of Worries – Frank Rogers –
how to deal with overwhelming thoughts.
The Kid’s Guide to Staying Awesome and In Control – Lauren Brukner – strategies to cope with feelings strategies.
In My Heart: A Book of Feelings – Jo Witek – explaining how emotions feel inside.
The Invisible String – Patrice Karst – offers a simple and imaginative approach to overcoming loneliness, separation, or loss.

_{^{A GUIDE TO THE PRIMARY YEARS}}_^|_{^{MENTAL & EMOTIONAL HEALTH}}_{^{| FRIENDSHIPS}}

How do I help my child manage their friendships?

As children get older, friendships become more complex and can change on a daily basis. While it may feel like an emotional rollercoaster, navigating the twists and turns helps children develop empathy and forgiveness, and learn how to stand up for themselves.

Don’t rush to intervene
Your first instinct might be to contact the school or the other child’s parents. However, your child might just need to talk it through with you and find their own solutions.

Practising what to say to friends can build the confidence to have those conversations for real.

Recognise when it’s bullying
Occasional disagreements are normal, but bullying is repeated, deliberate, and involves a power imbalance. Helping your child understand the difference helps you and the school take genuine bullying seriously.

Stay connected with the school
A friendly check-in with a teacher can solve most issues. If things are getting more serious, many schools have a bullying policy that you can check online.

_{^{A GUIDE TO THE PRIMARY YEARS}}_^|_{^{MENTAL & EMOTIONAL HEALTH}}_{^{| ASSESSMENTS}}

How can I support my child through school assessments?

Primary school assessments can sometimes cause your child stress, especially if they sense our anxiety too.

Here are a few things you can do to help your child through them:

Try not to share your anxieties – children pick up cues very easily, so if you’re calm it’ll help them be calm too.
Keep doing normal activities such as hobbies, sports and time with friends and family.
Whatever the result, don’t show disappointment – tell them you’re proud of how hard they’ve worked, and make sure they know that they have qualities no test can measure.

What worries you most about your child's school assessments?

My child's anxiety levels
How they'll compare to other children
Whether results will affect their confidence
My own stress about their performance
Not sure / doesn't worry me

_{^{A GUIDE TO THE PRIMARY YEARS}}_^|_{^{MENTAL & EMOTIONAL HEALTH}}_{^{| WHEN TO ASK FOR HELP}}

When do I need to ask for more help?

A little low mood now and again is part of growing up.

Here are some first things to try:

Encourage them to talk about it or write it down if they can. This gets the worries out of their head.
Use a ‘worry monster’ or ‘worry eater’ – a toy that the child can ‘feed’ worries to.
Don’t tell them they’re being silly worrying about something that seems small to you.
Keep talking, even if your child’s worry or low mood manifests as challenging behaviour. Their behaviour is a way of expressing what’s going on inside.

It may be time to get help – sooner rather than later – if that worry:

continues for several weeks
stops your child doing things they normally enjoy
affects school attendance
is creating physical symptoms such as sickness or self-harming behaviour.

To get more support:

Talk to your GP and ask about a Child and Adolescent Mental Health Service (CAMHS) referral.
Speak to your child’s teacher, school pastoral team or special needs team.
Speak to a childhood mental health charity – lots of them have helplines.

It may help to note down your concerns beforehand.

_{^{A GUIDE TO THE PRIMARY YEARS}}_^|_{^{MENTAL & EMOTIONAL HEALTH}}_{^{| HOW AXA HEALTH CAN HELP}}

Being a parent, navigating everyday life and having worries for your child is natural, however, sometimes it can build up. Don’t forget to look after yourself and remember there is always help out there. From friends, family members, colleagues and more formal support if things get too much from a GP or online NHS support groups. Don’t let things build up – talking does help and it can lead to positive action and change. Your own wellbeing matters too.

How AXA Health can help

AXA Health members who are 18+ can call our 24/7 health support line to speak to a counsellor or nurse and chat through worries about your child.

The 24/7 health support line cannot respond to emergencies. If you need an urgent response or have a medical emergency, please call 111/999 or go to A&E. Our health professionals don’t diagnose or prescribe, and don’t replace your GP.

_{^{A GUIDE TO THE PRIMARY YEARS}}_^|_{^{MENTAL & EMOTIONAL HEALTH}}_{^{| TIPS FOR WELLBEING}}

Top tips for childhood wellbeing

Talk through whatever’s bothering them.
Don’t rush to fix things – let them find their own solutions.
Teach them it’s ok to fail – it’s the effort you put in that matters.
Keep to normal routines even in times of change.
Trust your instincts – you know your child better than anyone.

Dr Imren Sterno

Head of mental health
& Consultant clinical psychologist

Did you find this information helpful?

Yes
No
Unsure

_{^{A GUIDE TO THE PRIMARY YEARS}}_^|_{^{MENTAL & EMOTIONAL HEALTH}}_{^{| WHERE CAN I FIND OUT MORE?}}

Where can I find out more?

If you have concerns, or you just want to find out more, you may find these resources helpful:

NHS advice for parents	Advice and support for parents who have children struggling with a mental health issue.
Childline	Support for young people and parents via a helpline, emails and chat. See their site written specially for under-12s.
YoungMinds	Support for young people and children via a helpline and webchat.
AXA family health hub and AXA mental health hub	Articles and videos to help you navigate family life, including: Tips and tools to help your teen/tween’s mind health Dealing with anxiety in children
HappyMaps	A one-stop shop for children and young people’s mental health with a dedicated page for under 12s and links to other sources of support.