CHICAGO, IL – July 24, 2024 – A recent national survey by Action for Healthy Kids (AFHK) reports that among parents’ top concerns for their children’s health is their mental health, but less than 20% of parents indicated awareness of all the mental health resources and services schools provide to support children’s mental health and well-being.
The Parent and Child Mental Health Survey asked more than 1,000 parents and caregivers from across the country what worries them most about their children’s health and what would help resolve those concerns. The survey was designed to understand parents’ perceptions of safe and supportive school environments and schools’ role in providing support and resources for youth mental health.
Key findings from the survey include:
Parent Concerns
76% of parents surveyed worried about their child spending too much time on a computer, television, or tablet.
70% of parents surveyed worried about a student or another individual bringing a weapon to school.
67% of parents surveyed were concerned about their child struggling with their mental health.
Mental Health
Less than 20% of parents surveyed were aware of all the mental health resources and services schools provide to support children’s mental health and well-being. About 40% had limited to no awareness of the types of resources and services their child’s school offers.
63% of parents surveyed are supportive of schools providing training for parents and caregivers to better understand and support their child’s mental health; only 17% shared that they are aware of training in their child’s school.
Race and Ethnicity
55% of middle and high school parents identifying as Black and 39% of parents identifying as Hispanic worry more about their child experiencing racism, as compared to 15% of parents identifying as White.
42% of parents identifying as Black and 49% of parents identifying as Hispanic, believe their schools provide their child with access to talk with a trusted teacher or other adult at school; nearly 68% of parents identifying as White believed their schools provide this resource.
Gender/Sexual Identity
Of the 63 parents who responded their middle or high school student identifies as LBGTQIA+, 57% reported their child feels safe and supported with 43% saying no/unsure.
This survey is part of a series of surveys exploring parents’ mindsets commissioned by Action for Healthy Kids in partnership with the CDC Foundation. You can find the report from the Parent and Child Mental Health Survey online.
To respond to parents’ needs for more mental health supports, AFHK launched the Confident Connections campaign to offer more than 30 free resources for parents and caregivers of children in grades K-12 to learn about and support youth mental health. The resources, based on findings from the Parent and Child Mental Health Survey, were created with input from AFHK’s parent advisory board.
With approaches including conversation prompts and family games, Confident Connections provides guidance to parents and caregivers to engage in meaningful conversations, activities to connect in authentic ways, and information to deepen their understanding of youth mental health. The resources are based on age-appropriate approaches for children from grades K-12.
“In our surveys, parents and caregivers have been consistent in their desire for access to more resources to support their child’s mental health,” said Rob Bisceglie, Executive Officer & President at Action for Healthy Kids. “Through our Confident Connections campaign, AFHK is providing parents and caregivers with many of the resources they want and need to address the mental health issues that concern parents the most.”
“These resources offer helpful tips for parents and caregivers to stay close, connected, and involved with their children and adolescents, at home and in their schools,” said Dr. Kathleen Ethier, Director, CDC’s Division of Adolescent and School Health. “Adolescents experience fewer health risks when their parents know what is going on with them and their lives—staying engaged can make a big difference in preventing youth mental health issues.”
“Supporting parents and caregivers is crucial in fostering the mental health and well-being of our students,” said Catherine Zilber, vice president of infectious disease programs at the CDC Foundation. “By providing these resources, we can create a nurturing environment that promotes resilience, reduces stigma and ensures every student has the opportunity to thrive.”
About the Survey
Action for Healthy Kids conducted two waves of the Parent and Child Mental Health Survey:
Wave 1 was a 48-question online survey of 1,016 parents and guardians across the U.S., from both rural and non-rural areas, with children enrolled in public K-12 schools. The survey was fielded in English and Spanish in December 2023.
Wave 2 was a 56-question online survey of 1,047 parents and guardians across the U.S., from rural and non-rural areas, with children enrolled in public K-12 schools. The survey was fielded in English, Spanish and Korean in March – April 2024.
This project on Improving Mental, Behavioral and Academic Supports to Students and Families, Part 2 is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $434,555 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government. The contents also do not necessarily support the official views of the CDC Foundation.
ABOUT ACTION FOR HEALTHY KIDS
Action for Healthy Kids believes that healthy children make a better world. As a national nonprofit, Action for Healthy Kids’ mission is to foster learning environments that support optimal child health and well-being. Through its core programming and family-school partnerships, Action for Healthy Kids has impacted more than 20 million children in 55,000 schools nationwide to address systemic challenges in underserved communities. To learn more, visit actionforhealthykids.org.
This guide provides an overview of the social-emotional milestones throughout development and what you can do to help your child practice the social-emotional skills of their developmental age.
Most children and teens need to:
Spend time with family and friends without screens.
Spend time outside.
Get good sleep, eat healthy foods, play and exercise.
Have open, non-judgmental talks with their family and friends.
Have regular, consistent communication with teachers, coaches, and other trusted adults.
The ages listed should be used as a loose guide! Neurological differences between children (differences in their brains), their personality, birth order and family composition, their experiences of trauma, and other factors shape the way that children develop.
You are the expert on your child’s unique strengths and challenges. If you have questions or concerns about your child’s development, trust yourself and talk with their teacher or doctor about what you’re noticing.
Many of the developmental milestones in this section were adapted from Yardsticks by Chip Wood (2017). This guide focuses on school-aged children. For information about mental health from birth to aged 3, see Zero to Three.
4-year-olds…
Can appear clumsy or physically awkward.
Can play with other children, but also do a lot of parallel play (when children play next to each other but not together).
Enjoy responsibilities or “chores.”
Are learning to be able to calm themselves down and control their impulses.
Older fours are sometimes fearful or worried and may have nightmares.
Love bathroom language or “potty talk.”
Are often very talkative.
Love to be read to.
Learn through play, exploring things, rhythm, and repetition.
Are egocentric: they don’t yet understand that other people have different views or experiences than they do. For example, they might think they are hiding by putting a pillow over their face!
You can help them grow by:
Giving them words or phrases to understand what they might be thinking or feeling:
“You are throwing blocks, which tells me you are feeling mad or frustrated.”
“We are not going to take that toy out of his hands. If you want a turn, you can say: ‘Can I have a turn with that when you’re done?’”
“You see that he’s feeling sad right now. You can check in with him and ask if he wants a hug.”
Helping them practice self-regulation and impulse control. This might sound like:
“It seems like you’re getting frustrated by that puzzle. Let’s take 3 deep breaths before we try again.”
“I hear that you want my attention right now, but I’m not finished talking to Uncle Mark. In 2 minutes I’ll be able to give you my full attention.”
Helping them practice healthy social behaviors. Give specific examples such as:
“I like the way you gave Jojo a turn with the ball.”
“It is not OK to kick when you’re mad with someone. You can tell Diego you didn’t like that with your words, but not with your body.”
“You’re sad because I took away the tablet. You can be sad, but you cannot hit me. Do you think running outside would help you get out your feelings?”
Their imagination is how they experience the world. You can encourage it by being playful:
“Do you think Puppy wants to snuggle too?”
“Let’s walk to the potty like we’re flamingos!”
“Are you buckled in your car seat and ready for space launch? Can you help me count down? Helmets on!”
5-year-olds….
Like to be helpful.
Enjoy rules and routines.
Think out loud.
Can be literal and have difficulty seeing other viewpoints or perspectives.
Do not yet have logical thinking: they are not yet able to think through a problem successfully every time.
Learn through play and experimenting.
Older fives tend to test authority and limits.
May have tantrums or complain or whine a lot.
Play with whoever is around and is playing what they want to play: “Are you playing what I want to play?” or “If you don’t play like this, I won’t be your friend.”
You can help them grow by:
Being consistent. If that’s not possible, try to give them advanced warning when changes are coming up.
“Today is going to be a little different because Grandma is picking you up and giving you dinner. I’ll be home before bathtime.”
Helping them imagine and prepare for different things that might happen.
“If we get to the playground and the slide is wet, can you think of other things you’d be excited to play?”
“Last time we went to the ice cream shop, they were out of mint chip. What else might you want to try?”
Encouraging them to try new things.
“What if you tried…”
“How do you think it would be different if…”
6-year-olds…
Love to know and create rules. Because of this, many kids this age tattle.
Love to do things fast and competitively, which can lead to sloppiness.
Are loud!
Love to be told what they did well, and can have a tough time when things don’t go well.
Love surprises and treats.
Can be bossy or critical of others.
Are more likely to push back and question the rules.
Often complain.
Learn best through discovery.
You can help them grow by:
Letting mild arguments or disagreements happen with friends or siblings. Allow them to figure out how to handle being fair and taking turns as long as the situation remains physically and emotionally safe.
Helping them tell the difference between tattling and telling. “Telling” is done to help keep everyone safe. “Tattling” is done to get someone else in trouble.
Modeling how to be a good sport when losing or winning.
7-year-olds…
Often feel deeply and have psychosomatic complaints. This might be a new term to you: psychosomatic complaints means that their feelings can show up physically, in their bodies. For example, they may complain of stomachaches when they are nervous, or headaches when they feel overwhelmed.
Can be moody.
Like structure.
Are sensitive to criticism and try not to make mistakes.
Can be serious.
Like praise.
Can think more deeply.
Like to understand how things work by taking things apart.
You can help them grow by:
Celebrate how they did something rather than what they did.
Help them notice what they’ve learned from successes and failures.
Offer reassurance.
Help them practice coping strategies. This will help them with big feelings.
8-year-olds…
Are often energetic and talkative.
Are full of ideas.
Have a limited attention span.
Can bounce back more quickly from mistakes and disappointment.
Have trouble with limits and boundaries.
Tend to have bigger friend groups.
Exaggerate and may try out sarcasm.
Are very aware of fairness and justice.
Start engaging in clique behavior, meaning that there may be “in” groups and “out” groups of friends.
You can help them grow by:
Helping them see others’ perspectives or points of view as often as possible.
Keeping boundaries and rules consistent, and explaining your reasoning.
Asking for their thoughts when making a family decision.
9-year-olds…
Have lots of psychosomatic complaints, which means they feel their feelings in physical ways. For example, they may feel extremely tired or nauseated when they have to do something they don’t want to do.
Can be impatient, worried, anxious, and critical of themselves and others.
Can be moody.
Are very aware of fairness and justice.
Often use “baby talk.”
Can exaggerate by saying things such as “I hate it,” “You never let me do anything by myself,” or “He always gets to go first.”
Are curious.
Begin to recognize the bigness of the world.
You can help them grow by:
Including them in big conversations using age-appropriate language.
Helping them practice their coping skills to help with big feelings.
Supporting healthy self-esteem.
10-year-olds…
Can be quick to anger and quick to forgive.
Are figuring out right and wrong and are usually truthful.
Recognize social issues and are very interested in fairness and justice.
Are expressive and talkative.
Enjoy sharing and explaining.
Are often happy.
Are good problem solvers and are open to thinking about different ways to deal with a problem.
Puberty usually begins around this age for girls.
Find a lot of importance in friend groups, but groups can change often. For example, they may form clubs that last about a week.
You can help them grow by:
Letting them in on decision-making. Say aloud your thoughts and ask for their ideas.
Having conversations with them about what’s happening in your community and in the world.
Helping them think about what they look for in a friend.
Talking about puberty and what to expect.
11-year-olds…
Can be restless, fidgety, and constantly moving their bodies.
Often are going through a growth spurt, especially girls.
Need more sleep.
Often feel hungrier and need more physical activity.
Can be moody and sensitive.
Enjoy testing limits.
Can be impulsive.
Commonly have strong friend groups, and sometimes can be mean to those who are not in their group.
Want to feel like they belong.
May argue a lot.
Can see the world from different perspectives or viewpoints.
You can help them grow by:
Paying attention to what they hear about body image from social media, TV, movies, and other people. As their bodies change, they can often feel more self-conscious.
Helping them understand how their behavior can impact other people.
Maintaining your family’s boundaries and rules, and helping them understand your reasoning.
12-year-olds…
Tend to have lots of energy and enthusiasm.
Have growth spurts.
Often have changes to their sleep patterns.
Are better able to plan and think through more difficult things.
Care more about their friends’ opinions than those of adults’.
Enjoy talking with adults.
Show more empathy.
You can help them grow by:
Helping them get good sleep.
Encouraging them to show empathy, or care for others.
Talking to them about what’s happening in the world.
13-year-olds…
Have lots of energy.
Puberty in full swing: most boys will be beginning; most girls will have reached almost full physical development and have gotten their periods.
Skin problems are common and hygiene becomes more important.
May respond to talk about sex, health, and puberty with silliness, rudeness, or embarrassment.
Can be moody, insecure, and unwilling to take risks.
Often criticize adults.
Can have difficulty working in groups.
May feel and use peer pressure.
Social media begins to be an area of focus.
You can help them grow by:
Teaching them that changes to their bodies are normal.
Teaching them regular hygiene habits.
Being patient! They are figuring out how to be more independent.
Using humor and lightheartedness when appropriate.
14-year-olds…
Have lots of energy.
Are growing! Need lots of snacks, exercise, and sleep.
Begin to be aware of and interested in sex.
Strongly feel shame, embarrassment, and insecurity.
Age of the “know it all.”
Are turned off by adult lectures.
Try to “act grown”, but still depend on adults.
Enjoy learning through breaking things down.
You can help them grow by:
Keeping lines of communication open, showing an interest in what they like, asking open-ended questions, and being non-judgmental.
Maintaining your family’s boundaries and rules and helping them understand your reasoning.
Respecting their need for privacy and space.
Regularly talking about sex, dating, drugs, alcohol, peer pressure, vaping, and other topics.
15-18 year-olds…
Are developing their sense of who they are, and may experiment with different styles, opinions, friend groups, and interests.
Are able to think more abstractly.
Usually spend more time with friends than with family.
Have sexual feelings.
Want privacy and independence.
Often experience short periods of sadness and depression.
Are experiencing major changes in their brains. They have a fully developed limbic system, which means they feel pleasure, sadness, excitement, and other feelings very intensely. At the same time, their prefrontal cortex – which helps with decision-making, planning, and organization – is still growing. There is a lot of change happening in their brains during this stage!
You can help them grow by:
Keeping lines of communication open, especially about their own mental health experiences. Risky behaviors like drug and alcohol use, unprotected sex, and texting while driving can be common during adolescence, especially in response to big feelings. Being open to your child means that your child is more likely to go to you for advice and help.
Helping them slow down and think about their choices and decision-making strategies. The limbic system of their brain is working like a gas pedal towards new experiences, and their prefrontal cortex – which should be the brake – is still growing! Being there to talk with them about their decisions and support them through mistakes and hard times is helpful.
Asking open-ended questions to learn about their thinking.
This resource list is intended for educational and informational purposes only and should not be used to diagnose or treat any medical condition, including mental health conditions. Action for Healthy Kids recommends seeking consultation with a licensed medical professional. If you are concerned about the immediate safety of yourself or someone else, call 911 (emergency services) or 988 (suicide and crisis lifeline).
For many teens, social media is an important means for communicating with friends and connecting beyond their immediate communities. For many parents, their teen’s social media use can be a source of conflict or concern. Understanding the risks and best practices is one way to determine your family’s expectations around social media use and to ultimately nurture your child’s healthier relationship with technology.
Is social media bad for my teen?
According to the latest health advisory from the American Psychological Society (2023), social media platforms are technological tools that can offer both opportunities for authentic connection and the risk for increased mental health and well-being concerns including depression, anxiety, negative self-perceptions, and exposure to racist or hateful content.1
The impact of social media on your teen will have to do with their personality, their vulnerabilities, their relationships in the real world, their digital media literacy, and other environmental factors. The types of accounts they follow, the algorithms, and the apparent and the concealed features built into platforms also play a significant role in the impact on teen health and well-being.
Children aged 10 to 14 are most likely to be easily influenced by what they see on social media because of where they are developmentally. Children this age are less likely to have the digital media literacy skills that allow them to be critical and thoughtful of what they see online. Their brains are also developing and they are especially sensitive to feedback from friends, both real and online, and are less able to exercise the self-control needed to monitor their own social media use.
What about younger children?
Most apps require users to be at least 13 years old. Because of this, there is little research on kids under 13, but younger children are likely more vulnerable to the risks involved in social media use because their brains are still developing the skills needed to use social media in a healthy, positive, balanced way.
What can parents do to nurture healthy social media use?
Parents and caregivers can help teens use social media for connection, inspiration, and creativity. Learning how to use technology safely and thoughtfully can help teens avoid the risks that can be associated with social media use. Parents can consider the following suggestions when determining their family’s social media use expectations.
Look at social media together. Keep an open-minded, curious approach about what they’re liking, following, and interested in. Remember that social media is an important part of teens’ lives. Being dismissive or judgmental can shut them down and shut you out. You can ask questions like:
What makes that post funny/interesting/shocking to you?
What do you think about that idea?
Why do you think that person is following you?
Why are you following that person?
Talk to your teen about how to tell if what they see online is true. Misinformation and deception is widespread online. Helping your child think critically about what they see is one way of supporting their digital literacy skills. You can ask questions like:
Does that seem true?
Where do you think that information coming from, and is that source trustworthy?
How do you know?
Why do you think this was posted?
What do you think the post is trying to make you feel?
Talk to your teen about how to deal with hateful and deceptive content. Exposure to hateful content and social “standards” can have negative influences on mental health. You can interrupt this by teaching your child to question what they see on social media:
Does that seem true?
What do you think about that idea?
How does that idea make you feel and think about yourself?
Is that a message you get from other places?
Teach your teen to notice how social media affects them. Teens are still establishing their self-esteem, and so are especially vulnerable to negatively comparing themselves against what they see online. Help your child deal with this by reminding them:
Many photos online are edited: they are likely not showing reality, and so comparing ourselves to what we see online doesn’t make much sense!
Posters are deciding what they want to show; they are not showing all of reality. What story do you think they’re trying to tell here?
Encourage your teen to use social media to connect with friends. Messaging through social media apps can be an important and beneficial way for teens to connect with peers. Help your child distinguish between passive scrolling and engaging with friends online.
Set limits. Make use of parental controls within social media apps and on your child’s phone. Monitor how much time your child is spending on social media and encourage them to pay attention to it too. Consider setting time limits on daily social media use.
Model healthy habits. Your relationship to technology and social media will influence your children’s use! Consider incorporating ideas like:
Tracking your own time on social media.
Turning off social media notifications when possible.
Establishing screen-free time throughout the day or week.
Limiting the number of platforms you’re using.
Creating a family social media plan, and stick to it!
When should I be worried about my teen’s use?
Excessive social media use can cause brain reactions similar to those seen in gambling, substance use, or other addictive behaviors.2 Because of this, parents should monitor their teens’ use and behavior closely. The following signs can suggest that your child’s social media use may be problematic or negatively influencing their health:
They are not able to stop, even when they want to.
Their use is interfering with daily routines: sleep, meals, extracurricular activities, or work.
Their use is interfering with real-life relationships and schoolwork.
They experience cravings, or are lying or engaging in deceptive behavior to spend more time online.
What should I do if I’m worried about my child?
If your child is showing the above signs, or you are worried about their social media use for other reasons, talk to their pediatrician about your concerns. You can also learn more about the APA’s recommendations or the US Surgeon General’s advisory. You can also view a video about media literacy from the CDC Foundation here.
Suicide prevention is relevant to parenting at all ages, because it can start at a young age by talking openly and honestly about feelings, and providing an open and safe environment to seek help and support from trusted adults.
Supporting a child who is, or is suspected to be, struggling with suicidal thoughts, feelings or behaviors can be overwhelming. By having open and honest conversations that are developmentally appropriate, you can help your child feel less alone and more supported, while also connecting your child to additional support through a mental health care provider, your child’s pediatrician, or school support staff.
Talking honestly about suicide with your child is crucial in keeping them safe. Scroll through these developmentally appropriate tips to start a conversation about suicide prevention.
For Young Children (Ages 5-10)
Teach children that all emotions are okay and are normal to feel.
When a young child is displaying warning signs, or uses words or behaviors that could mean they are harming themselves, use simple and direct language such as, “I notice you are having a big feeling and [talking about or hurting your body]. I’m here to keep you safe, and you can always come to me for help”. Ask your child’s pediatrician or a mental health care professional for help.
Reassure them that they can always talk to you about anything.
Use gentle language and be prepared to answer questions honestly.
If a young child asks about suicide, keep it simple. This can sound like, “Suicide is when someone is having big, hurtful feelings and they decide they do not want to live. They forget they can get help, and stop their body from working.”
For Preteens (Ages 11-13)
Provide factual information about suicide.
Encourage open conversations about mental health, and ask directly about thoughts and feelings about suicide. This can sound like, “Sometimes when kids your age are struggling, they have thoughts about hurting themselves or even about dying. Is this something you think about?”
Discuss the importance of seeking help from trusted adults, and help your child think about who that might be for them.
Emphasize that they are not alone and support is available.
When a preteen asks about suicide, you can say, “Suicide is when someone decides that their pain or problem is too unbearable, and stops living on purpose. It’s important to know that there is help available when someone is struggling with suicide, and I am always here to listen and help you find help if you need it.”
For Teenagers (Ages 14-18)
Respect their autonomy and validate their feelings. This might sound like, “I hear that this argument with your find feels painful and unbearable. This sounds so hard. Do you want me to offer my perspective, or just to listen?”
Ask directly about suicidal thoughts and feelings. This might sound like, “Sometimes when someone feels this way, they might think about or feel like dying. I’m here to listen, and find help together.”
Keep communication honest and direct. This can sound like, “I’ve noticed you seem really down lately, and I want you to know that if you’re ever feeling like you want to hurt yourself or end your life, I’m here to listen and help you find support.” Your teenager might find this corny, and that’s OK! You are communicating your willingness to talk about hard topics.
