February 2026

Building Mental Health in the First Five Years: The 5Cs to Know

The Kids Mental Health Foundation Icon
Whitney Raglin Bignall, PhD; J’Nelle Stephenson, PhD; Tyanna Snider, PsyD

Article Summary

 
  • A child’s mental health begins developing at birth. Loving relationships, closeness and support help their brain grow and teach them about feelings and behaviors.
  • Support young children with the 5 Cs: Build Connection, set Consistent Rules and Routines, give Clear Instructions, practice Co-regulation and Coping skills, and Caring for Yourself.
  • If your young child often has strong tantrums, seems very anxious, struggles with sleep, avoids other kids or has physical complaints without a medical cause, talk with their primary care provider.
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When should I start working on my child’s mental health?

As soon as a child is born!

The brain grows faster during the first several years of life than at any other time.

Every interaction you have with your child can foster their mental wellness. As children grow and develop, your presence and interactions create healthy relationships with your baby and child. This helps their brain grow strong connections and helps them learn how to manage and navigate their behaviors and emotions.

Additionally, tantrums and meltdowns are common and expected in early childhood. The way you support and manage these behaviors and emotions is important to the relationship with your child and their learning of managing emotions. The goal is not for young children to handle all their feelings and behaviors alone. It’s to help them learn when they can try on their own and when they should ask for help.

What helps young children’s mental health?

We use the 5 Cs to make it easy to remember!

The 5 Cs are: Connection, Consistent Rules and Routines, Clear Instructions, Co-Regulation (helping a child manage their feelings by staying calm, supportive and connected so they can learn to calm themselves) and Coping, and Caring for Yourself.

5Cs

Examples:

Connection: a healthy parent-child relationship is foundational to mental wellness.

0-1 years

  • Play: For example, Peek-a-Boo is a great way to engage and connect with your baby.
  • Read and tell them stories: Reading early has shown to positively impact communication and social interactions later in life.
  • Talk with them: When they’re looking at you, label what they’re doing with their body. When they look away or are touching objects, label what they’re looking at or playing with.
  • Label feelings: Help your baby identify when they’re feeling “OK” or “Not OK.”
  • Physical contact: Be with them in their ALL feelings through touch and/or holding.

2+ years

Consistent Rules and Routines: routines give children a sense of control and decrease behavior battles.

Clear Instructions: simple instructions help children listen and build confidence.
  • Get their attention:
    • Keep your voice calm and face neutral.
    • Look them in the eye and/or hold their hands.
  • Keep instructions simple.
    • “Put your toys on the table.”
  • Avoid saying what to stop; offer what to do instead.
    • Instead of “Stop running,” say “Walk calmly.”
  • Have them repeat instructions back if possible.

Co-regulation and Help with Coping: staying calm and connected helps children learn to calm themselves.
  • Model calming yourself when upset.
  • Step away briefly when frustrated (if safe).
  • Practice calming skills together like breathing or mindfulness.
  • Ask how you can help as they get older.

Caring for Yourself: caring for your needs helps you be a better caregiver.

When should I be concerned about my child’s mental health?

Children develop mental health challenges for a variety of reasons, including genetics, environment and other experiences. Look for the following warning signs in young children:

  • Severe, frequent tantrums that take place multiple times per day and limit your family's ability to do what you need and want to do.
  • Persistent crying or feeling/acting scared or anxious that it disrupts your family's life. This may also include doing the same actions repeatedly to keep bad things from happening.
  • Difficulties sleeping, including frequent nightmares or seeming sleepy during the day more days than not.
  • Trouble making friends, including disinterest in playing with other children.
  • Struggling to sit still unless they’re doing an activity they like. This can get in the way of them participating or cause significant disruption. 
  • Complaining about physical problems (stomachaches, headaches) but medical professionals can’t find a source

If you see these warning signs in your young child, seek help from their primary care provider. It may help to keep track of the behaviors you’re seeing.

Treatment can provide support and reduce long-term symptoms and complications. Keep in mind that treatment might look different for young children and will often include significant caregiver involvement.

Taking action early can really help! Sometimes, it can be hard to reach out for help for a young child – you may wonder if they’ll just grow out of it or if it’s part of normal development.

If you have concerns from the list above, reach out to your primary care provider.

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References:

Zero to Three. Advancing Infant and Early Childhood Mental Health. Zero to Three. Accessed January 2026.

Center on the Developing Child Harvard University (2017, June 19). 5 Steps for brain-building serve and return. A Guide to Serve and Return. Center on the Developing Child Harvard University. Accessed January 2026.

Gee DG, Cohodes EM. Caregiving Influences on Development: A Sensitive Period for Biological Embedding of Predictability and Safety Cues. Curr Dir Psychol Sci. 2021 Oct 1;30(5):376-383. doi: 10.1177/09637214211015673.

Cohen AK, Hazelton T, Bassey H, Gutierrez-Padilla M, Novosel C, Nichols CR, Jain S. Improving Functioning of Children Birth to Five with Emotional and Behavioral Problems: The Role of Comprehensive Mental Health Services and Supports. Pediatr Rep. 2023 Jan 9;15(1):33-44. doi: 10.3390/pediatric15010005.

Izett E, Rooney R, Prescott SL, De Palma M, McDevitt M. Prevention of Mental Health Difficulties for Children Aged 0-3 Years: A Review. Front Psychol. 2021 Sep 29;11:500361. doi: 10.3389/fpsyg.2020.500361.

Komanchuk J. et al. (2023). History of “Serve and Return” and a Synthesis of the Literature on Its Impacts on Children’s Health and Development. Issues in Mental Health Nursing, 44(5), 406–417. https://doi.org/10.1080/01612840.2023.2192794

Schore A. (2001). Effects of a secure attachment relationship on right brain development, affect regulation, and infant mental health. Infant Mental Health, 22(1-2), 7-66. doi:10.1002/1097-0355(200101/04)22:13.0.CO;2-N

Swain JE. et al. (2007). Brain basis of early parent-infant interactions: physiology, and in vivo functional neuroimaging studies. Journal of Child Psychology and Psychiatry, 48 (3-4), 262-287. doi:10.1111/j.1469-7610.2007.01731.