Fear of monsters is common at six, and a child’s imagination can make those fears feel very real. **Sammy’s worsening distress, disrupted sleep, and episode of running to you screaming deserve an appointment with his pediatrician or GP soon.** Persistent fear that affects everyday life is a reason to seek help. [NHS guidance](https://www.nhs.uk/mental-health/children-and-young-adults/advice-for-parents/anxiety-in-children/)

I can understand why that episode frightened you. His words alone can’t tell us whether he was imagining something, reacting to a real person, or experiencing something else. When he’s calm, gently ask, “Tell me what happened,” and “What do you mean by ‘he’?” Let him describe it in his own words; avoid suggesting a person or repeatedly questioning him. If he identifies someone who chased, threatened, or hurt him, take that seriously and keep him away from that person while seeking help.

For now:

- Reassure him calmly: “I can see you’re frightened. I’m here with you.”
- Use a predictable bedtime routine, a nightlight, and a comforting toy. Avoid frightening videos or stories.
- Keep reassurance brief and gradually reduce repeated monster searches, which can reinforce the fear. [Children’s Hospital of Philadelphia](https://www.chop.edu/conditions-diseases/nightmares-and-night-terrors)
- Note when episodes happen, whether he is fully awake, what he says, and any changes at school or home. Bring those notes to his appointment.

**If he says he actually sees or hears someone while fully awake, contact his doctor promptly.** Such experiences have several possible causes and need assessment. Seek urgent medical care if he becomes confused, develops fever with unusual behavior, or cannot be kept safe. If an actual person poses an immediate threat, call emergency services. [AACAP guidance](https://www.aacap.org/AACAP/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Hearing-Voices-and-Seeing-Things-102.aspx)

Was Sammy fully awake during the episode last week, and does he describe *seeing or hearing* “him,” or feeling afraid that something might be there?