Signs And Symptoms Of Childhood Schizophrenia

Childhood schizophrenia can be extremely rare and difficult to diagnose. This can possibly be because children can have overactive imaginations, which could lead one to believe they hallucinate or are having delusions related to a mental illness (when they aren’t, clinically).

This active imagination can be a part of normal childhood for many children. However, in those living with childhood schizophrenia, many other symptoms may be present in addition to this overactive imagination that could disrupt one’s quality of life.

Navigating the possibility of childhood schizophrenia?

Find support from a licensed therapist

If your child has been having mental health concerns for some time, you might want to familiarize yourself with the signs and symptoms of childhood schizophrenia, as well as the available treatment options that can help. Read on to learn more.

Overactive imagination in children 

Children who appear to have an overactive imagination may display symptoms that overlap with conditions such as schizophrenia, bipolar disorder, or obsessive-compulsive disorder (OCD). These symptoms might include intense or unusual preoccupations and heightened sensitivity to stimuli, warranting careful evaluation by mental health professionals to differentiate and address potentially related mental health conditions effectively.

Working with a mental health professional to understand the complex interplay between imaginative tendencies and symptoms of psychiatric disorders can facilitate early intervention and support to promote the child's overall well-being.

What is childhood-onset schizophrenia?

Childhood-onset schizophrenia is generally defined as a potential diagnosis of schizophrenia, which can be given to children under the age of thirteen. It is regarded by many to be extremely rare, often occurring alongside a range of individualized symptoms. 

What are common symptoms associated with childhood schizophrenia? 

Childhood schizophrenia can follow the same symptomology as schizophrenia in adults. The same guidelines that psychiatrists use for diagnosis in adults are generally also used for children. Many believe this is why the DSM-V doesn’t have a separate diagnosis entry for childhood schizophrenia vs. adult-onset schizophrenia.

To be diagnosed with childhood schizophrenia per the DSM-V diagnostic pathway for “traditional” or adult schizophrenia, the child generally must have two or more of these symptoms, lasting for at least one month in a six-month period:

Delusions

Delusions can be one of the common symptoms of childhood schizophrenia. However, many parents might find that it can be difficult to know if your child is having delusions, or if they are just playing pretend as kids will often do. An example of a delusion could be, for example, if your child truly believed they had superhuman powers—or that someone or something supernatural was against them. “True” delusions often extend beyond the realm of pretend play and can trigger tangible emotions or reactions in your child that can persist after playtime is over. 

For this reason (and many others), it can be important that there are other symptoms of childhood schizophrenia present before reaching that conclusion. A licensed practitioner can help you to determine if your child is presenting with clinical symptoms that could be associated with a diagnosis of schizophrenia.

Hallucinations

Another common symptom of childhood schizophrenia can be the presence of hallucinations. Hallucinations can occur when children believe they are hearing or seeing things that do not exist. 

Again, it can be important to be very careful when monitoring your child for this symptom, as you work to determine what could be true clinical presentation vs. one’s imagination in pretend play.

Disorganized speech

Disorganized speech is generally considered to be a hallmark of childhood schizophrenia, and it can be a symptom that is more definitive than the others. 

Your child might be experiencing disorganized speech if they speak and you cannot understand what they are trying to communicate to you, even though they feel they were clear. Disorganized speech can also occur if your child frequently derails conversations, changes topics quickly or suddenly says something unrelated to the topic of conversation.

Disorganized or catatonic behavior

Disorganized or catatonic behavior can be another symptom of childhood schizophrenia. However, children can seem disorganized in their behavior without a mental illness being involved, so this can be difficult to judge depending on the age of the child. A practitioner can help you to discern what could be a symptom, and what could be normal childhood behaviors. 

Catatonic behavior is generally a cause for concern and can be more easily discernable compared to other associated symptoms. Catatonic behavior can occur when the child stares off with a blank look and does not respond to stimulation—such as someone calling their name, talking to them, or touching them to get their attention. These occurrences can occur for prolonged periods of time in a true catatonic episode.

Negative symptoms

Beyond the symptoms listed above, there are also a few negative symptoms of childhood schizophrenia that your child's doctor might look for throughout the diagnostic process. One of these can be affective flattening, which is a term that can define periods of time that the child has limited emotional expression. In these periods, they may have immobile or unresponsive facial expressions, poor eye contact and little or no body language with the presence of stimulation.

Another negative symptom your practitioner might look for can be alogia, in which the child might have difficulty speaking. They may have difficulty choosing their words, lack verbal fluency or speak very little overall. 

The final negative symptom that we will list here is avolition, which is a term that can refer to a loss of motivation in a general sense. If your child is experiencing avolition, they may sit for long periods of time doing nothing at all— taking little interest in their surroundings.

Aggressiveness

If your child is experiencing childhood schizophrenia, they may present with aggression often—possibly when defending their delusions, experiences or hallucinations. 

A practitioner can support you in determining what may be true childhood earnestness and sincerity, and what could be signs of a mental health condition.

Misdiagnoses of psychiatric disorders

Many children who end up with a diagnosis of childhood schizophrenia might first go through many misdiagnoses of their mental health condition. Ruling out other mental illnesses and learning disabilities can be a vital part of the diagnostic process, possibly helping to connect the child to treatment in a more effective way. It’s generally best to employ the help of your child’s care team and practitioner to help you find the most effective and accurate means of support for them, no matter what symptoms they might be experiencing. 

Childhood schizophrenia treatment

In many cases, childhood schizophrenia can be treated with a combination of therapy and medication. We’ve summarized the possible impact of each avenue below: 

Therapy

As with many mental health conditions, therapy can play an important role in limiting one’s symptoms and improving one’s quality of life. Currently, the Mayo Clinic recommends cognitive behavioral therapy as the leading form of psychotherapy for children who may be experiencing symptoms of childhood schizophrenia.

Medication

Some children with childhood schizophrenia may be treated with atypical neuroleptics, although some children are not responsive to this treatment. Studies also support the use of clozapine in childhood schizophrenia treatment. However, clozapine and other medications can have some serious side effects—meaning that it is important that parents and practitioners closely monitor children on clozapine.

Getting help: How can online therapy help parents of children living with childhood schizophrenia?

It can be important that you seek help for your child quickly if you believe that they are displaying signs of childhood schizophrenia. 

Therapists and psychiatrists can accurately and efficiently evaluate your child and their symptoms, possibly helping you to rule out all other possibilities before giving a formal diagnosis of childhood schizophrenia. They can then work alongside you to create a personalized plan of support for your child’s unique needs. 

However, we do want to acknowledge that it can be easy for parents to feel overwhelmed or burned out throughout the process. Online therapy can be helpful for those who are looking for extra support during this time and throughout the course of treatment. Parents might also appreciate the opportunity to connect with the nature of online therapy, as it can be used from home or anywhere else with an internet connection. 

Is online therapy effective? 

Studies have found statistics that suggest that online therapy can be effective, objectively offering similar gains to in-person therapeutic intervention. In a recent study published in the International Journal of Environment Research and Public Health, positive effects were quantitatively observed in both the parents of the children and in the children themselves—possibly suggesting that the positive impacts are both sustainable and comprehensive enough to facilitate true change. 

For parents living with children who experience childhood schizophrenia, this can be impactful—as it can suggest that therapy can offer new and meaningful parenting techniques that can offer positive impacts on the children, no matter what stage of growth they might be in.