Childhood Schizophrenia
Schizophrenia is a lifelong, incapacitating mental disorder that makes it difficult to recognize between real
and imaginary events. People with schizophrenia sometimes hear voices while others don’t hear any, they
may imagine that people are reading their minds, controlling their thoughts, or plotting to harm them. These
experiences can make them nervous and distracted and create difficulties when attempting to build
relationships with others. These situations are upsetting and may cause fearfulness, withdrawal, or extreme
frustration. People with schizophrenia may not make sense when they speak, may sit for hours without
moving or talking much, or may seem perfectly fine until they talk about what they are truly thinking.
Consequently, the way they communicate and behave often appears to be unbalanced, irrational, antisocial,
delusional and/or paranoid.

Schizophrenia can occur at any age affecting an estimated 1 in 40,000 children under the age of 13. During
early teen years, the rate of schizophrenia onset in the general population begins to increase, and the peak
rates of onset fall between the ages of 15 and 30. Males tend to experience the first signs and symptoms of
schizophrenia at the younger end of this range, while onset in females is usually at the older end. While
childhood schizophrenia is basically the same brain disorder as schizophrenia in adults, the early age of onset
suggests special considerations for diagnosis, treatment, educational needs, emotional and social
development, family relationships, and other issues.

Although there's no cure for schizophrenia, medications and individualized mental health care services can
help families manage the disorder, learn strategies to cope with the effects of childhood schizophrenia, and
address other child and adolescent developmental needs. Studies find that children share with adults many of
the same abnormal brain structural and neuropsychological features associated with schizophrenia. In
addition, children seem to have more severe cases than adults, with more pronounced neurological

Common Symptoms of Childhood Schizophrenia

When childhood schizophrenia begins very early, the disorder often becomes apparent gradually and builds
up to the first psychotic episode. Early signs of the disorder may include social withdrawal, disruptive
behaviors, learning difficulties, speech or language impairments, or other developmental delays. These early
signs aren't specific to childhood schizophrenia and may indicate a variety of other conditions.

In adolescents, schizophrenia may also begin gradually, but the unexpected start of psychotic symptoms and
decline in hygiene and functioning is more common in this age group than in younger children. Although
very young children can start showing signs of schizophrenia, it's extremely rare to get an official diagnosis
before a child is 7 years old. Children with childhood schizophrenia often have hallucinations in the form of
sounds, voices, images, odors, or tastes things that do not really exist. Other symptoms these children may
encounter include:

•        Problems paying attention
•        Impaired speech
•        Difficulty with memory and reasoning
•        Absent or inappropriate facial expression of emotion
•        Poor social and self care skills
•        Depressed mood, thoughts, and feelings
•        Inability to make decisions
•        Inconsistent body movements
•        Believing in make-believe ideas about reality
•        Hearing voices or experiencing other sensory incidents that aren't real (hallucinations)
•        Disorganized thinking
•        Excessive motions with no purpose
•        Little verbal communication with other people

Children with childhood schizophrenia many times may show few or no feelings; they may laugh at a sad
occasion, make poor eye contact, and show little body language. It is important to remember that as children
grow, they naturally have frequent mood and behavior changes that are a part of their normal growth and
development. Only an evaluation by a mental health professional can determine if a child is developing
childhood schizophrenia.

Types of Schizophrenia

Paranoid-type schizophrenia is described by delusions and auditory hallucinations but have fairly normal
intellectual functioning and expression for concern. The delusions can often be about being victimized
unjustly or being some other person who is famous. People with paranoid-type schizophrenia can exhibit
anger, unfriendliness, anxiety, and become confrontational.

Disorganized-type schizophrenia is described by speech and behavior that is delirious or difficult to
understand, and empty or improper emotions. People with disorganized-type schizophrenia may laugh at
insignificant incidents or at something not closely related to what they are saying or doing. Their
disorganized behavior may disrupt daily activities, such as showering, dressing, and preparing meals.

Catatonic-type schizophrenia is described by disturbances of movement. People with catatonic-type
schizophrenia may keep themselves completely motionless or constantly in motion. They may not say
anything for hours, or they may repeat anything you say or do senselessly. Either way, the behavior is puts
this form as high risk because it impairs their ability to take care of themselves.

Undifferentiated-type schizophrenia is described by some symptoms seen in all of the above types but
not enough of any one of them to classify it as a specific type of schizophrenia.

Residual-type schizophrenia is described by a past history of at least one episode of schizophrenia, but the
person currently has no active symptoms (delusions, hallucinations, erratic speech or behavior). It may
signify the person is in between an actual episode and possibly complete remission, or schizophrenia may
continue for years without any further psychotic episodes.

Most importantly Schizophrenia does not mean split personality.

Schizophrenia Possible Causes

There is no precise cause for the disorder. Scientists do not yet understand what causes schizophrenia, but
believe it may be a combination of genes, environment, behavior, and other factors. Researchers are
investigating all of these factors to learn the cause. Most researchers believe that schizophrenia results from
problems with early brain development.

Studies have focused on the way brain cells communicate with each other through nerve pathways. Too
many or too few connections in the vital pathways of emotional directing may lead to psychotic symptoms.
More specifically, certain areas of the brain that are rich in the chemical dopamine (compounds that function
as neurotransmitter found in the brain and essential for the normal functioning of the central nervous
system) seem to be affected frequently in schizophrenia.

The reasons associated with the development of these brain-pathway problems are controversial and are
being carefully investigated. Some of the areas of current research include the possibility of related genes
and stressful childhood environments in genetically susceptible children. If a parent has schizophrenia, the
chance for a child to have the disorder is 10 to 15 percent. Risks increase with multiple affected family

Schizophrenia and Hereditary

Scientists have long known that schizophrenia has a genetic predisposition. It occurs in 1 percent of the
general population but is seen in 10 percent of people with first-degree family members (a parent, brother, or
sister) with the disorder. People who have second-degree relatives (aunts, uncles, grandparents, or cousins)
with the disorder also develop schizophrenia more often than the general population. The identical twin of a
person with schizophrenia is most at risk, with a 40 to 65 percent chance of developing the disorder.

People who have a close relative with schizophrenia are more likely to develop the disorder than people who
do not have a relative with the illness. The risk of schizophrenia in the general population is about 1%.
Scientists think that there are several genes that may make a person more likely to develop schizophrenia.
Environmental factors, such as prenatal illness or birth complications, may also influence the development of
schizophrenia. Even with this information, doctors are not yet able to predict who will develop the illness.

Although there is a genetic risk for schizophrenia, it is not likely that genes alone are sufficient to cause the
disorder. Interactions between genes and the environment are thought to be necessary for schizophrenia to
develop. Many environmental factors have been suggested as risk factors, such as exposure to viruses or
malnutrition in the womb, problems during birth, social/emotional, psychological behaviors, and
circumstances like stressful environmental conditions.

Childhood Schizophrenia Evaluation

Parents concerned that their child is experiencing two or more symptoms of childhood schizophrenia and
he/she is having difficulty in daily living in areas such as school, friendships, and self-care, they should
contact the child's pediatrician or family doctor for a physical exam. An assessment can help rule out the
possibility of a child having another disorder with similar symptoms. This is usually done before a doctor
refers a child for an evaluation by a mental health professional specifically trained and skilled at evaluating,
diagnosing, and treating children and adolescents with mental health disorders.

The child’s doctor will most likely refer you to a psychiatrist for evaluation. A complete diagnostic check-up
will include:

•        A complete medical, social and family history.
•        Interviews with the child and parents or guardians to review any possible psychotic symptoms,
changes in behavior and the chance of other psychiatric disorders.
•        Testing to evaluate cognitive skills and functional abilities in daily life.
•        A review of school records or other contributions from school staff.
•        Blood and brain-imaging tests to rule out additional medical conditions.

This process takes time. The psychiatrist will make a diagnosis of schizophrenia only if psychotic behaviors
and other diagnostic criteria continue for at least six months, and no other causes for the signs and
symptoms have been found.

During that time the doctor should know about all behaviors observed, and any thoughts the child may
express. For example, your psychiatrist will want to know whether problems occur only at home or at
school or whether they're appear in all settings. He or she will inquire about many educational, personal,
domestic and social aspects that may contribute to your child's condition.

Diagnostic challenges

Childhood schizophrenia is difficult to diagnose for a number of reasons. Because it's rare, doctors not
specializing in pediatric psychiatry may have limited knowledge with diagnosing schizophrenia in younger

Behaviors or thoughts that may seem related to delusions or hallucinations may simply be the result of a
lively imagination, especially in younger children. However, these behaviors or thoughts should normally not
cause impairment.

Some signs and symptoms of schizophrenia are similar to those of other mental health or developmental
disorders. In fact, the psychiatrist will want to rule out these disorders before making a diagnosis of

•        Bipolar disorder
•        Schizoaffective disorder, a form of both schizophrenia and mood disorder
•        Severe anxiety disorders
•        Severe major depression with psychotic features
•        Post-traumatic stress disorder
•        Substance abuse disorders (particularly cocaine and methamphetamine)
•        Delusional disorders
•        Medical disorders that affect the brain
•        Personality disorders
•        Autism spectrum disorders

Treatment for Childhood Schizophrenia

Treatment types for childhood schizophrenia are based mostly on adult treatments and interventions, which
have been studied more thoroughly. Medications known as atypical anti-psychotics are the foundation of
treatment. These medications help to control psychotic behaviors through regulation of dopamine associated
nerve pathways. These drugs may prevent the recurrence or lessen the intensity of psychotic episodes.

A child's first experience with a psychotic incident can be very frightening and disturbing. While there may
be much to learn about your child's condition over the course of several months, dealing with the immediate
crisis of a psychotic episode is essential.

Other Forms of Therapy for Schizophrenia

Other interventions for childhood schizophrenia intended to be used along with drug treatment may include:

•        Ongoing, age appropriate education about the disorder and treatment options for both the child and
family members, including siblings.

•        Social skills and basic life skills training at home, school and in the community.

•        Psychotherapy for child and parents or guardians that focuses on coping strategies, problem-solving
skills, and awareness of symptoms and the circumstances that may prompt or aggravate them.

•        Special educational programs that address learning and developmental needs.

•        Day programs or at-home services for children who can't attend school for an entire day.

It's important to report any visible medication side effects to your doctor immediately. By detecting
medication problems early, your physician can adjust dosing or brand of prescription. Hospitalization may be
necessary when psychotic behaviors aren't effectively managed by drug treatment or when behaviors,
particularly paranoid delusions or hallucinations, present a danger to the child or others; parents may have
reason for concern if their child who is 7 years or older is experiencing these behaviors. Such behaviors
could be symptoms of childhood schizophrenia.

Schizophrenia is a mental health disorder that currently has no cure and will not disappear, but its symptoms
are manageable with treatment. Treatment for schizophrenia includes biological, educational, and social          Developmental Disorders          Autism          Parenting Issues