Hallucinations in children involve false perceptions of reality, such as hearing voices or seeing images that aren’t real. While they may seem concerning, most are temporary and resolve on their own.
Hallucinatory experiences occur in about 10% of children. These experiences can involve seeing, hearing, or experiencing something that isn’t there in reality.
For example, children may hear a voice that others can’t hear or see an image that isn’t real.
While hallucinations may be concerning, they’re often a normal part of childhood development. Some hallucinations, however, may be a sign of more serious issues. This can include mental health conditions like depression, physical illness, and psychotic disorders like schizophrenia.
It’s important for parents to understand the types, symptoms, and causes of hallucinations so they know when to reach out for help.
Hallucinations in children can affect any of the five senses:
- Auditory hallucinations involve hearing sounds that aren’t real.
- Visual hallucinations involve seeing visual images that aren’t real.
- Tactile hallucinations involve feeling something without any real, external cause.
- Olfactory hallucinations involve smelling something that isn’t actually there.
- Gustatory hallucinations involve tasting something without any external stimuli.
In addition to sensory experience, hallucinations can be further classified by:
- level of disruption of daily life
Some common childhood experiences may seem similar to hallucinations, such as imaginary friends, fantasies, and night terrors. However, medical professionals view these as different from hallucinations.
Imaginary friends and fantasies typically appear or disappear at the child’s wish, don’t pose any threat, and are a source of comfort. Night terrors often involve misperceiving furniture, curtains, or shadows as frightening objects, which is an illusion rather than a hallucination.
Auditory hallucinations are the most common type of hallucination in children. Symptoms can include:
- voices that make critical comments
- voices that command them to harm themselves or others
- voices that sound like someone familiar, such as a family member
Less commonly, children may hear voices that have a conversation with them.
Visual and tactile hallucinations often occur along with auditory hallucinations. Symptoms can include:
- seeing simple images of lights, colors, or shapes
- seeing more elaborate images of unidentified people or family members, animals, or objects
- feeling like they’re being touched, hurt, burned, or pushed
In rare cases, children may experience hallucinatory symptoms such as:
- bad smells like vomit, urine, or smoke
- strange or unpleasant tastes
Hallucinations related to psychotic disorders have a different presentation. Symptoms of psychotic disorder include:
There are many possible causes of hallucinations in children, which may or may not be related to a mental health condition.
Causes can include:
- normal development
- nutritional deficiencies
- family dysfunction
- developmental difficulties
- sociocultural interaction
- deceased parent
- physical disorders, such as migraine and seizures
- side effects of medication or substances like alcohol or cannabis
Because there are many potential causes of hallucinations in children, diagnosis can be
Doctors will start by clarifying whether the hallucinatory experiences are actually:
- illusions or misrepresentations of sensory inputs
- fantasy-related, such as with imaginary friends
- intrusive thoughts or inner images
- post-traumatic flashbacks
Once doctors confirm the child’s experience meets the definition of a hallucination, they’ll interview the child to understand the hallucination’s complexity.
Simple hallucinations, such as occasionally seeing shadows, are not considered clinically significant. Hallucinations are considered clinically significant if they’re:
- occurring without clouding of consciousness
- distressing and impairing daily functioning
- linked to physical illness, active psychopathology, or suicidality
From there, doctors will assess if hallucinations are related to:
- psychotic disorders
- nonpsychotic disorders
- other stressors
- medication or substance use
Doctors may also order laboratory tests to investigate underlying physical causes.
Treatment for hallucinations in children depends on the cause.
Effective treatment options can include:
- mental health counseling, particularly cognitive behavioral therapy (CBT)
- psychoeducation for both the child and parent or caregiver
- medication to treat mental or physical conditions
- lifestyle changes
Hallucinations may be an emergency if your child:
- wants to harm themselves or another person
- hears voices telling them to harm themselves or another person
- is not making sense when speaking
- has a seizure
Call your doctor or local emergency number if you’re concerned about your child’s hallucinations.
Research suggests 75–90% of childhood hallucinations are temporary and resolve on their own over time.
Often, hallucinations in children can be managed with understanding and gentle reassurance from parents without the need for treatment. For children with nonpsychotic disorders, stress management and psychotherapy can help improve distress related to hallucinations.
Rarely, for hallucinations that persist and don’t respond to other treatments, antipsychotic medication may be helpful.
What triggers hallucinations?
There are many different causes of hallucinations. Triggers can include:
- sleep deprivation
- bipolar disorder
- major depression with psychotic features
- neurological disorders
- psychotic disorders
- medication or substance use
What do psychosis hallucinations look like?
Visual hallucinations may involve elaborate visual images of people, animals, or objects. Auditory hallucinations may include things like people crying, music, and other noises that others do not hear.
What is the difference between a hallucination and a delusion?
A hallucination involves hearing, seeing, smelling, tasting, or feeling something that isn’t there in reality. A delusion is a false belief that a person thinks is real.
What helps stop hallucinations?
Effective ways to reduce hallucinations include:
- stress management
- regular exercise
- good sleep
- avoiding substances like alcohol
Most hallucinations in children are temporary and resolve on their own. Yet some may indicate underlying issues that need treatment, such as stress, anxiety, depression, or other issues.
If you’re concerned about your child having a hallucinatory experience, talk with your doctor. They can help evaluate your child and determine if treatment is needed.