Childhood schizophrenia is an uncommon but severe mental illness. In most cases of schizophrenia, symptoms first appear when a person is in their late teens and 20s. In childhood schizophrenia, symptoms appear when a child is under the age of 13.

Diagnosing schizophrenia in children is challenging. There are other conditions with similar symptoms, such as bipolar disorder or depression. Your child’s doctor will do a thorough assessment of symptoms over an extended period before reaching a diagnosis.

The symptoms for children with schizophrenia may be different from adults. That’s because a child’s brain is still developing. There are many types of childhood schizophrenia, so not everyone will have the same symptoms.

It’s important to look for changes in behavior when assessing symptoms in children. For example, children who are socially outgoing may suddenly become withdrawn or isolated. Other signs to look out for are unusual fears and incoherent speech. Often, school teachers are the first to notice the behavior changes in children with schizophrenia.

Other symptoms that may signal childhood-onset schizophrenia are:

  • seeing things or hearing voices that aren’t there
  • difficulty sleeping
  • odd speech patterns or behavior
  • the inability to separate television from reality
  • varying emotional patterns
  • paranoid thoughts that others are out to harm them
  • decrease in self-care or personal hygiene

It’s important to separate age-appropriate behaviors from pathological symptoms. For instance, depending on the child’s age, imaginary friends can be common. The presence of an imaginary playmate doesn’t indicate schizophrenia.

Researchers aren’t sure what causes schizophrenia in children. It’s likely caused by a combination of factors, including:

  • changes in the brain and neurotransmitters
  • genetics
  • environmental factors

Many other psychiatric conditions have similar symptoms to schizophrenia. These include bipolar disorder and depression. This can make it difficult to diagnose. A diagnosis will only be given after all other conditions have been ruled out.

Before receiving a diagnosis, a mental health professional must check the symptoms to see if they fit into the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). DSM-5 is a created by the American Psychological Association.

To receive a diagnosis, your child must have two or more of the following symptoms:

  • delusions
  • hallucinations
  • disorganized speech
  • extremely disorganized behavior
  • limited speech
  • apathy
  • failure to make choices
  • reduced or absent facial expressions
  • poor attention to daily activities

Your child’s doctor will also need to exclude mood disorders, substance abuse, or other medical conditions before reaching a diagnosis of schizophrenia. There are several tests and exams your doctor may use to rule out other conditions, including:

  • physical exam
  • MRI
  • CT scan
  • alcohol or drug use screening
  • psychological assessment

There’s no cure for schizophrenia. Symptoms can be managed with an effective treatment plan. Learn more about treatments for schizophrenia.

Treatment plans should be led by an experienced child psychologist with an understanding of child-onset schizophrenia. Other members of your child’s treatment team will include:

  • family members
  • a social worker
  • a pharmacist
  • a case manager

There are three main treatment options, including:

Your child will likely need a combination of treatments, and treatments will need to continue even as symptoms improve.

Your child’s doctor may also recommend family therapy to help family members understand the condition.

Inpatient treatment

Occasionally, symptoms are too severe to manage at home. During these times, hospitalization may be the most effective method of treatment. Mental health inpatient facilities ensure children with schizophrenia have their basic needs met. These include food, self-care, and rest. Inpatient facilities also provide a routine-based environment to help manage symptoms.

It’s important to rule out all other disorders and environmental causes before diagnosing a child with schizophrenia.

If you suspect your child may have schizophrenia, work with a doctor trained in treating children with this condition. They’ll be more familiar with the signs, which can improve your child’s chances for a correct diagnosis. The earlier your child is diagnosed, the sooner a treatment plan can begin.