Schizophrenia is a mental disorder that makes it hard to distinguish between real and imaginary situations. Sometimes people with schizophrenia think they hear voices, see things others do not, are paranoid believing others are out to hurt them or fully believe others are trying to read their thoughts or control their actions. Though schizophrenia can occur at any age, it general begins to manifest in both males and females between 15-30 years of age. When schizophrenia appears earlier than age 13, it is known as early-onset or childhood schizophrenia.
Childhood schizophrenia is rare, occurring in approximately 1 in 40 thousand children under age 13 each year. Childhood schizophrenia is the same disease as adult schizophrenia but due to the young age, special considerations must be taken for diagnosis and treatment. Schizophrenia always affects emotional needs, family, and social relationships. When it occurs during early childhood, educational needs and other issues are even more complicated.
Early Symptoms of early-onset Childhood Schizophrenia
The first signs and symptoms of childhood schizophrenia may begin early but misdiagnosis is common in young children. Disruptive behaviors, agitation, speech or language difficulties, or developmental delays may indicate a number of other conditions in young children including ADD or autism. Because these early symptoms are not exclusively linked to schizophrenia, early –onset childhood schizophrenia is often undiagnosed or is mislabeled as another condition. Though children with early-onset schizophrenia may begin showing these signs at very young ages, it is unlikely that an official diagnosis for schizophrenia will be assigned before 7-8 years of age.
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Late Symptoms of early-onset Childhood Schizophrenia
Later signs of childhood schizophrenia include; trouble paying attention, difficulty remembering things or following reason. Facial expressions may be absent or inappropriate. Children may also have poor social skills and lack attention to self-care normally deemed age-appropriate. Depression, mood swings, irrational thoughts, and little verbal communication with others are other signs of childhood schizophrenia. Children may experience hallucinations in the form of tastes, voices, sights, or sounds of nonexistent people or things. While mood and behavior swings are a normal part of childhood, with schizophrenia these swings are extreme and continue longer than expected. If you have any concerns over what may be a normal behavioral pattern, or your child’s behavior begins to change suddenly, have your child evaluated by a doctor.
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Cause and Risk Factors of Childhood Schizophrenia
To date, there has been no known cause definitely linked to schizophrenia. Indicators suggest it may be a combination of genetic disposition or environmental factors. Researchers believe some sort of trauma or disruption alters early development of the brain and under certain conditions, that increases the individual’s risk of schizophrenia. There has been some indication that a combination of stressful childhood events in someone already genetically susceptible could trigger schizophrenic episodes. However, much more research is necessary to confirm these suspicions.
If you have a relative with schizophrenia, you have an increased risk of developing schizophrenia. Schizophrenia is found in approximately one percent of the general population. If someone in the family has schizophrenia, your risk of developing the disease increase according to your relationship with that person. If your parent, grandparent, or sibling has schizophrenia, your risk is about ten percent. It is stressed that a genetic risk does not mean you will get the disease. Even among identical twins, the risk of one having schizophrenia if the other has been diagnosed with the disease is between 40-65 percent. Current research seems to indicate that genetic disposition alone is not enough to trigger schizophrenia. Environmental factors or trauma such as environmental toxins, viruses, emotional or social stressors, abuse, malnutrition, or birth complications could all be part of that equation.
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Complications of Schizophrenia
If you notice changes in your child’s behavior that causes concern, it is important to have him evaluated as soon as possible. Without treatment, schizophrenia can lead to serious complications in behavioral issues both personally and socially. Depression, self-destructive behaviors such as drug and alcohol abuse, self-mutilation resulting from hallucinations, or “hearing voices” telling them to harm themselves may lead to suicidal behavior in extreme cases. Anti-social behaviors and withdrawing from relationships can also lead to homelessness or legal problems. Early treatment may prevent or delay long-term complications as long as medication and treatment recommendations are followed and regular screening takes place.
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Treating Childhood Schizophrenia
Because the early signs and symptoms of childhood schizophrenia are also seen in other more common childhood conditions, treatment is often a challenging combination of ruling out other disorders and underlying medical conditions and then finding the right balance and combination of treatment options based on the individual child.
Since a child is still developing physically and the medications that are used to treat schizophrenia have not (yet) been completely tested or approved for use in children, a health care team will work together to address all your child’s needs. There are four main treatment options for child schizophrenia. Treatment is the same as treatments used for adult schizophrenia. The four treatment options are medication, psychotherapy both individually and as group therapy with family, social training and educational skills, and hospitalization. Hospitalization is often used only during acute episodes.
Anti-psychotic medications have serious side effects and must be closely monitored and adjusted. Because young children cannot always tell you how a medication is affecting them side effects have the potential to be more dangerous in children. As with other medications, never give your child any new vitamins, supplements, or medications without first speaking with your child’s doctor. Monitor your child’s reactions to any new medications closely and notify the doctor if you have any concerns.
Psychotherapy can help your child learn to deal with the stress and challenges of schizophrenia. Behavioral therapy can help your child to understand the importance of their treatments, overcome certain phobias, and assist in helping find ways to do well in school and social situations. Schizophrenia affects the entire family. For that reason, family therapy is also recommended. Therapy can help the entire family communicate better and cope with the stress and conflicts due to handling your child’s needs day in and day out.
Social training and educational skills for childhood schizophrenia include helping your child to function appropriately in school and social situations. Children with schizophrenia usually have difficulty with relationships and without guidance may develop problems in school. Academic training can help your child to work through the distractions of their condition and focus on the task of learning. With assistance, many children can do well in school and continue to progress in an age-related manner. Social training will also reinforce your child’s attention to self-care details such as day-to-day tasks involved in personal hygiene.
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Childhood Schizophrenia Support for Families and Friends
Schizophrenia does not affect just the child; it affects everyone involved with that child. Family, friends, classmates, and others may feel lost trying to understand what is going on. Stresses, fear, worry, even anger about the situation are all normal emotions that will surface. Schizophrenia may improve for a time with early treatment and intervention but it will never simply go away. Knowing what you can do to deal with the stress and cope with the changes and challenges will keep you and your family ready to move forward as strong and as effectively as possible.
Learn all you can about the disease and treatment options. Understanding what is going on with the overwhelming changes that occur and understanding the reasons for various treatments will help you and your child stay with treatment. Stay focused on recovering or at least regaining as much of a normal lifestyle as possible. Work together towards goals by taking one day at a time and staying positive. Find professional help and a peer support system that understands the mental stress and challenges faced each day. Knowing that others have been through this can offer you hope of moving forward when treatments need to be readjusted or your child is experiencing an acute episode that may require hospitalization.
Have a daily plan. Children with schizophrenia do best in a structured environment where they know what to expect, know they are loved, and where they feel safe. Find ways as a family to work off stress and frustration. Take walks, play games together, and simply unwind. Also, remember to take individual time to yourself. A few hours alone can go a long way to recharging your mental, physical, and emotional energies to handle another day strong and positive. There are support groups and associations ready to help; you just need to make the first move to reach out to them.
While there is no way to prevent early onset childhood schizophrenia, with early diagnosis and treatment extreme psychotic episodes may be delayed or avoided reducing the risk of serious complications that will occur if the condition is left untreated.