By Vanessa Rasmussen, © 2004, All rights reserved.

Schizophrenia is believed to be a neurodevelopment disorder, which is marked by problems in social development, language difficulties, and cognitive dysfunctions. It is an uncommon psychiatric illness in children and is hard to recognize in its early phases. The behavior of children and teens with schizophrenia may differ from that of adults with this illness. It is considered that the earlier the disorder is found in its course, the more treatable it is.

While schizophrenia sometimes begins as an acute psychotic episode in young adults, it emerges gradually in children, often preceded by developmental disturbances, such as lags in motor and speech/language development. Such problems tend to be associated with more pronounced brain abnormalities.

Child and adolescent psychiatrists look for several of the following early warning signs in youngsters with schizophrenia:

  • Children with schizophrenia often see or hear things that do not really exist (hallucinations)
  • trouble discerning dreams from reality
  • harbor paranoid and bizarre thoughts and ideas
  • odd and eccentric behavior, and/or speech
  • difficulty in distinguishing television and dreams from reality
  • unclear thinking and difficulty in concentrating
  • extreme moodiness
  • believe that people are "out to get them," or are talking about them
  • behaving younger than their actual age
  • impaired memory and reasoning
  • severe problems in making and keeping friends
  • withdrawn and increased isolation
  • decline in personal hygiene
  • inappropriate or flattened expression of emotion

Most schizophrenic children show delays in language and other functions long before their psychotic symptoms (hallucinations, delusions, and disordered thinking) appear, usually at age seven or later.

Schizophrenia is a life long disease that can be controlled but not cured. A combination of medication and individual therapy, family therapy, and specialized programs (school, activities, etc.) is often necessary. Psychiatric medication can be helpful for many of the symptoms and problems identified. Standard antipsychotic drugs appear to be effective for schizophrenic children and adolescents. These medications require careful monitoring by a child and adolescent psychiatrist.

Individual therapy typically employs a cognitive-behavioral approach that includes training in social skills, problem-solving strategies, and self-help skills. Social skills are comprised of several different areas that are easily taken for granted in the schizophrenic individual. These social skills are generally not taught but children learn them on their own. Social perception skills such as listening to what others are saying, getting clarification, responding correctly and relevantly, suitable timing of interaction, and identifying emotions as well as reacting appropriately are highlighted in this portion of therapy. Eye contact, voice volume and tone, speech rate, and physical gestures are all part of the conversational skills that are enforced.

Copyright 2001, 2004. All rights reserved. Any reproduction of this article in whole or in part without written or verbal permission is strictly prohibited. For information about reprinting this article, contact the copyright owner: Vanessa Rasmussen, Ph.D, Starting a Day Care Center,