Written by:Dr. Karmen Smith, LCSW, DD

Published On: June 29, 2022

Medically reviewed by: Bisma Anwar, MA, MSc, LMHC

Reviewed On: June 29, 2022

Updated On: July 17, 2023


It’s estimated that approximately 1 in 10,000 children aged 13 or younger in the United States are living with childhood schizophrenia. Childhood-onset schizophrenia (COS) is a rare mental health condition marked by hallucinations, disordered speech, negative or confused thoughts, fear of harm, disorganized speech, and/or catatonic behavior. It’s so uncommon, in fact, that we don’t know much about it.

That said, it’s important for parents to be aware of the symptoms of childhood-onset schizophrenia so they can help a child who may be dealing with it. Because schizophrenia in children can present differently than adult schizophrenia, understanding as much as possible, including the signs and symptoms, is key if you want to help a young person who’s living with this serious mental health condition.

Read on to learn more about schizophrenia in teens and children.

Signs & Symptoms of Schizophrenia in Children & Teens

Most often, schizophrenia isn’t found in children younger than 12 years old. While still rare, if a child develops the condition, it’s typically discovered in the middle to late teen years. Early-onset schizophrenia diagnosis in children is most often found in young boys. Once the teen years are reached, however, just as many girls as boys can develop symptoms and be diagnosed.

Schizophrenia can be challenging to diagnose in children and teens, since even healthy children are apt to have mood swings and occasionally display odd behavior. This can be particularly true during the hormonal early teen years. However, there are a few distinguishing symptoms and signs of schizophrenia in children to be aware of.

Childhood schizophrenia signs

Early signs of schizophrenia in children usually involve issues with odd thinking, behavior, and emotions. This can include symptoms such as bizarre ideas or speech, confusing fantasy with reality, lacking emotions, or hearing voices.

In young children, some early signs of schizophrenia may include:

  • Odd speech
  • Aggressive behavior
  • Difficulty with self care and/or proper hygiene
  • Confusing TV, dreams, or imagination with reality
  • Not sleeping well
  • Being excessively irritable
  • Struggling with motivation
  • Having a lack of emotion
  • Developing odd fears
  • Social withdrawal
  • Having problems thinking clearly

Childhood schizophrenia symptoms

As children get older, there are some of the more classic schizophrenia symptoms to look out for.

Symptoms of schizophrenia in older children may include:

  • Delusions: Some adolescents and teens who experience schizophrenia-related delusions might develop false beliefs and ideas that aren’t based in reality.
  • Hallucinations: People, including children, with schizophrenia, might have hallucinations that cause them to see or hear things and voices that aren’t really there. Auditory hallucinations are the most common, usually accompanied by visual hallucinations. For the person experiencing them, though, the experience is quite real.
  • Flat affect: A monotone, or “flat,” voice is common in children with schizophrenia. Other symptoms in this category include an apathetic appearance and dull or nonexistent facial expressions. Children may avoid eye contact and appear unable or unwilling to show any type of emotion. They also might seem stiff, as if they cannot move their arms or heads.
  • Disorganized thought patterns: Incoherent, meaningless, or derailed speech is common in children and teens who exhibit disorganized thinking as a symptom of schizophrenia. They might answer with incomplete thoughts or give answers that are unrelated to the topic being discussed.
  • Speech and thought paucity: Sometimes schizophrenia in adolescents and teens causes short answers or the tendency to speak only when spoken to.
  • Increasingly odd behavior: Bizarre behavior isn’t uncommon in children with schizophrenia. A child might have urges or act inappropriately in public, or they may behave much younger than they are. Sometimes they might sit motionlessly and simply stare off.

Additional symptoms can include increasingly violent behavior, withdrawal from family and friends, excessive suspicions and paranoia, and depressed moods. Compared to adults, children are more likely to have visual hallucinations and hear voices but are less likely to have delusions.

Suicidal thoughts are also common for those with schizophrenia at any age.

What Causes Schizophrenia in Children & Teens?

As noted, childhood schizophrenia is rare. Typically, schizophrenia doesn’t manifest until someone is between 18 and 25 years old. However, schizophrenia in teens and children does exist.

The full understanding of schizophrenia causes, at any age, isn’t fully understood. It’s believed and widely accepted that the condition can stem from a combination of parents’ genes and brain chemical and neurotransmitter imbalances, such as off-levels of dopamine and glutamate.

“It’s considered best practice to defer official diagnosis until after 18 years of age, but in recent years younger children under the age of 13 are being treated for schizophrenia. Diagnosis is difficult and controversial because many of the symptoms could be due to developmental issues.”

Licensed Clinical Social Worker (LCSW), DD Karmen Smith

A few things appear to make it more likely for a child to develop schizophrenia. They can include:

  • A family history of mental illness
  • An older father
  • Taking psychoactive drugs during teen years
  • An increased immune response, such as from inflammation or an autoimmune disease
  • Pregnancy complications (malnutrition, viruses that affect brain development, exposure to certain toxins)

The Importance of Addressing It Early On

Early treatment is a critical component in effectively managing symptoms of schizophrenia at any age. Over time, both positive symptoms and negative symptoms of schizophrenia can become more obvious, and a child may develop psychosis. Especially in children, treatment can help prevent or limit the severity of psychotic episodes, which can be understandably scary for a child and their parents to try and navigate alone. 

How to Help a Child with Schizophrenia

“When treating a child with schizophrenia, the family also needs to be referred to services, including family therapy. A team of professionals including psychiatrists, social workers, teachers, and therapists offer support to the family.”

Licensed Clinical Social Worker (LCSW), DD Karmen Smith

Seek a diagnosis

Diagnosing schizophrenia in a child, whether younger or in their teenage years, involves first ruling out any other mental or physical condition or medication issues that might be causing or contributing to symptoms.

For that reason, the first step in diagnosis is typically a full medical exam, a screening to rule out drug or alcohol abuse, and an MRI or CT scan to make sure the child doesn’t have a medical condition that causes similar symptoms.

After ruling out medical or medication issues, a teen or child will be given a psychiatric evaluation. This will typically involve:

  • Getting a family history
  • Observing a child’s appearance and demeanor
  • Asking about feelings and thoughts, including negative thinking patterns
  • Asking about harmful intentions (to self or others)
  • Evaluating critical thinking skills
  • Looking for any anxiety and possibly psychotic symptoms

Explore treatments

Childhood schizophrenia is a chronic condition that requires a lifetime of treatment. However, by addressing the condition early, your child’s healthcare provider can help prevent the disorder from progressing and prevent the child from possibly harming themself or others.

Schizophrenia treatment options will depend on the child, their age, and how severe their condition is. Usually, care will involve antipsychotic medication and a team of mental health professionals who specialize in the treatment of schizophrenia in kids. Families are almost always encouraged to play an active role in treatment. Treatment teams might include social workers, caseworkers to coordinate care, school counselors, psychiatric nurses, and pharmacists as well.

The primary treatment options for a child or teen with schizophrenia are:

  • Psychotherapy. Psychotherapy (talk therapy) is generally always recommended to treat schizophrenia in children. During therapy sessions, a child will talk with their doctor or therapist about feelings and issues. Sessions can be individual, with just the child and the therapist or doctor, or they might occasionally also involve family members.
  • Medications. Certain medications for schizophrenia might help teens. Sometimes antipsychotic medication is used to help manage hallucinations and delusions. Mood-stabilizing drugs may also be effective in addressing mood symptoms.
    *Note: There are no antipsychotic drugs approved by the FDA for use by children younger than age 12.
  • Life training skills. This might include developing skills aimed at building and sustaining relationships, social skill training, and, depending on the age, training for a job skill. Speech and language therapy is not uncommon.
  • Hospitalization. Hospitalization is used as a last resort for treating schizophrenia in teens and children. It’s usually only recommended when there’s a probability of the child harming themself or others.

Help them find ways to cope

Dealing with schizophrenia can be difficult for a child or teen. After all, this is the age when a child wants to fit in, not stand out because of unusual behavior.

Schizophrenia in kids and teens can be particularly difficult as most kids lack the skills necessary to deal with their condition. That’s why early treatment is so critical. It’s also why it’s so necessary to be proactive and get adequate and appropriate support for your child at school. Encourage them to interact with other children and be sure to get them the therapy and help they need to develop effective coping skills.

Finding Support as You Navigate it All

As upsetting as having a child diagnosed with schizophrenia can be, there is some good news. If you want it, there’s support available for you, too. Don’t be afraid to ask for help as you try to navigate treatment options and all the ups and downs that come with a schizophrenia diagnosis.

Your child’s mental health team can put you in touch with a support group for parents with a child with schizophrenia. In addition, the National Alliance on Mental Illness can connect you with a support group in your area.

Talkspace’s online therapy platform is an excellent place for parents to get support and guidance so they can help their child. If you’re trying to figure out how you can best assist a child or teen who’s been diagnosed with schizophrenia, or if you suspect your child might need help, reach out today to get the assistance you need. You’re not in this alone…help is there, for you and your child.

See References

Dr. Karmen Smith, LCSW, DD

Dr. Karmen Smith is a board-certified Clinical Social Worker in the state of Nevada. She has worked over 20 years for Clark County Family Services with abused and neglected children in the shelter, adolescents in juvenile detention, and adults who have suffered severe trauma. Dr. Smith is a shamanic teacher and minister of metaphysics and her doctorate is in Pastoral Counseling.

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