Is your little one having a big problem? Let's talk about Childhood Schizophrenia

Have you noticed that your little one has been acting a little strangely lately, in a way that doesn't suit their age? Does he sometimes say incomprehensible things, do things that don't make sense, or does he feel like he's not the same child he used to be? It's normal for a parent to feel a lot of fear and anxiety when you see things like this. Today we're going to talk about a mental illness that is very rare in young children, that is, very rare, but if it occurs, it can affect them for the rest of their lives. This is what doctors call `Childhood Schizophrenia` or childhood schizophrenia .

What is Childhood Schizophrenia ?

Simply put, this is a complex and severe mental illness that affects the mental health of children under the age of 13. This can cause a lot of changes in the way the child sees the world, thinks, and behaves. In particular, this condition can cause a state called `psychosis`, which is a state of detachment from reality. At the same time, there can be changes in the child's movements and even thinking (`cognitive functions`).

This condition, ``Childhood Schizophrenia'', affects a child's:

• As they think
• For memory power
• Sensory sensations (things seen, heard, felt)
• To behave

This can disrupt a child's daily life, schoolwork, relationships with friends, and family. If not treated properly, the child may not be able to regulate their thoughts, may even show behaviors that could harm themselves or others, and may be more likely to develop other illnesses or accidents.

At what age does this condition begin in a child?

To be diagnosed with childhood schizophrenia, the child must be under the age of 13. However, these symptoms, especially in young children, can be confused with other mental or developmental problems. For example:

• `Depression`
• Anxiety
• Attention-deficit/hyperactivity disorder (ADHD)
• `Autism spectrum disorder`

Often, symptoms of these other conditions can appear before the onset of psychosis, so it can be difficult to tell exactly when a child's schizoaffective disorder began.

This condition is also called `very early-onset schizophrenia`, `childhood-onset schizophrenia`, or `pediatric schizophrenia`. This `very early-onset schizophrenia` is when it occurs in children under the age of 13. This is different from `early-onset schizophrenia`, which occurs in adolescence.

Imagine how rare this condition called `Childhood Schizophrenia` is,This occurs in about one in 10,000 children, which means it's very rare.

What are the first signs of schizophrenia in young children?

Often, the first signs of this condition are some delays in the child's social interactions and development. For example:

• There may be delays in motor skills, such as starting to walk .
• It's hard to stay focused.
• Poor eye contact when speaking .
• Schoolwork skills are declining.
• Difficulty doing everyday tasks alone, such as brushing your teeth.
• Difficulty controlling one's emotions (lack of impulse control). This means that one takes things at a glance, says things immediately, or gets angry quickly.
• Big emotions that don't fit the situation (laughing excessively when you shouldn't, or getting very upset over small things).
• Speech delays or other problems. For example, repeating words or sounds that others say exactly the same way (echolalia).

If you see these things in your child, don't assume that it's all schizoaffective . However, if you see more than one of these symptoms over a long period of time, it's best to seek medical advice.

What are the main symptoms of schizophrenia-like disorder ?

The symptoms of schizophrenia in young children are similar to those of schizophrenia in adults. Your child may have symptoms like these:

Hallucinations and Delusions

• `Delusions`: These are false beliefs that a child holds strongly, despite all the evidence and evidence that they are wrong. For example, a child may believe that someone is controlling their thoughts, what they say, and what they do. They may believe that someone on TV is giving them special messages. Or they may constantly fear that someone is coming to harm them.
• `Hallucinations`: This is when a child feels like they are seeing, hearing, smelling, touching, or tasting things that are not there. Children often hear voices that seem to be speaking to them . These voices may command them, scold them, or talk about them.

Imagine your child saying that someone is talking to them through the walls of their room, or that there are strange animals that only they can see. It is normal for children to talk to their `imaginary friends` in childhood. This is healthy. But `hallucinations` are different, where the child feels that these things are really happening, and may even be frightening.

Disorganized speech and behavior

• Disorganized or incoherent speech:Your child may have difficulty organizing their thoughts when speaking. This means they may jump from one topic to another, their words may be too confusing to understand, and they may use words in strange ways.
• Disorganized or unusual movements: Your child may move in ways that you would not expect. For example, they may run around for no apparent reason, struggle to stay in one place, or sometimes remain motionless (a condition called catatonia). They may also hold strange postures.

Negative Symptoms

This means that the child's ability to do things they normally do is reduced or lost. These can be difficult to diagnose, as they can be confused with other conditions, such as depression.

• For example, the child's face may be expressionless , and they may speak in a flat tone, lacking any emotion.
• Lack of interest or motivation in anything. In particular, you may lose interest in playing with friends or doing things you used to enjoy. You may withdraw from society and try to be alone.
• Talking less.
• You may become careless about your own cleanliness.

Why do children have this condition?

It is difficult to pinpoint a single cause for childhood schizophrenia. Experts believe that the condition is caused by a combination of factors .

• Hereditary: Schizophrenia tends to run in families. This means that if someone in the family has the condition, there is a risk that the child will also develop it. But that does not mean that they will definitely develop it.
• Problems with brain development before the baby is born: Some problems occur during the development of the baby's brain during pregnancy.
• Complications during pregnancy: Things like malnutrition in the mother, or certain viral infections.
• Complications at birth.
• The loss of connections between different parts of the child's brain.
• Imbalances in the chemicals (neurotransmitters) used to communicate between brain cells.

The most important thing is to understand that this situation is not your fault. Many parents blame themselves. But this is no one's fault.

What complications can occur due to this condition?

Childhood Schizophrenia can affect a child's entire life. It can also affect:

• To learn
• For memory power
• Relationships with others (family, friends, teachers)
• Productivity (inability to complete a task properly)

There is no cure for schizophrenia. Even as a child grows into an adult, symptoms may persist to some degree. Therefore, ongoing treatment and support are essential for the child to live a safe, productive life.

How do doctors accurately diagnose this condition?

For a doctor to diagnose childhood schizophrenia, a child must have symptoms for more than six months . Recognizing schizophrenia in young children can be difficult. This is because even healthy, normal children can sometimes have hallucinations or delusions. For example, it is perfectly normal for a young child to talk to an imaginary friend.

There are also many other medical and psychiatric conditions that can cause symptoms of `psychosis`. Doctors first try to `rule out` such other conditions.

Other medical conditions:

• Changes in blood flow to the child's brain.
• Encephalopathy (impaired brain function).
• Endocrine disorders.
• Infection.
• `Metabolic disorders`.
• Insufficient intake of certain vitamins.
• Rheumatic and autoimmune diseases such as lupus.
• Reye's syndrome.
• Substance use.
• Temporal lobe epilepsy (a type of epilepsy).
• `Wilson's disease`.

Other developmental and mental conditions:

• `Autism spectrum disorder`.
• `Depression`.
• Bipolar disorder.
• Eating disorders.
• `Obsessive-compulsive disorder (OCD)`.
• `Post-traumatic stress disorder (PTSD)`.
• `Schizoaffective disorder`.
• `Schizophreniform disorder`.

Therefore, a doctor will not immediately say that a child has schizophrenia . This decision is made only after conducting many tests and making sure that there are no other causes.

What tests are done?

There is no single test that can tell if a child has schizophrenia . Psychiatrists diagnose the condition through a combination of mental and physical tests. To see if there are any physical causes, your child's psychiatrist may do tests like these:

• Imaging tests: Things like a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan can look for a brain tumor, stroke, brain damage, or other changes in brain structure.
• Blood, urine, and cerebrospinal fluid (`cerebrospinal fluid` - taken through a `spinal tap`) tests: These look for chemical changes in the body fluids that could be causing the child's behavioral changes.
• Brain function testing: An electroencephalogram (EEG) test records the electrical activity of the brain. This helps rule out conditions such as epilepsy.

After doing all of this, doctors make a diagnosis of this condition by taking into account many factors, such as the child's symptoms, behavior patterns, and family history.

What are the treatments for schizoaffective disorder in young children?

Treatment for very early-onset schizophrenia varies from child to child. Treatment also varies depending on the type and severity of symptoms. Treatment usually includes:

• Medications: Depending on the child's age, the doctor may prescribe antipsychotic medications and sometimes antidepressants to control symptoms.
• Therapy and Counseling: Counseling and various therapeutic methods (e.g., speech therapy, social skills training) are provided to the child and family. These help the child to live with the condition, manage emotions, have good relationships with others, and do well in school.
• Education and support for the family: It is very important for the entire family to be aware of this condition and learn how to support the child.

In some cases, hospitalization may be necessary for the child's safety. This may be necessary, especially if the child is at risk of harming themselves or others, if the symptoms are too severe to control, or if a new medication is being started.

Let's also be aware of the side effects of medications.

Some antipsychotic medications used to treat schizophrenia in young children can cause significant weight gain and heart problems . Therefore, your child's doctor will carefully weigh the benefits of treatment against the possible side effects before prescribing these medications. Then, they will regularly check your child's health, including:

• Measures of obesity: Body Mass Index (BMI), waist circumference, blood glucose levels.
• Measures of heart health: blood pressure, blood lipid levels.

Therefore, it is very important to send your child for tests at the scheduled times as recommended by the doctor.

How long after starting treatment will the child feel better?

The doctor who treats your child can give you the right answer to this. Because different medications and treatments take different amounts of time to show results. Some children may start to feel better quickly, while others may take longer. If the first treatment doesn't work, your doctor will also tell you about other alternative treatments. It's important to be patient and follow your doctor's instructions.

Can this situation be prevented? How can the risk be reduced?

Since there is no single cause, it is not possible to completely prevent childhood schizophrenia. However, there are steps you can take to reduce your child's risk of developing the condition.

• If someone in your family (a close biological relative) has schizophrenia , it may be a good idea to talk to a genetic counselor about preconception counseling before having a child .
• Some studies suggest that family planning when both partners are under 40 may help to some extent.
• Try to avoid malnutrition during pregnancy . If you have morning sickness, eat small, nutritious meals throughout the day, and seek help from your pregnancy care team.

It's very important to remember that even if you do everything right, there's still a chance that your child will develop pediatric-onset schizophrenia. It's not your fault.

If my child has schizophrenia , what should I expect?

Not all children with schizophrenia are the same, and their symptoms can vary. Some children's symptoms may appear suddenly, quickly. For others, their symptoms may appear gradually, increasing and becoming more severe over time.

You will need to keep track of your child's medications and their timing, especially if they are taking more than one medication to control their symptoms. You will also need to see your child's psychiatrist regularly. It can be helpful to keep a diary of your child's symptoms – as well as their eating and sleeping patterns – and bring it to each doctor's appointment.

Your child may need extra support at school. Your child's medical team will advise you about this. Medical appointments may also increase the number of days your child misses school. Therefore, it is important to maintain good communication with the school's teachers and principal from the beginning.

If your child has schizophrenia , how do you take care of them? (You need to take care of yourself too!)

Caring for a child with a mental illness like Childhood Schizophrenia can be very challenging. You want to do everything you can for your child and make their life successful. But, it's also important to take care of yourself.Here are some things to help you care for your child and get the support you need:

• Make a medication schedule and stick to it: Ask your child's psychiatrist for help and make a medication schedule that is as simple as possible. Tell your medical team if your child has any side effects, such as drowsiness, during school hours (as this can affect your child's schoolwork). Be sure to follow the medication schedule and dosage exactly.
• Meet with your child's psychiatrist as scheduled: The doctor will tell you when to see them. These appointments are very important to manage your child's condition.
• Don't ignore or ignore symptoms: The sooner the disease is recognized and medical treatment is started, the more likely the child will respond well to treatment and have good outcomes.
• Actively engage with your child's teachers and counselors: Ask your child's medical team to stay in regular contact with school counselors so they can work together to develop and monitor an accommodations plan for your child.
• Talk to the adults in your child's life: Talk to the leaders of activities your child participates in, such as sports and clubs, and let them know about your child's condition. Also tell them what to do in case of an emergency.
• Find support for yourself: Raising a child is hard. Raising a child with a mental illness is even harder. But you don't have to face it alone. There are many support groups (sometimes even online) for parents of children with mental illnesses.

When should you see a doctor? What to do in an emergency?

You should see your child's medical team as recommended by your doctor. Also, if you notice a change in your child's symptoms, for example, if symptoms get worse while taking medication, see your doctor right away. If the side effects of the medication are severe enough to interfere with your child's life, talk to them about that too. Your child's psychiatrist may be able to recommend other medications or treatments that can better treat the condition without the side effects.

Emergency:

If your child is talking about harming themselves or is behaving in a way that could harm others, you need to take action immediately. In Sri Lanka, you can call the police emergency number 119 , or call the Suwaseriya ambulance service at 1990. Alternatively, take your child to the nearest hospital emergency department immediately. It is important to get help quickly at times like these. The risk of self-harm (`suicide risk`) is higher among children with schizophrenia-like symptoms , especially among boys who are also using drugs. So be very careful about this.

When your child starts showing signs of a serious mental illness like Childhood Schizophrenia, it's normal to feel a lot of emotions. Your child's behavior can make you feel scared. You may feel like the child you knew is gone, and you may wonder if you'll ever see them again. You may blame yourself (but remember, it's not your fault!). Caring for a child with a mental illness can be overwhelming. So, prepare as much as you can by asking your child's psychiatrist about parenting classes, support groups, and books. Many people don't understand what life is like at home, so it's important to find people who understand.

Take-Home Message

• Childhood Schizophrenia is a severe mental illness that rarely affects children under the age of 13.
• In this case, the child may show symptoms such as `psychosis`, `hallucinations`, and `delusions`. Also, speech, behavior, and expression of emotions may be confused.
• There is no single cause for this. It is caused by a combination of factors, such as genetic influences and brain development problems. This is not the fault of the parents.
• Diagnosing the disease is complex. Doctors arrive at this decision after ruling out other diseases.
• Treatment includes medication, therapy, and family support. Although there is no complete cure, treatment can help the child live a better life.
• You are not alone. There are doctors, counselors, and support groups to help you and your baby on this journey. The most important thing is to seek help early.

If you have any further questions or concerns about this, please speak to a qualified doctor, especially a child psychiatrist.

` Childhood Schizophrenia-Emotional , Childhood Schizophrenia, Children's Mental Health, Psychosis, Hallucinations, Superstitions, Child Psychiatry