There is no known, exact cause for childhood schizophrenia according to Boston Children’s Hospital. It is thought to be linked to genetics, with a child having a 10 to 15 percent chance of developing schizophrenia if a parent has it. This significantly increases if more than one family member has schizophrenia. It may also be linked to a number of environmental factors during pregnancy, such as exposure to certain viruses, drug or alcohol use, extreme stress, and exposure to certain chemicals.

Many symptoms of schizophrenia are similar in children and adults, however, children are more likely to experience auditory hallucinations. Delusions do not usually appear until teenage years or laterm according to the Children’s National Health System. Early warning signs in children include:

• Difficulty distinguishing dreams or TV from reality
• Bizarre thoughts
• Fear that someone is going to harm them
• Seeing or hearing things that aren’t there
• Catatonic behavior

Psychotic symptoms can occur along a continuum of time, according to the National Alliance for Mental Illness (NAMI). Often, these warning signs aren’t recognized as problems or signs of schizophrenia until a child reaches a crisis point.

Signs of schizophrenia can be seen as normal childhood development according to NAMI. For example, many young children have a pretend friend. Hearing voices may be mistaken for that. Early signs of schizophrenia in teens include social withdrawal, poor school performance, trouble concentrating and thinking clearly, or a decline in self-care. All these signs may be attributed to normal teen development.

In recent years, researchers have found that early recognition, diagnosis, and treatment lead to better outcomes, including improved functioning, greater involvement in school and work, and a better quality of life according to a report published in the Journal of Psychoses and Related Disorders. Early intervention refers to treatment after the first psychotic episode.

Schizophrenia is diagnosed over several months, according to the Brain & Behavior Research Foundation. Two or more symptoms must be present for at least six months. For those who hear voices, only one symptom is needed. A mental health provider evaluates the symptoms over a period of months and rules out other psychiatric conditions, such as bipolar. The primary doctor may complete an examination and perform tests to rule out other causes, such as tumors, according to NAMI.

Schizophrenia is uncommon in children under the age of 12 years old, according to the Children’s Hospital of Philadelphia. Psychotic symptoms usually appear between the ages of 16 and 30, according to the Brain & Behavior Research Foundation. It rarely develops in those who are over the age of 45.

Treatment for schizophrenia usually involves a combination of different therapies, according to the Children’s Hospital of Philadelphia. It can include antipsychotic medications, mood-stabilizing medications, individual and family therapy, specialized programs such as social skills or vocational training, and self-help and support groups.

Successful family therapy programs focus on providing information about the illness and its management but also work with parents and caregivers on promoting positive attitudes and empathy, according to a report published in 2015. The prognosis is worse in families where there is a negative attitude toward the child with schizophrenia, including the belief that the presence or absence of symptoms are within the child’s power, than in households where there is empathy.