Schizophrenia in school-aged children is rare but not unheard of. Childhood schizophrenia essentially appears the same as schizophrenia in adults, except that the onset starts early in life and can have a profound impact on the child’s development and behaviors. The affected child may experience a combination of hallucinations, delusions, and disordered thoughts, making it difficult for them to interpret reality. It is a severe and chronic disease that requires lifelong treatment and early discovery to have positive outcomes.
Schizophrenic symptoms typically appear in an adult’s mid-to-late 20s. Early-onset in children can occur from as early as 13 years old to age 18. It is hard to diagnose children with schizophrenia because the symptoms in early phases may pass as other disorders such as ADHD. Some of the early signs of schizophrenia may include delay in language and walking as well as unusual motor behaviors such as rocking or arm flapping (Mental Health America). Symptoms in teenagers are difficult to recognize as well because some of these behaviors are common for the age group, including withdrawal from peers and family, a drop in performance at school, trouble sleeping, mood swings, lack of motivation, substance use, etc (MayoClinic.org).
There have been studies conducted to compare the academic performance of children who were later diagnosed with schizophrenia and their peers. One case-control study done by Helling et al. found no significant correlation between underachievements in school and early onset of schizophrenia; the teenagers with schizophrenia performed almost as well as their peers. This is supported by the study’s results that at age 9, there was no difference in performance; at age 12, some patients with schizophrenia tended to excel in the arts and language; at age 15, some remained proficient in the arts but performance in PE dropped. Overall, this study concluded that it is hard to spot a young patient with schizophrenia completely based on their grades in school.
However, another study done by Jundong et al. (2011) suggested a contradiction. Using longitudinal data in Sweden, they found that offsprings of schizophrenia patients have overall poorer performance in school compared to offsprings of non-schizophrenia parents. This study also suggested that genetic factors (vs. environmental causes) causing cognitive deficits account for poorer academic performance in school-aged children whose parents have schizophrenia. With these findings came the conclusion that early detection of signs of schizophrenia and intervention is important for a better prognosis.
Aside from academic performances in school, there is also research demonstrating that some children with schizophrenia may experience severe emotional disturbances (SEDs). According to an article by Chen et al., “[Children] with histories of SED are among the lowest-performing special needs students, especially when they have additional comorbid learning and psychiatric conditions.” SEDs are also associated with poor impulse control and other disruptive behaviors in school, thus requiring special educational services. Nevertheless, according to the same article, these additional services are often underprovided and rarely incorporate instructional goals to help with social skills. Hopefully, in the future, the needs of children with schizophrenia will be better accommodated so that children growing up and living with a chronic disease like schizophrenia can experience more positive outcomes.
Chen Y-L, Rittner B, Manning A, Crofford R. Early Onset Schizophrenia and School Social Work. Journal of social work practice. 2015;29(3):271-286.
Childhood schizophrenia. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/childhood-schizophrenia/symptoms-causes/syc-20354483
Helling I, Öhman A, Hultman CM. School achievements and schizophrenia: a case-control study: School performance and schizophrenia. Acta psychiatrica Scandinavica. 2003;108(5):381-386.
Jundong J, Kuja-Halkola R, Hultman C, Långström N, D’Onofrio BM, Lichtenstein P. Poor school performance in offspring of patients with schizophrenia: what are the mechanisms? Psychological medicine. 2012;42(1):111-123.
Psychosis (Schizophrenia) In Children And Youth. Mental Health America. https://www.mhanational.org/psychosis-schizophrenia-children-and-youth