A hallucination is an experience of sensing something that is not actually there. There are several different types of hallucinations: auditory, visual, and tactile. Auditory hallucinations are the most common type of hallucinations. There are many reasons children experience hallucinations. This is why when it comes to discussing hallucinations in children, context is important. Hallucinations in children is fairly common and isn’t always pathological. Hallucinations also need to be distinguished from normal development and age-appropriate play.

For example, if a child sees a flitting shadow at night it would be reasonable especially for young children to say something like “I saw a ghost.” Another example is a child that has an imaginary friend.  This is often due to children having unbounded imaginations and a strong inclination to use make-believe scenarios in their play. So when they vividly describe what is occurring during play, they are describing fantasy.

True hallucinations can have many precipitating factors that do not necessarily stem from organic psychiatric illness. A few examples include: physical or emotional trauma, stress either in the home or at school including bullying, lack of sleep, mood disorders like depression, adverse medication reaction, toxic ingestion, substance use, and physical illness ie. seizures, infection, hyperthyroidism and others.

True psychosis in young children is very rare, however, when it is present the symptoms are usually severe and significantly inhibit the child’s ability to function. According to the Mayo Clinic the earliest signs of schizophrenia in childhood may include: language delays, late/unusual crawling/walking, or abnormal motor behaviors. It is important to note that these symptoms are not unique to schizophrenia so a full evaluation should be done to rule out other conditions like developmental/learning disabilities and learning disorders.

If a child develops persistent hallucinations and has a disorganized thought process where they are not making sense, confuse things like television with reality, become isolative, suspicious of others, or become agitated/aggressive, etc. immediate evaluation is warranted. Since children spend the majority of their day at school, the first signs of decline may be noticed by your child’s teacher.

If you have concerns about your child know that help is out there. There are clinicians including psychologists, pediatricians, and child and adolescent psychiatrists that specialize in mental health in children who can help with management of both physical and mental health concerns.

*Originally published on the Inpathy Bulletin

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