Jani Schofield, afive-year-old girl, physically attacked her infant brother. It was because “Wednesday”,a rat, told her to hit him and it would not stop biting her until she complies.Wednesday was only one of Jani’s over a hundred hallucinations from her imaginaryworld she calls Calalini, according to an article from Oprah in 2009. Jani’sfriend from the University of California Los Angeles (UCLA) psychiatric ward,Becca Stancil, has also been having hallucinations for years.
She has beenseeing terrifying creatures like wolves as indicated by Stohler (2011), andparticularly, a six-foot tall man who follows her everywhere as documented byWeinraub (2010). Another child, an eight-year-old named, Morgan Frank, wantedto kill their family dogs and ran after them with a knife, Frank reported in2015. Jani, Becca, and Morgan have allbeen suffering from a severe mental disorder – schizophrenia. According to Nordqvist (2017), schizophreniamanifests more commonly in early adulthood, from ages 16 to 30. However,Gochman and colleagues (2011) posited that in extremely rare cases, it can alsobe diagnosed during childhood with a prevalence rate of 1 in 40,000. Diagnosedprior to the age of 13, child schizophrenia, as stated by Bartlett (2014), is markedby the deterioration of affective, behavioral, and cognitive processes whichsignificantly disrupts the child’s overall functioning and development. Schizophrenia, in both children and adults, has two broadcategories of symptoms – positive symptoms and negative symptoms; positivesymptoms include delusions, hallucinations, disorganized speech, thinking, and behavior;whereas, negative symptoms include blunt or flat affect, alogia (diminishedspeech patterns), asociality (the loss of interest in social interactions), avolition(the lack of motivation), and anhedonia (the inability to experience pleasure),as indicated in the 5th revision of the Diagnostic and StatisticalManual of Mental Disorders (DSM-V) by the American Psychiatric Association (2013).
The main difference between child schizophrenia and adult schizophrenia is itsclinical presentation as stated by MacGill (2017); he asserted that the initialphase, more aptly referred to as the prodromal phase, is particularly more strikingand evident in children than in adults. During this phase, which may start atthe first months to years of life, a child may exhibit some of the earliestsigns which could lead up to psychotic symptoms. According to an article fromMayoClinic.
org (2016), these may include language delays, social deficits, latewalking, and other abnormal motor behaviors — rocking, posturing, or armflapping. Visual and auditory hallucinations are very common and therefore shouldbe distinguished from normal imaginative play as explained in the DSM–V (2013).Delusions are simpler and are usually related to childhood themes according toCobert (2010). Other indications of childhood schizophrenia may include socialwithdrawal, decline in academic performance, decreased ability to accomplish self-careand daily activities, bizarre hygiene and eating behaviors, lethargy, aggression,and hostility, as Masi, Mucci, & Pari reported in 2006. All these symptomsand features may appear to be very specific; however, as Bartlett (2014)stated, diagnosis remains difficult and challenging for mental healthprofessionals, as most of these symptoms overlap with other disorders (autismspectrum disorder, attention deficit hyperactivity disorder, etc.).
Thus far, there has been no definite etiology found forthe development of child schizophrenia according to Bartlett (2014); she statedthat most theories suggest biological and environmental factors for thecausation of the disorder. Some experts believe that it could be explainedthrough genetics,Coghill ascertained in 2009. Svrakic andassociates (2013) supposed that a child is genetically predisposed todeveloping schizophrenia with 10-15% risk if either of the parents isschizophrenic, and with 35-46% risk if both parents are schizophrenic. Accordingto an article from ChildrensHospital.org (n.d.), other researchers believe thatchild schizophrenia may be linked to environmental, specifically, prenatalfactors that include exposure to harmful chemicals or viruses, poor nutritionfrom unhealthy diet, drug or alcohol use, and extreme stress. Also, a studyconducted by Arseneault and colleagues (2011) revealed that childhood traumawas significantly associated with childhood psychotic symptoms.
Similar with the etiology, there has also been no knowncure for childhood-onset schizophrenia to date as indicated by Cobert (2010). Khuranaand associates (2007) claimed that available treatments focus on managing andmitigating the symptoms of the disorder. Bartlett (2014) stated thatantipsychotic medications are utilized as the first-line of treatment; specifically,atypical antipsychotics, which include risperidone, olanzapine, and clozapine,as these have been revealed to be more effective and bring about lesser sideeffects than the typical antipsychotics. According to Mayo Foundation for MedicalEducation and Research, (2013), side effects may include high cholesterol, weightgain, diabetes, and seizures. Another form of treatment for child schizophreniais psychotherapy which generally targets social, interpersonal, anddevelopmental problems; and may include individual therapy, family therapy, andsocial skills training according to an article from MayoClinic.org. Khurana andassociates (2007) explicated that clinical studies support the combination ofthese two forms of treatment in addressing childhood-onset schizophrenia.
Moreover,changes in lifestyle such as minimizing stress and taking fish oils have alsobeen considered helpful as stated in an article by MentalHealthAmerica.net(n.d.). Generally, the long-term functioning of patients withchildhood-onset schizophrenia has been considered as worse compared to thosewith adult-onset schizophrenia and even those with other psychotic disorders,as contended by Clemmensen, Vernal, andSteinhausen (2012). Loth and Dunn (2014)explicated that schizophrenic children may experience few close relationships,less academic achievement, unemployment, and less capacity to liveindependently in their adulthood.
They are also at a high risk of death fromsuicide with a mortality rate of 5-11% according to longitudinal studies. Fortunately,with early detection and proper treatment, they may have the opportunity to studyin college, work, and build families as adults, as stated in an article fromChildrensHospital.org (n.d.). Huey and associates (2007) also indicated that thefamily’s involvement, especially their care and support, is a crucial factor inthe treatment process. This is very much evident in the case of Jani Schofield,the schizophrenic child who had hallucinations of animals telling her to hurther younger brother.
Schofield Productions (2015) has been chronicling Jani’sdaily life; showing the activities of the now fifteen-year-old girl, attendingschool, playing sports, and even doing volunteer work at a horse ranch. Albeita bit overweight and having some eye problems which could be side effects fromthe medications she has been taking, Jani has been getting better and trying tolive life as normally as she can. Childhood-onset schizophrenia is indeed a devastating andhighly debilitating disorder affecting children under the age of 13, Bartlettreported in 2014. As indicated in the DSM-V (2013), it is characterizedprimarily by hallucinations, delusions, disorganized thinking, speech, andbehavior, as well as the lack of appropriate affect which severely andadversely affects a growing child. Due to its rare occurrence (1 in 40,000)(Gochman et al., 2011), childhood-onset schizophrenia remains understudied andpoorly understood; and as such, there is still no definite cause and cure foundto date, as stated by Cobert (2010). Bartlett (2014) claimed that expertsattribute its etiology to biological and environmental factors; whereas,treatment approaches include medications and psychotherapy as indicated in anarticle by MayoClinic.org (n.
d.). The outlook for the schizophrenic child isregarded as insidious with a high risk of mortality from suicide according toLoth & Dunn (2014). Fortunately, with early detection and proper treatment,schizophrenic children may grow up to be functioning adults as posited in anarticle by ChildrensHospital.