We are the association for  Child and Adolescent mental   health or ACAMH for short and this is ACAMH Learn. To recognise the early signs and symptoms of  schizophrenia Spectrum disorders in young children   we first need to know what they are schizophrenia  Spectrum disorders refer to a group of mental   disorders that share some similarities with  schizophrenia in terms of its symptoms causes and   development and these symptoms may vary depending  on how severe they are across individuals. These   symptoms are very rare in young children. It is  estimated that one in 10,000 children under 13   years of age receive a diagnosis. According  to the diagnostic and statistical manual uh   addition uh fifth edition the individual would  meet the diagnosis if they experienced at least   two out of the five symptoms for a sustained  period of time so usually six months or more   and if they are experienced impaired daily  functioning. The symptoms are delusions these   are fixed beliefs that are persecutory in nature  so thinking that others are out to cause you harm   they may be referential thinking that ordinary  events have special meaning. They may even be   somatic believing that you have a physical  defect or deformity sometimes these can be   religious in nature so these beliefs are rooted  in religious themes and faith, or even grandos   so beliefs of special powers wealth and mission.  Hallucinations seeing things and hearing things   that aren't really there like voices or seeing  ants crawling up your arms smelling or tasting   things that are not there for example smelling of  a foul odour disorganised thinking so this is uh   maybe reflected in the individual's behaviour  um in terms of their uh way in which they're   jumping to conclusions or jumping from ideas to  ideas sometimes we might call it a bit scattered   brained um speaking incoherently and not really  answering the question that they are being asked.   Fourth disorganized behaviours this is when the  individual has abnormal motor behaviours due to   their mental state so sometimes they may be very  hyperactive other times they may be very still and   mute and finally negative symptoms this refers to  blunted affect so showing little emotion and then   also lacking eye contact with others The way in which symptoms are expressed vary  across individuals as in adults young children   may experience the symptoms in varying levels  of severity intensity and frequency and whether   the symptoms are easily picked up by others in  the environment and whether it impairs daily   functioning with young children their immediate  sphere their immediate sphere of socialisation is   usually the school and the home so symptoms may  be more easily picked up by teachers and close   family members than say adults whose symptoms  May force them to lead a more self-isolating   lifestyle that said symptoms of schizophrenia  spectrum disorder may be heavily stigmatised   causing fear for both the child and the adult  so they can go under the radar too and also be   simply ignored when thinking that children may  grow out of it or simply just their fantasy.  Being a parent is tough I would say noticing  the symptoms that I outlined earlier and   ask are the delusional beliefs held with  conviction when provided with alternative   explanations does my child change their mind  are the hallucinations intense free frequent   and severe and are the symptoms impairing the  child's daily functioning does this persist   for over six months and if in doubt I would  say parents should seek professional advice.  Generally a mental health professional such as  a psychiatrist or psychologist would conduct the   assessment of schizophrenia spectrum disorders  in children there are also of course freely   available questionnaires online and resources for  parents to better understand various aspects of   schizophrenia Spectrum disorders and the symptoms  so for example the social mistrust scale for   children as well as the Schizotypal personality  questionnaire child version these will help you   drill down on some of the symptoms that we've  discussed but I would say a thorough interview   and assessment by mental health professional such  as a psychiatrist or psychologist would be best.  Like many mental health conditions there is no  single intervention currently available that   fits every child with a schizophrenia Spectrum  Disorder since the causes of schizophrenia   Spectrum disorders are complex with a combination  of genetics environment and neurological factors   that interact across development affecting  about 2% of children being diagnosed with   this treatment is also complex and may vary  on a case-by-case level on balance if I were   to suggest early support for children with  schizophrenia Spectrum Disorder it would   be to seek advice promptly from Specialists who  are better able to advise on next steps um also   these may be related to cognitive behavioural  therapy um with pharmaceutical intervention and   or family intervention and cognitive remediation  uh therapy um but simply don't be held back by   the stigma it can be a very scary experience  for you and for your child so uh it needs to   be even more supported and um you need to  be more patient with your child as well Depending on the types of symptoms experienced  yes when you say effective I would caveat this   as interventions that are promising the  first would be perhaps known as cognitive   behavioural therapy CBT this has been found to  be helpful in addressing children's thoughts   anxiety paranoia concerns and also in helping  them develop better coping strategies which   in turn can then lead to changes in their  behaviour cognitive remediation therapy   also known as CRT have also been found to be  effective in restoring cognitive functioning   say improving attention cognitive flexibility  which in turn leads to changes in uh children's   behaviours compared to standard care  alone and finally family therapy and   sometimes in combination with pharmaceutical  interventions um has been found to be helpful   for some children and those around them as  changes in communication resolving family   conflict habits and essentially the dynamics  can help support both the child and the family Although schizophrenia Spectrum disorders are  rarely are rare in early childhood they do   present in clinics and it can be very severe  from the research some genetic risk factors   including having a close family member uh with  a history of Schizophrenia or Schizophrenia   Spectrum disorders can increase one's risk and  also having certain gene mutations such as 22q   11.2 deletion Syndrome has also been found to  increase the risk having multiple risk genes   can accumulate and increase increase the  risk for later uh Schizophrenia Spectrum   Disorder environmental risks include exposure  to certain prenatal and perinatal complications   like influenza malnutrition substance abuse  as well as childhood adversity like trauma   and neglect and negative peer experiences like  bullying as well as urbanisation that said is   not a simple checklist where taking all the  risks would lead to developing Schizophrenia   or Schizophrenia Spectrum disorders  some people are at a higher risk but   also do not develop the disorder because  of other proect protective factors as well Experts have found specific brain structure  and functioning disruptions in neurotransmitter   systems and cognitive impairments being associated  with schizophrenia Spectrum disorders these   include brain regions specifically like the  prefrontal cortex hippocampus and phalus which   are all responsible for regulating our thoughts  actions emotions planning ahead learning memory   and attention as children's brains are undergoing  an important developmental stage there is also   initial evidence from prospective longitudinal  studies so these are studies following children   and birth cohorts across a long period of  time showing that poor nutrition at age three   years old is also associated with increased  schizophrenic-like symptoms 20 years later of   course this relationship is not as simple and  also in the study uh authors found that this   relationship was mediated by cognitive functioning  factors such as verbal ability and performance IQ There are currently no single biomarker or Imaging  techniques that can be reliably used for the early   diagnosis of schizophrenia Spectrum disorders  in young children the research is growing and   continues uh and is likely to continue to  rely on the triangulation of assessments   so this is getting multiple measures across  different instruments across different settings   and multiple people and in consideration of  children's developmental history and functioning Teachers and educators are great source of support  as they have the advantage of seeing many children   in the same setting and usually on a daily basis  this puts them in a good position to recognize   whether certain children may be struggling with  their peer relation relationships or maybe having   trouble relating to others around them their  school experiences and school performance are   obvious indicators as well of course schools  are busy places and we shouldn't just rely on   teachers to come up with ways to help support our  children but with more support and more resources   teachers may be in a good position to have ch a  conversation with children to better understand   what's actually going on as with most mental  health difficulties it is about developing   a safe and trusting space for children to share  how they are feeling be this at home or at school Parents of children with schizophrenia  Spectrum Disorder diagnosis may find   it incredibly challenging to know how best to  support their child particularly with the stigma   that is often attached to schizophrenic like  experiences it is also important not to place   blame on themselves or the child however it's  important to recognise that these experiences   of delusions and hallucinations can be very  disabling for the child and often times this   is a very scary experience that can impair their  daily functioning often times children wouldn't   know who to share this with without feeling  judged and so an important first step is to   not shy away from the conversation seek  professional support for your child and   then to find out more about the condition and  what the child is actually going through each   child will have different needs and so it's  best to understand what it is like for them   alongside a professional and then to come  up with a good solution for them as well Stigma around mental health and especially  schizophrenia prevents people from having   those important conversations and seeking help  early for many individuals they do not wake up   one day and find themselves with a disabling  condition like schizophrenia this means that   early signs may have surfaced but may have gone  unnoticed to reduce stigma I think it's important   for us to empathise with the experiences of  hearing voices or seeing things that are not   there as this can be incredibly scary not only  disabling and also challenging knowing more about   schizophrenia and schizophrenia Spectrum  disorders by talking about them can make   the experience less lonely and provide a safe  space for those people to speak out raising   issues sooner rather than later will also help  in increase early assessment and support [Music]