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NICHCY (2010, June). Emotional disturbance: NICHCY Disability Fact Sheet #5. https://blackboard.angelo.edu/bbcswebdav/courses/11451.202110/emotional%20disturbance%20fact%20sheet%282%29.pdf

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Parent Resources of Emotional Disturbance

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Parent Resources of Emotional Disturbance

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Links updated, November 2021
This information in Spanish

The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years. ( 1)

We refer to mental disorders using different "umbrella" terms such as emotional disturbance, behavioral disorders, or mental illness. Beneath these umbrella terms, there is actually a wide range of specific conditions that differ from one another in their characteristics and treatment. These include (but are not limited to):

anxiety disorders;

bipolar disorder (sometimes called manic-depression);

conduct disorders;

eating disorders;

obsessive-compulsive disorder (OCD); and

psychotic disorders.

You may be reading this fact sheet with one of these specific disorders in mind, or you may be looking for information about emotional disturbances in general. In either case, keep reading to find out what different emotional distubances have in common, how they are defined in federal law, and where to find more detailed information on specific disorders.
Quick-Jump Menu
Definition
IDEA defines emotional disturbance as follows:
We've chosen to use the term "emotional disturbance" in this fact sheet because that is the term used in the nation's special education law, the Individuals with Disabilities Education Act (IDEA).

"...a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:

(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.

(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

(C) Inappropriate types of behavior or feelings under normal circumstances.

(D) A general pervasive mood of unhappiness or depression.

(E) A tendency to develop physical symptoms or fears associated with personal or school problems." ( 2)

As defined by IDEA, emotional disturbance includes schizophrenia but does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance. ( 3)

Characteristics

As is evident in IDEA's definition, emotional disturbances can affect an individual in areas beyond the emotional. Depending on the specific mental disorder involved, a person's physical, social, or cognitive skills may also be affected. The National Alliance on Mental Illness of Southern Arizona puts this very well:

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life. ( 4)

Some of the characteristics and behaviors seen in children who have an emotional disturbance include:

Hyperactivity (short attention span, impulsiveness);

Aggression or self-injurious behavior (acting out, fighting);

Withdrawal (not interacting socially with others, excessive fear or anxiety);

Immaturity (inappropriate crying, temper tantrums, poor coping skills); and

Learning difficulties (academically performing below grade level).

Children with the most serious emotional disturbances may exhibit distorted thinking, excessive anxiety, bizarre motor acts, and abnormal mood swings.

Many children who do not have emotional disturbance may display some of these same behaviors at various times during their development. However, when children have an emotional disturbance, these behaviors continue over long periods of time. Their behavior signals that they are not coping with their environment or peers.

Causes

No one knows the actual cause or causes of emotional disturbance, although several factors-heredity, brain disorder, diet, stress, and family functioning-have been suggested and vigorously researched. A great deal of research goes on every day, but to date, researchers have not found that any of these factors are the direct cause of behavioral or emotional problems.

According to NAMI, mental illnesses can affect persons of any age, race, religion, or income. Further:

Mental illnesses are not the result of personal weakness, lack of character, or poor upbringing. Mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan. ( 5)

Frequency

Of the 74.5 million children in the United States, an estimated 17.1 million have or have had a psychiatric disorder. ( 6) Half of all psychiatric illness occurs before the age of 14, and 75% by the age of 24. The most common psychiatric disorders in childhood are anxiety disorders, AD/HD and disruptive behavior, depression and bipolar disorders, and eating disorders. ( 7)

Help for School-Aged Children

IDEA requires that special education and related services be made available free of charge to every eligible child with a disability, including preschoolers (ages 3-21). These services are specially designed to address the child's individual needs associated with the disability-in this case, emotional disturbance, as defined by IDEA (and further specified by states). In the 2016 school year, more than 349,000 children and youth with emotional disturbance received these services to address their individual needs related to emotional disturbance. ( 8)

Determining a child's eligibility for special education and related services begins with a full and individual evaluation of the child. Under IDEA, this evaluation is provided free of charge in public schools.
10 Basic Steps in Special Education Questions Often Asked by Parents about Special Education Services Evaluating Children for Disability Developing Your Child's IEP
There is a lot to know about the special education process, much of which you can learn here on the CPIR site. We invite you to read the wide range of publications we offer on the topic, especially:

A Look at Specific Emotional Disturbances

As we mentioned, emotional disturbance is a commonly used umbrella term for a number of different mental disorders. Let's take a brief look at some of the most common of these.

We all experience anxiety from time to time, but for many people, including children, anxiety can be excessive, persistent, seemingly uncontrollable, and overwhelming. An irrational fear of everyday situations may be involved. This high level of anxiety is a definite warning sign that a person may have an anxiety disorder.

The term "anxiety disorder" is a broad term covering several different disabilities that share the core symptom of irrational fear. These include such different disorders as generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder (also called social phobia), and specific phobias. ( 9)

According to the Anxiety Disorders Association of America, anxiety disorders are the most common psychiatric illnesses affecting children and adults. ( 10) They are also highly treatable. Unfortunately, only about 36.9% of those affected receive treatment. ( 11)

Also known as manic-depressive illness, bipolar disorder is a serious medical condition that causes dramatic mood swings from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. ( 12)

For most people with bipolar disorder, these mood swings and related symptoms can be stabilized over time using an approach that combines medication and psychosocial treatment. ( 13)

Conduct Disorder

Conduct disorder refers to a group of behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. ( 14) This may include some of the following behaviors:

aggression to people and animals;

destruction of property;

deceitfulness, lying, or stealing; or

truancy or other serious violations of rules. (15)

Treatment will depend on the child's symptoms, age, and general health. It will also depend on how severe the condition is. Treatment may include:

helping the child learn how to better solve problems, communicate, and handle stress, as well as how to control impulses and anger (what's known as cognitive-behavioral therapy);

family therapy;

peer group therapy (to help better social and interpersonal skills); and

medications (although these are not typically used to treat conduct disorder). (16)

Eating disorders are characterized by extremes in eating behavior-either too much or too little-or feelings of extreme distress or concern about body weight or shape. Females are much more likely than males to develop an eating disorder. ( 17)

Anorexia nervosa and bulimia nervosa are the two most common types of eating disorders. Anorexia nervosa is characterized by self-starvation and dramatic loss of weight. Bulimia nervosa involves a cycle of binge eating, then self-induced vomiting or purging. Both of these disorders are potentially life-threatening. ( 18)

Binge eating is also considered an eating disorder. It's characterized by eating excessive amounts of food, while feeling unable to control how much or what is eaten. Unlike with bulimia, people who binge eat usually do not purge afterward by vomiting or using laxatives. ( 19)

According to the National Eating Disorders Association:

Treating an eating disorder generally involves a combination of psychological and nutritional counseling, along with medical and psychiatric monitoring. Treatment must address the eating disorder symptoms and medical consequences, as well as psychological, biological, interpersonal, and cultural forces that contribute to or maintain the eating disorder... Many people utilize a treatment team to treat the multi-faceted aspects of an eating disorder. ( 20)

Obsessive-Compulsive Disorder

Often referred to as OCD, obsessive-compulsive disorder is actually considered an anxiety disorder (which was discussed earlier in this fact sheet). OCD is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors (handwashing, counting, checking, or cleaning) are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety. ( 21)

A large body of scientific evidence suggests that OCD results from a chemical imbalance in the brain. ( 22) Treatment for most people with OCD should include one or more of the following:

therapist trained in behavior therapy;

Cognitive Behavior Therapy (CBT);

medication (usually an antidepressant). (23)

"Psychotic disorders" is another umbrella term used to refer to severe mental disorders that cause abnormal thinking and perceptions. Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that someone is plotting against you. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that is not there. Schizophrenia is one type of psychotic disorder. ( 24) There are others as well.

Treatment for psychotic disorders will differ from person to person, depending on the specific disorder involved. Most are treated with a combination of medications and psychotherapy (a type of counseling). ( 25)

More about School

As mentioned, emotional disturbance is one of the categories of disability specified in IDEA. This means that a child with an emotional disturbance may be eligible for special education and related services in public school. These services can be of tremendous help to students who have an emotional disturbance.

Typically, educational programs for children with an emotional disturbance need to include attention to providing emotional and behavioral support as well as helping them to master academics, develop social skills, and increase self-awareness, self-control, and self-esteem. A large body of research exists regarding methods of providing students with positive behavioral support (PBS) in the school environment, so that problem behaviors are minimized and positive, appropriate behaviors are fostered. (See the resource section at the end of this fact sheet for more information on PBS.) It is also important to know that, within the school setting:

For a child whose behavior impedes learning (including the learning of others), the team developing the child's Individualized Education Program (IEP) needs to consider, if appropriate, strategies to address that behavior, including positive behavioral interventions, strategies, and supports.

Students eligible for special education services under the category of emotional disturbance may have IEPs that include psychological or counseling services. These are important related services available under IDEA and are to be provided by a qualified social worker, psychologist, guidance counselor, or other qualified personnel.

Recognizing and Addressing the Impact of COVID-19 | As young people return to in-person schooling in the 2021-2022 school year, they may bring with them the impact of the pandemic's trauma. This makes it essential that schools consider the possibility that many students will need to be re-evaluated to determine if they need additional services, especially behavioral support and mental health services, than they needed prior to COVID-19. Two resources of great relevance to reopening schools and returning students are the following:

Other Considerations

Children and adolescents with an emotional disturbance should receive services based on their individual needs, and everyone involved in their education or care needs to be well-informed about the care that they are receiving. It's important to coordinate services between home, school, and community, keeping the communication channels open between all parties involved.

The Importance of Support

Families often need help in understanding their child's disability and how to address the needs that arise from the disability. Help is available from psychiatrists, psychologists, and other mental health professionals that work in the public or private sector. There is also a network of mental health support operating in every state as well as locally.

To locate systems of support in your community or state, visit the organizations we've listed below. They can connect you with local resources, including support groups that provide connection and understanding, information, referral, and advocacy for those living with emotional disturbance.

There are also support groups available from organizations that address specific mental disorders under the umbrella term of emotional disturbance. See the resources at the end of this fact sheet to identify some of these groups.

Resources of More Information

AACAP | American Academy of Child and Adolescent Psychiatry | AACAP offers Facts for Families, a series in English, Spanish, and several other languages that includes many briefs on specific mental disorders, including the ones mentioned in this publication.

AACAP also operates different Resource Centers, which offer consumer-friendly definitions, answers to frequently asked questions, clinical resources, expert videos, Facts for Families, and much more. Visit the Resource Center home page if you are concerned with one of the following:

Anxiety Disorders

Autism

Bipolar Disorder

Conduct Disorder

Depression

Oppositional Defiant Disorder

NIMH | National Institute of Mental Health | NIMH is clearly a source of authoritative information on specific mental disorders. Phone: 1.866.615.6464. TTY: 1.866.415.8051

NAMI | National Alliance on Mental Illness | NAMI is an excellent source of information and connection on mental illness, including the individual disorders mentioned in this fact sheet. NAMI's website and toll-free helpline are available in English and Spanish.

SAMHSA is the Substance Abuse & Mental Health Services Administration. It offers many resources to consumers, including:.

Detailed information on specific emotional disturbances, or related issues such as positive behavior supports, is also available from these sources:

Anxiety Disorders Association of America | https://adaa.org/

Center on Positive Behavioral Interventions and Supports | The PBIS Center provides research-based information on how to provide behavioral supports to children who need them. | https://www.pbis.org

Conduct Disorders | A soft place to land for battle-weary parents
https://www.conductdisorders.com/community/

Encyclopedia of Mental Disorders | http://www.minddisorders.com/index.html

National Eating Disorders Association
1.800.931.2237 | www.nationaleatingdisorders.org

Something Fishy | (eating disorders)
https://www.something-fishy.org

**Highly Rated Resource! This resource was reviewed by 3-member panels of Parent Center staff working independently from one another to rate the quality, relevance, and usefulness of CPIR resources. This resource was found to be of "High Quality, High Relevance, High Usefulness" to Parent Centers.
________________________________________

References

2 | Code of Federal Regulations, Title 34, §300.8(c)(4)(i)

3 | Code of Federal Regulations, Title 34, §300.8(c)(4)(ii)

5 | Ibid.

7 | Ibid.

11 | Ibid.

13 | Ibid.

14 | American Academy of Adolescent and Child Psychiatry. (2013, August). Conduct disorder: Facts for families. Washington, DC: Author. Available online at:
http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Conduct_Disorder_33.aspx

15 | Ibid.

16 | Johns Hopkins Medicine Health Library. (n.d.). Conduct disorder in children. Baltimore, MD: Author. Online at:
https://www.hopkinsmedicine.org/healthlibrary/conditions/mental_health_disorders/conduct_disorder_90,P02560

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Links updated, November 2021 This information in Spanish The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years.

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Herbert, J. (2016). Counseling persons with disabilities. American Counseling Association.

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From Dr. Tamar Chansky Creator of Worrywisekids.org

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Inside Higher Ed | Higher Education News, Events and Jobs

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More than half of the college students who visited their campus counseling centers during the 2015-16 academic year reported symptoms of anxiety, according to a survey by the Association for University and College Counseling Center Directors.

This marks the seventh year in a row that anxiety has been the top complaint among students seeking mental health services. This year, 51 percent of students who visited a counseling center reported having anxiety, followed by depression (41 percent), relationship concerns (34 percent) and suicidal ideation (20.5 percent). Many students reported experiencing multiple conditions at once.

Since 2009, when anxiety overtook depression as the No. 1 concern among college students, the number of students experiencing anxiety has steadily increased.

This survey was conducted between September 2015 and August 2016. In total, 529 counseling center directors representing that many institutions responded to the survey, with an even split between public and private institutions. The majority of respondents came from four-year colleges, but community colleges, professional schools and art schools were also included.

In an effort to reflect the makeup of their student bodies, counseling centers have diversified their clinical staff members. Of new hires, 62.2 percent are white, 15.3 percent black, 7.5 percent Latino and 10 percent Asian. This compares to current clinical staff, who are 70.9 percent white, 10.1 percent black, 7.3 percent Latino and 7.9 percent Asian.

"Student populations have become more diverse," said Micky Sharma, president of the AUCCCD and director of counseling and consultation services at Ohio State University. "Counseling services work to create a staff that represents their student bodies."

At Ohio State, for example, the counseling center now offers clinical services in nine different languages to meet the needs of their international students, who make up about 12 percent of the student body, Sharma said.

Regardless of race, ethnicity, gender or sexual orientation, "anyone could show up with anxiety or depression or a relationship issue," Sharma said. "A university counseling center is charged with providing help for everybody."

Another key finding in the survey is that 41.6 percent of counseling centers hired additional staff members in the last academic year, compared to about 26 percent in 2011 and 36 percent in 2016.

College counseling centers continue to grow to match the demands of their students, according to David Reetz, the lead researcher and coordinator for the 2016 survey and director of counseling and psychological services at the Rochester Institute of Technology.

"More students are seeking services because we continue to be more and more aware that a student's health and well-being have a lot to do with their success in their academic programs and the quality of their student life experience," Reetz said.

In fact, of the students surveyed, about 72 percent who used counseling services said it helped their academic performance in some way.

As more students continue to seek out mental health services and campus counseling centers try to keep up with new hires, the question of student wait times becomes key.

For the first time, this year's survey asked counseling center directors about average wait times for students based on the number of business days between when the appointment was scheduled and when it occurred.

The survey team found that, on average, students waited between six and eight business days for counseling services. However, as might be expected, institutions with a lower ratio of professional staff to students saw shorter wait times.

Reetz noted that the wait-time average is a "tricky number," given that some students opt to schedule their first appointment farther out to accommodate their own schedules.

"Students don't necessarily want to be seen right away," Reetz said, adding that, generally, "the more staff a center has, the shorter that wait time is between initial contact and first appointment."

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Anxiety and depression are the primary concerns for students seeking counseling services

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Survey of campus counseling centers finds increased demand for services, as well as additional positions and more diversity in hiring.

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This page contains affiliate links, read the disclosure statement Inside: Kid tested strategies used by child therapists for calming anxiety, including ideas to calm down, books to read and videos that can help
It's happening again. Your daughter is frustrated and stomping away down to her room, slamming the door and in general "has her cranky pants on". You say calm down, but she yells back "I don't know how to do that!!!"

We tend to tell our kids to "calm down" without ever giving them explicit directions on how to deal with stress and anxiety. Here's a collection of the best tools and tips I've found to teach children how to calm down and relax.

Sometimes you'll need a quick way to help your child calm down and you don't have much with you. Maybe it's when you're out at Target or stuck in traffic. These tips will come in handy at those times:

Imagine your favorite place - it's like taking a mini vacation wherever you are

Think of your favorite things

Name animals alphabetically (alligator, bear, cow, dog, etc...)

Squeeze Something (play dough, clay, silly putty, your fists, a stress ball)

Get a Cold Drink of Water

54321 Grounding - go through each of your 5 senses

1. Put your arms straight out in front of you, palms facing out.

2. Put one hand over the other at the wrists and interlace your fingers.

3. Swoop your hands and arms toward your body and then place your interlaced hands on your chest.

4. Cross your feet at the ankles and put your tongue on the roof of your mouth.

5. Stay still for one minute.

It's great to have a big list of coping skills to try when your child needs to calm down. Here are two more short lists of ideas for calming down at home or at school.

From Imperfect Families - Strategies to use at home

From Encourage Play - 10 Strategies to Help Kids Calm Down at school or home

People usually roll their eyes initially when they hear "breathing is important". But I will continue to say it and explain why. It's so simple, yet has such a big impact on your body's physiology.

When you and calm and relaxed, your body is in "rest and digest" mode. You breathe normally, your heart rate is lower and your muscles are relaxed. However, when stress or anxiety or anger occurs, your body automatically switches into "flight, fight or freeze" mode. Your muscles tense up, your heart rate increases and your breathing becomes more shallow.

Taking deep breaths, instead of shallow breaths, is one way to tell your body to get back to resting and digesting. That's why deep breathing is important!

Luckily, there are some fun ways to teach kids deep breathing techniques

Things to use

Things to say

Breathe in like you are smelling a flower, breathe out like you are blowing out birthday candles

Arms up and breathe in, arms down and breathe out

Pretend your belly is a balloon. Breathe in and make the balloon bigger, then breathe out and make the balloon shrink.

Videos to watch
4 - 7 - 8 Breathing by GoZen
Breathing at Sea Otter Cove from Stress Free Kids

A Coping Skills Toolbox is a kit that you create to help your child calm down when they are upset, anxious or worried. In order to get the most benefit from this, you should create this kit before an issue occurs. When your child experiences anxiety, then they can pick out an item from their Coping Skills Toolbox. This is one of my favorite ways to help kids learn to calm their anxiety.

Here are some other fantastic ideas for what to put in a coping skills toolbox/calm down kit from And Next Comes L

You can create a place specially designed to allow to calm down in a few steps

Find a spot and make it cozy (ask your child for help with that - maybe they can place a favorite blanket or stuffed animal inside)

Add calming tools

Explain how to use it and practice before

When they are starting to escalate, catch it early and give them a calm reminder about their calm down spot

Use the following phrases as a way to support your child, let them know that you're going to support them and help them in any way that you can.

"I'm here for you"

"Talk to me and tell me what's going on"

"How can I help?"

"Together, we can work on this. We're a great team"

"I love you"

"Do you want a hug?"

Here are some more ideas of what to say to calm an anxious child.

From Go Zen - 49 Phrases to Calm an Anxious Child

From Lemon Lime Adventures - What to Say to Calm an Anxious Child

Did you know there are podcasts with stories for children? Usually the hosts have a soothing voice and the stories tend to be pretty short. Your child can listen to these podcasts as a way to have some down time.

There are scripts you can read to your child to help them relax and calm down. Slowly and carefully read the words as your child listens and follows the instructions. Check out Inner Health Studios list of scripts you can use with your child. If you prefer not to read a script, there are ones that are pre-recorded.

There are also scripts to practice mindfulness with children. Eline Snel has written a great book on Mindfulness with Kids, Sitting Still Like a Frog. Here are the several scripts that can be used from that book!

Annaka Harris also has several pre-recorded scripts to help kids practice mindfulness

Confused about how to introduce mindfulness to kids? Check out these resources:
Simple Ways to Introduce Mindfulness and Meditation to Children 11 Simple But Effective Ways to Teach Mindfulness to Kids
What you need:

I've used empty soda bottles, empty water bottles, glass jars and plastic containers. Use whatever makes sense for you and your family. For instance, for the calming jars the kids have in their room, I used a heavy duty plastic bottle. I didn't want them to accidentally knock over a glass jar in the dark - that would be a huge mess!

I've had the best results when I've used warm water - it makes it easier for the water and paint to combine.
Glitter Paint
I prefer using glitter paint (or glitter glue) instead of glitter because then I'm not cleaning up glitter for weeks at my house after we make them :-)

To make your jar, add glitter paint to the bottom of the jar until it just covers the bottom of it. Add warm water. Put the cover on and shake to help the ingredients combine. Once you are satisfied with the look of your jar, then you can super glue the lid shut so it doesn't spill. In a pinch, I've also used duct tape to secure the lid.
Watch Make a Simple Calming Jar from Coping Skills for Kids on YouTube Wet Ingredients
Sometimes you want the glitter/other items to stay afloat longer or for a shorter amount of time. Here are some different ingredients you can use as the wet ingredients.
Dry Ingredients
To see several other ways to make calming jars, take a look at what Preschool Inspirations did.

One of the first things I always like to do with kids if they are struggling is to start using visuals. When you're stressed and anxious, it's harder to read and take in information. Visuals are easier.

I like to keep calming cue cards in my children's coping skills toolboxes so that they can make a decision about what coping skill they can use. Sometimes pulling out a list is too much in the moment. You can make your own cue cards.

1. Take several index cards or small pieces of cardstock

2. On each one, write or draw one coping skill

3. Hole punch the cards and place them on a keyring (to make them extra sturdy, you can laminate them)

4. Put them into the coping skills toolbox for easy access

Using visuals is a powerful way to help kids. When kids are overwhelmed, sometimes it's hard for them to figure out what to do. By having cue cards, your child can have a visual reminder of what calms and relaxes them.

To make things a little easier, I've created ready to use coping skills cue cardsfor you. There are four different sets: Calming, Physical, Distracting, and Processing. If you'd like all 4, I created a set where you can download them all together.

If your child is anxious, they may also be having a difficult time getting settled for bedtime. Here are some ideas to help your child get settled at bedtime.

PINPOINT WHAT THE FEAR IS

One of the most important things to do is to figure out exactly what is causing the anxiety. Is it fear of the dark? Is it a worry about something in the closet? Is it monsters? Is it spiders? Figuring out the cause of the fear will help you come up with ways you can help your child combat it.

REARRANGE THE ROOM

Are there particular spots of the room that seem to be darker or cause more fear at night than others? Go into the bedroom during the day with your child and talk about the spots that make your child nervous. Try moving night lights and furniture around for a more calming room arrangement.

TRANSITIONAL OBJECTS

If your child has a hard time separating from you, try a transitional object. This is a special item that helps your child feel comforted. It helps them feel like part of you is still present even when you're not there. It could be something like a stuffed animal or a special stone or necklace, or a sweatshirt of yours. The object isn't what matters, it's what the object represents. They can keep it and hold it all night long to help them relax and go to sleep.

Find more strategies here: 12 Kid Friendly Strategies to Calm Anxiety at Night

Looking for some calming guided meditation to help get to sleep at night? Try one of these: Best Guided Meditations for Sleep.

Whenever I sit down and talk with someone about their coping skills, one of the first
things I ask is if they have tried writing about it. Why do I always start with journaling as
a way of processing through difficult feelings?

It's easier to write about than talk about hard things

Journaling helps you process what's happening.

It's convenient.

It's not graded

It can help you solve a problem

It can help you re-frame your thinking

Looking for a journal for a child or teen? Check out Big Life Journals!

General Anxiety

The Coping Skills for Kids Workbook by Janine Halloran. This book has over 75 strategies for kids to try to help them manage their stress and worry. This book also includes colorful worksheets to help kids learn more about their anxiety and what they can do to manage their stress.

Wilma Jean the Worry Machine by Julia Cook I love that when Wilma Jean's physical reactions are described, they're also illustrated. When is says she has knots in her stomach and her knees lock, her stomach really looks like it's tied in a knot and there's a real lock around her knees. I love the activity she does with her teacher, going over worries she can control and worries she can't, it's a great way to help kids manage their anxiety.

David and the Worry Beast by Anne Marie Guanci David's anxiety is a beast, and the more anxious he gets, the bigger it grows. David learns to control his thoughts, and his beast shrinks. There's also a couple of pages for parents and kids in the back.

When My Worries Get Too Big by Kari Dunn Buron This book is wonderful! There are several pages where kids can add in their own thoughts, worries and what helps them relax. This book also uses the 5 point scale to talk about stress and different ways to manage it.

What To Do When You Worry Too Much by Dawn Huebner, PhD This book goes through several ways that can help kids manage anxiety, including setting a time for worries, thinking about things that make you happy and resetting your body with activity or relaxation. There are some interactive places in this book, where a child can write down their worries, draw some images of things that might help, etc.

What To Do When You're Scared and Worried by James J. Crist This is one of my favorite books for kids to help them deal with anxiety. Near the beginning of the book is a checklist that helps kids narrow down what they are anxious about. The beginning of the book covers the basics of what anxiety is and how to help manage with coping skills. The next section of the book goes into detail about different types of anxiety kids might experience, including Separation Anxiety, Phobias and Panic Attacks.

Separation Anxiety

The Kissing Hand by Audrey Penn Classic about managing separation anxiety when kids start school. My daughter's kindergarten teacher read this on our visit to school the first day.

When I miss you by Cornelia Maude Spelman This is perfect for little ones who have a hard time dealing with the fact that they are away from their parents during the day. It suggests a couple of things they can do to help and reassurance that parents will come back at the end of the day.

Wemberley Worried by Kevin Henkes Poor Wemberley worries about everything, and then she gets really worried when she is about to start school.

This E-Course offers you instant support from a Child Therapist.
You will get:
12 Videos that are quick and bite size

14 Exercises that will expand on the skills taught

6 Cheat Sheets that will serve as a reference
Along with the course you get:
Access to the instructor for ongoing support

Downloadable PDF versions of all lessons

Lifetime access to the course

More from Coping Skills for Kids about Anxiety in Children...

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Calming Anxiety - Coping Skills for Kids

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Inside: Kid tested strategies used by child therapists for calming anxiety, including ideas to calm down, books to read and videos that can help

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Buser, J. (2012). The school counselor’s role in addressing eating disorder symptomatology among adolescents. American Counseling Association.

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National Eating Disorders Association. (2015). NEDA Feeding hope: Educator’s toolkit. NEDA.

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Mental health problems ranging from depression to bipolar disorder are known as mood disorders, or affective disorders. In any of these disorders, a serious change in mood shapes your child's emotional state. Unlike a normal bad mood a child feels occasionally, a mood disorder involves thoughts and feelings that are intense, difficult to manage, and persistent. A mood disorder is a real medical condition, not something a child will likely just "get over" on his own.

Today, clinicians and researchers believe that mood disorders in children remain one of the most underdiagnosed health problems. Mood disorders that go undiagnosed can put kids at risk for other conditions, like disruptive behavior and substance use disorders, that remain after the mood disorder is treated. Children and teens with a mood disorder don't always show the same symptoms as adults. So it can be difficult for parents to recognize a problem in their child, especially since he or she may not easily express his or her thoughts or feelings.

The most common mood disorders in children and adolescents include:

Major depression. A depressed or irritable mood, lasting at least two weeks.

Persistent depressive disorder (dysthymia). A chronic, low-grade, depressed or irritable mood for at least 1 year.

Bipolar disorder. Periods of persistently elevated mood followed by periods of depressed or flat emotional response.

Disruptive mood dysregulation disorder. A persistent irritability and extreme inability to control behavior.

Premenstrual dysmorphic disorder. This includes depressive symptoms, irritability, and tension before menstruation.

Mood disorder due to a general medical condition. Many medical illnesses, including cancer, injuries, and chronic medical illnesses, can trigger symptoms of depression.

Substance-induced mood disorder. Symptoms of depression due to drug use, the effects of a medication, or exposure to toxins.

Girls are at least twice as likely as boys to develop depression. Boys and girls are equally likely to develop bipolar disorder and obsessive-compulsive disorder.

The causes of mood disorders are not well understood. Imbalances in brain chemicals play a role. Environmental factors, such as unexpected life events and/or chronic stress, can also contribute to a mood disorder.

Mood disorders often run in families, so there is a genetic component, too. Children who have relatives with depression are at increased risk for depression. In addition, a family history of bipolar disorder may predispose a child to have bipolar disorder or other mood disorder.

Sometimes, extreme stress or a life event can "turn on" a gene, causing the disorder to develop. This can happen especially with depression.

Children show symptoms differently, according to their age and biological makeup. Symptoms also vary according to the type of mood disorder. Overall signs of a mood disorder may include:

Sad, depressed, irritable, angry, or elevated mood that appears more intense than the child usually feels, lasts for a longer period of time, or occurs more frequently

Trouble with family, including difficult behavior

Lack of motivation or pleasure in previously enjoyed activities

Changes in sleep or eating patterns or weight

Frequent physical complaints, such as headaches, stomachaches, or fatigue

Loss of energy or fatigue

Difficulty achieving in school

Worthlessness, guilt, or low self-esteem

Severe recurrent temper outbursts

Increased energy or bursts of energy with racing thoughts or fast speech

Rebellious or high risk behavior

Running away or threats of running away from home

Difficulty with friends and peers

Expressions of suicidal thoughts, which should be evaluated immediately

If you believe your child is struggling with a mood disorder, you can ask your pediatrician for a referral to a therapist or child psychiatrist. An accurate diagnosis of the mood disorder, as well as any other conditions, is a crucial first step in managing the disorder effectively. At The Children's Hospital of Philadelphia, a specialist will perform a comprehensive evaluation. The evaluation may assess:

Your child's overall health and medical history

Your child's symptoms

Your child's behavior at home, at school, and with peers

Environmental factors that might be stressors in your child's life

Input from teachers or guidance counselor about issues at school

Your child's past experiences with specific medications or therapies

Your opinion or preference for treatment options

Mood disorders can be treated with evidence-based treatments, especially with early recognition of the problem. Treatment can help manage the episode, reduce the severity of symptoms, and help to prevent future episodes. It can also enhance your child's normal growth and development and improve his or her quality of life and relationships.

A CHOP specialist will design a personalized treatment plan based on your child's symptoms and other factors unique to her situation. The plan may include:
Individual therapy

The specialist will identify key problems in your child's life and help your child learn how to manage these stressors. The specialist may also use a variety of techniques to help your child manage the symptoms of the mood disorder, including

Cognitive-behavioral. This approach involves changing problematic thoughts, feelings, and behaviors that your child may be experiencing.

Interpersonal therapy. This technique focuses on building social skills and helping children with difficult relationships in their lives.

Family therapy
Families play a vital supportive role in any mood disorder. Families, including parents or guardians, can learn methods to help their child manage mood and behavior problems. The specialist may also explore potential stressors in a child's life and patterns of interaction within the family. A consultation with your child's teachers or guidance counselor may also be advised.
Medications
A variety of medications are very effective in treating mood disorders by altering the brain chemicals involved. Depending on the mood disorder and your child's symptoms, medications may reduce the severity or frequency of symptoms, decrease problematic behaviors, improve functioning, and prevent future episodes.

Many children who receive early and adequate treatment for their mood disorder may improve significantly and keep their condition managed with ongoing intervention or support . If the episodes recur, they can usually be managed with therapeutic support, including medications, therapy, and additional resources. Despite the mood disorder, children and adolescents are able to grow, develop, and have meaningful life experiences, especially when their mood disorder is managed appropriately and adequately.

Depending on your child's personalized treatment plan, your child and family may continue to meet with the specialist for a number of weeks or months. The focus of individual and family therapy may change over time, depending on your child's age, progress, and needs. Medication needs may also change over time depending on a number of factors. At CHOP, a specialist will monitor and manage your child's condition closely.

Children with mood disorders have a complexity to their condition that includes biology, genetics, factors like stress and physical health, family and peer dynamics, behavior and thought patterns, and sometimes other conditions operating alongside the mood disorder. This complexity means the accuracy of the diagnosis and assessment of your child is crucial and shapes the treatment approach. The right treatment then determines how effectively the mood disorder is managed-and how well your child flourishes in every domain: home, school, and among peers. The team at CHOP is specially trained to recognize, diagnose, and treat the full range of mood disorders in children. They design a personalized plan for your child based on the latest thinking and approaches to care. Their skill set leads your child to long-term success.

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Mood Disorders in Children and Adolescents

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Mood disorders in teens remain one of the most under-diagnosed mental health problems. These disorders also put teens at risk for other conditions that may persist long after the initial episodes of depression are resolved.

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Bipolar Disorder (Manic Depression)

Bipolar Disorder is a type of mood disorder with marked changes in mood between extreme elation or happiness and severe depression. The periods of elation are termed mania. During this phase, the teenager has an expansive or irritable mood, can become hyperactive and agitated, can get by with very little or no sleep, becomes excessively involved in multiple projects and activities, and has impaired judgment. A teenager may indulge in risk taking behaviors, such as sexual promiscuity and anti-social behaviors. Some teenagers in a manic phase may develop psychotic symptoms ( grandiose delusions and hallucinations). For a description of the depressive phase see depression. Bipolar disorder generally occurs before the age of 30 years and may first develop during adolescence.

For additional information see the following Facts for Families:
#38 - Bipolar Disorder (Manic-Depressive Illness) in Children and Teens

Not only adults become depressed. Children and teenagers also may have depression, as well. The good news is that depression is a treatable illness. Depression is defined as an illness when the feelings of depression persist and interfere with a child or adolescent's ability to function.

About 5 percent of children and adolescents in the general population suffer from depression at any given point in time. Children under stress, who experience loss, or who have attentional, learning, conduct or anxiety disorders are at a higher risk for depression. Depression also tends to run in families. Seriously depressed children and adolescents experience symptoms that are beyond the range of normal sadness.

For additional information see:

Facts for Families: The Depressed Child
AACAP Glossary of Symptoms and Illnesses-Symptoms of Depression The National Institute of Mental Health Site on Depression in Children and Adolescents National Alliance for Research on Schizophrenia and Depression (NARSAD), The World's Leading Charity Dedicated to Mental Health Research

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Bipolar Disorder (Manic Depression) Bipolar Disorder is a type of mood disorder with marked changes in mood between extreme elation or happiness and severe depression. The periods of elation are termed mania.

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Though the term "depression" can describe a normal human emotion, it also can refer to a psychiatric disorder. Depressive illness in children and adolescents includes a cluster of symptoms which have been present for at least two weeks.

In addition to feelings of sadness and/or irritability, a depressive illness includes several of the following:

Change of appetite with either significant weight loss (when not dieting) or weight gain

Change in sleeping patterns (such as trouble falling asleep, waking up in the middle of the night, early morning awakening, or sleeping too much)

Loss of interest in activities formerly enjoyed

Loss of energy, fatigue, feeling slowed down for no reason, "burned out"

Feelings of guilt and self blame for things that are not one's fault

Inability to concentrate and indecisiveness

Feelings of hopelessness and helplessness

Recurring thought of death and suicide, wishing to die, or attempting suicide

Children and adolescents with depression may also have symptoms of irritability, grumpiness, and boredom. They may have vague, non-specific physical complaints (stomachaches, headaches, etc.). There is an increased incidence of depressive illness in the children of parents with significant depression.
For additional information see the following Facts for Families:
#4 - The Depressed Child

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Though the term "depression" can describe a normal human emotion, it also can refer to a psychiatric disorder. Depressive illness in children and adolescents includes a cluster of symptoms which have been present for at least two weeks.

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Home - ADDA - Attention Deficit Disorder Association

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Empowering adults with adhd to live their best lives A Different Brain Requires a Different Approach Whether you're newly diagnosed, wondering if you have ADHD, or simply ready to take charge of your life - we're here to help. Have ...

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Response Ability. (2015). Disruptive and conduct disorders. Response Ability.

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Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry. These are called obsessions. To alleviate the anxiety caused by their obsessive thoughts, they perform repetitive, ritualized actions called compulsions. A child with OCD might need to line things up, touch things in a certain order when leaving the room or wash his hands repeatedly.

Obsessions Common in Kids With OCD

Contamination: Kids with this obsession are sometimes called "germaphobes." In schools, this plays out with kids worrying about other kids sneezing and coughing, touching things that might be dirty or getting sick in many different ways. This is the most common obsession seen in children.

Magical thinking: This is a kind of superstition, like "step on a crack, break your mother's back," taken to extremes. For example, kids might worry that their thoughts can cause someone to get hurt, or get sick. A child might think, "Unless my things are lined up in a certain way, mom will get in a car accident."

Catastrophizing: Some kids easily jump to the conclusion that something terrible has happened. For example, if her parents are five minutes late picking her up, a girl who is catastrophizing might tell herself that they've decided to abandon her.

Scrupulosity: This is when kids have obsessive worries about offending God or being blasphemous in some way.

What ifs: Kids may be plagued by a lot of different kinds of thoughts about bad things they could do. "What if I hurt someone? What if I stab someone? What if I kill someone?"

The "just right feeling": When OCD first develops, from about 6 to 9 years of age, kids may not know why they are doing something, but just that they need to do it until they get what we call the "just right feeling." So: "I'll line these things up until it just kind of feels right, and then I'll stop." And then over time - in the 9- to 12-year-old range - it evolves into magical thinking and becomes more superstitious in nature.

Behaviors You Might See in Students With OCD

Frequent requests to go to the bathroom: This could be to wash hands, if someone near the child was coughing or sneezing, or if she touched something that she perceives as contaminated. She could be washing items-pens, pencils, backpacks, books. It could also be an excuse to get out the classroom and just be away from everyone, and have some respite.

Constant reassurance-seeking: This takes the form of repetitive questions. "Are you sure that's the answer? Could you tell me again? Did you hear what I said?" Checking doors, windows, lockers, desks. Over and over and over again.

Getting stuck on tasks: Sometimes kids with OCD will need to finish something to completion, or understand it to completion, before they're able to move on. So if a child is working out what he did wrong on a math test, and the teacher says, "Now let's open the textbook and start a new chapter," he's not going to be able to shift gears.

Retracing: If a child leaves the classroom and worries that she left a pencil behind, she'll go back into the classroom and go to her desk and check. If she had a bad thought as she went through the doorway, she might have to "fix it" by going back through the doorway again saying a good word. If she had a bad thought when she went down a flight of stairs on the way to class, she might need to go back up that same stairway at the end of the period, even if it means being late to her next class.

Obsessive erasing: A child could be erasing a lot because the letters have to look perfect. Or he could have used a word that disturbs him. For example, if he has a fear of vomiting and he's written the word vomit, he might not be able to stand seeing that word, so he erases it. Kids start having erasers worn down to the metal. Teachers start to see holes in the paper. Words will be drawn over on the back of the page. A lot of different areas of writing become problematic.

Behaviors Often Confused With Another Disorder

Some behaviors associated with OCD are easy to confuse with ADHD, learning problems or being oppositional.

Distraction: If a child is busy thinking that if she doesn't turn the pen cap and count to four the right way then her mom is going to get sick, she's not going to be paying attention in class. And if her teacher calls on her to answer a question, her distraction might look like ADHD, but it isn't.

Slowness on exams, papers and tasks: Sometimes when kids take a long time, they're struggling with the perfectionism of needing to do things the right way. This could look like learning problems, or inattention, but it isn't.

Avoidance: Teachers might see a child who doesn't want to sit on the floor, or pick things up that touched the floor, or get his hands dirty in art class. He may avoid a lot of playground activities - kids with germ fears will view the playground the way some adults view the subway: it's gross. Why touch anything there?

Tapping and touching symmetrically: If a child sits down at her desk and she accidentally kicks the chair of the kid next to her with her right foot, she's going to have to then kick it with her left foot. That might look like somebody who's being oppositional, or somebody who's got too much energy, but actually it's OCD.

Complaints of anxiety and fatigue: There's one interesting theory that kids with OCD are smarter than other kids. And if you consider how much thinking they're doing, they're really using their brain more frequently than a lot of other kids are. But when that's coupled with a lot of anxiety, you can have a lot of fatigue. So it's common for kids with OCD to want to come home and take a nap after school.

How to Help Students With OCD

For children struggling with OCD, functioning in school can be complicated and very difficult. Here are some things you can do to help them, and the class as a whole, focus on learning:

Seating arrangement: If the school has noisy hallways, you might not want to have a child with OCD sit by the door. You might have her sit in the front, where she's less able to hear the noise and can stay more focused on her work. On the other hand, a child who has very observable symptoms, and doesn't want other kids to see her fidgeting with her hands, rocking or getting up a lot, might be better off closer to the door, toward the back of the room.

Extended time for tests and papers: If writing is a problem for a child who needs to find the perfect way to say something, he's going to need more time to finish those essay questions or papers.

Laptops for writing: If writing and rewriting/erasing is really problematic for a child, consider letting her use a laptop for taking notes, and having all assignments be typed instead of handwritten.

Private testing rooms: Research is quite clear that kids with OCD do better, are less overwhelmed and are more in control of their thoughts and their reactions if they're in a quiet place away from the other kids.

Skip reading out loud: Kids who feel they need to read perfectly may have to go back and reread sentences or whole paragraphs over and over to make sure they've got them right. So reading becomes a very laborious task, and reading in front of the class can become a nightmare. So if we know doing this is a problem for children, we can spare them.

Books on tape: If kids get so hung up reading that it takes forever, listening to the books can be a solution.

Break homework into chunks: If looking at a whole page of math makes kids feel overwhelmed and anxious - think of the potential for mistakes! - the problems can be broken up over four pages. It helps kids stay focused on doing the problems instead of worrying.

How to Minimize Behavioral Problems

Plan an escape route: Try working out a communication system so that if the student feels symptoms coming on, she can signal to you and leave the classroom, or go to a protected place in the classroom, without interrupting the class. It can prevent an embarrassing and disruptive blowup of symptoms in the classroom, and the other kids picking on or bullying her about it.

Be aware of triggering events: It's very important for teachers to know what kind of things might trigger the symptoms. Fatigue is a huge piece of OCD, and it can be exacerbated by medication. So it's important to know that if a child is drowsy in class, and maybe he's putting his head down, it's not because he's being oppositional or disrespectful, but because he's overwhelmed with fatigue.

Advance notice: Irritability and frustration are two of the longer-lasting things that kids with OCD are feeling on a daily basis. Changes in schedule can be very disruptive for a child with OCD, so it can be helpful for teachers to give advance notice of things. Kids who know what to expect are less likely to be thrown by the change.

Children with OCD are often teased and bullied because of their symptoms. Kids feel very uncomfortable about their rituals, knowing that they're being watched. It can be helpful to educate the whole class about what's going on, especially if a child is going to be in the same school for a number of years, and it can inspire a surprising amount of support from other children.

Peer understanding program: A peer understanding program includes a presentation in the classroom that explains (with the child participating) what OCD is. The child might say, "Listen, I have OCD. It's an anxiety disorder. It makes me think that my hands are dirty and I have to wash my hands a lot, so if you see me getting up and going to the sink to wash my hands, that's why." Psychologists can role-play with the teacher and child ahead of time, to anticipate questions his classmates might ask, and how to answer them.

A buddy system: A buddy is like a peer coach who sits next to the child and prompts him to keep up with note taking and staying on task. It can be great for the buddy, to foster a sense of confidence and pride and to be able to help someone in need, and great for fostering friendship.

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares. Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry.

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Credit: Julius-Maximilians-Universität Würzburg, JMU

An overactive molecular signal pathway in the brain region of the amygdala can lead to obsessive-compulsive disorder (OCD). A research team from Würzburg has established this connection.

Some people have an extreme fear of dirt or bacteria. As a result, they may develop a habit of compulsive washing and repeatedly cleaning their hands or body. They are trapped in a vicious circle, as the fear of new contamination returns quickly after washing. Sufferers see no way out. They are even incapable of changing their behaviour when the excessive washing has led to skin irritation or damage.

Around two percent of the general population suffer from some kind of obsessive-compulsive disorder (OCD) at least once in their life. The disorder is characterised by persistent intrusive thoughts which the sufferers try to compensate for by repetitive ritualized behaviour.

Like depression, eating disorders and other mental diseases, OCD is treated with antidepressants. However, the drugs are non-specific, that is they are not tailored to the respective disease. Therefore, scientists have been looking for new and better targeted therapies that have fewer side effects.
Missing protein triggers urge to wash
Professor Kai Schuh from the Institute of Physiology at the Julius-Maximilians-Universität (JMU) Würzburg (Germany) and his team explore the underlying causes of obsessive-compulsive disorder in collaboration with the JMU's Departments of Psychiatry and Neurology.

"We were able to show in mouse models that the absence of the protein SPRED2 alone can trigger an excessive grooming behaviour," Schuh says. He believes that this finding is crucial as no clear trigger for this type of disorder has been identified until now. Previous research pointed to multiple factors being responsible for developing OCD.

Occurring in all cells of the body, the protein SPRED2 is found in particularly high concentrations in regions of the brain, namely in the basal ganglia and the amygdala. Normally, the protein inhibits an important signal pathway of the cell, the so-called Ras/ERK-MAP kinase cascade. When it is missing, this signal pathway is more active than usual.
Hyperactive signal cascade in the brain
"It is primarily the brain-specific initiator of the signal pathway, the receptor tyrosine kinase TrkB, that is excessively active and causes the overshooting reaction of the downstream components", biologist Dr. Melanie Ullrich explains.

Administering an inhibitor to attenuate the overactive signal cascade in the animal model improves the obsessive-compulsive symptoms. Moreover, the JMU research team was able to treat the OCD with an antidepressant, similarly to standard therapy in humans. Their detailed results have been published in the journal Molecular Psychiatry.
New targets for therapies pinpointed
"Our study delivers a valuable new model that allows the disease mechanisms to be investigated and new therapy options for obsessive-compulsive disorders to be tested," Professor Schuh says.

The recently discovered link between OCDs and the Ras/ERK-MAP kinase cascade also opens up new targets for therapy. Drugs that inhibit this cascade are already available and some of them are approved for human treatment.

According to Melanie Ullrich, these are cancer drugs, as overactivation of the Ras/ERK-MAP kinase cascade is also a frequent trigger of cancer: "So we are wondering whether such drugs could also be effective in the treatment of obsessive-compulsive disorders and whether they are beneficial in terms of side effects."

More information: M Ullrich et al. OCD-like behavior is caused by dysfunction of thalamo-amygdala circuits and upregulated TrkB/ERK-MAPK signaling as a result of SPRED2 deficiency, Molecular Psychiatry (2017). DOI: 10.1038/mp.2016.232

Provided by Julius-Maximilians-Universität Würzburg

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An overactive molecular signal pathway in the brain region of the amygdala can lead to obsessive-compulsive disorder (OCD). A research team from Würzburg has established this connection. Some people have an extreme fear of dirt or bacteria. As a result, they may develop a habit of compulsive washing and repeatedly cleaning their hands or body.

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Schizophrenia In Children

No. 49; Reviewed October 2018

Schizophrenia is a serious psychiatric illness that causes changes in thinking, feelings, and unusual or strange behavior. It is uncommon in children and hard to recognize in its early phases. Symptoms that are more prominent may be noted in adolescents and young adults. The cause of schizophrenia is not known. Current research suggests a combination of brain changes, biochemical causes, genetic and environmental factors. Early diagnosis and medical treatment are important. Schizophrenia is a life-long disease that can be controlled but not cured.

The symptoms and behavior of children and adolescents with schizophrenia may be different from those of adults with this illness. The following symptoms and behaviors can occur in children or adolescents with schizophrenia:

seeing things and hearing voices which are not real (hallucinations)

odd and eccentric behavior and/or speech

unusual or bizarre thoughts and ideas

confusing television and dreams from reality

confused thinking

new academic problems

extreme moodiness

personality changes

ideas that people are out to get them or talking about them (paranoia)

severe anxiety and fearfulness

difficulty relating to peers and/or keeping friends

withdrawal and increased isolation

worsening personal grooming

The behavior of children with schizophrenia may change slowly over time. For example, children who used to enjoy relationships with others may start to become more shy or withdrawn and seem to be in their own world. Sometimes youngsters will begin talking about strange fears and ideas. They may start to say things that do not make sense. These early symptoms and problems may first be noticed by the child's teachers. Children with these symptoms must have a complete evaluation. Parents should ask their family physician or pediatrician to refer them to a child and adolescent psychiatrist, who is specifically trained and skilled at evaluating, diagnosing, and treating children with schizophrenia. Treating children with schizophrenia can involve a combination of medication, individual therapy, and family therapy, and specialized programs (school, activities, etc.) are often necessary. Psychiatric medication can be helpful for many of the symptoms of the illness. These medications require careful monitoring by a psychiatrist (preferably a child and adolescent psychiatrist).

An experienced child and adolescent psychiatrist should be able to differentiate changes in thinking, feelings, and unusual behavior that could be due to a person's or their families' cultural belief system versus changes caused by a mental illness. Families should feel comfortable discussing these beliefs with their mental health providers; for example, some cultures believe they can communicate with deceased individuals, and so on. Please let your doctor know if these or other beliefs are part of your family's belief and cultural structure.

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Schizophrenia In Children No. 49; Reviewed October 2018 Schizophrenia is a serious psychiatric illness that causes changes in thinking, feelings, and unusual or strange behavior. It is uncommon in children and hard to recognize in its early phases. Symptoms that are more prominent may be noted in adolescents and young adults.

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Psychosis (Schizophrenia) in Children and Youth

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Psychosis (Schizophrenia) Schizophrenia and other psychotic disorders are medical illnesses that result in strange or bizarre thinking, perceptions (sight, sound), behaviors, and emotions. Psychosis is a brain-based condition that is made better or worse by environmental factors - like drug use and…

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American School Counselor Association. (2014). Mindsets and behaviors for student success: K-12 college- and career- readiness standards for every student. Alexandria, VA.

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Missouri Professional School Counselors and Counselor Educators. (2015). Professional school counselor small group counseling guide: A professional school counselor’s guide to planning, implementing, and evaluating school-based counseling groups. https://dese.mo.gov/sites/default/files/guid-respon-serv-small-group-counseling-guide-2015.pdf

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Texas Education Agency. (2018). The Texas model for comprehensive school counseling programs (5th ed.). Texas Counseling Association. https://tea.texas.gov/sites/default/files / Pub_2018_Texas-Model_5th-Edition.pdf