Perfect Parenting Tips

Every child is different, and every parent is different. Perfect parenting is parenting with a plan. It is based on action, rather than reaction. Knowledge, rather than chance. Thoughtfulness, rather than anger. Common sense, rather than nonsense. Just as labeling one the "perfect marriage" doesn't mean that both partners are perfect human beings, Perfect Parenting doesn't imply that a parent can, or should even strive to, be "perfect." Perfect Parenting is a process whereby parents, in all their human flaws and weaknesses, do their personal best to raise capable, responsible, happy children.

The Perfect Parenting Keys:
Key #1: Take charge. If your child doesn't clearly understand that YOU are the boss, even minor issues can cause you major headaches. Your first response to this statement may be, "Oh, but my children know who's the boss in our house." You may think they do, but there are many ways we give mixed messages and confuse our kids over this issue. The keys presented here will help you identify the areas where you can make some changes. The first step to taking charge is simply to give yourself permission to be in charge, and begin expecting your children to obey you. With this solid foundation you will build a loving, trusting relationship with your children. And, perhaps even more important, you will be able to lead your children into adulthood with values, wisdom and life skills that only a strong, supportive parent can impart.

Key #2: Tell, don't ask. One popular mistake parents make is asking instead of telling. The way you phrase your words determines whether your children see your request as optional or required. Banish all wishy-washy phrases from your vocabulary. When you want your child to do something (or stop doing something) make a clear, specific statement that leaves no room for confusion. Take a look at the difference between these two types of requests:

1) OPTIONAL 2) REQUIRED
1) It would be nice if somebody cleaned. 2) Steven, please put all the toys up in this family room and back in the playroom. Kyle, please gather the dishes and put them in the dishwasher.
1) Kids, don't you think it's time to get ready for bed? 2) It's eight o'clock. Time to shut off the TV and put on your pajamas.
1) I sure wish you'd get down from there. That's not a place to climb. 2) Please get down.
1) Gather up your stuff now, okay? 2) Please get your backpack, jacket and shoes.

Key #3: When you say it, mean it. The first time. Some parents are in the habit of repeating a request over and over and over (and over!) before taking any action to see that a child complies with the request. Do you know anyone like this? (Perhaps intimately?) Children have radar that tells them exactly when adults really mean what they say, and when they don't. Some parents really mean it only after repeatedly ignored requests. This is usually highlighted by a red face, a tense body, a child's middle name clenched between gnashing teeth, and a fist pounding the table to the tune of, "...and I mean it young man!" Make yourself a promise to mean what you say - the first time you say it. What this means is that after you've made a clear statement of what is required (see Key #2) you take action. For example, if you call your child in from the yard and he doesn't immediately respond you will have to put forth the extra effort to go out to the yard, take him by the hand and announce, "When I call you I expect you to come." The beauty of this style is that you only have to "prove" yourself once or twice for your child to understand that, indeed, when you say it you mean it. The first time. (For those with older children who have already learned that they can ignore you the first few times with no repercussions, it may take more "proving" before they believe that you have really changed. Your children can learn to believe that when you say it you mean it. Hang in there. Be consistent. It's definitely worth the effort.)

Key #4: Be brief and specific. There is a disease that is rampant among parents. It's called lecture-babble-itis. The most obvious symptom is an emotional run-on sentence that goes on forever, punctuated by highlights of previous award wining monologues. As an example, you send your children upstairs with a polite request to get ready for bed. Half an hour later you discover that they're having a pillow fight. The parent infected with lecture-babble-itis says, "I sent you kids up here thirty minutes ago to get ready for bed and nobody's even STARTING to get ready and it's after eight o'clock and it's a school night and WHY do we have to go through this EVERY single night couldn't you just ONCE get ready for bed without my getting angry about it and why is this room such a MESS again can't you ever ....." (Is it any wonder why kids roll their eyes?) There is a cure for this dreaded disease. It involves making an effort to talk less, but say more. In other words, be very specific in your description, but use as few words as necessary. Even when the kids have ignored the first polite request, the above disastrous speech can be transformed into something like this, "Kids, it's eight thirty. Pajamas. Now." As you can see, this statement is clear and short. It is easy to understand. The advantages of using this technique are twofold. Your kids will cooperate more frequently with a brief, specific statement than they will with a lengthy tirade. And, it's fun and easy for you to do this!

Key #5: Don't give in to nagging, whining and pressure. Many parents start out on the right track, but are derailed by an incredibly persistent child. It seems that when children couple their youthful energy with an extraordinary ability to pinpoint their parent's weak spots, the result is disaster. If you're doing your job as a parent there are many times when your decisions won't be popular with your kids. When your child is nagging, whining and pleading with you, it's a sure sign that you've made the right decision. It's also a sign that you need to disengage from your youngster and teach him that you won't be swayed by his persistence. Your most important goal as a parent is NOT to make your children happy on a short-term basis. It's to raise capable, responsible human beings. There are many times when your children will be unhappy with your decisions. Usually, this means you've made the right decision! We have an incredible amount of information and knowledge at our fingertips, more than any other generation of parents in our history. Take advantage of this information. Read. Think. And be confident in your actions.

Key #6: Give choices, ask questions. A primary goal of all children is to become independent. Instead of fighting against this very natural process, a wise parent will use it to his advantage. As an example, let's look at the very common problem of a child's messy bedroom. A parent can rightly expect that a child's room be neat and clean. A typical mistake is for the parent to demand that the child clean it - on the parent's time schedule, and to the parent's exact specifications. The typical child responds with a full-blown temper tantrum, which ignites the parent's adult-sized temper tantrum, which results in a lot of anger, and a still-messy room. A better choice is to engage the child's decision-making skills and utilize his desire to be in control of his own room and his own life. A parent might offer several well-thought-out choices, such as, "Would you like to clean your room after school today, or would you prefer to do it after baseball practice tomorrow?" Another choice might be, "What would you like to do first, change your bedding or vacuum your carpet?" Yet another choice would be, "Would you like to clean your room yourself, or shall I help you?" It's clear that a child will respond better to any of these choices than he would to the statement, "Clean your room and do it now." Another way to approach this problem is to ask helpful questions and direct the child into coming up with solutions on his own. Therefore you might ask, "I notice that your homework is scattered all over your room. Do you think it might be easier to keep track of if you create a 'homework place'? How can I help you solve this problem?" Yet another example of this approach is to take the time to discuss the issue with your child and ask for his ideas. "I know the mess in your room doesn't bother you, but I find it difficult to change your bed or put away your clothes. Can you help me come up with some solutions?" As you can see, any of these techniques provide the parent with a variety of ways to encourage the child to become involved in solving the problem.

Key #7: Use rules and routines. Chores, homework, mealtime, bedtime, getting out the door in the morning. These are the things life is made of. If you have very specific rules and routines you will find that things flow. If you don't - chaos. It's well worth the time to establish family priorities, rules and schedules for the usual daily routines. The first part of this key takes more than a few minutes of thought. You'll need to sit down and take time to ponder your daily activities. You'll need to make some decisions about priorities and what's most important in your family. Once you've done this, create charts to cover the steps involved in each major task, such as the morning routine, the after school routine, or the bedtime routine. Purchase and post a large family calendar to show all the family activities and commitments. (This helps the adults in the family stay organized just as much as it helps the kids!) A second part of this key is to evaluate your expectations for your children. Create a list of rules. These rules should cover expected behavior by clearly identifying two things: what is NOT allowed AND what behavior IS expected. In other words, listing, "No fighting" as a family rule is only the first part of the equation. "Be kind and respectful to each other" clarifies the important concluding concept. When everyone knows what to expect you'll find yourself nagging and complaining much less, and the kids cooperating much more.

Key #8: Build a foundation of love, trust and respect. Imagine that you've been invited to a friend's home for dinner. Your friend welcomes you at the door and you step inside. Suddenly, your host shouts, "What is the matter with you! Your shoes are all muddy and you're getting my carpet dirty!" Embarrassed you mumble, "Sorry" and remove your shoes. As you do, you notice the hole in your sock, and so does your friend, who announces, "Geez. Don't you think you could have dressed properly for dinner? You look like a slob." As you take your place at the table, your host knocks your elbow off the table with a whispered "tsk, tsk". The dinner conversation is primarily your friend's story about a guest that joined them for dinner last night who had lovely manners and no holes in her socks. The story is sprinkled with your friend's occasional corrections to your table manners. When you finish your meal you stand up only to hear your friend say, "It sure would be nice if somebody helped clear the table." I'm sure you get my drift by now. Many parents treat their children in ways that they would never treat a friend. In their efforts to raise respectable children, they become so focused on the end goal that they don't realize that the primary message coming though to their children is not a pleasant one. Take a close look at your daily interactions with your children. Make sure that the primary message to them is, "I love you, I trust you, and I respect you." Children who are confident that they loved, trusted and respected by the important adults in their lives will respond overall in a much more pleasant way. How do you get this message through to your children? First, by giving them what they want most from you - your time. It's much more effective to give small chunks of time every day than to try to pack in a "quality" experience once a month. Second, give them your ear. Children thrive when they have someone who really listens to them. It's not as important to give advice and solve problems as it is to just plain listen. Third, praise and encourage your children daily. Look for reasons, both big and small, to give your children positive feedback. Fourth, tell them you love them. Tell them you trust them. Tell them you respect them. Use your words, and your actions to convey this most important message of all, "I love you, I trust you, and I respect you."

Key #9: Think first, act second. The times when you act before you think reflect the worst moments in parenting. Those are the times when you lose your patience; those horrible moments when you screech, bellow, threaten or hit. These moments occur most often to parents who are unprepared for the parenting job. None of us are born knowing how to be parents. We can love our kids with our whole heart and soul, but we aren't born with a gene that gives us an instinctual knowledge of the right consequence to impart when our children misbehave, nor do we automatically know how to solve daily child rearing problems. We won't learn a Perfect Parenting process by chance. It takes research, thought and planning to decide upon the best solution to any problem.

Don't think any chef, no matter how skilled, could enter my kitchen and without any direction, recipe or ingredients end up creating a four-course meal with a five-star desert. It would increase the odds of our having a delicious meal if that person had access to my best cookbook, and passage to the local grocery store. In much the same way, you will be a much more successful parent if you have access to ideas and solutions whenever you come across a parenting problem. Perfect Parenting is your guidebook to a multitude of ideas. Use it as your basis to create thoughtful, purposeful solutions to your parenting problems. Whenever you come across a situation that baffles you or creates strife in your family life, take a few minutes to look up the ideas for that entry and any others that are similar. Contemplate how the ideas fit into your parenting style, how they match up to the personality of your child, and how they might work for you. Then create a plan of action. And follow through. Enjoy the benefits of this handbook of knowledge. Enjoy the benefits of thinking before you act. Enjoy the benefits of perfect parenting!

How to Encourage a Love of Reading

It's unlikely that your child will begin to learn how to read before the age of three or four, but there are things you can do from birth to encourage early reading. Teach your child to love books and he or she will be reading before you know it. There are several ways you can do this, and they are fun, easy, and worth every minuet of your time.



10 Ways to Encourage a Love of Reading

1. Expand children's oral language. Depending on their skill level, children can read a story or have a story read to them, or even take turns reading and listening. When the story is finished, invite your child to identify favorite parts of the story. Reading stories together enables the child to have fun picking out words and deciding when to move to the next page.
2. Read several stories every day to children. The more children are exposed to stories and other literary works, the more likely that reading will become part of their daily lives. Each story introduces new concepts, phonemic awareness and much more.
3. Teach children rhymes and songs. Growing up, we were all exposed to rhymes, jingles and songs. Many of them might resonate in our minds even today. Rhymes and songs are creative ways to encourage memorization, rhyming and melody with children. This is also a great way to introduce poetry and other creative writing styles. Families can sing together on trips, on walks or at the table as an after dinner activity. Add hand gestures or dance moves to enrich the overall experience.
4. Support reading and writing development through children's play. After a day of family fun, encourage your child to write a story about the experience. Or, sit down with your child and write a play. Gather friends and other family members to put on a show.
5. Point at the words occasionally when you read with children. Pointing to words helps children understand that written words on a page stand for meanings they already know. It also shows that 1) written words are associated with sounds and 2) a word is a unit of print, which are two main goals of the Head Start program.
6. Encourage children to experiment with writing every day. Promote writing in a fun way. Help your child keep a daily journal about their experiences. Encourage your child to write and mail a letter to a different family member every week or even become a pen pal with a student from the other neighborhood school. Children love to receive mail, and it will make your child's day to read her own name on the front of an envelope.
7. Provide children a special area where they can experiment with print and books. Choose a place in the house designated especially for reading. Purchase a beanbag or a colorful chair to make the area inviting and fun. Books can be stored on a special bookshelf nearby. A unique environment might help parents with reluctant readers.
8. Be a literacy advocate by modeling reading and writing every day. Children learn by example in every realm of their life. If parents incorporate reading into their own lives, there will be a good chance their children will as well. Encourage your child to set reading goals and when they achieve them, give recognition and rewards.
9. Encourage children to notice print and how words are read and spelled. When reading with your child, take turns noticing sounds, letters and their relationship to the meaning within the context of the sentence and the story as a whole. Correct letter formation and spelling will help children on their spelling and grammar tests.
10. Encourage a special time each day for enjoying books and writing. Set up a time each day for reading. Both you and your child can read together or separately. Young children need as many special times with books and other literature as they can get.

Effects Of Television On Children

Is it important to know what your kids are watching? Of course it is. Television can expose your child to things that you have tried to protect them from, especially violence, drug abuse, sex, etc. In addition to the actual television show, your child can also be influenced by what she sees during the commercials.

You can begin to choose proper shows for your children to watch by learning about television guidelines or using a V-Chip, but that may not screen out all inappropriate shows. Even television with a rating of 'Y' for all children or 'G' for general audiences may not be totally free of violence.

To help parents protect their children from the negative effects of watching too much television, the American Academy of Pediatrics has recommended that they 'limit children's total media time (with entertainment media) to no more than 1 to 2 hours of quality programming per day.'

What are some of the negative effects of watching too much television?

• One study, Television-viewing habits and sleep disturbance in school children, found that watching too much TV during the day or at bedtime often caused 'bedtime resistance, sleep onset delay, and anxiety around sleep, followed by shortened sleep duration.'
  
• Another study, Television viewing and aggressive behavior during adolescence and adulthood, found a 'significant association between the amount of time spent watching television during adolescence and early adulthood and the likelihood of subsequent aggressive acts against others.'
• Many studies have found an association between kids watching a lot of TV, being inactive and overweight.

It doesn't take a research study for parents to discover how TV can affect your child's behavior. How do kids act after watching the Power Rangers? You will find most boys jumping around, hitting and kicking. That doesn't mean that the show will make your child violent, but if he is already aggressive and has problems hitting others, watching these types of shows will likely not help matters.

And if your child is inside all day watching TV, then he can't be outside playing and being involved in more physical activities.

Still, there are many good shows on TV that are not violent, which can teach your child positive values and which have good characters that find healthy ways to resolve conflicts and solve problems. Some good picks for younger children include:

• Sesame Street
• Barney & Friends
• Mister Rogers' Neighborhood
• Bob The Builder
• Bear in the Big Blue House
• Arthur
• Dragon Tales
• Clifford the Big Red Dog
• Rollie Pollie Ollie
• Blue's Clues
• Dora Explorer
• Thomas the Tank Engine
• Spongebob Squarepants

Older kids will likely enjoy:

• Bill Nye the Science Guy
• Wishbone
• Beakman's World

The most important thing to remember is that just because a show is a cartoon, it doesn't mean that it is good for your child to watch.

Shows that you may want to avoid, especially if your child is under age 7 include:

• Power Rangers
• Digimon
• Ed, Edd n Eddy
• Johnny Bravo
• Power Puff Girls

The only real way to know if a show is appropriate for your child is to watch a few episodes, either before you let your child watch, or with your child, and then ask yourself some questions:

• What are the characters doing?
• What is the main story or theme of the episode?
• Do the characters fight a lot?
• Do the characters make fun of each other?
• Are they doing anything illegal or that with an adult theme?
• How does your child act after watching the show?

When deciding what shows your family should watch, keep in mind that the TV Parental Guidelines and/or the use of a V-Chip does not substitute for your responsibility to guard your children from the influence of inappropriate television shows. Some tips to protect your children include:

• Limit television viewing to 1-2 hours each day.
  
  
• Do not allow your children to have a TV set in their bedrooms.
  
  
• Review the ratings of TV shows that your children watch.
  
  
• Watch television with your children, and discuss what is happening during the show, discuss alternative and more acceptable things that characters could have done for inappropriate behaviors and actions, and teach your children to be critical of the messages that the media sends through their programming.

Effective Communication With Your Children

Feelings of worth can flourish only in an atmosphere where individual differences are appreciated, mistakes are tolerated, communication is open, and rules are flexible - the kind of atmosphere that is found in a nurturing family.
- Virginia Satir

Effective communication skills are essential in determining our ability to have rewarding relations with others and to achieve satisfaction in life. The quality of our relationships with friends, spouses, children, and colleagues are all dependent upon sound communication skills.

Ten Steps To Effectively Communicate With Your Children

• Set a time each day to talk to and get to know your children. Good times to talk are in the car on the way to school or at the dinner table. Have meals together as a family as often as possible.
• Encourage your children to talk to you. Be supportive, accepting, non- judgmental and understanding, without encouraging self-destructive behaviors, of course. Listen more than you talk. Make eye contact. Smile when appropriate.
• Stimulate curiosity and imagination by asking thought-provoking questions about your children’s opinions and values on various issues. Include your children in family discussions.
• Express love and affection frequently. Hug and touch your children, no matter how old they are. Keep your sense of humor. Avoid criticism, sarcasm, and hurtful teasing.
• Be honest and patient with your children. Be accepting and consistent. Admit when you are wrong and apologize when appropriate.
• Relax and have fun with your children. Engage in activities that everyone might enjoy such as taking a walk, cooking, playing games, and visiting museums. Choose activities that include chances to talk. If you go to a film together, go out to eat before or after.
• Work to understand their questions. Ask for more information and draw them out. Their viewpoints, though different, can be valuable and thought-provoking for you, too.
• Remember how it felt to be their age. Growing up can be difficult and confusing. Educate yourself on issues that children face, such as drugs and sex. Know what they are watching, reading, and listening to.
• Let them know you respect their point of view, taking the time to explain how you feel, listening to and respecting their opinions. Don’t interrupt.
• Encourage children to see the best in themselves and recognize their unique potential. Help build their self-esteem by supporting their interests and giving positive feedback and praise through encouraging words.

Causes Of Childhood Schizophrenia

Although it's unclear whether schizophrenia has a single or multiple underlying causes, evidence suggests that it is a neurodevelopmental disease likely involving a genetic predisposition, a prenatal insult to the developing brain and stressful life events. The role of genetics has long been established; the risk of schizophrenia rises from 1 percent with no family history of the illness, to 10 percent if a first degree relative has it, to 50 percent if an identical twin has it. Prenatal insults may include viral infections, such as maternal influenza in the second trimester, starvation, lack of oxygen at birth, and untreated blood type incompatibility. Studies find that children share with adults many of the same abnormal brain structural, physiological and neuropsychological features associated with schizophrenia. The children seem to have more severe cases than adults, with more pronounced neurological abnormalities. This makes childhood onset schizophrenia potentially one of the clearest windows available for research into a still obscure illness process.

For example, unlike most adult-onset patients, children who become psychotic prior to puberty show conspicuous evidence of progressively abnormal brain development. In the first longitudinal brain imaging study of adolescents, magnetic resonance imaging (MRI) scans revealed fluid filled cavities in the middle of the brain enlarging abnormally between ages 14 and 18 in teens with early onset schizophrenia, suggesting a shrinkage in brain tissue volume. These children lost four times as much gray matter, neurons and their branch-like extensions, in their frontal lobes as normally occurs in teens. This gray matter loss engulfs the brain in a progressive wave from back to front over 5 years, beginning in rear structures involved in attention and perception, eventually spreading to frontal areas responsible for organizing, planning, and other "executive" functions impaired in schizophrenia. Since losses in the rear areas are influenced mostly by environmental factors, the researchers suggest that some non-genetic trigger contributes to the onset and initial progression of the illness. The final loss pattern is consistent with that seen in adult schizophrenia. Adult-onset patients' brains may have undergone similar changes when they were teens that went unnoticed because symptoms had not yet emerged, suggest the researchers.

In addition to studies of brain structural abnormalities, researchers are also examining a group of measures associated with genetic risk for schizophrenia. Early onset cases of illness have recently proven crucial in the discovery of genes linked to other genetically complex disorders like breast cancer, Alzheimer's and Crohn's diseases. Hence, children with schizophrenia and their families may play an important role in deciphering schizophrenia's molecular roots. Evidence suggests that the rate of genetically-linked abnormalities is twice as high in children as in adults with the illness. Similarly, schizophrenia spectrum disorders, thought to be genetically-related to schizophrenia, are about twice as prevalent among first-degree relatives of childhood onset patients. In one recent study, a third of the families of individuals with childhood onset schizophrenia had at least one first-degree relative with a diagnosis of schizophrenia, or schizotypal or paranoid personality disorder. This profile of psychiatric illness is remarkably similar to that seen in parents of adult onset patients, adding to the likelihood that both forms share common genetic roots. Other anomalies associated with adult schizophrenia, such as abnormal eye movements, are also more common in families of children with the illness.

Families of children with schizophrenia who are interested in participating in research are encouraged to fill out the NIMH Childhood-Onset Schizophrenia Survey, to help determine eligibility for studies.

Can schizophrenia be inherited?

Scientists have long known that schizophrenia runs in families. It occurs in 1 percent of the general population, but is seen in 10 percent of people with a first degree relative (a parent, brother, or sister) with the disorder. People who have second degree relatives (aunts, uncles, grandparents, or cousins) with the disease also develop schizophrenia more often than the general population. The identical twin of a person with schizophrenia is most at risk, with a 40-65 percent chance of developing the problem.

Our genes are located on 23 pairs of chromosomes that are found in each cell. We inherit two copies of each gene, one from each parent. Several of these genes are thought to be associated with an increased risk of schizophrenia, but scientists currently believe that each gene has a very small effect and is not responsible for causing the disease by itself. It is still not possible to predict who will develop the disease by looking at their genetic material.

Although there is a genetic risk for schizophrenia, genes alone are not likely to be sufficient to cause the disorder. Interactions between genes and the environment are thought to be necessary for schizophrenia to develop. Many environmental factors have been suggested as risk factors, such as exposure to viruses or malnutrition in the womb, problems during birth, and psychosocial factors, like stressful environmental conditions.

Do people with schizophrenia have faulty brain chemistry?

It is likely that an imbalance in the complex, interrelated chemical reactions of the brain involving the neurotransmitters dopamine and glutamate (and possibly others) plays a role in schizophrenia. Neurotransmitters are substances that allow brain cells to communicate with one another. Basic knowledge about brain chemistry and its link to schizophrenia is expanding rapidly and is a very promising area of research.

Do the brains of people with schizophrenia look different?

The brains of people with schizophrenia look a little different than the brains of healthy people, but the differences are small. Sometimes the fluid-filled cavities at the center of the brain, called ventricles, are larger in people with schizophrenia, overall grey matter volume is lower, and some areas of the brain have less or more metabolic activity. Microscopic studies of brain tissue after death have also revealed small changes in the distribution or characteristics of brain cells in people with schizophrenia. It appears that many of these changes were prenatal because they are not accompanied by glial cells, which are always present when a brain injury occurs after birth. One theory suggests that problems during brain development lead to faulty connections that lie dormant until puberty. The brain undergoes major changes during puberty, and these changes could trigger psychotic symptoms.

The only way to answer these questions is to conduct more research. Scientists in the U.S. and all over the world are studying schizophrenia and trying to develop new ways to prevent and treat the disorder.

Symptoms & Diagnosis Of Childhood Schizophrenia

A child's stage of development must be taken into account when considering a diagnosis of mental illness.

Behaviors that are normal at one age, may not be at another. Rarely, a normal young child may report strange experiences—such as hearing voices—that would be considered abnormal at a later age. Clinicians look for a more persistent pattern of such behaviors. Parents may have reason for concern if a child of 7 years or older often hears voices saying derogatory things about him or her, or voices conversing with one another, talks to himself or herself, stares at scary things—snakes, spiders, shadows—that aren't really there, and shows no interest in friendships. Such behaviors could be signs of schizophrenia, a chronic and disabling form of mental illness.

Fortunately, schizophrenia is rare in children, affecting only about 1 in 40,000, compared to 1 in 100 in adults. The average age of onset is 18 in men and 25 in women. Ranking among the top 10 causes of disability in developed countries worldwide, schizophrenia, at any age, exacts a heavy toll on patients and their families.

Children with schizophrenia experience difficulty in managing everyday life. They share with their adult counterparts hallucinations, delusions, social withdrawal, flattened emotions, increased risk of suicide and loss of social and personal care skills. They may also share some symptoms with—and be mistaken for—children who suffer from autism or other pervasive developmental disabilities, which affect about 1 in 500 children. Although they tend to be harder to treat and have a worse prognosis than adult-onset schizophrenia patients, researchers are finding that many children with schizophrenia can be helped by the new generation of anti-psychotic medications.

Symptoms and Diagnosis

While schizophrenia sometimes begins as an acute psychotic episode in young adults, it emerges gradually in children, often preceded by developmental disturbances, such as lags in motor and speech/language development. Such problems tend to be associated with more pronounced brain abnormalities. The diagnostic criteria are the same as for adults, except that symptoms appear prior to age 12, instead of in the late teens or early 20s.

Children with schizophrenia often see or hear things that don't really exist, and harbor paranoid and bizarre beliefs. For example, they may think people are plotting against them or can read their minds. Other symptoms of the disorder include problems paying attention, impaired memory and reasoning, speech impairments, inappropriate, or flattened, expression of emotion, poor social skills, and depressed mood. Such children may laugh at a sad event, make poor eye contact, and show little body language or facial expression.

Misdiagnosis of schizophrenia in children is all too common. It is distinguished from autism by the persistence of hallucinations and delusions for at least 6 months, and a later age of onset—7 years or older. Autism is usually diagnosed by age 3. Schizophrenia is also distinguished from a type of brief psychosis sometimes seen in affective, personality and dissociative disorders in children. Adolescents with bipolar disorder sometimes have acute onset of manic episodes that may be mistaken for schizophrenia. Children who have been victims of abuse may sometimes claim to hear voices of—or see visions of—the abuser. Symptoms characteristically pervade the child's life, and are not limited to just certain situations, such as at school. If children show any interest in friendships, even if they fail at maintaining them, it's unlikely that they have schizophrenia.

Schizophrenia In Children

What is Schizophrenia?
Schizophrenia is a medical illness that causes strange thinking, abnormal feelings, and unusual behavior. It is an uncommon psychiatric illness in children and is hard to recognize in its early phases. The behavior of children and teens with schizophrenia may differ from that of adults with this illness.

Mounting evidence indicates that schizophrenia has neurodevelopmental roots. The appearance of schizophrenic symptoms before age 12 is rare (less than one-sixtieth as common as the adult-onset type), but studying these cases is important for an understanding of this disorder.

Neurodevelopmental damage seems to be greater in childhood schizophrenia than in the adult-onset type. Most schizophrenic children show delays in language and other functions long before their psychotic symptoms (hallucinations, delusions, and disordered thinking) appear, usually at age seven or later. In the first years of life, about 30% of these children have transient symptoms of pervasive developmental disorder, such as rocking, posturing, and arm flapping. Childhood home movies indicate uneven motor development, such as unusual crawling, in adult-onset schizophrenic patients. Children with schizophrenia may be even more seriously impaired in this respect; they are also more anxious and disruptive than adult-onset schizophrenic patients were as children.

Early Warning Signs:

• trouble discerning dreams from reality
• seeing things and hearing voices that are not real
• confused thinking
• vivid and bizarre thoughts and ideas
• extreme moodiness
• peculiar behavior
• concept that people are “out to get them”
• behaving younger than chronological age
• severe anxiety and fearfulness
• confusing television or movies with reality
• severe problems in making and keeping friends

The behavior of children with this illness may change over time. The schizophrenic psychosis develops gradually in children, without the sudden psychotic break that sometimes occurs in adolescents and adults. Children may begin talking about strange fears and ideas. They may start to cling to parents or say things that do not make sense. Children who used to enjoy relationships with others may become more shy or withdrawn and seem to be in their own world.

Treatment
Early diagnosis and medical treatment are important. Children with the problems and symptoms listed above must have a complete evaluation. These children may need individual treatment plans involving other professionals. A combination of medication and individual therapy, family therapy, and specialized programs (school, activities, etc.) is often necessary. Psychiatric medication can be helpful for many of the symptoms and problems identified.

Standard antipsychotic drugs appear to be effective for schizophrenic children and adolescents, and the atypical drug clozapine is helpful for at least half of those who do not respond to typical drugs. In a few cases their psychotic symptoms seem to disappear entirely. Unfortunately, children may be more susceptible than adults to the toxic effects of clozapine; about one third of them have to stop taking it because of the side effects. Newer antipsychotic drugs that may be safer and just as effective are now being tested.

Parents need to 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.