"These are children, some of them barely old enough to have a job, and from every socioeconomic and cultural demographic you can imagine," explained lead research Brabara Nicholas. "They are just starting out in the world. It breaks my heart to see them like this and we have no answers."
Schizophrenia, a disorder of impaired cognition and unusual emotional responses to environmental stimuli, is most commonly diagnosed in young adults. This trend in onset during the toddler years is troubling to experts like Nicholas, as well as the general pediatricians that are often the first to see the early signs. The reason for this stark increase in incidence remains a mystery to mental health professionals.
Toddler schizophrenia, similar to older pediatric patients and adults, is diagnosed when a young child, during a one month period, has at least two of the following symptoms:
1. DelusionsBut the presentation of these symptoms is for the most part specific to these young children. Delusions, firmly held beliefs which persist despite powerful evidence of their being false, frequently manifest as the conviction that a variety of magical entities, such as a morbidly obese man-elf and an excessively anthropomorphized rabbit will deliver candy and consumer goods in return for exemplary behavior. Pediatricians frequently describe ritualistic behavior in schizophrenic toddlers. One nearly ubiquitously described example occurs after the shedding of a child's primary tooth, culminating in the placement of said tooth under a pillow and the expectation of finding money in its place in the morning.
3. Disorganized speech
4. Grossly disorganized behavrior
5. Negative symptoms
There are many additional symptoms that meet criteria for schizophrenia and are toddler specific. Some of the most intriguing frequently involve complex interactions with nonexistent "friends". Experts like Nicholas describe these encounters as entirely within a world of the patient's own creation, dependent on some aspect of human cognition which has yet to be fully understood by neuroscientists. These playmates aren't real but the patient appears unable to differentiate reality from fantasy.
Schizophrenic toddlers often display disorganized speech, to the point that at times only the primary caregiver has the ability to interpret their attempts at communication. Toddlers with disorganized behavior typically dress inappropriately, desiring to wear a playful costume to a formal event such as a funeral for example, or cry intermittently and with seemingly no reasonable provocation. These episodes of intense crying, often accompanied by screaming and flailing of the limbs, can be quite distressful to both parents and observers should they occur in public. Sometimes effected toddlers will simply go limp, making their removal from the scene more challenging.
In order to be officially diagnosed with schizophrenia, toddlers must also display social or occupational dysfunction. This can involve significant impact at preschool, during job interviews, or with peer relationships but also the impairment of their ability to care for themselves. Many, unfortunately, are rendered completely helpless by the diagnosis, and would likely not survive without extreme interventions from caregivers and medical professionals. Nicholas, whose own child was diagnosed with schizophrenia at age 19 months, hopes that more research will lead to better therapies and perhaps even a cure. "They can't prepare their own meals, dress themselves, or even find suitable employment. What kind of future do these lost children have?"