Jani infant brother. It was because “Wednesday”, a

Jani Schofield, a
five-year-old girl, physically attacked her infant brother. It was because “Wednesday”,
a rat, told her to hit him and it would not stop biting her until she complies.
Wednesday was only one of Jani’s over a hundred hallucinations from her imaginary
world she calls Calalini, according to an article from Oprah in 2009. Jani’s
friend from the University of California Los Angeles (UCLA) psychiatric ward,
Becca Stancil, has also been having hallucinations for years. She has been
seeing terrifying creatures like wolves as indicated by Stohler (2011), and
particularly, a six-foot tall man who follows her everywhere as documented by
Weinraub (2010). Another child, an eight-year-old named, Morgan Frank, wanted
to kill their family dogs and ran after them with a knife, Frank reported in
2015.  Jani, Becca, and Morgan have all
been suffering from a severe mental disorder – schizophrenia.  According to Nordqvist (2017), schizophrenia
manifests more commonly in early adulthood, from ages 16 to 30. However,
Gochman and colleagues (2011) posited that in extremely rare cases, it can also
be diagnosed during childhood with a prevalence rate of 1 in 40,000. Diagnosed
prior to the age of 13, child schizophrenia, as stated by Bartlett (2014), is marked
by the deterioration of affective, behavioral, and cognitive processes which
significantly disrupts the child’s overall functioning and development.

            Schizophrenia, in both children and adults, has two broad
categories of symptoms – positive symptoms and negative symptoms; positive
symptoms include delusions, hallucinations, disorganized speech, thinking, and behavior;
whereas, negative symptoms include blunt or flat affect, alogia (diminished
speech patterns), asociality (the loss of interest in social interactions), avolition
(the lack of motivation), and anhedonia (the inability to experience pleasure),
as indicated in the 5th revision of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-V) by the American Psychiatric Association (2013).
The main difference between child schizophrenia and adult schizophrenia is its
clinical presentation as stated by MacGill (2017); he asserted that the initial
phase, more aptly referred to as the prodromal phase, is particularly more striking
and evident in children than in adults. During this phase, which may start at
the first months to years of life, a child may exhibit some of the earliest
signs which could lead up to psychotic symptoms. According to an article from
MayoClinic.org (2016), these may include language delays, social deficits, late
walking, and other abnormal motor behaviors — rocking, posturing, or arm
flapping. Visual and auditory hallucinations are very common and therefore should
be distinguished from normal imaginative play as explained in the DSM–V (2013).
Delusions are simpler and are usually related to childhood themes according to
Cobert (2010). Other indications of childhood schizophrenia may include social
withdrawal, decline in academic performance, decreased ability to accomplish self-care
and daily activities, bizarre hygiene and eating behaviors, lethargy, aggression,
and hostility, as Masi, Mucci, & Pari reported in 2006. All these symptoms
and features may appear to be very specific; however, as Bartlett (2014)
stated, diagnosis remains difficult and challenging for mental health
professionals, as most of these symptoms overlap with other disorders (autism
spectrum disorder, attention deficit hyperactivity disorder, etc.).

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            Thus far, there has been no definite etiology found for
the development of child schizophrenia according to Bartlett (2014); she stated
that most theories suggest biological and environmental factors for the
causation of the disorder. Some experts believe that it could be explained
through genetics,
Coghill ascertained in 2009. Svrakic and
associates (2013) supposed that a child is genetically predisposed to
developing schizophrenia with 10-15% risk if either of the parents is
schizophrenic, and with 35-46% risk if both parents are schizophrenic. According
to an article from ChildrensHospital.org (n.d.), other researchers believe that
child schizophrenia may be linked to environmental, specifically, prenatal
factors that include exposure to harmful chemicals or viruses, poor nutrition
from unhealthy diet, drug or alcohol use, and extreme stress. Also, a study
conducted by Arseneault and colleagues (2011) revealed that childhood trauma
was significantly associated with childhood psychotic symptoms.

            Similar with the etiology, there has also been no known
cure for childhood-onset schizophrenia to date as indicated by Cobert (2010). Khurana
and associates (2007) claimed that available treatments focus on managing and
mitigating the symptoms of the disorder. Bartlett (2014) stated that
antipsychotic medications are utilized as the first-line of treatment; specifically,
atypical antipsychotics, which include risperidone, olanzapine, and clozapine,
as these have been revealed to be more effective and bring about lesser side
effects than the typical antipsychotics. According to Mayo Foundation for Medical
Education and Research, (2013), side effects may include high cholesterol, weight
gain, diabetes, and seizures. Another form of treatment for child schizophrenia
is psychotherapy which generally targets social, interpersonal, and
developmental problems; and may include individual therapy, family therapy, and
social skills training according to an article from MayoClinic.org. Khurana and
associates (2007) explicated that clinical studies support the combination of
these two forms of treatment in addressing childhood-onset schizophrenia. Moreover,
changes in lifestyle such as minimizing stress and taking fish oils have also
been considered helpful as stated in an article by MentalHealthAmerica.net

            Generally, the long-term functioning of patients with
childhood-onset schizophrenia has been considered as worse compared to those
with adult-onset schizophrenia and even those with other psychotic disorders,
as contended by Clemmensen, Vernal, and
Steinhausen (2012). Loth and Dunn (2014)
explicated that schizophrenic children may experience few close relationships,
less academic achievement, unemployment, and less capacity to live
independently in their adulthood. They are also at a high risk of death from
suicide with a mortality rate of 5-11% according to longitudinal studies. Fortunately,
with early detection and proper treatment, they may have the opportunity to study
in college, work, and build families as adults, as stated in an article from
ChildrensHospital.org (n.d.). Huey and associates (2007) also indicated that the
family’s involvement, especially their care and support, is a crucial factor in
the treatment process. This is very much evident in the case of Jani Schofield,
the schizophrenic child who had hallucinations of animals telling her to hurt
her younger brother. Schofield Productions (2015) has been chronicling Jani’s
daily life; showing the activities of the now fifteen-year-old girl, attending
school, playing sports, and even doing volunteer work at a horse ranch. Albeit
a bit overweight and having some eye problems which could be side effects from
the medications she has been taking, Jani has been getting better and trying to
live life as normally as she can.

            Childhood-onset schizophrenia is indeed a devastating and
highly debilitating disorder affecting children under the age of 13, Bartlett
reported in 2014. As indicated in the DSM-V (2013), it is characterized
primarily by hallucinations, delusions, disorganized thinking, speech, and
behavior, as well as the lack of appropriate affect which severely and
adversely affects a growing child. Due to its rare occurrence (1 in 40,000)
(Gochman et al., 2011), childhood-onset schizophrenia remains understudied and
poorly understood; and as such, there is still no definite cause and cure found
to date, as stated by Cobert (2010). Bartlett (2014) claimed that experts
attribute its etiology to biological and environmental factors; whereas,
treatment approaches include medications and psychotherapy as indicated in an
article by MayoClinic.org (n.d.). The outlook for the schizophrenic child is
regarded as insidious with a high risk of mortality from suicide according to
Loth & Dunn (2014). Fortunately, with early detection and proper treatment,
schizophrenic children may grow up to be functioning adults as posited in an
article by ChildrensHospital.org (n.d.).



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