Sometimes, children experience things that seem strange or unusual. They might hear voices that others can’t or see things that aren’t there. They might become suspicious of others for no reason or have beliefs that don’t seem real. They might also act in ways that are hard to understand. These experiences can be frightening for both the child and their caregivers. It’s important to remember that these problems are not the child’s fault and that help is available. Early intervention and support can make a big difference.
What is typical?
It’s common for young children to have active imaginations. They might have imaginary friends, talk to themselves, or believe in magical creatures. This is a normal part of development. As children grow, they learn to distinguish between fantasy and reality. Here’s what you might typically see:
- By age 5: Children engage in pretend play and may have imaginary friends.
- Between ages 6 and 8: Children start to understand the difference between real and pretend, but their imaginations are still active.
- By ages 9 and 11: Children’s thinking becomes more logical and realistic.
- By ages 12 and 14: Children’s thinking becomes more abstract and complex, but they generally understand reality.
When should I be concerned?
While imagination is normal, there are times when a child’s experiences may be cause for concern. If these experiences are frequent, distressing, or interfere with their daily life, it’s important to seek professional help.
Concerning signs may include:
- Hallucinations: The child sees, hears, smells, tastes, or feels things that others don’t. This might include seeing shadows or figures, hearing voices talking to them or to each other, or feeling things crawling on their skin.
- Delusions: The child has strong beliefs that are not based in reality. They might believe they have special powers, that others are trying to harm them, or that they are being controlled by outside forces.
- Disorganised thinking and speech: The child’s thoughts and speech may be jumbled, making it hard to understand them.
- Unusual or bizarre behaviour: The child may act in ways that are strange or inappropriate for their age, such as talking to themselves in public, neglecting their hygiene, or having unusual rituals.
- Withdrawal and isolation: The child may withdraw from friends and family and lose interest in activities they used to enjoy.
- Changes in mood and behaviour: The child may experience significant changes in their mood, such as becoming more anxious, irritable, or withdrawn.
- Difficulties with schoolwork: The child may have trouble concentrating, remembering things, or completing assignments.
- Changes in sleep patterns: The child may have difficulty falling asleep, staying asleep, or experiencing nightmares.
What can I do to help?
If you are concerned about a child experiencing these difficulties, providing support and seeking professional help is crucial. Here are some things you can try:
- Stay calm and listen: Provide a safe and non-judgmental space for the child to talk about their experiences.
- Reassure and validate: Let the child know that you believe them and that you are there to support them.
- Maintain a consistent routine: Regular sleep schedules, mealtimes, and activities can provide stability.
- Encourage healthy habits: Promote good nutrition, exercise, and stress-reducing activities.
- Limit exposure to stressors: Reduce exposure to stressful situations or triggers whenever possible.
- Avoid challenging the child’s beliefs: Arguing or trying to convince the child that their experiences aren’t real can be counterproductive.
- Seek professional help: If you notice significant changes in your child’s motivation, thinking, or behaviour, the first step is to visit their paediatrician to rule out any medical conditions or substance use. After that, a psychiatrist or psychologist will assess your child. This process might take several visits to understand how symptoms develop and change over time. A key part of the diagnosis is determining whether your child can recognise that their experiences are not real. If they can, it suggests the symptoms are in the early stages. As symptoms become more severe, these beliefs become harder to challenge. The mental health professional will use interviews, questionnaires, and observations to make a diagnosis and decide on the best treatment plan.
What kind of professional support can I seek out?
If your child is experiencing these difficulties, it’s important to seek professional help immediately. Early intervention can significantly improve outcomes. Do not delay seeking help if you are concerned.
Talk to your child’s paediatrician or family doctor. They can refer you to other specialists, such as mental health professionals.
Mental health professionals can help both the child and the caregivers. They can work with you to support your child at home and in therapy.
Public services are also available at your local clinic.
When looking for affordable services, it may also be helpful to explore local non-governmental organisations which offer services to families.
Local universities may offer services to the public as part of professional training programmes.
Please don’t give up if you don’t have success in your first attempts at getting help. Go back to the services listed above and look at our online list for additional resources or support. Your child is worth the effort.
Where to find more information
For detailed information on mental health conditions, visit our guides for health professionals.