Why children hallucinate

For all its reputation for causing emotional mayhem, puberty might be a stabilising force on our perceptions. Childhood hallucinations are often sparked by life stresses, poor sleep and periods of low mood that fade when the difficult situations do. If the hallucinations are upsetting or persistent, however, it may be time to ask for a professional assessment.

Renaud Jardri has seen many children with hallucinations in his clinical practice and also researches the area as part of his role as a professor of child and adolescent psychiatry at the Lille University school of medicine. In rare cases, medical problems can be the cause. Epilepsy can cause hallucinations, as can sleep disorders that affect consciousness and lead to the dream world invading the waking hours.

But when such conditions occur, the hallucinations can be both striking and terrifying. Then there are imaginary friends that are not hallucinations but vivid fantasies, which have been the subject of much adult hand-wringing over the years.

Children and adolescents may seek help for hallucinations, presenting themselves to community health services, general practitioners, outpatient clinics and emergency services, 5 , — and a number of treatment options are available.

Kapur and colleagues investigated the experience of children and adolescents with hallucinations and their parents when engaging in mental health services. These young voice hearers reported feeling lost, not listened to, and found it difficult to obtain useful information.

Parents sought a holistic approach including counseling, peer groups, meditation, drug information sharing, and alternative educational opportunities , whereas the children and adolescents preferred a more normalizing and destigmatizing approach.

In line with the need for a more holistic approach, psychological interventions with a transdiagnostic and symptom-specific focus are deemed more acceptable by both clinicians and children and adolescents. Furthermore, Ruffell and colleagues conclude that targeted cognitive behavioral therapy CBT for PE in children and adolescents is recommended to improve clinical outcome.

Currently, such tailored interventions are being developed. In the Netherlands, Maijer and colleagues 5 see their supplementary material for more information developed Stronger Than Your Voices STYV , which is a form of CBT developed at an outpatient clinic for children and adolescents suffering from hallucinations that can be applied regardless of age or possible underlying psychiatric disorder.

STYV is currently being assessed within a feasibility study. The relation-based therapies for hallucinations that are being developed for adults might also be useful for young people eg, relating therapy , given their emphasis on responding in more adaptive ways to difficult relationships irrespective of the seen [social] or unseen [auditory hallucination] nature of the relational other.

This focus on relationships addresses the aforementioned need for therapy to incorporate holistic and normalizing approaches. Medication does not play a primary role in the treatment of hallucinations. When hallucinations are present in children and adolescents in the context of an established psychotic disorder, treatment with antipsychotic medication can be considered, following treatment guidelines. Other hallucination-focused interventions for children and adolescents include repeated transcranial magnetic stimulation rTMS as an add-on to therapy for persistent hallucinations.

Although no new research on rTMS specifically for hallucinations in children and adolescents has emerged since , 1 earlier findings highlight the potential beneficial effects of low-frequency rTMS on reducing early-onset treatment-resistant hallucinations.

There remains a need for large controlled trials to test its efficacy, which may aid in determining optimized stimulation parameters and evaluate its long-term therapeutic effect. The use of virtual reality and avatars in the treatment of several dimensions of psychotic symptoms is promising, , although there is still limited research, which is only restricted to adults at this time. In addition to digital assessment tools, online and virtual treatment strategies might be specifically appealing to children and adolescents and should be explored in future research.

Attention has been drawn to the needs of children and adolescents actually seeking help for hallucinations, as the duration and severity of their complaints are often substantial, and there can be a variety of severe comorbid psychopathology. A holistic perspective can maximize engagement at this stage and the provision of psychoeducation about hallucinations, especially within the framework of the continuum model, may be helpful.

The experience of the clinicians working at the specialized outpatient clinic for youth with AVH at the UMC Utrecht suggests that in many cases, hallucinations subsequently decrease or even diminish when underlying causative factors such as psychiatric [co]morbidity can be adequately targeted. To provide knowledge and information on hallucinations, the psychoeducation section of such treatment protocols might be used for children and their parents before or without applying a whole treatment protocol.

A stepwise guide for clinicians is given in figure 1. In addition, as hallucinations are strongly associated with suicidal behavior, it is critical to perform suicide risk assessment in young people reporting hallucinations. For example, does this definition include auditory illusions and forms of inner speech often a silent monologue without intrinsic sound or vocal quality? Is hearing noise or music as much a hallucinatory experience as hearing voices?

Also, large-scale cohort studies including young age ranges are still needed to unravel factors biological, psychological, and social that influence age of onset, persistence, and differential outcome. More uniformity in assessing the hallucinations should be strived for, whereas research could also focus on debating how it is possible that—giving the fact that they mostly ask more or less the same questions—that prevalence numbers vary so widely.

Despite the often transient nature of hallucinations in children and adolescents, these experiences, even at a young age: 1 can cause severe distress and reduced functioning; 2 can occur across diagnostic boundaries; 3 often go together with comorbid psychopathology; and 4 may cause or coincide with increased risk of suicidality.

Current insight suggests the application of a more general staging model, in which hallucinations can occur from a benign and transient phenomenon at one end to a symptom of severe psychopathology of several interacting domains at the other. As a consequence, hallucinations in both child and adult studies still represent a broad phenotype. Nevertheless, although hallucinations in youth are often transient and possibly a benign phenomenon, children and adolescents seeking help for hallucinations often suffer prolonged from their hallucinations and encounter difficulties in receiving the appropriate care.

Since , clinical care has improved with the recent knowledge and development of youth-specific questionnaires and intervention strategies. Finally, although the implementation of large hallucination detection programs in the general population is unnecessary, further knowledge is required on the extent and early identification of children and adolescents with hallucinations that might be in need for care.

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At times, children may imagine that they hear or see things as part of a game or as a result of their worries and fears. Younger children may even have an imaginary friend they want to sit next to at the table and have conversations with. These examples are usually just part of the normal growth of a child. They can most often be managed with understanding and gentle reassurance on the part of parents.

Hallucinations are when one has heard, seen, or experienced something that is not there. They can occur in any of our senses including sound, sight, touch, taste, and smell. An auditory hallucination is when one has heard something that is not there.

It is the most common type of hallucination. A visual hallucination is when one has seen something that is not there.