Summary
A parent is concerned about an 11-year-old daughter’s changes at school and home, including reports of seeing and hearing a figure who gives violent instructions. A family history of schizophrenia and an online test have increased the parent’s worry.
The answer cautions that an online assessment cannot establish a diagnosis and that several conditions could explain the changes.
It emphasizes prompt professional evaluation, beginning with the child’s pediatrician or primary care doctor and a psychiatric referral, because the reported voices and family history require attention.
Question
Reader · Identity withheldMy daughter is 11 yrs old. She started puberty about 6 months ago. Shortly after, she started having problems in school. She has a 97% testing score but a 30-40% homework score. She has begun compulsively lying, forging her dad’s signature and acting out. Recently, we caught her carrying on conversations when no one else is around. She goes outside when walking the dog at night when we thought she was sleeping.
We had her do an online assessment and she scored fine in every area but one. It came back on a scale from 1-100 with 1 being no symptoms and 100 being severe symptoms for Schizophrenia. Her score for Schizophrenia was a 67.
My biggest reason for being concerned is my father has schizophrenia. After her dad and I spoke he talked to her and she told him she hears and sees a male that has told her to do violent things.
What do you think we should do?
Answer
Allan Schwartz, Ph.D.Online self tests should be viewed with a great deal of caution. Tests are only as good as their “reliability” and “validity.” Reliability means that a test consistently shows similar results over a long period of time and with a diverse number of people. Validity means that a test is truly measuring what it claims to measure. While online tests might point in a certain direction, they lack reliability and validity. Given the results of your daughter’s performance for the schizophrenia test, it may or may not mean something. The next step is to go to take her to a mental health expert to do an evaluation of her for many things, such as schizophrenia, major depression, bipolar disorder, etc.
There are two very serious signs that must be taken seriously: 1. There is a history of schizophrenia in the family, 2. She admits to hearing voices that tell her to hurt people. Because acute mental illnesses do tend to run in families indicates that she may have a disposition to some type of psychotic illness.
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Hearing voices is the most serious symptom of mental illness that you know she has, thus far. Could the onset puberty set ignite a psychotic illness in someone who has that vulnerability? Perhaps, because hormones are in full flow. Remember, this can happen in someone with that vulnerability. For the average youngster, there is no such danger.
Recall what I stated at the start of my response to you: If your daughter has an acute mental illness there is no certainty that its schizophrenia.
In my opinion, she needs to be seen by a psychiatrist who can determine what is going on with her. I indicate a psychiatrist over a psychologist because medication might be called for and at this point only a psychiatrist can medicate. In the future that may change to include psychologists but not as yet. You can find a psychiatrist by starting first talking to your pediatrician or primary care doctor. Then, she will be referred. After she is seen by the psychiatrist she could be referred to a clinical psychologist for psychotherapy, whether she is on medication or not.
It is important to act quickly in order that she begin getting the help she needs.
Good Luck
