Schizophrenia involves a range of problems with thinking, behavior or emotions. Signs and symptoms may vary, but usually involve delusions, hallucinations or disorganized speech, and reflect an impaired ability to function. The effect can be disabling. In most people with schizophrenia, symptoms generally start in the mid- to late 20s, though it can start later, up to the mid-30s. Schizophrenia is considered early onset when it starts before the age of 18. Onset of schizophrenia in children younger than age 13 is extremely rare. Symptoms can vary in type and severity over time, with periods of worsening and remission of symptoms. Some symptoms may always be present. Schizophrenia can be difficult to recognize in the early phases. Early signs and symptoms Schizophrenia signs and symptoms in children and teenagers are similar to those in adults, but the condition may be more difficult to recognize in this age group. Early signs and symptoms may include problems with thinking, behavior and emotions. Thinking: 
Problems with thinking and reasoning
Bizarre ideas or speech
Confusing dreams or television for reality
 Behavior: 
Withdrawal from friends and family
Trouble sleeping
Lack of motivation — for example, showing up as a drop in performance at school
Not meeting daily expectations, such as bathing or dressing
Bizarre behavior
Violent or aggressive behavior or agitation
Recreational drug or nicotine use
 Emotions: 
Irritability or depressed mood
Lack of emotion, or emotions inappropriate for the situation
Strange anxieties and fears
Excessive suspicion of others
 Later signs and symptoms As children with schizophrenia age, more typical signs and symptoms of the disorder begin to appear. Signs and symptoms may include: 
Delusions. These are false beliefs that are not based in reality. For example, you think that you're being harmed or harassed; that certain gestures or comments are directed at you; that you have exceptional ability or fame; that another person is in love with you; or that a major catastrophe is about to occur. Delusions occur in most people with schizophrenia.
Hallucinations. These usually involve seeing or hearing things that don't exist. Yet for the person with schizophrenia, hallucinations have the full force and impact of a normal experience. Hallucinations can be in any of the senses, but hearing voices is the most common hallucination.
Disorganized thinking. Disorganized thinking is inferred from disorganized speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. Rarely, speech may include putting together meaningless words that can't be understood, sometimes known as word salad.
Extremely disorganized or abnormal motor behavior. This may show in several ways, from childlike silliness to unpredictable agitation. Behavior is not focused on a goal, which makes it hard to do tasks. Behavior can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement.
Negative symptoms. This refers to reduced or lack of ability to function normally. For example, the person may neglect personal hygiene or appear to lack emotion — doesn't make eye contact, doesn't change facial expressions, speaks in a monotone, or doesn't add hand or head movements that normally occur when speaking. Also, the person may avoid people and activities or lack the ability to experience pleasure.
 Compared with schizophrenia symptoms in adults, children and teens may be: 
Less likely to have delusions
More likely to have visual hallucinations
 Symptoms may be difficult to interpret When childhood schizophrenia begins early in life, symptoms may build up gradually. Early signs and symptoms may be so vague that you can't recognize what's wrong. Some early signs can be mistaken for typical development during early teen years, or they could be symptoms of other mental or physical conditions.
 As time goes on, signs may become more severe and more noticeable. Eventually, your child may develop the symptoms of psychosis, including hallucinations, delusions and difficulty organizing thoughts. As thoughts become more disorganized, there's often a "break from reality" (psychosis) frequently requiring hospitalization and treatment with medication.