Hallucinations are abnormal perceptual experiences. They are often described as a sensation without its corresponding object: something that is seen, heard, smelled, savored, touched or felt within; but without any real stimulus that can explain it.
While it is true that they have often been framed in a psychopathological context, and more particularly in disorders such as psychosis, these are experiences that can occur in any healthy individual under certain conditions.
Most of the scientific literature on the issue focuses on the adult population, for which the presence of the phenomenon has been explored with more emphasis, but it would not be fair to shy away from other periods of life in which it can also appear.
Therefore, in this article we will try to answer only one question: Can boys and girls hear hallucinatory voices? To do this, we will turn to scientific evidence on the subject.
Can children hallucinate voices?
There is the popular idea that, for some reason, young children are able to perceive certain nuances of reality that escape the accustomed eye of the adult man. This belief is common in many cultures around the world and it is very easy to find evidence describing it. the apparent encounter of a child with a being that only he seems to notice, In front of the astonished gaze of those who could be on the scene. There are even some viral videos on the subject, which have become popular on the net.
The explanations given for this phenomenon have been varied. At first, assumptions of a paranormal nature were used, using a spiritual or transcendental view of childhood. Today, and thanks to the development of scientific knowledge, we can bring greater empirical solidity to this particular fact, by drawing operational hypotheses that fit with explanations that are less obscure and closer to reality.
Before delving into the phenomenon of auditory hallucinations in children, it is essential to remain calm on the matter. These experiences are generally not an indication of mental illness., And there are even authors who regard them as an intrinsic stage in the development of the central nervous system. In these lines, we will discuss the knowledge on the subject in the light of scientific evidence.
Is this common?
Today, we have a fairly precise knowledge of the prevalence of auditory hallucinations at all age periods.
Studies dealing with the issue show that during childhood (nine to twelve years) 17% of children experience it, reducing this percentage to less than half (7.5%) among adolescents. Other research shows more similar percentages, so there appears to be slight discrepancies between the authors.
There is a consensus in the scientific community that childhood is a favorable stage for such experiencesBut it is in adulthood that their presence most clearly suggests a possible underlying mental disorder, although the absolute prevalence rate at this age period is significantly reduced. This fact supports theoretical models that see hallucination as a normative element in the development of the central nervous system, although we do not yet understand the mechanisms involved.
The “physical” properties of these forms of perception are described in different ways.. There are children who say they hear very simple sounds, such as pushing or the like, but in some cases have more complex experiences (human voices requiring attention or conversations between two or more “invisible figures”). Sometimes they can generate emotions of fear, promoting the warmth of related characters.
Hallucinations have been described in children up to the age of five and even younger, so the classification subtype “early onset” was coined.
Why is this happening?
We will now discuss five of the most common causes of hallucinations in childhood depending on the state of the problem. Physiological, psychological and social factors will be included.
1. Imaginary friends
A very high percentage of children report having (or having had) imaginary friends at some point in his life, and the literature indicates that in these cases there is a greater tendency to refer to visual and auditory hallucinations. This phenomenon, which is not of concern, haunts five leaders: regulating emotions and solving problems, exploring ideals, finding someone to have fun with, endure loneliness, and practice social behaviors or roles.
Most parents don’t consider this to be a negative situation, so they usually don’t worry too much or consult their pediatrician. It is generally considered to be one of the contexts in which hallucination can present itself in a mild manner. On a related note, there are even witnesses who claim that imaginary peers supported the child during developmental transitions, such as the birth of a younger brother or first contact with school or kindergarten ( and the corresponding absence of affection figures).
To finish, almost all children are able to recognize their imaginary friend as a creation of their own, Which does not exist beyond its own head. This ability to “realize” is a good prognostic factor for childhood hallucinations in general, and not just for the innocuous hypothesis of imaginary friends.
2. Adverse life events and emotional distress
Emotional discomfort, cognitive distortions and traumatic events they constitute a triad that has been associated with the onset of positive symptoms of psychosis (hallucinations and delusions), which has also been replicated in the population of children and adolescents.
This risk factor would be directly linked to the hypothesis of diathesis-stress, and would be linked to genetic factors of any kind. The model suggests that only vulnerability to psychosis is passed on from parents to children, but not the disorder itself (through specific alterations in neuronal migration during development).
However, experience intense stress if it acted as a detonating element, Precipitating its definitive clinical expression (from genotype to phenotype).
Not all children who report hallucinations have suffered traumatic situations, and not all who have experienced this type of event end up living. What she was able to corroborate was that when this phenomenon occurs in a child without signs of psychosis, due to the adversity he may experience, the symptom tends to dissolve in direct proportion to the situation of the child. conflict being resolved.
3. Sleep deprivation
Sleep deprivation has been associated with hallucinations at all ages, from adulthood to childhood. There is evidence that lack of sleep causes cognitive alterations (memory, attention, etc.), mood changes and distortions of perception. All of this occurs in healthy children without a diagnosis of mental disorder, and also in adults. Situations such as extreme sensory isolation can also cause them, along with intense fatigue and hyperthermia.
4. Metacognition: distinction between the mental and the real
Metacognition is the ability of human beings to become aware of their internal processes, such as thoughts and emotions. It is a way of thinking about what you are thinking, or even feeling what you are feeling. This higher function is essential in distinguishing what is created “on the inside” from what is perceived on the outside, and has been postulated as a key element in understanding why hallucinations occur.
Research on metacognition places all the functions that are integrated into it (mnemonic, perceptual, etc.) the prefrontal cortex, precisely the region of the brain that takes the longest to mature (Until well into the second decade of life). This delay might explain the age gradient for the prevalence of hallucinations (more frequent in infancy and progressively more rare). Thus, as this circuit developed, the subject would be more able to correctly differentiate their thoughts and external stimuli, so that the hallucinations would be permanently diluted.
Other studies indicate that childhood hallucinations are more common in children children in difficulty for a normative development of the theory of mind (Theory of Mind), that is, the ability to know oneself as individuals separated from one’s environment and to attribute oneself to other internal states other than one’s own. Although very interesting, this theory and the one referring to metacognition need more research in the future.
Neuroimaging studies with children with auditory hallucinations indicate a functional impairment of the faulty neural network, which is responsible for the things we think and feel when the mind is at rest. It is a set of structures that are activated when apparently “nothing is done”, And which seem to aim to prepare the central nervous system to activate spontaneously when needed.
It has also been described that the primary / secondary auditory cortex, which responds to the perception of an objective sound stimulus, is activated at the same time as children indicate hearing a hallucination.
In conclusion, and recovering the question with which we opened this text (can children hear voices by hallucination?), The answer would be yes. Despite this, there are still many questions that need to be answered regarding the causes and factors that determine the prognosis.
Hallucinations in childhood it is usually a mild and transient phenomenon, Which tends to full resolution over time. However, in some cases complications may arise to be considered, as they may require a specific therapeutic approach.
It has been observed that the hallucinatory experience of childhood it may be associated with significant emotional distress and the onset of other emotional problems of clinical importance. In adolescence, a higher frequency of suicidal ideation has been described in those who report suffering from the symptom, after controlling for the accompanying health problems. Therefore, as long as the symptom persists and causes the person suffering, it will be necessary to seek professional help.
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- Fleming, S. and Dolan, RJ (2012). Neural basis of metacognitive ability. Philosophical Transactions The Royal Society Publishing, 367 (1954), 1338-1349.
- Kanwar, A. (2010). Hallucinations in Children: Diagnostic and Treatment Strategies. Current Psychiatry Archives, 9 (10), 53-56.
- Maijer, K., Hayward, M., Fernyhough, C., Calkins, M., Debbané, M., Jardr, R…. Bartels-Velthuis, A. (2019). Hallucinations in children and adolescents: an updated review and practical recommendations for physicians. Schizophrenia Bulletin, 45 (1), 5-23.