What is schizophrenia?

What is schizophrenia?
Schizophrenia is a mental health disorder that causes a person to think and act abnormally. It is rare in children less than 10 years of age and has its peak age of onset between the ages of 16 and 25. This disorder affects about 1 percent of the population, and thus high school teachers will likely see children who are in the early stages of the illness. Schizophrenia can be difficult to recognize in its early phases, and the symptoms often are blurred with other mental health disorders.
Schizophrenia usually comes on gradually, and teachers are often the first to notice the early signs. The early signs are usually non-specific. For example, students who once enjoyed friendships with classmates may seem to withdraw into a world of their own. They may say things that don’t make sense and talk about strange fears and ideas. Students may also show a gradual decline in their cognitive abilities and struggle more with their academic work. Since the disorder can come on quite gradually, it may be difficult to appreciate this decline in cognition without a longitudinal perspective over several academic years. The typical onset period lasts about 2 to 3 years. Some children show difficulties with attention, motor function, and social skills very early in life, before the onset, whereas others have no problems at all before the disorder sets in.

The signs of schizophrenia include hallucinations (hearing, seeing, smelling or feeling things that are not there), delusions (fixed false beliefs); and difficulties in organising their thoughts. A student may talk and say little of substance or the child may have ideas or fears that are odd and unusual (beyond developmental norms). Many, but not all students with schizophrenia may show a decline in their personal hygiene, develop a severe lack of motivation, or they may become apathetic or isolative. During adolescence the illness is not fully developed, and thus it is at times difficult to differentiate schizophrenia from a severe depression, substance abuse disorder, or bipolar disorder. Students who show signs of schizophrenia should be referred to appropriately qualified staff.

Educational Implications
Students with schizophrenia can have educational problems such as difficulty concentrating or paying attention. Their behaviour and performance may fluctuate from day to day. These students are likely to exhibit thought problems or physical complaints; or they may act out or become withdrawn. Sometimes they may show little or no emotional reaction; at other times, their emotional responses may be inappropriate for the situation. They may also have possible frequent or extended absences from school for medical intervention and difficulties with relationships.

Possible Educational Adjustments
Educational adjustments are designed to meet student needs on a case-by-case basis. Possible adjustments could include:
Help the student set reasonable goals
Be flexible, as symptoms may come and go – it may happen on a daily basis
Be accepting, caring and supportive – provide a safe environment for the student
Break tasks down into smaller pieces, minimize distractions, have a plan to redirect the student to help him/her return to the task at hand
Assist the student with planning and organizational skills
Have additional materials, books, supplies available for the student to use if he/she doesn’t bring them
Work with the student to relieve anxiety and have a plan if the student does become overly anxious.
Socialising may be exhausting for this student – she/he may have difficulty with groups or when everyone is excited, so plan accordingly
Give short, concise directions
Try to avoid sensory overload
Negotiated attendance (part day attendance) followed by a plan to gradually re-integrate the student into a mainstream class/program when deemed appropriate
Identified potential triggers and cues for distress and/or violence by conducting a Functional Behavioural Assessment (FBA)
Virtual schooling
Reduction of subject load
Alternative assessment
Extended time for assessment – assignments, exams
Exemption or alternative arrangements (refer to QSA Policy for Special Consideration)
Immediately addressing any negative behaviour by peers towards the student
Providing copies of class teacher’s or other students’ notes to cover emergency absences where possible
Exit plan
Allowance of break periods as needed for rest and taking of medication
Access to external agency support (Child and Youth Mental Health Services)
Regular access to a guidance officer or school based youth health nurse.