Unusual Thoughts and Experiences

Although not as common as other mental health issues, some children and adolescents do experience unusual thoughts or hear or see things that do not exist. These symptoms can be very frightening for a child and may be a sign of a very serious mental health problem. If a child reports these types of experiences, a health professional should be consulted as soon as possible.

Checklist of Symptoms

Below is a list of symptoms that children with impaired thinking might experience.

  • Delusions - The child may have ideas that may seem real to them but are not based in reality. For example, a child might believe that he is being spied on by the government.
  • Hallucinations- A child may see, hear, or feel things that are not there.
  • Disorganized speech - A child’s speech may not make sense or they may change topics so frequently that they are difficult to understand.
  • A child may wonder around in a confused manner.
  • Decline in normal everyday functioning - The child may become distant from others, withdraw, or have no energy for people or activities.

Possible Diagnoses or Explanations of Behavior

In some instances, a physical condition, such as a brain tumor, can cause hallucinations or delusions. Such medical problems should be ruled out by a physician.

Below are some possible explanations and diagnoses that may result in thought problems or unusual behavior in children and teens. Click on the disorder name to learn more about it from the A-Z Disorder Guide provided by the NYU Child Study Center.


Schizophrenia is a disorder that causes delusions and hallucinations. Research suggests that it is an inherited disorder that is caused by abnormalities in the brain. It is rare in children under the age of 12, but affects about 1% of the population in the United States. A child is at greater risk of developing schizophrenia if a parent or sibling has the disorder.

Posttraumatic Stress Disorder

In some cases, children who have been through severe traumatic events may experience auditory hallucinations or paranoid thoughts.

Substance Use Disorder

The use of some drugs can result in experiences similar to hallucinations or delusions. Therefore, it is important to rule out the use of substances.


Severe cases of depression can at times be accompanied by hallucinations or delusions. If these problems occur only during periods of depression, a child may be experiencing a mood disorder with psychotic features.

Learn about Evaluation and Treatment of mental health problems among children.



Information provided on this website about common emotional and behavioral problems experienced by children is drawn from sources including:

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author.

Boston Bar Association. (2009). The Parents' How-to Guide to Children's Mental Health Services in Massachusetts (2nd edition). Boston: Author.  URL:http://www.bostonbar.org/theguide/bba_theguide_jan2009.pdf. Accessed: 2010-12-09. (Archived by WebCite® at http://www.webcitation.org/5ur8YAB1Z)

Klimkeit, E. I., Mattingley, J. B., Sheppard, D. M., Farrow, M., Bradshaw, J. L. (2004). Examining the Development of Attention and Executive Functions in Children with a Novel Paradigm. Child Neuropsychology, 10 (3), 201-211.

NYU Child Study Center. A-Z Disorder Guide. URL:http://www.aboutourkids.org/families/disorders_treatments/az_disorder_guide. Accessed: 2010-12-09. (Archived by WebCite® at http://www.webcitation.org/5ur83VhUw)


Date Reviewed: May 31, 2011