Very early hallucinatory experiences: a school‐based study

Abstract

Background The prevalence and clinical significance of hallucinatory experiences among children below 7 years of age remain unknown. We aimed to determine the independent influences of sensory deficits, the presence of an imaginary companion and metacognition on hallucinatory experiences. We assumed that hallucinatory experiences were associated with (a) sensory deficits, (b) the presence of an imaginary companion (IC) and (c) metacognition defaults (i.e. first‐ and second‐order theory of mind default). Methods All children in the third year of preschool from a region of Northern France underwent medical screening. We compared the prevalence rates of visual, auditory and audio‐visual hallucinatory experiences based on (a) the presence of visual or auditory deficits, (b) the actual presence of an IC and (c) metacognition. The analyses were adjusted for age. Results A total of 1,087 children aged between 5 and 7 years were included. The prevalence rates of auditory, visual and audio‐visual hallucinatory experiences were 15.8%, 12.5% and 5.8%, respectively. The prevalences of different types of hallucinatory experiences were not significantly different according to sensory deficit. The prevalences of all types of hallucinatory experiences were significantly higher among children with an IC and among children with metacognition defaults. Conclusions The association between hallucinatory experiences and sensory deficits might concern only long‐lasting deficits. The association with the presence of an IC confirms experimental findings of the likelihood of perceiving words among meaningless auditory stimuli. Relations between hallucinatory experiences and theory of mind need to be addressed in longitudinal studies.

Hallucinations in Children and Adolescents: An Updated Review and Practical Recommendations for Clinicians

“…46,47 For example, Clemmensen et al 46 found paranoid delusions but not hallucinations to be associated with hyper-theory-of-mind. However, Pignon and colleagues 19 did find deficits in theory-of-mind skills in children with hallucinations. Perhaps the difference in age (and thus developmental stage) between these 2 studies can explain these different findings.…”

“…However, these measurements commonly assess the presence of hallucinations in the auditory domain only, using just a single item (eg “Have you ever heard voices or sounds that no one else can hear”). 19,29 Merely assessing the presence of hallucinations may be useful, but does not incorporate specific characteristics and qualities of hallucinations. For the purpose of this review, the focus will be on outlining (new) instruments specifically designed to assess the phenomenology of hallucinations in youth.…”

“…Hallucinations are reported in children as young as 5 years old, and the terms “early onset hallucinations” and “very early onset hallucinations” have used to refer to hallucinatory experiences occurring in young children. 5,19 Although these terms might imply relevance for clinical outcomes, research findings are somewhat contradictory. For example, it is unclear what early or very early age of hallucination onset suggests about clinical course.…”

Mosaic trisomy 20 and mitigation in capital crimes sentencing: A review and case report

“…By age 3 he was experiencing intense, terrifying visual hallucinations of monkeys that caused him extreme distress. Childhood visual hallucinations of this quality and severity are an unusual symptom in younger children (Pignon et al, ). We found that the literature has not provided much detail regarding psychiatric symptomatology associated with trisomy 20.…”

Association between childhood trauma and multimodal early-onset hallucinations

“…In this vein, some authors recently pointed out the value of more subtle phenomenological properties of hallucinations to decipher their mechanisms. 4 Despite the high occurrence of voices during development, even before 6 years of age, 5 the multisensory nature of experiences and their vividness were mentioned as particularly interesting properties in paediatric clinical populations. 6 The number of sensory modalities in hallucinations was even proposed as a proxy of the developmental vulnerability to hallucinations.…”