How to Help a Child Who Is Hearing Voices

A child saying they hear voices is frightening for most parents, but it is a far more ordinary experience than its reputation suggests, and for most children it is not a sign of serious mental illness.1The Conversation. Parents, don’t panic if your child hears voices, it’s actually quite common How adults respond tends to matter more than the voices themselves. Calm, belief and curiosity help a child cope, while alarm can make them hide it. Voices are also often a signal of something else the child is struggling with, so helping usually means looking past the voice to the child’s life.

How Common Hearing Voices Is in Children

Around 8% of young people, roughly 1 in 12, hear voices at some stage in childhood.2The Conversation. Parents, don’t panic if your child hears voices, it’s actually quite common That makes it about as common as asthma or dyslexia in children.3The Conversation. Parents, don’t panic if your child hears voices, it’s actually quite common Many of these are one-off experiences, with up to three in four children hearing a voice only once.4The Conversation. Parents, don’t panic if your child hears voices, it’s actually quite common Childhood hallucinations are usually simple and short-lived.5PubMed. Fifteen minute consultation on children ‘hearing voices’: when to worry and when to refer

Among children brought to a specialist clinic for voices, only about 1 in 9 met the stricter definition of a psychotic disorder.6PubMed. Children seeking help for auditory verbal hallucinations; who are they? Even among children whose voices worried families enough to seek help, most needed explanation and coping skills rather than antipsychotic medicine.7PubMed. Children seeking help for auditory verbal hallucinations; who are they? Parents often jump straight to schizophrenia, but it usually begins in the late teens or adulthood, rarely in young children.

What children hear varies. It may be a single word, their name being called, or whispering. Some voices are friendly or comforting, others critical or scary. Some children say the voice comes from inside their head, others from outside.

One voice experience, or a brief run of them, tells you very little about the future. What matters more is whether the voices persist and cause distress or disrupt daily life. A clear trigger, such as a stressful week, illness or a bad night’s sleep, is one reassuring clue among several, though not a guarantee. A child who is still going to school, playing, keeping friends and eating normally fits the pattern most often seen when voices turn out to be harmless.

What to Say and Do When Your Child Tells You

The most important thing is to stay calm and show you are not afraid of the voices or think your child is “mad.”8Voice Collective. Voices & Visions: A straight talking introduction for parents, carers and family members of young people who hear voices or see visions Believe them: hearing voices is common enough in childhood that if your child says it happens, it likely does.9Voice Collective. Voices & Visions: A straight talking introduction for parents, carers and family members of young people who hear voices or see visions Then talk with your child and gently find out what exactly they are experiencing.10AACAP. Hearing Voices and Seeing Things

In that first conversation, thank them for telling you. Say something simple and true: you believe them, lots of children hear voices, and the two of you will work it out together. Don’t promise the voices will vanish by a certain date. Promise that you’ll stay with them and help with whatever comes next.

Give them space to talk, because experiences kept inside are hard to make sense of.11Voice Collective. Voices & Visions: A straight talking introduction for parents, carers and family members of young people who hear voices or see visions If what they describe sounds strange, listen without judgement, since they are trying to describe something unusual.12Voice Collective. Voices & Visions: A straight talking introduction for parents, carers and family members of young people who hear voices or see visions Avoid debates about whether the voice is real, and focus on how they feel.13Voice Collective. Voices & Visions: A straight talking introduction for parents, carers and family members of young people who hear voices or see visions

A few questions help you understand without interrogating. When do you hear it, and what is happening at the time? What does it say, and how does it make you feel? Is it friendly, scary, or telling you to do things? Does anything make it quieter?

Some common reactions backfire. Saying “it’s not real” can make a child stop telling you. Visible panic teaches them the voices are dangerous. Making voices the main topic every day can raise anxiety, so check in lightly instead.

It is easy to assume the voices are the whole problem, but that can leave the real worry, such as bullying or trouble at school, unaddressed.14Voice Collective. Voices & Visions: A straight talking introduction for parents, carers and family members of young people who hear voices or see visions Some young people prefer home as a safe place to feel normal, so let your child set how often voices come up.15PubMed Central. “Figuring out how to be normal”: Exploring how young people and parents make sense of voice‐hearing in the family context

If you talk to the school, ask teachers about changes in mood, friendships or bullying. Share only what your child agrees to, to protect trust. It also helps to agree on a quiet place or a trusted adult for times when the voices flare at school.

What Can Cause a Child to Hear Voices

For many children, voices begin around life problems and the feelings they bring.16Intervoice. It’s not the end of the world Ordinary pressures such as exam stress, friendship trouble, moving house, a family separation or a bereavement can all be linked with voices starting. Voices may reflect what is on the child’s mind; a voice that criticises, for example, often echoes the child’s own worries about being good enough. Looking for what changed in the weeks before the voices began is often more useful than focusing on what they say.

Hurtful experiences such as abuse, neglect and serious family difficulties are linked with hearing voices, and the more such experiences, the stronger the link.17PubMed Central. The role of inner speech on the association between childhood adversity and ‘hearing voices’ Childhood sexual and emotional abuse make people more likely to hear voices, both distressing and non-distressing ones.18PubMed. Childhood trauma and auditory verbal hallucinations Most children who hear voices have not been abused, though. Across people outside psychiatric care who hear voices, about 1 in 5 reported sexual abuse.19PubMed. Voices from the storm: a critical review of quantitative studies of auditory verbal hallucinations and childhood sexual abuse In young people with trauma-related stress, voices may come from the mind “switching off” from overwhelming feelings.20PubMed Central. Voice hearing in young people with posttraumatic stress disorder (PTSD) following multiple trauma exposure

Being bullied, at school or online, is one of the hurtful experiences that can sit behind voices, and children often hide it out of embarrassment. Voices that mock or threaten may mirror what the child hears from peers, so the content is worth gently noticing. If bullying turns up, dealing with it directly with the school is part of helping with the voices.

To consider whether something has happened to your child, ask open questions about school, friends and the adults in their life. Don’t push for details; tell them they can tell you anything. If you suspect abuse, contact child protection services or your doctor promptly.

Hearing or seeing things while falling asleep or waking up is very common and usually harmless.21PubMed Central. From Phenomenology to Neurophysiological Understanding of Hallucinations in Children and Adolescents Rarely, frequent sleep-related hallucinations are part of a sleep disorder such as narcolepsy.22PubMed Central. From Phenomenology to Neurophysiological Understanding of Hallucinations in Children and Adolescents Voices only at the edge of sleep are usually normal, and good sleep routines can reduce them. Sudden falling asleep in the day, or muscle weakness when laughing, warrants a doctor’s visit. Voices can also sometimes be the first sign of a physical illness rather than a mental health problem.23PubMed. Early warning signs in misrecognized secondary pediatric psychotic disorders: a systematic review

Helping Your Child Cope With the Voices

Young people taught coping strategies say they learned ways to block out the voice and not dwell on it.30PubMed Central. Coping strategy enhancement for the treatment of distressing voices in young people: A service evaluation within routine clinical practice The aim is control and less distress, not necessarily making voices vanish.

A younger child may do best with concrete tools such as a comfort toy, a drawing or a favourite song, while a teenager may prefer music through headphones, journaling, or messaging a friend. Let your child choose what to try, since a tool imposed by a parent is less likely to be used when the voices come. Not every tool works every time, so several options give them something to turn to if the first fails.

You can build a coping plan together. Write a short list of what helps and keep it on their phone or bedroom wall. Practise the tools on calm days so they’re ready, and review what worked after a hard moment.

If a voice tells them to do things, remind them they don’t have to obey it. Agree that they will tell you if a voice tells them to hurt anyone. Treat such commands as a reason to seek help soon.

When to Get Professional Help

Voices that persist are more often linked to other emotional and behaviour problems.31The British Journal of Psychiatry. Course of auditory vocal hallucinations in childhood: 5-year follow-up study Hearing several voices, or voices felt to come from outside the head, makes persistence more likely.32The British Journal of Psychiatry. Course of auditory vocal hallucinations in childhood: 5-year follow-up study Persistent voices have also been linked with poorer school results.33The British Journal of Psychiatry. Course of auditory vocal hallucinations in childhood: 5-year follow-up study So book a doctor’s visit if voices are severe, repeated, or affecting school, sleep or friendships. Seek emergency help if your child talks of harming themselves or others.

Distress shows up in everyday life. A child who avoids being alone, cannot sleep, stops eating, or cries or becomes angry after voices is telling you the voices are a problem. A child who describes voices calmly and carries on as normal is less urgent, but still worth mentioning to a doctor if the voices keep happening over weeks. Your own sense that something is not right is a valid reason to book a visit.

Other changes alongside the voices call for assessment sooner: marked withdrawal, a sharp drop in school performance, unusual fears or suspicions, or odd speech. Low mood, extreme anxiety, or talk of feeling hopeless matter as much as the voices, since they can need treatment of their own. Write down what you’ve noticed and roughly when it began, because the pattern over time helps the doctor more than a single example.

Start with your family doctor or pediatrician. They will ask about the voices, mood, sleep, school and stressful events, and may check for physical causes before mental health ones.

Many families struggle to find support and clear information. Ask directly for a child mental health referral, and don’t hesitate to ask services to really listen to you and your child.

What Treatment Looks Like

CBT (cognitive behavioural therapy), a talking therapy, helps people react to voices in ways that are less upsetting rather than trying only to remove them.34Child Mind Institute. How Does CBT Help People With Psychosis? In a small trial of therapy for youth aged 10 to 16, the voices’ overall impact fell by about 40%.35PubMed. Stronger than your voices: A cognitive behavioral therapy for youth suffering from auditory verbal hallucinations Good therapy looks at the child’s relationship with the voice and with the people around them.36PubMed. Whispers, echoes, friends and fears: forms and functions of voice-hearing in adolescence

Sessions usually involve the child and therapist working together to understand what triggers the voices, what the child believes about them, and how they respond. The therapist may help the child test frightening beliefs, such as that the voice has power over them, and practise calmer ways to respond. Work is often done at the child’s pace, with parents sometimes joining part of the sessions.

Treatment may also reach the problems around the voices. If they’re linked to bullying, family stress or past trauma, that can mean family sessions or trauma-focused therapy. Help with anxiety, low mood or sleep difficulties can reduce how much the voices trouble the child, and schools may be asked to adjust workload or give extra support.

At home, help your child practise skills between sessions and ask the therapist how you can respond. Expect gradual change over weeks.

Only the roughly 1 in 9 with a stricter psychotic disorder were prescribed antipsychotic medicine.37PubMed. Children seeking help for auditory verbal hallucinations; who are they? These medicines can cause side effects such as weight gain and movement problems.38PubMed. Management of schizophrenia in children and adolescents: focus on pharmacotherapy So doctors should start low, increase slowly, and check movement symptoms at months 1, 2, 3, 6 and 9, then regularly.39PubMed Central. Neurological Adverse Effects of Antipsychotic Medication in Children and Young People If medicine is proposed, ask why it is needed now rather than talking therapy alone, which side effects to watch for, how often checks and blood tests happen, and how long it might be taken.

Will the Voices Go Away

For about 6 in 10 children, voices disappear as they grow and learn to handle the problems behind them.40Intervoice. It’s not the end of the world In one long-term follow-up, about a quarter of children still heard voices five years later,41The British Journal of Psychiatry. Course of auditory vocal hallucinations in childhood: 5-year follow-up study and after 11 years only about 6% still did.42PubMed. Course of auditory vocal hallucinations in childhood: 11-year follow-up study Voices lasting into adolescence were linked to traumatic events and post-traumatic stress.43PubMed. Course of auditory vocal hallucinations in childhood: 11-year follow-up study

These figures describe groups of children, so they show what is likely and cannot predict what will happen to any one child. Noting whether the voices are rarer, quieter or less upsetting gives a more useful picture than asking whether they have gone entirely.

Parents often come to accept the voices and hope for the future despite the uncertainty.44PubMed Central. “Figuring out how to be normal”: Exploring how young people and parents make sense of voice‐hearing in the family context Seeing the voices as separate from the child helps some parents.45PubMed Central. “Figuring out how to be normal”: Exploring how young people and parents make sense of voice‐hearing in the family context

Caring for a voice-hearing child is emotionally heavy.46PubMed Central. “Figuring out how to be normal”: Exploring how young people and parents make sense of voice‐hearing in the family context Peer support groups for parents of voice hearers exist, and they can be a place to put some of that weight down.