"One minute she would be really sweet and loving and all of sudden she'd just turn. Literally it was like the Exorcist -- she would become another person. Her eyes would change, her demeanor changed, her voice flattened out," Schofield said. "Her imaginary friends are not imaginary at all but command hallucinations. They tell her to hurt herself or someone else."
Schofield and his wife also had a difficult time getting help for Jani because of the stigma that aggressive behavior in a child indicates that the parents are at fault due to abuse or neglect.
Though schizophrenia has a strong genetic component, some triggers can precipitate the disorder. In children, these triggers can be a history of brain trauma, having a seizure disorder or being premature. Alcohol or drug use during pregnancy can also increase the risk for brain damage.
Controling schizophrenic hallucinations and other symptoms requires strong drugs that have side effects including weight gain, diabetes, and hypertension.
Jani's current regimen is Tegretol, an anti-seizure drug that is also a mood stabilizer, Thorazine, the only anti-psychotic that has worked for her, and lithium, which helps the effects of the Thorazine.
For many, medications can successfully control psychotic episodes, but nothing can prevent the disorder from developing and there is no cure. As children grow, the schizophrenia persists, slowly robbing their minds of their cognitive abilities.
"People with childhood-onset are more impaired because they haven't gone through normal developmental processes, unlike people afflicted in their 20s, who have acomplished some of those developmental tasks," said Dr. Dost Ongur, clinical director of the Psychiatric Disorders Division at McLean Hospital in Boston. "Schizophrenia leads people to live very limited lives. In general, the prognosis for schizophrenia is poor."
As children become more aware of the difference between themselves and those around them they constantly struggle between what they know to be reality for themselves and what they are told is the true reality. Medications and therapy are meant to help make that distinction, but it is easier for people with childhood-onset schizophrenia to regress back to their own world.
"Kids are much more likely to simply respond to the delusions," said Dr. Donald Condie, assistant professor of child psychology at Harvard Medical School, and adults are better able to talk their way out of them. "Therefore, the cognitive behavior therapy you can try with adults won't work with kids."
Lacking the proper development, children with schizophrenia can develop maladaptive coping strategies as they get older -- avoiding difficult tasks, refusing to go to class or speak with their teacher if they have trouble, and self-defeating attitudes that keep them from trying new things.
"It's very tough on a family seeing a child whose development is derailed very early," Condie said.