What Parents and Caregivers Should Know
Hearing your child say they saw or heard something that wasn’t there can be unsettling. For many parents and caregivers, it raises immediate questions, and sometimes fear. But hallucinations in children and teens are more complex than they may seem, and not all of them point to a serious problem.
According to the American Psychiatric Association, hallucinations are “perception-like experiences that occur without an external stimulus… vivid and clear, with the full force and impact of normal perceptions, and not under voluntary control” (2022). In simpler terms, a hallucination is when someone sees, hears, smells, tastes, or feels something that isn’t actually there, but feels completely real to them.
While we often think of hallucinations as hearing voices, they can affect any of the five senses, and even the body itself.
The most common type, especially among children and teens, is auditory hallucinations. This can include hearing voices or sounds that others do not hear. Sometimes these voices are neutral, but in more concerning situations, they may tell a child to do something harmful or frightening. Other times, children may report hearing things like sirens, footsteps, or doors slamming when nothing is there.
Visual hallucinations are also fairly common and involve seeing things that aren’t present. A child might describe shadowy figures, objects moving on their own, or images that seem real in the moment but have no external source. Less commonly, hallucinations can involve smell, taste, or touch, such as sensing a strong unpleasant odor, tasting something metallic or unusual, or feeling like something is crawling on the skin.
In more severe cases, some individuals experience somatic hallucinations, which involve internal physical sensations. These can be particularly distressing, such as feeling like something is happening inside the body that isn’t actually occurring.
With all of this in mind, it’s important to remember something that often surprises parents: not every hallucination in a child is a sign of mental illness.
Children naturally have active imaginations, and certain experiences can be part of normal development. Many children talk to imaginary friends, especially in early childhood. Others may misinterpret shadows, especially at night, or become frightened after a bad dream and believe they are seeing something real. A child who insists there’s a “monster” in the room may truly believe it in that moment, but this is often tied to fear and imagination rather than a clinical concern.
However, there are times when hallucinations may signal something more serious.
In some cases, hallucinations are associated with mental health conditions, including psychosis. Psychosis is not a diagnosis on its own, but rather a group of symptoms that affect how a person thinks and perceives reality. A child experiencing psychosis may seem confused, withdrawn, or agitated. They may have difficulty organizing their thoughts, speak in ways that don’t make sense, or behave in ways that seem unusual or out of character.
According to the American Academy of Child & Adolescent Psychiatry (2024), psychotic disorders in children are relatively rare but can significantly impact a child’s ability to function. Hallucinations in these cases are often accompanied by delusions, which are fixed and false beliefs that the child strongly holds as true.
Hallucinations can also appear in children and teens who are struggling with severe anxiety or depression. For example, a child who hears voices telling them they are worthless or encouraging self-harm may be experiencing symptoms tied to depression rather than a psychotic disorder. These are sometimes referred to as non-psychotic hallucinations. Similarly, children dealing with overwhelming stress, such as the loss of a loved one, may briefly see or hear things connected to their grief.
It’s also important to consider that hallucinations are not always related to mental health at all. In some situations, they may be caused by underlying medical conditions. High fevers, infections, migraines, and certain neurological or hormonal conditions can all lead to hallucinations. Even reactions to medications can sometimes produce these experiences.
Because of this, one of the most important steps a parent can take is to seek medical evaluation first. Ruling out a physical cause helps ensure that nothing serious is being overlooked. If no medical explanation is found, the next step is to pursue a mental health evaluation with a qualified professional, such as a psychiatrist or psychologist.
If your child reports hallucinations, your response matters. Staying calm, listening carefully, and avoiding dismissal or panic can help your child feel safe enough to share what they’re experiencing. At the same time, certain situations require immediate attention, especially if the hallucinations involve commands to harm themselves or others, or if your child seems increasingly withdrawn, fearful, or confused.
Hallucinations can feel overwhelming, but they are also treatable and manageable, especially when addressed early. With the right support, children and teens can better understand what they’re experiencing and receive the care they need to stay safe and healthy.
References
American Academy of Child & Adolescent Psychiatry. (2024). Hearing voices and seeing things. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Hearing-Voices-and-Seeing-Things-102.aspx
American Psychiatric Association. (2022). Schizophrenia Spectrum and Other Psychotic Disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev).
