73 Jared is a 6-year-old boy who comes to the PMHNP for an evaluation

with his father. The father reports that he is worried about Jared because he has had problems fitting in at school ever since he started kindergarten. He does not have any friends at school and does not seem to know how to play with others. Dad reports that Jared has never been “very talkative” and sometimes switches from one topic to another without any reason. When considering early-onset schizophrenia, the PMHNP recognizes that which of the following must be present?

A. Visual or auditory hallucinations
B. Deteriorating function over the last several months
C. A history of normal developmental milestones
D. Negative symptom onset before age 5 years