Obsessive-compulsive disorder in children and adolescents has become more common in recent years. There are about one in every 200 children with OCD. All children have worries and negative thoughts sometimes. But a child with OCD can’t stop their disturbing thoughts, images, and urges, no matter what they do. These obsessive thoughts tend to make them behave in a particular and repetitive way1. Parents and caregivers should understand the unique impact that a child with OCD can experience, so they can help the child receive effective treatment. While the signs and symptoms of OCD in children and adults share many similarities, there are important differences.

Similar Symptoms of Other Conditions

In addition, the signs of OCD in children can be similar to those of ADHD, autism, and Tourette’s syndrome. A thorough medical and psychological evaluation can help the doctor make an accurate diagnosis.

What Does a Child with OCD Feel?

A child with OCD does not always talk about their fears or the reasons for their behaviors. They may feel embarrassed or confused by their fear and keep it to themselves. Many children try to hide the rituals they perform. Because they worry about being bullied by other children for their fears and rituals. A child with OCD feels unable to stop focusing on their obsessions. They feel the need to carry out the rituals to protect themselves against bad things they imagine could happen. For some children, performing a ritual is the only way to feel “that everything is okay.”

What Signs Can Parents Notice?

A child with OCD may have symptoms for some time before parents, teachers, or doctors notice. Often, parents only find out about their child’s OCD when the child tells them, or when they notice that the child seems overly worried or is engaging in behaviors that seem like rituals.

Difficulties Faced by a Child with OCD

Sometimes, parents may notice other difficulties that can result from OCD. For example, a child with OCD may:

  • Have trouble concentrating on schoolwork or enjoying activities;
  • Become irritable, upset, sad, or anxious;
  • Seem insecure if they don’t know that everything is okay;
  • Have trouble making decisions or choosing;
  • Take a long time to complete daily tasks such as getting dressed, organizing their backpack, finishing homework, or taking a shower;
  • Get upset and lose patience if they can’t do something perfectly or notice something out of place;
  • Insist that parents say or do something in an exact way.

What Symptoms Does a Child with OCD Have?

A child with OCD experiences symptoms involving repetitive thoughts or images called obsessions2. Compulsions are the ritual behaviors they perform repeatedly to get rid of the thoughts.

Obsessive Thoughts

Examples of obsessive thoughts in a child with OCD can include:

  • Excessive worry about germs, dirt, or illness
  • Repeated doubts, such as if the stove is turned off
  • Constant thoughts about a parent having an accident
  • Excessive worry about symmetry, order, and accuracy
  • Disturbing thoughts that don’t align with the religious teachings they study
  • Excessive worry about knowing or remembering facts that seem very trivial
  • Irrational attention to details
  • Excessive worry that something bad will happen, like a car accident or someone breaking into their home
  • Aggressive thoughts and urges (may be more likely in teenagers)

Compulsive Behaviors

Examples of compulsive behaviors in children with OCD may include:

  • Excessive hand-washing, often more than 100 times a day
  • Repeatedly checking to make sure the stove is off or the door is locked
  • Strictly following self-imposed rules, like arranging personal objects on a shelf in a certain way and getting very upset if someone moves them
  • Counting and recounting everything, like floor tiles or bricks on a wall
  • Worry about the sequence or grouping of objects
  • Excessive repetition of the same questions
  • Repeating words spoken by themselves or others
  • Repeating sounds, words, numbers, or music to someone or themselves

Causes of OCD in Children?

Experts do not fully understand what causes the development of OCD in children or in adults. Studies point to the involvement of a combination of biological and environmental factors.

Biological Factors

Research shows a link between insufficient levels of the neurotransmitter (chemicals produced by neurons) and serotonin in the development of OCD in children. There is some evidence that parents may pass on serotonin inefficiencies to their children. Because of this, scientists also suspect heredity plays a role in the development of OCD.

Environmental Factors

Certain stressful or environmental situations can trigger OCD in a child who is predisposed to the disorder. Environmental situations that may cause or worsen symptoms include:

  • Physical or emotional abuse
  • Major changes to living environment
  • Illness (such as streptococcal infections)
  • Death of a loved one
  • Parental divorce
  • Changes or problems related to school
  • Other traumatic events and experiences

Since there is no laboratory test to diagnose a child with OCD, doctors base their diagnosis on a comprehensive psychiatric evaluation, after ruling out other physical causes for the OCD symptoms.

Treatment for a Child with OCD?

Individualized treatment for a child with OCD will depend on the doctor’s assessment of the following information:

  • Physical exam, overall health, maturity level, medical condition
  • Severity of symptoms
  • The presence or absence of co-occurring disorders
  • Tolerance level for certain medications
  • Tolerance for certain therapeutic strategies
  • Expectations for the possible course of the illness

A child with OCD can be effectively treated, especially if the disorder is diagnosed early. Doctors commonly use a combination of therapy and medication. The usual therapy strategy for OCD involves a cognitive-behavioral therapy approach. Selective serotonin reuptake inhibitors (SSRIs) are the most effective class of medication for treating OCD in both children and adults3. The doctor or mental health professional may also recommend family therapy because parents play a critical role in their child’s treatment and recovery. A considerable number of children with OCD also have a comorbid disorder (more than one illness at the same time), which also requires treatment.

What Can Parents Do About It?

Talk to your child about what is happening. Speak with support, listen, and show love. Say something that relates to your child’s situation, such as: “I see that you get worried about small things, like whether your socks are clean or if your shoes are lined up.” I notice that you get stressed when you can’t solve something.” Explain that something called OCD may be causing the worry and fixation. Tell your child that an appointment with a doctor can find out if this is what is really going on. Reassure them as best you can, saying it can get better and you will be there to help. Book an appointment with a child psychiatrist or psychologist. Your child’s pediatrician can help you find the right professional. Be part of your child’s therapy. Learn everything you can about how parents can help when a child has OCD. Overcoming OCD is a process. There will be many therapy appointments, and it’s important to attend all of them. Practice the things the therapist recommends. Encourage your child. Get support, and offer it. There are many resources and support for parents and families dealing with OCD. Knowing you are not alone can help you cope. Sharing success stories with other parents can give you hope and confidence. See Also: Music Therapy for Children Photos: derivative work