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What to Know About OCD in Children

Reviewed by Dan Brennan, MD on March 10, 2021

Mental health is just as important as physical health for your child. About 1 in 100 school-aged children develop obsessive-compulsive disorder (OCD). Knowing the symptoms and treatments of childhood-onset OCD can help you recognize it in children and get them the help they need.

What to Know About OCD in Children

OCD is a mental illness that involves unwanted repetitive thoughts and worries (obsessions), and repetitive behaviors (compulsions) that someone feels like they must do to address their obsessions.

OCD-related obsessions are different from everyday unwanted thoughts. These obsessions cause such anxiety that it affects your everyday quality of life and you can’t control or move past them. Examples of obsessions include:

  • Fear of germs or getting sick
  • Fear of accidentally hurting someone else
  • Thoughts of hurting yourself or others (even though you don’t want to)
  • Sexual thoughts or images
  • Fear of losing objects or possessions
  • Concern with even or odd numbers of objects
  • Extreme worry over your actions being morally right or wrong

Compulsive behaviors usually aim to prevent negative outcomes of your obsessive fears or worries, even though it might not make sense to others. You feel as though something bad may happen if you don’t perform a specific behavior or ritual. Examples of compulsions include:

  • Checking things in the house multiple times before you leave such as turning off the oven, turning off the heat, or locking the door
  • Counting numbers of objects in a group repeatedly
  • Avoiding a certain place or object at all costs such as public bathrooms
  • Washing your hands or body a specific number of times
  • Touching or tapping a specific object
  • Organizing or placing things until you feel they're just right

Symptoms of OCD in Children

Children as young as three years old can develop OCD, although most children with OCD start showing signs at around ages 10-12. Symptoms of OCD in children can be different from those in adults based on how they appear in the classroom and at home. You may notice signs of child-onset OCD through what they say, such as:

  • Repeatedly asking questions like “Will I be okay?” or “Are you sure that’s the answer?” and seeking reassurance
  • Complaining that they’re tired — dealing with the thoughts and fears that are part of OCD can be mentally and physically exhausting
  • Apologizing often, either to a person or a religious figure like God
  • Saying seemingly random lucky words or phrases 

You may also notice signs of OCD through a child’s behavior, such as:

  • Avoiding specific activities in group settings such as picking things up off the floor or touching something others have touched
  • Tapping or touching things such as chairs, desks, and writing utensils with hands, feet, or another body part
  • Taking a long time to finish tests and assignments, often because of repeated checking
  • Returning to rooms to check for small things they may have forgotten or to correct something “wrong” they did while leaving somewhere the first time
  • Repeatedly going to the bathroom, often to wash their hands
  • Distraction and inability to shift topics during class learning, especially if they didn’t fully understand something

Causes of OCD in Children

Scientists aren’t sure what exactly causes OCD. Research suggests that chemical imbalances and other parts of the brain play a part. 

A child may be more likely to develop the disorder if they have closely-related family members with OCD or if they’ve recently experienced a major life event like a loved one’s death, parents’ divorce, starting a new school year, or moving houses.

Sometimes, infections like the flu or Lyme disease can trigger sudden symptoms of OCD in children through an immune response that affects the brain.

Treatment of OCD in Children

A doctor, psychiatrist, or other mental health professional can diagnose OCD in a child by asking questions about their thoughts and behaviors. Once the child receives an official diagnosis, the doctor will offer a few different treatment options.

Therapy can address the thoughts and beliefs that cause OCD in children. Cognitive behavioral therapy (CBT) focuses on identifying unhelpful thought patterns and replacing them with healthier thoughts and behaviors to deal with stress. A therapist might slowly expose a child to their fear through a method called exposure and response prevention which will help the child overcome the obsessions and compulsions based on that fear.

A doctor might also recommend medication like serotonin reuptake inhibitors (SRIs), which help reduce the chemical imbalances in the brain that link to OCD. These medications don’t get rid of OCD on their own, but they can make the intrusive thoughts less severe. If the OCD symptoms are related to an infection or immune system issue, the doctor will prescribe antibiotics or other medications for those conditions.

WebMD Medical Reference

Sources

SOURCES:

Cedars Sinai: “Obsessive-Compulsive Disorder (OCD) in Children.”

Child Mind Institute: “What Does OCD Look Like in the Classroom?”

HelpGuide: “Obsessive-Compulsive Disorder (OCD).”

International OCD Foundation: “About Medications for Pediatric OCD,” “About OCD,” “What Causes OCD?” “What is OCD?” “What is PANDAS/PANS?”

Nip in the Bud: “Recognising OCD in Children.”

NYU Langone Health: “Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder in Children.”

Obsessive Compulsive Foundation of Metropolitan Chicago: “How to Help Your Child: A Parent’s Guide to OCD.”

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