The Early Signs of OCD in Children: What to Look For
Obsessive-compulsive disorder (OCD) isn’t just about being organized or cleanly. It’s a complex, diagnosable mental health condition that can be a struggle to live with. Children are difficult to diagnose, because they may not yet have the vocabulary to articulate what they’re going through. Here are the signs of OCD in children to watch out for.
What Is OCD in Children?
OCD in children manifests similarly to OCD in adults, but it may present differently due to developmental stages. Children with OCD have obsessive thoughts they cannot control and engage in compulsive behaviors to alleviate the anxiety that these thoughts produce. For example, a child might be consumed by fears of germs and feel compelled to wash their hands repeatedly, even if their hands are raw or painful.
Common Obsessions in Children
Fear of Contamination: A heightened fear of germs, dirt, or illness — this may result in avoiding certain places, objects, or people perceived as “unclean.”
Excessive Doubts or Need for Reassurance: Constantly questioning whether they’ve done something correctly, like locking a door or finishing homework
Symmetry and Order: An intense need for things to look, feel, or be arranged in a specific way
Harm Obsessions: A fear of causing harm to themselves or to their loved ones, even if the thought is completely out of character
Magical Thinking: Belief that specific thoughts or actions can influence unrelated events, such as believing a loved one will be safe if they touch a doorknob a certain number of times
Worries About Household Safety: A preoccupation with whether the doors are locked, the alarm is set, the stove is off, or the windows are shut, for example
Common Compulsions in Children
Excessive Cleaning: Frequent handwashing, showering, or cleaning objects
Checking: Repeatedly checking locks, appliances, or schoolwork
Repetitive Actions: Touching objects a certain number of times, retracing steps, or repeating words or phrases
Counting or Arranging: Counting objects in a specific pattern or rearranging items until they feel “just right”
Seeking Reassurance: Frequently asking parents, teachers, or friends for confirmation that everything is okay
Early Behavioral Signs
OCD symptoms can start to appear as early as preschool age, though the condition is most commonly diagnosed between ages 8 and 12. Here are some early behavioral signs to watch for:
Avoidance: Children with OCD might avoid situations or objects that trigger their obsessions, such as avoiding the playground for fear of germs.
Distress During Interruptions: If their rituals or routines are disrupted, children with OCD may experience extreme distress or throw a tantrum.
Excessive Time Spent on Tasks: Daily activities like getting dressed or completing homework may take much longer than usual due to compulsive behaviors.
Mood Swings: When a child is unable to perform their compulsions or when others don’t understand their behaviors, they may become angry and frustrated.
Difficulty Concentrating: Persistent intrusive thoughts can make it challenging for children to focus on schoolwork or play.
When Is It Normal Childhood Behavior?
Many children have their own rituals or strong preferences, especially during certain developmental stages. For instance, it’s common for kids to want their favorite toys arranged in a particular way. However, the key difference lies in the level of distress and how much they impact their daily functioning. OCD behaviors are time-consuming, cause significant anxiety, and interfere with a child’s ability to participate in home and school activities.
When to Seek Help
If you notice signs of OCD in your child, it’s important to seek professional help sooner rather than later. Early intervention can prevent symptoms from worsening and improve your child’s quality of life, both now and in adulthood. A child psychologist or psychiatrist can conduct a thorough evaluation and recommend appropriate treatment options. These may include cognitive-behavioral therapy (CBT), exposure and response prevention (ERP), and, in some cases, medication. Schedule a consultation with us today to develop a therapy treatment plan for your child.
About the Author
Michelle Hession, LCSW is a Georgia licensed clinical social worker and the founder of Key Counseling Group. She provides counseling to individuals dealing with anxiety, depression, grief, stress, life transitions, OCD, substance abuse, eating disorders, trauma, ADHD, autism, infertility, postpartum depression, miscarriage, and career-related issues. She also works with children. Michelle uses modalities including IFS, brainspotting, somatic experiencing, the Gottman Method, EMDR, and mindfulness when working with clients. She offers sessions in her Atlanta, Decatur, and Roswell, as well as online.