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Obsessive Compulsive Disorder (OCD) in Kids

‚ÄčOCD Parent Handout

What Is OCD?

  • Obsessive-compulsive disorder (OCD) is a condition that causes kids to have unwanted thoughts, feelings, and fears. These are called obsessions, and they can make kids feel anxious. To relieve the obsessions and anxiety, OCD leads kids to do behaviors called compulsions (also called rituals). Children sometimes describe their obsessions as “bad thoughts” or fears or worries.  And in some cases, they have a very hard time describing or putting into words what it is that is bothering them.  But they feel compelled to engage in rituals that help to reduce their anxiety or discomfort – albeit temporarily.


    Who Is Affected By OCD?

  • Millions of people around the world have OCD.  In the U.S., current estimates are that approximately 1 in 40 adults and 1 in 100 children suffer with this potentially debilitating disorder.


    What Other Disorders Might Co-exist with My Child’s OCD?

    A number of other mental health disorders frequently occur with OCD.  In fact, it is the rule, rather than the exception, that your child will have at least one other co-existing disorder.  A trained mental health professional can diagnose and provide appropriate treatment for these conditions as well as OCD. 


These disorders include:

  • Anxiety Disorders

  • Depression (e.g., Major Depressive Disorder)

  • Bipolar Disorder

  • Attention-Deficit/Hyperactivity Disorder (AD/HD)

  • Feeding/Eating Disorders

  • Autism Spectrum Disorders (ASD)

  • Tic Disorders/Tourette Syndrome (TS)


What Are Obsessions?

  • Obsessions are fears that kids with OCD can't stop thinking about. They may realize their thoughts don't make sense, but they still feel anxious about certain things.


These fears might include whether:

  • They, or someone else, will get sick, hurt, or die

  • They said a bad word, had a bad thought, or made a mistake

  • They have broken a rule, done a bad thing, or sinned

  • Something is clean, dirty, or germy

  • Something is straight, even, or placed in an exact way


What Are Compulsions?

  • Compulsions (rituals) are behaviors that kids with OCD do repeatedly. OCD causes kids to feel they have to do rituals to "make sure" things are clean, safe, in order, even, or just right. To kids with OCD, rituals seem to have the power to prevent bad things from happening.


Rituals include things like:

  • washing and cleaning

  • often erasing things, re-writing, re-doing, or re-reading

  • repeating a word, phrase, or question much more than necessary

  • going in and out of doorways several times in a row

  • checking to make sure a light is off, a door is locked, or checking and re-checking homework

  • having things in a specific order

  • counting to a certain 'good' number, avoiding "unlucky" numbers


Why Do People Get OCD?

  • Kids with more negative temperaments and behavioral inhibition are more likely to develop obsessive-compulsive disorder, as are those with first-degree relatives who have OCD. Likelihood particularly increases with relatives who had child-onset OCD. Children who have experienced abuse or other stressful or traumatic events are also more at risk.

  • Some children experience a sudden onset of OCD symptoms associated with various infectious agents and a post-infectious autoimmune syndrome (also known as PANDAS or PANS).


What's It Like for Kids With OCD?

  • Kids don't always talk about the fears and behaviors OCD causes. They may feel embarrassed or confused about their fear and keep it to themselves. They may try to hide rituals they do. They may worry that others will tease them about their fears and rituals.

  • Young children experience OCD differently than adolescents and adults. The disorder can manifest as early as 5, but a child may lack the self-awareness to recognize that his thoughts and fears are exaggerated or unrealistic, and he may not be fully aware of why he is compelled to perform a ritual; he just knows that it gives him a “just right” feeling, at least momentarily. Later, what professionals call “magical thinking” emerges: Though he knows it is far-fetched, a child finds himself compelled, if he has scratched his left shoulder, to scratch his right shoulder, so mom will be less likely to die in a car accident, for instance. In any case, the response is highly structured and repetitive, making the child appear rigid and rule-bound and interfering with normal functioning.


What Might Parents Notice?

  • Many kids have OCD for a while before parents, teachers, or doctors realize it. Parents might only learn about the OCD if their child tells them, or if they notice the child seems overly worried or is doing behaviors that seem like rituals.

  • Sometimes, parents may notice other difficulties that can be a result of OCD. For example, OCD can cause kids to:

  • have trouble concentrating on schoolwork, or enjoying activities

  • feel and act irritable, upset, sad, or anxious

  • seem unsure of whether things are OK

  • have trouble deciding or choosing

  • take much too long to do everyday tasks

  • get upset and lose their temper if they can't make something perfect or if something is out of place

  • insist that a parent say or do something an exact way


OCD At School

  • Symptoms of OCD may be obvious at school.  But even if your child hides his or her OCD during school hours, the disorder may be negatively affecting him or her academically, socially, emotionally, or behaviorally.  The decision about whether to tell your child’s teachers about OCD is a personal one.  But it’s important to know that there are benefits to informing school personnel about your son’s or daughter’s OCD. You’ll need to weigh the benefits of openness against privacy and other concerns.


Resources for OCD Information Online