OCD in children: What parents need to know

The possibility that your child has obsessive-compulsive disorder (OCD) can be frightening. Learn about OCD in children, how it is diagnosed, how it is treated, and how you can help your child at home.

Treatment for OCD works by assisting children in confronting difficult feelings, so they do not feel compelled to perform rituals to block them.

What exactly is OCD?

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterised by obsessions and/or compulsions. Obsessions are recurring, upsetting, and unwanted thoughts that can cause a great deal of distress and worry, whereas compulsions are rituals a child may feel compelled to perform to rid themselves of the unwanted feelings.

What are the symptoms of OCD in kids?

Obsessions in children with OCD may be unhealthy. They may be obsessed, for example, with avoiding germs, keeping their family and themselves safe, or having things “just right”.

Some children will also count things, arrange their toys in a specific pattern, or arrange them symmetrically.

How is OCD diagnosed in children?

According to psychologists, an OCD diagnosis is somewhat subjective.

The length of time the rituals take is less important than how much they disrupt the child’s life. Does your child struggle to leave the house in the morning or transition to new activities? Can they pivot to doing something else when they need to organise things, or does shifting gears cause a lot of stress?You should question your child about the ritual to see if they feel compelled to perform it and if it bothers them.

Healthcare providers will also consider whether the child has PANDAS or PANS, a rare condition in which an infection, most commonly strep throat, can cause an abrupt and dramatic onset of OCD.

When can a child develop OCD?

OCD can appear at any age, but it is most common in children aged eight to 12. OCD is rarely diagnosed before the age of five.

Is it possible for OCD to go away on its own?

According to psychologists, if left untreated, OCD tends to worsen rather than improve. This may be a frightening thought for parents whose children are suffering from OCD, but there is hope.

With treatment, OCD can improve.

Furthermore, treatment may be easier to obtain now than in the past. COVID has opened a few more doors because people can now meet with a therapist online, even if they live in remote areas.

What is the treatment for OCD in children?

The gold standard for OCD treatment is exposure and prevention therapy, a type of cognitive behavioural therapy (CBT). This entails gradually exposing the child to things they are afraid of so that they can learn to tolerate rather than avoid their feelings.

Your chosen therapist may assist your child in rating their fears on a scale of one to 10 (with one being the least frightening and 10 being the most frightening). The child will then be exposed to something at the bottom of the hierarchy (a three or a four) and gradually progress toward tolerance of more stressful triggers.

The goal is to help the child recognise that nothing bad will happen if they do not perform the ritual they normally do to calm themselves.
Although antidepressants are sometimes used to treat children with severe OCD, many experts say medications only work about half of the time and prefer to begin treatment with cognitive behavioural therapy.

How to help an OCD child at home

• To help distract your child from the rituals, provide them with ways to self-soothe, such as a soft toy or animal or a fidget toy to play with.
• Prioritise your child’s worries and provide reassurance when they need it.
• Collaborate with your child’s teacher and family members so that they can support your efforts at home.