When Should I Be Concerned
About My Child's Worries?
What Every Parent Wants to Know
About Childhood OCD
 We
all worry sometimes, and a certain amount of anxiety or fear is
normal. If you find that your child's worrying is very distressing
or if it is interfering with his/her functioning at school or with
friends, then it may indicate a more serious problem. Certain rituals
are a part of normal development whereas other behaviors may need
to be brought to your pediatrician's attention (or need other professional
help). For example, toddlers can have very rigid routines around
eating, bathing and bedtime. But if you find that your seven-year-old
needs to be tucked in "just right," and have a certain
stuffed animal put in an exact spot before he/she can go to bed
then there may be more to his/her worries than normal kid stuff.
While kids can have different kinds of problems with anxiety, there
is specialized help available. Our team of researchers at Rhode
Island Hospital is especially interested in children with obsessive
compulsive disorder (OCD). OCD affects about 1 in every 200 children.
The hallmark features of obsessive compulsive disorder (OCD) include
having distressing thoughts/feelings (obsessions) and/or rituals/repeated
behaviors (compulsions). Very young children may only have compulsions,
and they may not even express much distress about their symptoms.
Behaviors that are suspicious for an OCD diagnosis include
spending long, unproductive hours on homework, retracing over letters
or rereading paragraphs. Dramatic increase in laundry and toilets
overflowing from excessive use of paper may warn of contamination
fears. Long, rigid bedtime rituals, exaggerated needs for reassurance,
or requests for family members to perform certain acts to make the
child "safe" may all indicate a child who has OCD. Hoarding
of useless objects, such as fingernail clippings or used bandages
should be differentiated from normal childhood collecting of rocks,
baseball cards or sentimental treasures.
It is important to distinguish between normal developmental rituals/superstitions
and possible OCD behaviors. Although ritualized behaviors are common
for the young child around times of transition, OCD-related behaviors
are typically excessive and occur at a later than expected age.
If your child becomes distressed when prevented from doing that
behavior and the behavior takes up a lot of his/her time, it's more
likely a symptom of OCD.
If OCD sounds like a problem for your child, you may be
eligible for a treatment or assessment study at Rhode Island Hospital's
pediatric anxiety research clinic. Call us at 401-793-8284
and we'll be happy to answer your questions.
Provided by the division of child
and family psychiatry at Rhode Island Hospital
and originally published in Rhode Island Family Guide.
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