Obsessive-Compulsive Disorder, commonly known as OCD, is a common and treatable medical condition that affects more than one million children in the United States alone. OCD is a disorder of the brain and behavior. It involves both obsessions and compulsions, which take a lot of time and get in the way of important activities.

Research suggests that OCD runs in families. Having a first degree relative with OCD and/or a tic disorder increases the risk for OCD. While children as young as four or five years of age can develop OCD, research suggests that age 10 is a particularly common time for OCD symptoms to begin. Among those who are genetically predisposed, life stress is often associated with the onset and/or worsening of symptoms.

Assess the signs and symptoms of OCD in your child

Does your child have:

  • Persistent, disturbing worries, doubts, or fears?
  • Unreasonable, repetitive rituals?
  • Uncontrollable, inappropriate thoughts or mental images?
  • Habits or patterns of behavior that interfere with daily life?
  • A tendency to ask repeatedly for reassurance?
  • A need to do things “just right”?
  • Problems with frequent lateness or slowness?
  • Repetitive urges to wash, organize, or check?
  • Urges to hoard useless objects?
  • A tendency to avoid certain places or activities?

Assess your child's OCD symptoms. Take the online assessment.

What are common obsessions and compulsions?

Obsessions are unwanted or repetitive thoughts or impulses, persistent fears or doubts, or upsetting thoughts or images that a child cannot ignore or dismiss. Those thoughts come with uncomfortable feelings, such as dread, disgust, doubt, or a feeling that things have to be done in a way that is "just right." A person suffering from OCD finds obsessive thoughts disturbing and unwelcome, and they usually know they don't make sense.

Compulsions are repetitive behaviors, actions or rituals intended to relieve the anxiety caused by the obsessions. The relief is temporary, however, because performing compulsions ultimately reinforces the obsessions. However, without a better way to cope, they rely on the compulsion as a temporary escape. Some compulsions are physical, such as washing, checking, tapping, or walking in a certain pattern. Others are mental, such as silent counting or compulsive praying. Not all repetitive behaviors or “rituals” are compulsions. Bedtime routines, religious practices, and learning a new skill involve repeating an activity over and over again but are usually a welcomed part of daily life.

Common obsessions and compulsions include:
  • fear of contamination or germs and washing and cleaning
  • fear of harm or danger
  • fear of losing something valuable and hoarding
  • need for symmetry and “evening up” or arranging
  • need for perfection and seeking reassurance or doing things “just right”  

What parents should know about OCD

If you are the parent of a child with OCD, you may feel alarmed and confused. Your child’s behavior does not make sense, and you might not know how to respond or where to turn for help.

The disorder can disrupt the pleasures of childhood, interfere with family life and friendships, and cause problems at school. There are some facts you should know about OCD:

  • You are not to blame for your child’s OCD, and neither is your child. OCD is a medical condition, like asthma or allergies. Scientists believe that a difference in the way the brain processes certain chemicals leads to obsessions and compulsions.
  • For many years, OCD was considered rare and untreatable. Research has revealed that OCD is a common neurobiological illness that affects men, women, and children of all races, religions, and socioeconomic backgrounds. Fortunately, effective treatment is now available through a form of cognitive behavior therapy that works by training the brain to respond differently to obsessions.
  • Children with this disorder are suffering and need effective treatment to cope. There is no reason to feel ashamed to seek help. Proper diagnosis and treatment can teach your child to regain control and manage the disorder. OCD is an enemy you and your child can learn to defeat together.

How parents can help a child with OCD

  • Be sure you learn about and understand the disorder.
  • Find the right therapist to provide treatment. Proper treatment can give your child the skills needed to manage the disorder both at home and in the classroom.
  • Learn how to recognize and respond to symptoms at home.
  • Help teachers understand how OCD affects your child at school.

Treatment for OCD in children

Thanks to enormous advances in scientific research, effective treatment is now available for OCD.  Two approaches that have been found to be effective in treating OCD in children are a form of cognitive behavior therapy known as “exposure with response prevention” or ERP, and medication treatment with a class of medicines called serotonin reuptake inhibitors (SRIs).

The concept of “exposure” in ERP refers to helping the patient face the anxiety that comes along with the thoughts, images, objects and situations that trigger their obsessions. “Response prevention” is the part of the treatment in which the child makes a choice to not engage in the compulsive behavior so that the distress that follows from the obsessions attenuates on its own over time without reliance on the ritual.

Some children can learn to manage their OCD with ERP therapy alone. For others, a combination of therapy and medication will help to achieve the best results. The good news is with proper treatment, your child can learn to manage the symptoms and return to the childhood pleasures of fun, learning, and friendship.  

For more information on Bradley Hospital’s Intensive Program for OCD or how we can help your child, visit our website.

Abbe L. Garcia, PhD

Dr. Abbe Garcia is director of the Pediatric Anxiety Research Center (PARC) and clinical director of Bradley Hospital’s Intensive Program for OCD. Dr. Garcia is also an assistant professor (research) of psychiatry and human behavior at The Warren Alpert Medical School of Brown University.