Understanding Childhood OCD: A Guide for Parents
Obsessive-Compulsive Disorder (OCD) is often viewed as something only adults have, but kids can have it too. A therapist that specializes in OCD is able to provide your child with effective skills that can be used throughout the rest of their lives. As a parent, it's important to know what OCD looks like in children so you can help them. It’s common for children to have worries, fears, and some avoidance. How can you tell when something is “typical” for a child compared to when a fear is actually coming from OCD? Let’s talk through OCD, signs you can see in your child, daily impact, and how you can help.
What is OCD?
Obsessive Compulsive Disorder is a mental health disorder that involves obsessions and compulsions. It is a genetic disorder, meaning that it most commonly runs in families from generation to generation. Roughly 1 in 40 people have OCD within the United States.
Obsessions are unwanted thoughts or worries that cause a lot of anxiety. They are not things we can control, and they tend to run in themes. Common obsessions seen in children include: What if you leave me and never come back? What if you die? What if there are monsters that can hurt me overnight? What if I feel sick at school? What if something bad happens to me or someone else? What if I can’t do it on my own? What if I have a toilet accident? What happens after I die? How long is eternity? What if I vomit? What if something bad happens to me?
Compulsions are actions or rituals done to try to ease that anxiety. These can be physical acts or they can be mental and occur inside our mind. In kids, these can show up in different ways, so it’s important to know the difference between typical child behaviors and signs of OCD. Compulsions seen in children include: seeking reassurance you won’t leave them, tucking them in at night in a certain way, needing to use the toilet before leaving the house, asking over and over again the next time they will see you, reassuring themselves that something bad won’t happen, ritualized prayer, needing toys to be in a certain place, checking for risk, requiring lights to be on at night, coming into your room at night, asking if food is safe to eat, excessively washing their hands.
It’s important to note that many children with OCD can be misdiagnosed as having separation anxiety if their OCD compulsions include avoiding separation from their parents or siblings. An OCD expert can help differentiate between the diagnoses to see if the behaviors seen are falling within OCD. Another common misdiagnosis in children can be ADHD if their compulsions involve distraction or avoidance. Generalized Anxiety Disorder is seen throughout the lifespan as a misdiagnosis when compulsions involve lots of mental rituals.
Recognizing the Signs
Children with OCD may show several signs, which can be mistaken for regular childhood behaviors. Common symptoms include:
- Ritualistic Behaviors: Repeating actions like checking if the door is locked, arranging things in a certain order, wanting to do things a certain number of times, having a specific place in which they want you to say goodnight, or saying certain words or phrases over and over.
- Reassurance Seeking: Constantly asking parents or caregivers if things are okay, reasking questions that have been answered, repeating something you have told them out loud back to you to see if it has changed.
- Avoidance: Staying away from certain places, people, or activities that trigger their worries.
- Perfectionism: Needing things to be perfect or done in a specific way, and getting very upset if they’re not.
Impact on Daily Life
OCD can make a child's daily life very difficult. It can affect their schoolwork, friendships, and overall happiness. They might spend a lot of time on their rituals, which can make them late or unable to finish tasks. They might also find it hard to make or keep friends because of their unusual behaviors. Families also feel the burden of OCD. Parents often begin engaging in behaviors known as accommodations which are things done in order to help your child feel better. For example, you might check the closet every night to make sure a monster isn’t there, promise every morning you will pick up your child from school, avoid locations that make your child feel more fearful, or any other behavior done to protect your child from discomfort. Accommodation can eventually make a parent feel like they are walking on eggshells to keep their child from becoming upset, and it quickly can feel like your child is in charge of the house instead of parents. A parent quickly learns that the actions they take to reduce anxiety in their child provide only short-term relief, and the best way to support your child is actually to encourage them to experience things that bring on fear in order to decrease anxiety long-term.
How to Help Your Child
- Seek Professional Help: Get help early by talking to a doctor or mental health specialist who knows about childhood OCD. They can diagnose the condition and suggest treatments like therapy or medication. CalmOCD offers free 15 minute phone consultations if you are curious if your child’s anxiety might actually be OCD.
- Educate Yourself and Your Child: Learn about OCD to understand it better and reduce any fear or stigma. Books, support groups, and websites can be very helpful. It’s important for parents to help a child learn it is okay to feel fear and anxiety.
- Create a Supportive Environment: Be patient and understanding. Don’t punish or criticize your child for their OCD behaviors, as this can make things worse. Encourage them to talk about their thoughts and feelings without fear of judgment. Remember your child is not choosing these fears so validating their experience is helpful. Creating a supportive environment also includes learning how to reduce accommodations in order to help your child shrink the size of their OCD and face their fears with confidence.
- Establish Expectations: We want your child to learn you will no longer accommodate their OCD because the best thing you can do as a parent is believe in the abilities of your child to face their fears. An OCD expert can help guide you on ways to make it expected for your child to fully participate in life around them.
- Promote Healthy Coping: We often think of coping mechanisms focused on reducing anxiety. This is not the focus of OCD therapy. Instead, we focus on experiencing emotions such as fear, anxiety, worry, and doubt with acceptance and confidence. We do not want to cope by avoiding or working to remove emotion. Instead, we want to promote healthy coping by accepting our emotions and being brave. Your child will learn they are far more capable of facing uncomfortable emotions than every thought possible. You too will learn you no longer have to regulate your child's anxiety for them.
- Collaborate with School Personnel: Let your child’s teachers and school counselors know about their OCD. This is important so a child’s OCD worries are not accommodated in the school space. We want a child with OCD to fully participate in school and not be limited by their fears. CalmOCD enjoys being a part of a great team and this includes working with school teachers, counselors, and nurses to provide education on how they can help reduce OCD symptoms in their students. For clients near our in-person locations, we provide school visits to assist school teams in learning strategies to best support your child.
Raising a child with OCD can be tough, but with the right knowledge and support, you can help your child live a happy and balanced life. Early intervention, patience, and understanding are key to managing OCD. Remember, you're not alone—there are many resources and communities to support you on this journey. By taking proactive steps, you can empower your child to cope with OCD and thrive. While it can feel overwhelming to get started, OCD is very treatable when working with an OCD expert. At CalmOCD, we will walk alongside you as parents in addition to your child to fully understand OCD and assist in decreasing the presence of OCD in your daily lives so you can return to living life fully.
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