OCD In Children: Causes, Symptoms And Treatment

As a child, you may have just run around, kicked some dust, made a mess of your room, never folded sheets, and not bothered about your belongings! Shift the scene to your child who is so organized and clean and particular that if you put his toy car to the left side of the desk, he loses his temper or just runs to put it back on the right side!

Does that scenario sound familiar? If yes, then you’ve landed on the right page because MomJuntion is here to tell you about OCD or obsessive compulsive disorder in children! It may not be alarming but can be tricky. So, we have also added symptoms and treatments to help you deal with the situation better.

Understanding OCD

A behavioral disorder with a neurological basis, OCD compels an individual to do a particular action in a certain way (1). People with OCD spend significant time on their obsessive behavior. The obsessions are involuntary, which means that the person does not do them intentionally.

It is normal for kids to have fears or worries. But kids with OCD are unable to deal with their fears or worries and cannot get them out of their mind, no matter how hard they try. OCD affects one in 100 school-going children in the US and is more common than juvenile diabetes (2).

[ Read: Anxiety Disorders In Children ]

Symptoms Of OCD

OCD symptoms in children are quite evident, although you may miss them at first. Symptoms involve repetitive actions, gestures, and rituals based on obsessive thoughts.

Compulsions are caused due to obsessions, which are irrational fears and thoughts that the child develops (3).

Common obsessive thoughts that the child could have include:

• Preoccupation with germs and dirt, fear of illness and disease

• Checking and rechecking things – for example, checking multiple times to see if they have packed all the books for school

• fear about the safety of a loved one – worrying excessively that the parent might not return from a trip or will fall sick

• Obsession with symmetry, or for having things in a specific, uniform pattern

• Focusing on the minutest details of things, and fussing about them for perfection

• Persistent impulses or aggressive urges to do something, especially in teenagers

These obsessions make way for the compulsive behaviors that could include:

• Washing hands multiple times for fear of germs being on the hands even after washing them

• Not shaking hands or touching objects that seem unclean for the fear of catching germs. Some kids may insist on wearing gloves and full sleeved shirts due to fear of germs, regardless of the temperature outside

• Excessive and repetitive cleaning of the same object or place

• Repeating a specific word or a series of words multiple times

• Having to follow a strict routine or a specific order to do things, whether at home or school

• Repeating a specific activity or gesture multiple times or a specific number of times such as knocking the door exactly three times or tapping the chair three times before they sit on it

• Counting steps or other objects such that they only count the ‘good numbers’ and avoid the ‘unlucky numbers’

• Shouting obscenities or inappropriate behavior that makes other people uncomfortable, or silently repeating a word such as in a prayer

[ Read: Conduct Disorder In Children ]

The type of symptoms and their intensity may vary depending on the stage of the disorder. If not addressed early on, the severity of the symptoms may increase gradually.

Causes Of OCD In Children:

A common misconception is that poor parenting causes OCD in children. The way you talk to your child, discipline them, time you spend with them, or your relationship with your spouse (divorce or separation) do not cause OCD in the child (4). Yes, these factors may contribute to stress. And,

stress is not a cause of obsessive compulsive disorder, although it can make it worse.

That said, scientists are unable to pinpoint the cause of OCD. Research, however, suggests that children tend to develop this condition due to the following reasons.

• Biological factors or genetics play an important role in whether or not a child is at a risk of OCD. While there is no definitive research to suggest that the onset of OCD is due to biological factors, children with OCD are likely to have a blood relative who also has the disorder (5).

• Studies have also suggested links to Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) and OCD (5). These infections are due to exposure to strep antibodies, which can result in neurological changes in the body and lead to tics or OCD.

• Brain imaging of children with OCD has suggested that the disorder could be caused due to communication errors within the brain. There is also a suggestion that neurotransmitters such as serotonin, glutamate, and dopamine could be contributing to the onset of OCD in some way (4).

• Some kids dealing with depression may also develop OCD symptoms.

A number of other environmental, cognitive, and behavioral factors also contribute to the development of OCD in children. In fact, it is believed that some compulsions could be learned behaviors that help the child deal with difficult situations or anxiety-triggering events.

Diagnosis Of Obsessive Compulsive Disorder

It is not easy to diagnose OCD and its cause. Diagnosing OCD in children usually starts with the child’s interview with a trained psychiatrist or a psychologist and parents and children may have to fill in questionnaires for the doctor to know the child’s mental health.

Besides the psychological examination, the medical practitioner may also recommend a physical examination and a few lab tests to rule out other medical conditions. Ideally, the behavior of the child must interfere with his day-to-day activities for it to be considered a disorder (6).

[ Read: Child Behavioral Problems ]

Treating OCD In Children

There is no cure for OCD, but the symptoms can be alleviated with cognitive behavior therapy. Mild cases of OCD are usually treated with therapy, while some cases may need medication.

1. Psychotherapeutic

Exposure and response prevention therapy, which is a type of cognitive behavioral therapy, is the most effective treatment for OCD in children (7). The treatment helps modify the child’s compulsive behavior, by targeting the obsessive thoughts.

The therapist will try to understand the root cause of the obsessive thoughts and eliminate them, thereby eliminating the obsessions. The therapy takes time and can be difficult with young children who do not understand the irrationality of their thoughts.

2. Pharmacological

Medication for OCD in children becomes necessary when therapy is not a feasible option. Doctors usually prescribe Selective Serotonin Reuptake Inhibitors (SSRIs) to reduce the anxiety, which can make the kid receptive to behavioral therapy (8).

A combination of medications and cognitive behavioral therapy works well for severe cases of this disorder. The best course of treatment, however, also depends on the child’s response to each option.

How To Deal With OCD In Kids?

When a child has OCD, the entire family is affected. While the child suffers due to his compulsive actions, the parents struggle to find the best way to react to his behavior.

Siblings may feel confused as they may not know the best way to respond. They may also feel guilty and resentful for the sorry state of their sibling and for not getting enough attention from the parents.

[ Read: Tips To Deal Moody Children ]

Here are a few home care tips you must keep in mind to help your loved one who has OCD and the rest of the family who is affected by it (2).

• Educate yourself about OCD. Talk to the child’s therapist to know what the goals are and how you are going to contribute to the treatment.

• Tell your child about obsessive compulsive disorder. Educate him and make him understand that it is not his fault and he can learn to modify that behavior with a little help.

• Make OCD less overwhelming by giving it a nickname because children may be confused, and worry excessively if you tell them it is a medical problem. Nicknaming the condition such as Mr Bossy or the Bully can make it less threatening.

• Take one thing at a time and avoid pointing out all the behavioral issues at once.

• Do not criticize the child for his compulsive behavior as it is merely a symptom of the medical condition, not a flaw in his personality.

• Ensure that the child takes his medications regularly.

• Do not participate in or encourage the child’s rituals. Watch out for the early signs of OCD in children such as new behaviors or rituals and work together in eliminating them before they become strong.

• Talk to the siblings of the child about OCD. Educating them about it and setting expectations about what they can do can reduce their guilt. Also, try and make time for them, and explain that you may not be able to spend as much time for a while. This will handle the resentment issues, if any.

Remember that giving into the child’s rituals makes the condition, and not the child, stronger. No matter how much you try, the child won’t get better when you want him to. OCD treatment takes time and can be challenging as well. While you may not be able to prevent it entirely, you can watch for possible symptoms and get help as early as you can to keep it under control.

[ Read: Communication Disorders In Children ]

Have suggestions on managing obsessive compulsive disorder in kids ? Tell us about them here.

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