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Understanding and Treating OCD in Children

Understanding and Treating OCD in Children

It is very natural for children to have their own share of worries and doubts. But children with OCD are unable to stop worrying and it doesn’t matter how much they want it to stop! OCD (Obsessive Compulsive Disorder) is a disorder where a person is unable to say no to one’s obsessions and compulsions in many life situations. 

In the past, children with OCD were often wrongly diagnosed with other conditions as doctors widely believed that OCD was a very rare condition for a child to have. In reality, OCD occurs in 1% of all children and recent studies show that about half the number of adults with OCD had experienced the clinical symptoms of it at a young age. This, in particular, stresses the importance of making the right diagnosis at a young age.

Diagnosing OCD in young children presents unique challenges. Toddlers, for instance, may lack the verbal skills to express their fears or obsessions. Instead, signs may manifest through changes in behavior or disruptions in daily routines. Parental awareness and open communication with healthcare professionals are vital for addressing OCD in young children effectively.

What is OCD?

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions). Individuals, especially children with OCD often experience significant anxiety due to the obsessions, which drive them to perform compulsive rituals in an attempt to alleviate the distress. OCD can significantly impact daily functioning and quality of life if left untreated.

The causes of OCD include:

  • Family history
  • Imbalances in neurotransmitters
  • Abnormalities in brain structures
  • Childhood trauma
  • Infections or illnesses that impacted the central nervous system
  • Challenges in cognitive flexibility
  • Exposure to prenatal or perinatal complications

Some behavioral theories also indicate that OCD may develop due to the reinforcement or repeated performance of certain behaviors typically associated with anxiety relief.

Symptoms of OCD in Children

Though the symptoms vary much from child to child, some of the most widely observed ones include:

  • Obsessions
    • Intrusive, unwanted thoughts, visuals (imagination or drawings), or urges
    • Concerns about cleanliness or contamination
    • Fear of harm to oneself or others
  • Compulsions
    • Repetitive behaviors 
    • Repetitive mental acts
    • Counting, checking, or arranging items
  • Rigidity
    • Insistence on sameness and routines
    • Upset when routines are disrupted
  • Perfectionism
    • Excessive concern with order, symmetry, or perfection
    • Fear of making mistakes
  • Unusual Sensitivity
    • Heightened sensitivity to sensory stimuli
    • Overreaction to certain sounds, textures, or smells
  • Avoidance
    • Avoiding situations that trigger obsessions
    • Resisting activities due to fears
  • Distress and Impairment
    • Feelings of distress or discomfort
    • Impairment in daily functioning, academics, or relationships
  • Need for Reassurance
    • Constant seeking of reassurance from caregivers
    • Repeatedly asking questions about safety or events
  • Physical Symptoms
    • Tension, restlessness, or discomfort

Symptoms of OCD in Toddlers

Let’s take a look at the some of the common symptoms of OCD in toddlers:

  • Excessive attachment to certain objects or routines
  • Repetitive behaviors: engaging in repetitive, ritualistic behaviors, insistence on specific daily routines
  • Intense or extreme distress when routines are disrupted
  • Extreme or strong negative reaction to even minor changes
  • Unusual or intense fears, especially irrational or disproportionate ones
  • Compulsively or repeatedly checking certain things, like doors or toys
  • Unexplained tantrums or meltdowns that seem disproportionate or sudden
  • Avoidance of certain textures or discomfort with touch
  • Displaying an early preoccupation with symmetry or order
  • Showing signs of or always wanting perfectionism in play or activities
  • Intense need for routine and sameness

Signs of OCD in Children that Parents Need to Watch For

  • An exaggerated fear of contamination from being in contact with people and articles.
  • Doubts if one has properly locked the door, washed the plates, turned off the lights (and many more such) etc
  • Counts numbers. The child believes that if counting doesn’t happen during certain activities, it would trigger ‘bad’ things to happen to dear ones.
  • Fears harming close ones and friends
  • Compulsive cleaning, bathing etc
  • Ritualistic behaviors where the child has to touch certain body parts to go about other activities smoothly
  • Compulsive reassurance seeking from parents
  • Specific rituals around bedtime that affect sleep

What to do?

If you notice any form of obsession or compulsion regarding your child activities, don’t not jump to a conclusion right away. Make sure you get in touch with an expert regarding OCD to get to the bottom of things as soon as possible. Parents should go about this carefully, as some children fear that speaking out their worst fears to a parent or a doctor would make them come true.

Cognitive Behavioral Therapy for OCD at Plexus

Once OCD is identified, prompt treatment is essential to alleviate symptoms and improve the child’s quality of life. At Plexus, our therapeutic approach helps children identify and manage their obsessive thoughts while gradually reducing compulsive behaviors. 

The treatment for children with OCD involves a particular form of Cognitive Behavioral Therapy (CBT) called Exposure and Response Prevention. Let’s take a look at what this means:

Exposure: Involves facing feared thoughts, images, or situations gradually.

Response Prevention: Impedes the usual compulsive response that follows anxiety-provoking stimuli.

This process helps children break the cycle of obsessive thoughts leading to compulsive behaviors.

CBT is also known to help with cognitive restructuring, which typically involves targeting irrational and disturbing thoughts that contribute to obsessions. We help your child to challenge and modify these thoughts, and instill healthier beliefs and attitudes.

In very rare cases, doctors may prescribe selective serotonin reuptake inhibitors (SSRIs).

Early intervention is crucial for  addressing OCD in children. Parents and caregivers should be constantly attentive and observant. Timely intervention can prevent the escalation of symptoms in little children and significantly enhance the effectiveness of treatment strategies like CBT.


Is childhood OCD curable?

Effective treatments such as cognitive-behavioral therapy (CBT), medications, and consistent support can help manage symptoms of OCD. 

Is OCD common in 4 year olds?

OCD is rarely seen in children below 5 years of age. Early signs may include repetitive behaviors or intense fears. Timely intervention is key.

At what age is OCD developed?

Typically, OCD surfaces between late childhood and early adulthood. 

How do you know if a child has OCD?

Recognising OCD in children involves observing distressing and persistent obsessions and compulsions. Intense anxiety, extreme negative reactions to disruptions to daily life, behavioral changes, etc. may indicate the presence of OCD. The earlier sections of this blog have crucial signs and symptoms of OCD that parents need to watch for.

What is the root cause of OCD?

OCD is believed to be caused by a combination of genetic, neurological, behavioral, cognitive, and environmental factors. These include:

  • Family history
  • Imbalances in neurotransmitters
  • Abnormalities in brain structures
  • Childhood trauma
  • Infections or illnesses that impacted the central nervous system
  • Challenges in cognitive flexibility
  • Exposure to prenatal or perinatal complications
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