If a child has OCD, getting an accurate diagnosis is critical. Unfortunately, the disorder can be hard to spot. Children with OCD may keep their symptoms secret because of shame, guilt, or fear. They often get in trouble in school or at home because they can’t complete assignments due to obsessive thoughts or compulsions. The following case examples illustrate what might happen to a child with OCD.

Julie, a 3rd grader student, believes that her letters must be perfectly formed or something bad will happen to her family. This thought repeats in her mind over and over again (an obsession). In order to protect her family, she must carefully draw each letter on all of her written assignments (a compulsion). If she is not satisfied with the result, she throws her paper away and starts over. Julie’s teacher becomes frustrated with her and tells her that her writing is fine, just turn in the paper. Julie, terrified that her family is in danger, can’t stop herself. Her teacher finds Julie’s behavior irritating and disrespectful. So instead of getting help, Julie’s grades begin to drop.

Sam’s mother notices that her son is taking longer and longer to get ready for school in the morning. He takes forever to get dressed. With two younger sisters needing help, she expects 10 year-old Sam to be independent. She explains to him that either he gets ready to leave for school by 8 in the morning or he’ll have to get up earlier. The next day, she finds Sam on the floor in his room putting a sock on and then taking it off. Sam has an intense need for his socks to be even. The thought of clothing being “wrong” makes Sam very anxious. When his mother asks him what is the world he is doing, Sam replies, “nothing”.

He doesn’t understand why these urges to make things “just so” are overwhelming him. He believes that if he tells anyone about his troubles, they’ll think he’s weird. So, Sam remains silent and continues his compulsive dressing. His mother sets the alarm earlier. Within days, Sam find himself arranging and rearranging his books and late again. Frustrated, Sam’s mother gets angry.

Because children don’t tell their parents, teachers, or other family members about their obsessions and compulsions, some children are labeled as disrespectful, disobedient, or lazy. Kids with OCD sometimes get diagnosed with Attention Deficit Disorder because their obsessions are keeping them from paying attention. Parents and teachers should consider having a child evaluated by a mental health professional if symptoms such as the following occur and are interfering with the child’s happiness at school, at home, or with peers:

• Saying certain phrases over and over
• Insisting on having objects symmetrical
• Worrying excessively about contamination
• Checking door or window locks frequently
• Walking or moving in certain patterns
• Worrying about family member’s health
• Seeking very frequent reassurance of being loved
• Counting out loud in certain sequences
• Getting angry when routines are changed
• Staying in the shower for long periods of time
• Re-doing school work
• Having rituals that must be completed
• Becoming excessively anxious about religion
• Becoming fearful about unlucky numbers

There are two things to consider about this list. First, many children who are perfectly normal do these behaviors from time to time. If a child appears to be well adjusted and these activities are not interfering with his or her life, then they are likely not related to OCD. Second, this list is not complete; there are endless ways that OCD expresses itself in children. Our hope is to see more children get the help that they need, because OCD is a very treatable disorder.

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Prof.Lakshman (May 3, 2009)

From Psych Central's website:
PsychCentral (May 3, 2009)

DrDavidBallard (May 3, 2009)

    Last reviewed: 2 May 2009