OCD in Children:
Obsessive Compulsive Disorder

OCD in children is an anxiety disorder characterized by unreasonable thoughts or fears that lead to certain repetitive behaviors. The goal of these behaviors is an attempt to reduce anxiety.

It is believed that this disorder affects 1% of children in the United States. The cause of OCD may be due to an imbalance in the brain and often runs in families. Because a child with OCD can spend so much of their time performing ritualistic behaviors or dealing with obsessive thoughts, many of them qualify for special education services and have an individualized education plan (IEP).

SYMPTOMS:

OCD in children is usually diagnosed by a psychologist, psychiatrist or physician. Because “quirky” behaviors are common in childhood, it is important for parents to remember that not all ritualistic behaviors or obsessive thoughts are symptoms of OCD. We all have some degree of OCD type behaviors. In order for a child to be diagnosed with OCD, the anxiety is usually severe enough to interfere with daily life tasks including learning.

Examples of obsessive thoughts usually fall into one of these categories:

  • Washers: Fear of contamination and germs
  • Checkers: Fear of something happening to himself or herself or a loved one
  • Counters and Arrangers: Obsessed with order and symmetry, often have superstitions.
  • Hoarders: Fear if they throw something away, something bad will happen, or they feel overly attached to objects.

These thoughts cause severe anxiety, which is then reduced by the compulsive behavior.  

Examples of compulsive behaviors include:

  • Excessive hand washing
  • Excessive teeth brushing or showering
  • Strict eating or bedtime rituals
  • Skin picking
  • Performing a ritual over and over, like locking a door, checking the closet, turning off the oven or light switch
  • Counting or sorting things into patterns
  • Touching objects a certain number of times
  • Re-arranging things to create order
  • Refusal to part with anything and attaching sentimental value to senseless objects


TREATMENT:

Cognitive-behavioral therapy is usually the method of choice for OCD in children. Here, the therapist focuses on teaching the child to confront their fears and reduce anxiety without performing the ritual or behavior. There is also an overall emphasis on reducing catastrophic thinking.

Medications may also be prescribed. These usually include anti-depressants which can reduce overall anxiety. It should be noted that some studies have shown an increase in suicidal thoughts and/or behavior in children and adolescents who are prescribed anti-depressants so if you choose to have your child medicated, a physician should always closely monitor your child.

OCD and SPECIAL EDUCATION:

Because OCD symptoms can be severe enough to impact learning, some children with this disorder require modifications and accommodations to their school day. For children with mild symptoms and no other learning disabilities, a 504 plan can adequately implement accommodations. These might include extra time with assignments or some sort of hall pass to a designated person on campus if the child is feeling anxious and needs a time out from their environment.

It is also important to have regular parent teacher conferences to ensure that the child’s teachers understand that the child's inappropriate behaviors are a part of their disorder. Here, teachers might be asked to use cues to help the child choose a more appropriate behavior or ignore the behavior instead of constantly correcting it or issuing a consequence.


 OCD in children often also goes hand in hand with other learning disabilities and disorders. These can include ADHD, autism spectrum disorders, and other learning disorders like dyslexia.   If your child has been diagnosed with a learning disability along with OCD, it is important that the IEP address all of your child’s needs. Social and emotional goals should be included in the IEP along with academic goals in order to assist with reducing anxiety and developing appropriate coping strategies. 

If your child has recently been diagnosed with OCD, you should schedule a meeting with your school’s student study team (SST) in order to create an educational plan or you can request that your child be evaluated for special education.