What to do if my child has OCD?

Pediatric OCD is diagnosed in school-age children between age 7 to 12. The diagnosis of OCD in kids and teens is often overlooked and under-diagnosed. If your child struggles with the following symptoms, your child may struggle with OCD:

These obsessions are the most common among kids and teens:

  • Fear of dirt or germs
  • Fear of contamination
  • A need for symmetry, order, and precision
  • Religious obsessions
  • Preoccupation with body wastes
  • Lucky and unlucky numbers
  • Sexual or aggressive thoughts
  • Fear of illness or harm coming to oneself or relatives
  • Preoccupation with household items
  • Inrusive sounds or words

These compulsions are the most common among kids and teens:

  • Grooming rituals, including hand washing, showering, and teeth brushing
  • Repeating rituals, including going in and out of doorways, needing to move through spaces in a special way, or rereading, erasing, and rewriting
  • Checking rituals to make sure that an appliance is off or a door is locked, and repeatedly checking homework
  • Rituals to undo contact with a “contaminated” person or object
  • Touching rituals
  • Rituals to prevent harming self or others
  • Ordering or arranging objects
  • Counting rituals
  • Hoarding and collecting things of no apparent value
  • Cleaning rituals related to the house or other items

OCD is like the hiccups of the brain. It makes your child get stuck and cannot stop doing the compulsions. When you attempt to interrupt OCD, your child can have a melt down. The cause of OCD is believed to reside in the deep brain circutry that involves prefrontal cortex (orbitofrontal and anterior cingulate cortexes), basal ganglia, and thalamus. Very rarely, certain autoimmune process after streptococcus infection can trigger OCD and it is called PANDAS (pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections).

When you suspect your child struggles with OCD, it is very important to work with professionals who specialize in cognitive behavioral therapy (CBT). Your involvement in treatment process is also very important to the treatment outcomes. Sometimes, medications can facilitate the therapeutic process of CBT for severe cases of OCD. Other alternative treatment for refractory OCD include transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS).

Please check out the following website for resources if your child struggles with OCD.


What is obsessive compulsive disorder (OCD)?

Obsessive compulsive disorder (OCD) is defined as recurrent intrusive thoughts/images or repetitive behaviors due to urges or anxiety. It affects 1-3% of the US population, in both children and adults. The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) described the criteria as followed:


Recurrent and persistent thoughts, urges or images that are experienced, at some time during the disturbance, as intrusive, unwanted, and that in most individuals cause marked anxiety or distress. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some thought or action.


Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to the rules that must be applied rigidly. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation. However, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

The common symptom dimensions in OCD can be categorized into:

  1. symmetry, arranging, ordering
  2. aggressive obsessions (harm to self or others)
  3. contamination, cleaning
  4. forbidden thoughts
  5. religious obsessions, morality, scrupulosity
  6. checking
  7. hoarding, collecting
  8. magical thinking
  9. tapping, sensory phenomenon
  10. health and somatic obsessions

A thorough list of OCD symptoms are described in the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), a common scale used to quantify the severity of OCD.