OCD and Children

Obsessive-Compulsive Disorder in Children

Obsessive-Compulsive Disorder (OCD) is a challenging mental health condition that can affect children and adolescents. Children with OCD experience persistent, intrusive thoughts known as obsessions, and feel compelled to perform repetitive behaviors or mental acts called compulsions. These behaviors are performed in an attempt to alleviate the distress caused by the obsessions, but they often interfere with the child’s ability to function normally at school, at home, and in social settings.

What is OCD in Children?

Obsessive-Compulsive Disorder (OCD) in children is a mental health condition defined by intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that a child feels driven to perform.

OCD may begin in childhood due to a combination of genetic and environmental factors. A child with a family history of OCD is at a higher risk of developing the condition, with studies showing that 47% to 58% of children with OCD have a family member who also has the disorder. Additionally, certain environmental stressors or traumatic experiences can trigger the onset of OCD in children who are genetically predisposed.

What Age Does OCD Start?

OCD can start at any time from preschool through adulthood. However, there are two common age ranges when symptoms often first appear. The first is between the ages of 8 and 12, when children are still developing their cognitive and emotional processing skills. The second period is during the late teen years into early adulthood, when your child may be experiencing significant developmental changes and stressors.

How Common is OCD in Children?

It is estimated that about 1 in 200 kids and teens, or roughly 500,000 young people in the United States, have OCD. Early-onset OCD is one of the more prevalent mental health conditions in this age group, with studies indicating a prevalence rate between 1% and 3%.

How OCD is Diagnosed in Children

Diagnosing OCD in children can be challenging. Some children may be secretive about their behaviors, making it difficult for parents to notice the signs. Parents might observe that bedtime rituals have become very prolonged or that there is suddenly a lot of extra laundry because their child is showering or changing clothes frequently. Additionally, OCD often co-occurs with other mental health disorders which can complicate the diagnosis.

In many cases, the compulsive activities associated with OCD, such as handwashing or checking locks, can consume more than an hour each day. These behaviors cause significant mental distress and impact the child’s thought processes. While adults with OCD often recognize that their actions are irrational, children may not be able to see that their behavior is abnormal.

A child psychiatrist or other mental health expert can diagnose OCD through a comprehensive mental health evaluation. For a child to be diagnosed with OCD, they must exhibit obsessions and compulsions that are continuous, severe, and disruptive to their daily life. These behaviors must significantly interfere with the child’s day-to-day functioning.

Signs and Symptoms of OCD in Children

OCD in children can manifest in various ways, making it important for parents and caregivers to recognize the signs and symptoms. The symptoms are typically divided into three categories: obsessions, compulsions, and feelings. Understanding these can help in identifying and addressing OCD early on.


Obsessions are intrusive and unwanted thoughts that repeatedly enter a child’s mind, causing significant distress. These thoughts are persistent and hard to ignore, even though the child might desperately want them to stop.

Parents might observe their child experiencing intense fears or worries, such as:

  • Excessive concern about germs, dirt, or contamination
  • Fear of illness, injury, or harm to themselves or loved ones
  • Obsessive need for things to be in a specific order or place
  • Worry that certain thoughts might come true or cause bad events
  • Fixation on things being symmetrical, even, or arranged “just right”


Compulsions are repetitive behaviors or mental acts that children feel compelled to perform to alleviate the distress caused by their obsessions. These actions are often ritualistic and are intended to prevent some feared event or outcome.

Parents may notice behaviors such as:

  • Touching or tapping objects in a specific manner
  • Repeatedly arranging or organizing items
  • Frequently repeating words, phrases, or questions
  • Struggling to make decisions due to constant doubt
  • Excessive washing or cleaning
  • Taking an unusually long time to complete everyday tasks like dressing, showering, or eating

Children might also involve parents in their rituals, sometimes without the parents realizing it’s part of the compulsion. For example, a child might repeatedly seek reassurance or require parents to perform actions in a specific way or number of times.

Children and teens with OCD can experience either obsessions, compulsions, or both.


The cycle of obsessive thoughts and compulsive behaviors can be exhausting and stressful for children. While performing rituals might provide temporary relief, these actions often become time-consuming and energy-draining, leaving little room for normal activities and enjoyment.

Children with OCD might show signs of:

  • Anxiety or persistent worry
  • Irritability or frustration
  • Sadness or fatigue
  • Distress when unable to perform their rituals
  • A constant need for reassurance from parents

Some children might not openly share their OCD-related thoughts and behaviors due to feelings of embarrassment or confusion. They might try to hide their rituals, leading to the condition going unnoticed for some time. Recognizing these emotional signs is crucial for timely support and intervention.

Treatment Options for Childhood OCD

Treating OCD in children involves a combination of therapeutic approaches designed to manage and reduce symptoms. Early intervention is key to helping children cope with OCD and lead fulfilling lives. Here are some effective treatment options:

  • Cognitive-Behavioral Therapy (CBT): CBT is the one of the most effective treatments for childhood OCD. This therapy helps children understand and change their obsessive thoughts and compulsive behaviors. A specific type of CBT called Exposure and Response Prevention (ERP) involves gradually exposing children to their fears and teaching them to resist the urge to perform compulsive actions.
    Medication: In some cases, medication may be prescribed to help manage OCD symptoms. Selective Serotonin Reuptake Inhibitors (SSRIs) are commonly used to reduce the frequency and intensity of obsessions and compulsions.
  • Family Involvement: Family support is critical in the treatment of childhood OCD. Parents can learn strategies to support their child’s therapy, manage symptoms at home, and avoid accommodating compulsive behaviors. Family therapy can also help improve communication and reduce stress within the household.
  • Support Groups: Connecting with others who understand what your family is going through can be very helpful. Support groups provide a space for children and parents to share their experiences, gain insights, and receive encouragement from others facing similar challenges.
  • School Support: Collaborating with teachers and school counselors can ensure that your child receives the necessary accommodations and support in the educational environment. This might include adjustments to reduce stress and anxiety related to schoolwork or social interactions.
  • Healthy Lifestyle: Encouraging a healthy lifestyle can also support treatment. Regular physical activity, a balanced diet, sufficient sleep, and stress management techniques like mindfulness or relaxation exercises can all contribute to better overall mental health.

If you suspect your child may have OCD, seeking help early can help make a significant difference. Consult with a pediatrician or mental health professional to discuss your concerns and explore treatment options.