Obsessive Compulsive Disorder (OCD)

What Obsessive Compulsive Disorder (OCD) Looks Like in Children

Though it is typically diagnosed in young adulthood, OCD does manifest as young as six with traits that include obsessive cleanliness, tantrums if something gets “out of order,” and close attention to rituals. Learn more about common signs here.

A child with OCD refusing to get into the car
Child and dog near car

Obsessive compulsive disorder is a challenging mental illness for anyone who lives with its frequent and sometimes unsettling obsessions and compulsions. It can be especially tormenting for children, who may not understand the psychological underpinnings of their feeling or may become fixated on being a “bad kid.” OCD affects as many as 1 in 200 children — or about 500,000 kids in the US — and often exists in tandem with other conditions like ADHD, mood disorders, or anxiety, which can complicate a diagnosis and lead to problems at school and at home.

It’s painful for any parent to watch his or her child struggle with obsessions and compulsions, and it’s not uncommon for family members and even medical professionals to seek other explanations for a child’s odd behavior. This instinct is not incorrect; some obsessive or compulsive behaviors might be developmentally appropriate. A kindergartner may become fixated on “bad words,” for example, becoming hysterical if one is uttered in her presence. As always, it’s best not to rush to diagnosis.

[Self-Test] Obsessive-Compulsive Disorder in Children

OCD Symptoms at Home

So how can you tell if your child is experiencing symptoms of OCD, normal childhood behavior, or something else entirely? Children can be diagnosed with OCD as young as 6, though most don’t experience severe symptoms until their teen years. Early signs of OCD in children include:

  • Preoccupation with death, religious questions, or abstract concepts like good and evil
  • Repetitive and ritualistic movements, often with irrational justifications; touching her toes before getting in the car, for instance, because she believes it will stop the vehicle from crashing
  • Anxiety about making a mistake that will cause the house to burn down, a parent to die, or pain to a beloved pet
  • Tapping objects in repetitive sets or completing tasks symmetrically (if he touches a door with his right hand, for instance, he must go back and touch it with his left hand)
  • No interest in playing with other children or touching strange toys
  • Terrified of animals, trees, litter, or other common objects in the outside world
  • Spending too much time in the bathroom washing hands or possessions
  • Stopping and restarting art projects because of tiny mistakes

OCD Symptoms at School

In academic settings, OCD can look a lot like ADHD, a learning disorder, or defiance, depending on the nature of the child’s behavior. If your child is struggling in school, talk to his or her teacher about any of the following patterns — and ask your child about the motivations for his behavior. He may not be paying attention, for example, because he’s bored — or it may be due to an intrusive thought that he’s focusing on instead.

Other symptoms of OCD seen at school may include:

  • Repeatedly getting up from an assigned chair to engage in a repetitive behavior, like touching the chalkboard
  • Preoccupation with writing neatly or keeping a desk organized — often to the point of anxiety or not finishing assignments
  • Frequently requesting to go to the bathroom, with no medical explanation
  • Asking repetitive questions or seeking reassurance from the teacher that an answer was correct
  • Unable to shift between subjects abruptly, often melting down during transitions
  • Retracing steps; walking the same route to class three times before entering, for example
  • Erasing letters over and over until they’re “exactly right”
  • Being distracted during lectures; may not be able to answer questions if called on
  • Avoiding playground equipment or touching other kids during recess
  • Unusually tired or anxious during the day

For kids with OCD, daily functioning can be exhausting. If you or your child’s teacher notice patterns of repetitive or obsessive behavior, talk to your doctor about a diagnosis. The earlier your child starts treatment, the better chance she’ll have of overcoming OCD-related anxiety and living a successful life.