OCD is often called "the secret disorder" because symptoms often go unnoticed or unrecognized by parents and others.
When unusual behaviours are observed, many children either justify them or react so strongly that frustrated parents often tolerate or enable the behaviours to avoid conflict. But without follow-up and treatment, OCD can get worse.
General warning signs of OCD
In general, children and teens with OCD experience similar warning signs of worry as other children and teens, but they show them differently.
Key warning signs of OCD include:
- excessively seeking reassurance
- resisting change
- spending too much time completing things, getting dressed or eating a meal (longer than would be expected for the child's age)
- redoing tasks
- refusing to touch objects with bare hands
- excessively washing hands, body and so on
- having red, dry or cracked hands (for example from repeated washing or skin picking)
- being excessively interested in numeric patterns
- experiencing outbursts when unable to complete things in a certain way
Common obsessive symptoms in children and teens
The most common obsessive symptoms in children and teens include:
- fears of contamination or illness
- fears of harming others or themselves
- a need for symmetry and order
- excessive doubt
- religious fears (regarding guilt or moral values and divine punishment)
- taboo thoughts (such as sexual thoughts or thoughts considered as immoral)
Common compulsive symptoms in children and teens
The most common compulsive symptoms in children and teens include:
- prolonged and repeated washing of hands or body parts
- refusing to touch things
- repeated checking or counting
- needing to do things in a specific order or specific way
- needing to do things a certain number of times
- excessive interest in routines, rituals or patterns
- unusually frequent religious praying, well beyond what would be expected
Less obvious signs of OCD
Children and teens tend to display symptoms of OCD at home first, but not all of these are obvious. As a parent, it is important to be aware of the less obvious signs of OCD, as these can also impair a child's, and family's, quality of life.
Indirect signs to watch for include:
- excessive use of hot water, hand soap, shower gel or toilet paper
- frequent clogging of toilets
- excessive loads of "dirty" clothes for laundry
- wet floors (if a child or teen will not dry themselves with a towel)
- towels on the bathroom floor
- constant changing of clothing (for instance having "inside" and "outside" clothes)
- insistence on putting items used in school in just one area of the home
- using only one specific washroom in a public space, for example at school
- behaviour that isolates your child from others, such as avoiding going to friends' homes, not sharing pencils or pens, not sharing food, making friends repeat things and repeated questioning that does not seem to make sense.
How OCD is diagnosed
OCD is diagnosed through an interview with an experienced and regulated healthcare professional such as a psychologist or psychiatrist. During the interview, you and your child will be asked about your child's symptoms and how they affect your child's life.
The psychologist or psychiatrist may also use some standard questionnaires to help them make a diagnosis. Here are some common questions that they may ask you or your child about your child's thoughts and behaviour.
- Have you ever had a bad thought, image or picture in your head that bothered you and kept coming back even though you tried not to think about it?
- Have you ever had to do something over and over again that you couldn't stop doing, such as checking your school work or making sure you read all the words on a page?
- Did you ever feel like your hands were still dirty or had germs on them, even though you just washed them?
- Does your child take an unusually long time in the washroom or showering?
- Does your child ever appear 'stuck' in a routine, where they cannot move on to a different task until something has been completed a certain way?
The healthcare professional will usually ask questions about other problems or concerns about a child. This is because, for example, "bad" thoughts may not mean OCD but instead may be part of an anxiety disorder or even depression.
This is why it is important to get a thorough assessment of your child's symptoms. An early and proper diagnosis leads to effective treatment and an improved quality of life for both the child and the rest of the family.
Further information
For more information about OCD, please see the following pages:
OCD: How it affects your child's life
OCD: Treatment with psychotherapy and medications
Resources
The following books and websites have some useful advice about OCD for parents and teens.
Books
Chansky, T. (2001). Freeing Your Child from Obsessive-Compulsive Disorder: A Powerful, Practical Program for Parents of Children and Adolescents. Harmony.
Derisley, J., et al (2008). Breaking Free from OCD: A CBT Guide for Young People and Their Families. London: Jessica Kingsley Publishers.
Dotson, A. (2014). Being Me with OCD: How I Learned to Obsess Less and Enjoy My Life. Free Spirit Publishing.
Jassi, A. (2013). Can I Tell You about OCD? A Guide for Friends, Family, and Professionals. London: Jessica Kingsley Publishers.
Websites
International OCD Foundation (2016). OCD in Kids.
TeenMentalHealth.org (2016). Obsessive Compulsive Disorder.
AnxietyBC (2016).
Obsessive Compulsive Disorder.