Recognising Symptoms of OCD in Children
Obsessive Compulsive Disorder (OCD) is often misunderstood as a condition that primarily affects adults, but it can also present in children and teenagers. Recognising the signs early on is key to getting your child the right support. In this blog, I’ll guide you through how OCD may appear at different developmental stages, offer tips for managing it, and explain how counselling can help your child regain control of their life.
What is OCD?
OCD is a mental health condition where a child experiences intrusive, repetitive thoughts (obsessions) and feels driven to perform certain behaviours (compulsions) to reduce the anxiety these thoughts create. While many children have occasional repetitive behaviours or worries, OCD is more persistent and can interfere with daily life. Recognising the difference is crucial.
Recognising OCD in Young Children (Ages 4-7)
OCD can appear in children as young as 4 years old, although it’s harder to identify at this age because some compulsions may look like typical childhood routines. However, children with OCD will seem distressed or anxious if they can’t complete certain rituals.
Example: Six-year-old Lily washed her hands excessively—sometimes up to 20 times in an hour—after touching her toys or food. She feared that if she didn’t, she would get “bad germs” and make her family ill.
Tip for parents: If you notice your child becoming distressed by their thoughts or behaviours, it’s important to provide reassurance without reinforcing the rituals. A calm, structured routine with some distractions can help reduce anxiety, but avoid directly participating in or validating the compulsions.
OCD in Primary School-Age Children (Ages 8-11)
At this stage, children may start expressing their worries more clearly. Their OCD could manifest as perfectionism or checking behaviours, which can impact schoolwork or social life. They may feel that something bad will happen if they don’t perform their rituals just right.
Example: Jack, aged 10, spent hours redoing his homework, often erasing and rewriting answers until they felt “perfect.” He worried that if his work wasn’t flawless, he would disappoint his family and teachers. His teachers noticed delays in handing in assignments, as his compulsions took over more of his time.
Tip for parents: Encourage open dialogue with your child about their thoughts and fears. Help them understand that everyone makes mistakes and that imperfection is a natural part of life. You can also calmly reassure them during the process, “I know it’s hard, but nothing bad is going to happen. If they successfully resist the compulsion, praise their courage and reinforce the idea that the feared outcome didn’t happen.
OCD in Teenagers (Ages 12-18)
OCD in teenagers can become more complex and is often influenced by concerns about social interactions, morality, or the future. Teens may feel embarrassed by their symptoms and try to hide their rituals, fearing judgment from peers or family. This can lead to isolation.
Example: 15-year-old Mia became overwhelmed by intrusive thoughts about accidentally causing harm to her family. Despite knowing she would never hurt anyone intentionally, she constantly checked that her straighteners and plugs were turned off. Her compulsions stopped her from enjoying socialising with friends and family, as she spent more time managing her fears.
Tip for parents: It’s important to provide a safe and non-judgmental space for your teen to share their worries. Let them know that OCD is a recognised condition that can be managed with help. Offer support without feeding into the compulsions by gently reminding them to let go of checking routines and encourage healthy coping mechanisms like journalling and positive self-talk.
How Counselling Can Help
Recognising that your child may have OCD can be overwhelming, but early intervention can make a big difference. Counselling, including Cognitive Behavioural Therapy (CBT) and Play Therapy, can help children and teens manage their symptoms by giving them the tools to understand and challenge their obsessions and compulsions.
Cognitive Behavioural Therapy (CBT)
CBT is one of the most effective treatments for OCD. This approach teaches children and teenagers how to identify the connection between their thoughts, feelings, and actions. As a Counsellor I work with them to challenge their obsessions and reduce the compulsive behaviours that follow. For children, Exposure and Response Prevention (ERP)—a form of CBT—is particularly useful. ERP involves gradually exposing the child to the source of their fear in a controlled and safe way, helping them realise that their worst fears don’t come true when they resist the compulsion.
For instance, a child with contamination fears may be gradually exposed to dirt in the therapy session, learning that nothing bad happens if they don’t wash their hands immediately. Over time, these exposures reduce anxiety and help children regain control of their lives.
Play Therapy
For younger children, play therapy can be a highly effective way to address OCD. Children naturally express themselves through play, and it provides a safe space for them to communicate difficult thoughts and emotions that they might not yet have the words to describe. In play therapy, the child leads the session using toys, games, or art, while I observe and interact therapeutically.
Example: In a play therapy session, 7-year-old Sophie insists that her dolls must always be lined up perfectly in a specific order. She believes that if even one doll is slightly out of place, something bad will happen to her family. Through counselling and techniques like ERP, I can guide Sophie to gradually tolerate imperfections in her doll arrangement without feeling that harm will follow, helping her regain control over her anxieties.
Final Thoughts
Recognising the signs of OCD in your child or teenager can be daunting, but with the right support, they can learn to manage their symptoms and live a fulfilling life. Counselling offers them a safe, compassionate space to explore their fears and develop coping strategies. Play therapy can also be particularly beneficial for younger children, helping them express and overcome their worries through creative outlets.
If you’re concerned about your child’s behaviour or need more guidance, don’t hesitate to reach out to me to explore counselling support here https://findjoyinadversity.com/contact/. With patience, understanding, and the right help, children can overcome the challenges OCD presents and regain a sense of control.