OCD in Children:
Obsessive Compulsive Disorder

OCD in children is an anxiety disorder characterized by unreasonable thoughts or fears that lead to certain repetitive behaviors. The goal of these behaviors is an attempt to reduce anxiety.

It is believed that this disorder affects 1% of children in the United States. The cause of OCD may be due to a chemical imbalance in the brain and often runs in families. Because a child with OCD can spend so much of their time performing ritualistic behaviors or dealing with obsessive thoughts, many of them qualify for special education services and have an individualized education plan (IEP). Children with mild OCD may qualify for a 504 plan instead, if a few accommodations will help them with their school day.

SYMPTOMS:

OCD in children is usually diagnosed by a psychologist, psychiatrist or physician. Because “quirky” behaviors are common in childhood, it is important for parents to remember that not all ritualistic behaviors or obsessive thoughts are OCD. We all have some degree of OCD type behaviors. In order for a child to be diagnosed with OCD, the anxiety is usually severe enough to interfere with daily life tasks including learning.

Examples of obsessive thoughts usually fall into one of these categories:

• Washers: Fear of contamination and germs
• Checkers: Fear of something bad happening to himself or herself or a loved one unless they check or touch something over and over again.
• Counters and Arrangers: Obsessed with order and symmetry, often have superstitions, can spend a lot of time putting things in a "just right" position or place.
• Hoarders: Fear if they throw something away, something bad will happen, or they feel overly attached to objects.
  

Obsessive thoughts cause severe anxiety, which is then reduced by the compulsive behavior.  

Examples of compulsive behaviors include:

• Excessive hand washing
• Excessive teeth brushing or showering
• Strict eating or bedtime rituals
• Skin picking
• Performing a ritual over and over, like locking a door, checking the closet, turning off the oven or light switch
• Counting or sorting things into patterns
• Touching objects a certain number of times
• Re-arranging things to create order or putting things in a "just right" place
• Refusal to part with anything and attaching sentimental value to senseless objects

TREATMENT:

Cognitive-behavioral therapy is usually the method of choice for OCD in children. Here, a therapist focuses on teaching the child to confront their fears and reduce anxiety without performing the ritual or behavior. There is also an overall emphasis on reducing catastrophic thinking.

Medications may also be prescribed. These usually include anti-depressants which can reduce overall anxiety. It should be noted that some studies have shown an increase in suicidal thoughts and/or behavior in children and adolescents who are prescribed anti-depressants so if you choose to have your child medicated, a physician should always closely monitor your child.

Natural remedies are on the rise and I always suggest trying a holistic approach to any mental illness, if possible. With my own child, I noticed a correlation in anxiety and OCE with stress, technology and sleep. I also have upped her vitamin intake and removed preservatives and other toxins. There are calming supplements and essential oils out there as well, but as always, use caution and do your research as some supplements can be harmful. In doing research, I was surprised to find that there is strong correlation between tics, Tourettes Syndrome and some OCD as many OCD behaviors like counting, are very "tic like" in nature. Trying remedies used for tic disorders may also be effective for OCD. 

OCD and SPECIAL EDUCATION:

Because OCD symptoms can be severe enough to impact learning, some children with this disorder require modifications and accommodations to their school day. For children with mild symptoms and no other learning disabilities, a 504 plan can usually adequately implement accommodations. Examples of accommodations might include extra time with assignments or some sort of hall pass to a designated person on campus if the child is feeling anxious and needs a time out from their environment.

It is also important to have regular parent teacher conferences to ensure that the child’s teachers understand that the child's inappropriate behaviors are part of a disorder. Here, teachers might be asked to use cues to help the child choose a more appropriate behavior or ignore the behavior instead of constantly correcting it or issuing a consequence.

 OCD in children often also goes hand in hand with other learning disabilities and disorders. These can include ADHD, autism spectrum disorders, and other learning disorders like dyslexia.   If your child has been diagnosed with a learning disability along with OCD, it is important that the IEP address all of your child’s needs. Social and emotional goals should be included in the IEP along with academic goals in order to assist with reducing anxiety and developing appropriate coping strategies.