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How to Recognize OCD Symptoms in Your Child

Make sure you know the warning signs.


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She won’t eat dinner if her vegetables touch her pasta. She gets anxious when her toys or books aren’t lined up perfectly. She insists on doing her homework with the same green pencil. Are these just personality quirks, or warning signs of Obsessive-Compulsive Disorder (OCD)?

It’s a question plenty of parents ask themselves, since about 25 percent of people have symptoms by age 14—a third of them first experiencing symptoms in childhood, according to the Anxiety and Depression Association of America. Symptoms can manifest as early as age 5, according to Child Mind Institute.

What’s more, OCD, which is thought to run in families, is seen in as much as 1-3 percent of US kids and adolescents, according to the American Academy of Child and Adolescent Psychiatry. OCD is also often associated with depression, panic disorder, eating disorders and Tourette’s syndrome.

Here’s how to know when your kid may need professional help.

IS IT OCD OR JUST A QUIRK?

Retired child psychiatrist of 34 years Sherry Barron-Seabrook, MD, a former member of the New Jersey Chapter of the American Academy of Pediatrics and current associate professor at Rutgers Medical School, says it all comes down to how kids handle kinks in their routine. “Children with OCD get very stuck in rituals, and very upset if they’re interrupted.” An inability to distract the child or get her to try an activity another way might be a parent’s first clue. “On the surface, you may not think much of it,” she says, “until you realize the child can’t deviate from the plan in her brain.”

Schedules tend to be comforting for children who don’t suffer from OCD, but for those who have the disorder, they can become confining rituals that take on outsized importance. “When a child has OCD, the routine becomes more important than other things,” explains psychologist Tamar E. Chansky, PhD, author of Freeing Your Child from Obsessive-Compulsive Disorder: A Powerful, Practical Program for Parents of Children and Adolescents. “It’s no longer the way to get things done efficiently.”

THE TREATMENT

OCD can be managed with cognitive behavioral therapy, medication or both. Chansky and Barron-Seabrook suggest worried parents see a pediatrician who can rule out a specific type of OCD triggered by infections like strep and offer referrals to a therapist or child psychiatrist specializing in the disorder.

A combination of child cognitive-behavioral therapy and Positive Family Interaction Therapy (PFIT, aka treatment for your whole family that can help alleviate at-home conflict) can also greatly reduce symptom severity and impairment in kids with OCD, according to a 2017 study in the Journal of the American Academy of Child and Adolescent Psychiatry.

But if a child doesn’t respond to therapy in three months, says Barron-Seabrook, it’s time to consider a medication like SSRI sertraline (Zoloft). And while some parents worry about the side effects of the drugs given for OCD, Barron-Seabrook says, “in the right circumstances and with the right monitoring, medication is safe.”

LIFE AFTER TREATMENT

For many children, therapy is enough, though plenty struggle with the disorder in some form throughout their lives. “Because of the nature of OCD, we can’t cure it completely,” Chansky says. “But the good news is children learn how to spot the signs of OCD, so if another symptom comes along months or years later, they’ll know what to do to control it.”

Patricia Curtis has been writing and editing parenting, health and lifestyle topics for national and regional magazines for 20 years. She lives in Bergen County with her husband and three children.​

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