Many children struggle to express how they feel, which can make it difficult for adults to recognise whether they may be suffering from a mental health problem.
To help parents, carers and teachers identify whether a child has OCD, we have outlined the symptoms to look out for. Our guide also includes information on the steps that can be taken to help a child understand their feelings and the treatment that is available to address OCD early on.
Are you seeing these childhood OCD symptoms?
Symptoms of OCD can be slightly different in children. It is an anxiety disorder of two parts – obsessions and compulsions. Obsessions can occur in the form of thoughts, images or urges, while compulsions are the actions that can be taken to get rid of – or cope with – these obsessions.
Children are likely to have different concerns to adults and it is common for children to suffer from just obsessions or compulsions. Sometimes one will be more prominent than the other. As they don’t always appear in equal measure, this can lead to the signs being overlooked.
Here are what obsessions and compulsions may look like in children:
OCD symptoms in children at school
- Repeatedly getting up from an assigned chair to engage in a repetitive behaviour, like taking a book from a shelf or placing pens/pencils in a correct order.
- Avoiding playground equipment and not interacting with other children in the playground.
- Worrying about writing neatly or keeping their desk organised – often to the point of anxiety. For example, they might scribble out and screw up their work when they get anxious.
- Frequently requesting to go to the bathroom, with no medical explanation.
- Asking repetitive questions or seeking reassurance from the teacher that an answer is correct.
- Unable to shift between subjects abruptly, resulting in them getting angry or upset.
- Retracing or counting steps; for example walking the same route to class three times before entering.
- Erasing letters repeatedly until they are exactly right.
- Being continually disengaged and not listening in class. This might show that a child is engaging in a mental ritual, such as repeating certain numbers or words in their head to stop something bad from happening.
OCD symptoms in children at home
- No interest in playing with other children or unfamiliar toys.
- Scared of catching germs from common objects in the outside world, such as animals or litter.
- Collecting or hoarding objects in high quantities.
- Spending too much time in the bathroom washing their hands or possessions.
- Anxiety about making a mistake that will cause the house to burn down, a parent to die, or pain to a beloved pet.
- Repetitive and ritualistic movements, often with irrational justifications such as touching a door handle more than once to ensure it is locked so the house does not get burgled.
- Tapping objects in a repetitive order and ensuring objects in the house are not out of place. You may find they say the same words/sentences in exactly the ‘right way’, especially at bedtime.
- Preoccupation with death, religious questions, or abstract concepts like good and evil.
- Obsession with special numbers. For example, a child may only like the number four and therefore, will cut their food into that number of pieces each time they eat.
Symptoms can regularly change. They may not be consistent and can increase or decrease depending on how stressed or tired a child is. Even if they do fluctuate, this is the natural course of the illness and not a sign of recovery so it is important to still seek any necessary help.
Next steps and treatment for children with signs of OCD
If you have spotted any of the obsessions and compulsions listed and have concerns about a child who might be expressing these signs, speak to a GP for advice. They may also be able to refer the child for expert OCD treatment at Priory.
Our OCD guide by Dr Hayley van Zwanenberg (MBBS, MRCPsych, MMedSci) outlines the next steps and treatment options available: