How can I help a child with OCD?

  • OCD Awareness Week takes place on 13-19 October
  • A Priory expert explains how OCD affects children
  • Dr Hayley van Zwanenberg gives practical advice to parents and teachers on how to help children with OCD, or those who display similar symptoms
  • She explains the importance of parents being flexible in their routines 
  • Teachers can install ‘self soothe’ boxes in the classroom to help reduce anxiety

Obsessive Compulsive Disorder is a ‘hidden illness’ because often people can be so troubled and embarrassed by their thoughts that they can’t articulate them, says Priory child psychiatrist Dr Hayley van Zwanenberg.

When that person is a child, it can be especially difficult for them – and even more difficult for a parent or teacher to help them, she says.

More than 130,000 young people are affected by OCD in the UK.[i]

A quarter of those who develop OCD do so before the age of 14, with some even developing the condition before their sixth birthday.[ii]

To coincide with OCD Awareness Week (13-19 October), Dr van Zwanenberg, of Priory’s Oxford Wellbeing Centre, explains how OCD affects younger people, and advises parents and teachers on how they can help.

People with OCD have obsessions and compulsions; usually they have both together.

Dr van Zwanenberg says, “Obsessions come as repetitive thoughts, images of urges and the young person generally does not like them and cannot stop them.”

Obsessions can include having a fear that something will happen to them or someone they love. They might also fear that they will act violently towards someone they love. They might also worry about contamination or catching germs.

Compulsions are actions and routines that the person undertakes to reduce their anxiety.

These actions often involve repetitive and unusual behaviours. However, at times, the compulsions may only occur in the child’s head - for example repeating certain words over and over, or counting things to reach ‘special numbers’.

Dr van Zwanenberg says, “OCD is often a hidden illness as people can be so troubled and embarrassed by their thoughts, and feel they are a bad person. Obsessional thoughts are just thoughts, they do not fit with what the person believes or wants to do and the thoughts do not mean they are at risk of acting on them.”

She suggests there are various behaviours that could suggest OCD.

A child might have an interest in other children but not join them because play is too messy. They might be overly concerned about catching germs, which could result in them washing their hands repeatedly and refusing to eat off certain utensils.

A young person with OCD might ‘even things up’ by touching one side of their body and feeling the need to do the same with the other side. Taking part in repetitive and unusual behaviours is also a common behaviour, such as turning the light switch on and off and asking you to repeat sentences perfectly over and over. Other symptoms include collecting or hoarding objects.

In school, they might not listen or participate in lessons, and appear to be preoccupied.

If parents are concerned their child might have OCD, they should contact their GP for advice, which may lead to a referral to an appropriate specialist. Dr van Zwanenberg says, “OCD is treatable and it is such a relief for the young person and family when they recover.”

However, there are practical things parents can do to support those who already have a diagnosis, or those who are in the process of seeking professional support.

Dr van Zwanenberg suggests that parents, set boundaries but be flexible in their routine.

“You might not want to leave a child upset, but children need to learn that everything will be fine if you don’t follow the same routine each time, for example around bedtime or when you leave them."

Parents should make sure they take time to talk to their children. Dr van Zwanenberg says, “Many children don’t understand the depth of their own emotions and it’s important to help them realise why they are feeling this way. Point out these emotions to them when you see them, name the emotions and explain why they are feeling like this. This will help them manage their emotions in a healthy way.”

It is important to listen carefully to your child, and not dismiss anything that they might say, she says.

However, it can be useful to distract younger children, if they are crying, and to help them think about other, more positive, thoughts.

There are things that teachers can also do to help children in their class with OCD, or those with similar symptoms to the condition such as anxiety.

She suggests that teachers can introduce ‘self soothe’ boxes in the classroom where children can store objects that help them reduce their anxiety.

She says children can "decorate their boxes and then place a few items in them that relax them. They can then go to these when they feel themselves becoming upset. This will help soothe and manage their anxiety and stress.” Dr van Zwanenberg says that putting time aside for relaxation is crucial. Teachers can use a key word for a relaxation exercise, and if this particular word is spoken, everyone in class should stop their current task and practice a relaxation technique taught to them.

PHSE lessons and tutor group sessions can also be used as an opportunity to have discussions about mental health. Encouraging children to talk about the last time they felt worries or anxious and what they did to overcome can help them to develop coping strategies.

Dr van Zwanenberg has produced a special guide to parents and teachers which is available here.

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