\u00a0<\/span><\/p>The other thing is that in OCD the compulsions may seem more bizarre or disconnected from what\u2019s happening. Like that example of checking the door, it may need to happen in a particular pattern. Check the door by turning the knob twice, step away, turn back, turn it twice again. This is because in OCD the person is chasing that \u201cjust right\u201d feeling and it gets harder to reach the longer they stay trapped in the compulsion.<\/p>
Children who have OCD need their parents assistance in some of their compulsions and parents may not realize this. This often comes in the form of reassurances, which are also common in general anxiety, but may also show up in needing the parent to do things in a certain order. Such as say good night in a particular way. The child will meltdown if the parent says, \u201cGood night, sleep tight. Sweet dreams.\u201d Instead of, \u201cSweet dreams, good night sleep tight.\u201d The child will demand that the parent does it over and over until it\u2019s exactly the way the child needs to hear it. The parent may not realize that the obsessive thought has to do with, \u201cWhat if a robber breaks in\u201d and needs the parent to say good night exactly right to neutralize that obsessive, intrusive thought.<\/p>
Other common ways that OCD shows up is washing hands and concerns about contamination. A child may not be able to eat off a particular fork or needs to rinse already clean dishes. Checking is common, checking for homework or checking that no one\u2019s hiding in the closet. Children may need to enact particular rituals like repeating words to themselves or doing things in a particular order.<\/p>
Children may also need to confess their intrusive thoughts. Those thoughts are upsetting and remember they\u2019re assigning meaning to them. A child might think about going on a forbidden web site and then need to come and tell you that they thought about it. Or they may have an intrusive thought about hitting the dog and will need to confess it to you. Again, we all have intrusive thoughts. We might board the bus and randomly think, \u201cWhat if I kissed the bus driver\u201d and we forget about it almost as soon as we think it. The child with OCD will worry it means they want to kiss the bus driver. That might make them feel ashamed and they\u2019ll need to tell you about it or say hello to the bus driver in a particular way or squeeze their eyes shut repeatedly to try to neutralize that upsetting thought.<\/p>
This is another way that OCD gets diagnosed, is when a child has to blink or sniff or click their tongue or do some other repetitive motion that adults notice. These kinds of tics are not uncommon in childhood even for children who don\u2019t have OCD, but they tend to disappear after a few months. This is super common in younger children, like kids who get that chapped rash around their mouth because they can\u2019t stop licking their lips. Parents should consider getting their child evaluated for OCD if those tics continue for more than six months or start getting more complex like if A child who shrugs their shoulders after every question starts shrugging their shoulders then blinking or yawning, for example.<\/p>
In the latest version of the DSM, which is the DSM-5, OCD got moved out of anxiety disorders and into its own categorization. This is because the current theory is that OCD in itself isn\u2019t fueled by anxiety but that the obsessions CAUSE anxiety. Also it allowed them to move other disorders like hoarding and body-focused repetitive behaviors such as skin picking or hair pulling into the OCD category since this seems to be a more accurate way to case conceptualize. These, too, are marked by an intrusive thought or feeling of not-quite-rightness. Hoarding is about a worry of losing something important and everything might be important and body-focused repetitive behaviors are driven by an intrusive need to pull hair or skin pick, that feeling that things won\u2019t feel right until they do.<\/p>
Treatment for OCD is about helping the child to tolerate that uncomfortable feeling brought on by the intrusive thought and preventing them from doing the exposure. This is called Exposure Response Prevention and is an arm of CBT or cognitive behavioral therapy. Some children may also benefit from medication to help them calm their anxiety enough to work on the CBT piece. Because parents are usually part of a child\u2019s compulsions and because parents are such an important support, they should be part of the treatment. In fact most of the research around anxiety and parent involvement has focused on parents of children with OCD and it\u2019s clear that they are central to treatment success. In other words, the child won\u2019t get better if parents don\u2019t do their own work to support their child. My program, Child Anxiety Support, addresses the kinds of things that parents can do to support a child with OCD.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t