Understanding 0bsessive Compulsive Disorder in Children


Published:

Most of us are familiar with obsessive compulsive disorder in adults, yet OCD is one of the most common disorders in children and adolescents, with estimates ranging from 1-2 percent of children in the U.S., according to the American Academy of Family Physicians.

Obsessive compulsive disorder is characterized by intrusive thoughts known as obsessions and repetitive behaviors known as compulsions, according to the American Academy of Child and Adolescent Psychiatry. They define obsessions as “recurrent and persistent thoughts, impulses or images that are unwanted and cause marked anxiety or distress.”

Because of the time, attention and energy children expend on the disorder, their daily life is negatively affected, says Rebecca R. Jackson, executive director of Brain Balance Achievement Centers in Cary and Chapel Hill. They’re late for school and often experience struggles there, and may miss important play opportunities with friends. Lengthy rituals and intrusive thoughts keep them from sleeping well. Their obsessive thoughts dominate everything, to the point they aren’t able to think or talk about anything else.

“If they don’t act, they’re sure the results may be catastrophic,” Jackson says. Children and their parents end up stressed out, frustrated and upset.

An OCD diagnosis is made when the obsessions and compulsions cause significant stress and anxiety, as well as interfere with a child’s daily life, social activities, academics or relationships, says Kevin L. Gyoerkoe, psychologist and director of the Anxiety and OCD Treatment Center in Charlotte.

Child-Onset OCD

One-third of adults with OCD developed their symptoms when they were children, according to the International OCD Foundation. OCD symptoms manifest in much the same way for both children and adults.

In children, however, the specific thoughts and actions are typically age-appropriate. A child might have intrusive, anxiety-provoking thoughts about harm befalling his parents or siblings, Gyoerkoe says. She might feel intense anxiety if all of his or her toys aren’t lined up in one direction. Children often report needing to do things a certain way because everything must be “just right” or they feel anxious and stressed.

“One of the most significant differences between OCD in adults versus children is the level of self-awareness,” Jackson says. ”A child will have a hard time recognizing that the worry or action is beyond what’s acceptable. They simply have something on their mind that won’t go away.”

“The age of the child doesn’t affect the prognosis or hinder treatment,” Gyoerkoe says. However, the type of OCD — the specific thoughts and compulsions — will likely change as the child grows and matures. Research suggests child-onset OCD is also sensitive to environmental factors, with symptoms increasing during stressful events, according to a 2011 review published in the Dialogues in Clinical Neuroscience Journal.

Common Obsessions and Compulsions

The incessant thoughts children struggle with may include excessive concern over germs, diseases and illness. One child has irrational fears that he may accidentally or purposefully hurt others, such as causing a car crash. Another is convinced he didn’t do a chore correctly or finish his homework, even though he did.

To cope with this anxiety, a child develops rituals — activities or behaviors she must repeat over and over. She has to wash her hands until they’re chapped and reddened. She brushes her teeth until her gums bleed. She may check that the doors are locked numerous times or need to have her socks at the exact same height. She needs to redo a task or chore repeatedly until it “feels right.”

According to the International OCD Foundation, other common compulsions include erasing and rewriting, asking the same question over and over, confessing or apologizing, checking and rechecking, tapping, counting, ordering, arranging and hoarding.

Cause and Effect

The causes of OCD aren’t known; however, a 2014 study published in the Journal of the American Medical Association revealed that OCD has a genetic component. Another 2014 study, published in the Psychiatric Clinics of North America Journal, found that if a close family member has OCD, the genetic risk that a child will inherit the disorder is 20-25 percent.

However, genetics only explain part of the story, Gyoerkoe says. OCD can be triggered by environmental factors, such as a strep infection or stressful life event.

Jackson concurs that environmental considerations are now being factored into the equation. “OCD, like many things, can be a combination of our genetics as well as how the environment and our development impacts those genetics,” she explains. “Researchers have only recently shifted their focus to epigenetics, which looks at how our environment impacts the expression of our genes.”

Treatment

Child-onset OCD can be managed successfully with treatment. “Medication, behavior strategies and addressing the underlying area of concern in the brain are all treatment options,” Jackson says.

“The gold standard of treatment for OCD in children is cognitive-behavioral therapy, focusing on exposure and response prevention,” Gyoerkoe says. CBT is supported by numerous scientific studies and recommended by the Mayo Clinic, the National Institutes of Health, Harvard University Medical School and the American Academy of Child and Adolescent Psychiatry.

CBT therapy works to “retrain” the brain. The child learns behavior strategies to address and minimize their thoughts and compulsions. An experienced therapist works with the child and his or her family to develop a diagnosis and recommend a treatment plan. In addition, the American Academy of Child and Adolescent Psychiatry recommends medications such as serotonin reuptake inhibitors to help manage symptoms if therapy alone isn’t enough.

What Parents Can Do

If you’re worried your child might have OCD, schedule a consultation with a psychologist who specializes in the treatment of OCD, preferably one who is experienced with children. Gyoerkoe recommends that parents search for specialists in their area through the International OCD Foundation at iocdf.org or the Anxiety and Depression Association of America at adaa.org.

“While you may be able to control your thoughts and actions, your OCD child cannot,” Jackson says. “Know that this is outside of their control, and love them through it all.”

OCD and Strep Throat

A 2012 study published in the Pediatrics & Therapeutics journal suggests that a certain type of OCD may be related to strep infections, known as PANDAS (pediatric autoimmune neuropsychiatric disorder associated with streptococcus) or more recently, PANS (pediatric acute-onset neuropsychiatric syndrome.

“Children with PANS OCD experience a sudden onset of severe OCD symptoms like separation anxiety, extreme irritability, and neurological symptoms such as difficulty writing or memory loss,” says Kevin L. Gyoerkoe, psychologist and director of the Anxiety and OCD Treatment Center in Charlotte.

According to the National Institute of Mental Health, antibody formation may trigger an inflammatory reaction. Strep-triggered antibodies mistakenly attack specific brain circuitry, resulting in obsessional thoughts and compulsive behaviors.

“Increased inflammation has the potential to interfere with healthy function,” says Rebecca R. Jackson, executive director of Brain Balance Achievement Centers in Cary and Chapel Hill.

Kyla Steinkraus is the author of 25 children’s books. She loves reading, photography, and board games. Learn more about her at KylaSteinkraus.com.

Edit ModuleShow Tags

Related Content

Concierge and Direct Primary Care

Concierge medical care and direct primary care offer new ways to be treated by physicians. What are the pros and cons?

Digital Resources To Keep Your Family Healthy

Get the scoop on reliable health information sites where your research can guide you to informed decisions that will protect and improve the health of your family.

Reduce Your Chance of Having Another Preterm Baby

Learn more about a treatment that can help women who have had a preterm birth reduce their chances of experiencing another one.
Edit ModuleShow Tags
Edit ModuleShow Tags

Calendar

January 2017

Help Videri Chocolate Factory celebrate its 5th anniversary with special products available this day only and prizes at the door. Activities for kids include face painting, arts and crafts and a...

Cost: Free

Where:
Videri Chocolate Factory
327 W. Davie St., #100
Raleigh, NC  27601
View map »


Website »

More information

Listen and learn about the members of the woodwind family: flute, clarinet and bassoon. Family Concerts in Kirby Horton Hall last one hour. Come early to check out the instrument zoo. Ages 5 and...

Cost: $10 adults / $5 children and students

Where:
Kirby Horton Hall, Sarah P. Duke Gardens
420 Anderson Street
Durham, NC  27705
View map »


Sponsor: Mallarmé Chamber Players
Telephone: 919-560-2788
Contact Name: Ellye Walsh
Website »

More information

See the first feature documentary created about the famous writer, poet, actress and activist.

Cost: $5

Where:
The Cary Theater
122 E. Chatham St.
Cary, NC  27511
View map »


Website »

More information

Show More...
Show Less...

Join Bach to Rock for a day of Rock Band Camp on MLK Day. Students will name their band, design a logo, build their repertoire of songs, record their music in our studio, and finally...

Cost: $75

Where:
Bach to Rock
958 US 64
Apex, NC  27523
View map »


Sponsor: Bach to Rock
Telephone: 919-446-5386
Contact Name: Kelly Foster
Website »

More information

Spend the afternoon helping to maintain and beautify the area around the center in honor of MLK Jr. Day of Service. All ages. Registration required for either the 10 a.m.-noon or 2-4 p.m. session.

Cost: Free

Where:
Middle Creek Community Center
123 Middle Creek Park Ave.
Apex, NC  27539
View map »


Website »

More information

Triangle families are invited to celebrate MLK Day with a family-friendly birthday party for Dr. King. Enjoy English/ Spanish storytimes, kids’ zumba, interactive activities, crafts,...

Cost: Free

Where:
Northgate Mall
1058 W Club Blvd, Northgate Mall, I-85 Exit 176
Durham, NC  27701
View map »


Sponsor: MomsRising
Telephone: 919-696-0142
Contact Name: Beth Messersmith
Website »

More information

Ages 3-5 enjoy stories.

Cost: Free

Where:
Quail Ridge Books
4209-100 Lassiter Mill Rd.
Raleigh, NC  27609
View map »


Website »

More information

Show More...
Show Less...

Enjoy an hour-long nature series film, popcorn some scientific exploration. Participants may also take a dinner and watch the film. Register online by Jan. 13. Choose course #199053.

Cost: $1/person

Where:
Walnut Creek Wetland Center
950 Peterson St.
Raleigh, NC  27610
View map »


Sponsor: City of Raleigh Parks, Recreation and Cultural Resources
Telephone: 919-996-2760
Contact Name: Stacie Hagwood
Website »

More information

Show More...
Show Less...

Children delight in discoveries of shapes, colors and textures in nature. Ages 1 and older with parent. Registration required.

Cost: $8/resident, $10/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
View map »


Telephone: 919-387-5980
Website »

More information

Go on a hike, make a craft and learn how to help wild animal friends. Ages 3-5. Register online.

Cost: $3/child

Where:
Wilkerson Nature Preserve
11408 Raven Ridge Rd.
Raleigh, NC
View map »


Telephone: 919-996-6764
Website »

More information

Parent and child enjoy a craft, an engaging activity and a guided walk. Ages 2-6. Register online by Jan. 14. Choose course #199096. 

Cost: $3

Where:
Walnut Creek Wetland Center
950 Peterson St.
Raleigh, NC  27610
View map »


Sponsor: City of Raleigh Parks, Recreation and Cultural Resources
Telephone: 919-996-2760
Contact Name: Stacie Hagwood
Website »

More information

Show More...
Show Less...

CycleBar, a new concept in premium indoor cycling that offers a high energy workout in a concert-like atmosphere, celebrates its Cary studio grand opening by offering locals free rides from Jan. 19...

Cost: Free

Where:
CycleBar Alston
5022 Arco St.
Cary, NC  27519
View map »


Website »

More information

Children delight in discoveries of shapes, colors and textures in nature. Ages 1 and older with parent. Registration required.

Cost: $8/resident, $10/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
View map »


Telephone: 919-387-5980
Website »

More information

This workshop introduces parents to reasons behind common behaviors that create difficult situations while providing suggestions to prevent and manage parenting challenges. Parents are encouraged...

Cost: $20/person, $30/couple

Where:
Project Enlightenment
501 S. Boylan Ave.
Raleigh, NC  27603
View map »


Telephone: 919-856-7774
Website »

More information

Show More...
Show Less...

CycleBar, a new concept in premium indoor cycling that offers a high energy workout in a concert-like atmosphere, celebrates its Cary studio grand opening by offering locals free rides from Jan. 19...

Cost: Free

Where:
CycleBar Alston
5022 Arco St.
Cary, NC  27519
View map »


Website »

More information

Learn about grey squirrels, their habits, habitats, and the perils they face. Register online either the the 8:30-10:30 a.m. or 1:30-3:30 p.m. session.  

Cost: Free

Where:
Lake Crabtree County Park
1400 Aviation Parkway
Morrisville, NC  27560
View map »


Sponsor: Lake Crabtree County Park
Telephone: 919-460-3355
Contact Name: Carol Cunningham
Website »

More information

Parent and child enjoy music, stories and an art activity to provide a meaningful Shabbat experience led by seasoned preschool teacher Morah Elizabeth. Ages 5 and younger; older siblings welcome....

Cost: Free for members, $5/nonmember child

Where:
Raleigh-Cary Jewish Community Center
12804 Norwood Rd.
Raleigh, NC  27613
View map »


Sponsor: Raleigh-Cary Jewish Community Center
Telephone: 919-676-6170
Contact Name: Jill Lokitz
Website »

More information

Moms wanting breastfeeding help or those who simply want to interact with other breastfeeding moms enjoy a casual drop-in cafe with experts from La Leche League. lalecheleague.org/nb.html

Cost: Free

Where:
Grow, The Family Boutique
2885 Jones Franklin Rd
Raleigh, NC  27606
View map »


Telephone: 191-980-33521
Contact Name: Heather Dickens
Website »

More information

Enjoy a kid-paced hour featuring music, play and dancing with toddler stars singing on the mic at Cotton's gently amplified and participatory music show. Children delight in active,...

Cost: Free with admission

Where:
Pump it Up Briercreek
10700 World Trade Blvd, #112
Raleigh, NC  27617
View map »


Sponsor: Pump it Up
Telephone: 919-828-3344
Contact Name: Owner/manager Kellie Paterson McHugh
Website »

More information

Take part in a class that teaches individualized ways to foster motor development for your child. Learn about tummy time alternatives, best positions for your baby, how to help your child learn to...

Cost: $18

Where:
Open Arts
1222 Copeland Oaks Dr.
Morrisville, NC  27560
View map »


Sponsor: Babies On The MOVE
Contact Name: Rebecca Quinones
Website »

More information

A wonderfully kid-paced hour featuring music, play and dancing with toddler stars singing on the mic at Cotton's gently amplified & participatory music show. Children delight in...

Cost: Free with admission

Where:
"Pump it Up" Raleigh
10700 World Trade Blvd, #112
Raleigh, NC  27617
View map »


Sponsor: Pump it Up
Telephone: 919-828-3344
Contact Name: Owner/manager Kellie Paterson McHugh
Website »

More information

Take part in a class that teaches individualized ways to foster motor development for your child. Learn about carry positions, best positions for your baby, how to help your child learn to crawl,...

Cost: $18

Where:
Open Arts
1222 Copeland Oaks Dr.
Morrisville, NC  27560
View map »


Sponsor: Babies On The MOVE
Contact Name: Rebecca Quinones
Website »

More information

Discover wildlife, their habits and their habitats through hikes, activities and crafts. Ages 5-8. Registration required.

Cost: $12/resident, $16/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
View map »


Telephone: 919-387-5980
Website »

More information

Show More...
Show Less...

CycleBar, a new concept in premium indoor cycling that offers a high energy workout in a concert-like atmosphere, celebrates its Cary studio grand opening by offering locals free rides from Jan. 19...

Cost: Free

Where:
CycleBar Alston
5022 Arco St.
Cary, NC  27519
View map »


Website »

More information

Zaniac Learning invites all local residents to its grand opening event, which features refreshments, raffle prizes, tours of the brand-new center and a chance to meet the instructors. Attendees can...

Cost: Free

Where:
Zaniac Learning
1206 Parkside Main St.
Cary, NC  27519
View map »


Telephone: (919) 342-8536
Contact Name: Matt Pepe
Website »

More information

Parent and Me is a combination acrobatics and aerial class for young children. With a parent, kids ages 3-7 will build a foundation of coordination, flexibility, balance, and strength that can...

Cost: $25

Where:
Lux Performance Arts
1231 Perry Rd., Ste. 102
Apex, NC  27502
View map »


Contact Name: Jamie Trudeau
Website »

More information

Parents learn basic infant massage techniques to perform a full body massage for a baby to help promote bonding between parent and child (of any age), helps infants align their circadian rhythm...

Cost: $50

Where:
Grow, The Family Boutique
2885 Jones Franklin Rd.
Raleigh, NC  27606
View map »


Telephone: 191-980-33521
Contact Name: Heather Dickens
Website »

More information

Go nutty for nature as children satisfy some of their curiosity about the world around them and parents share in the joy of discovery. Ages 3-5 with parent. Registration required.

Cost: $10/resident, $13/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
View map »


Telephone: 919-387-5980
Website »

More information

Go on a hike, make a craft and learn how to help wild animal friends. Ages 3-5. Register online.

Cost: $3/child

Where:
Wilkerson Nature Preserve
11408 Raven Ridge Rd.
Raleigh, NC
View map »


Telephone: 919-996-6764
Website »

More information

Parent and child enjoy a craft, an engaging activity and a guided walk. Ages 2-6. Register online by Jan. 17. Choose course #199097. 

Cost: $3

Where:
Walnut Creek Wetland Center
950 Peterson St.
Raleigh, NC  27610
View map »


Sponsor: City of Raleigh Parks, Recreation and Cultural Resources
Telephone: 919-996-2760
Contact Name: Stacie Hagwood
Website »

More information

Each year, Cranberry Tree Farm donates its unsold trees to the Conservators Center for its animals to enjoy as a special form of holiday enrichment. During this walkabout, watch as wild animals...

Cost: $24 ages 12 and older, $18 ages 3-11

Where:
Conservators Center
676 E Hughes Mill Road
Burlington, NC  27217
View map »


Telephone: 888-650-1139
Website »

More information

Learn about birds and build a bird box. All ages with parent. Registration required.

Cost: $20/resident, $28/nonresident

Where:
Stevens Nature Center/Hemlock Bluffs
2616 Kildaire Farm Rd.
Cary, NC
View map »


Telephone: 919-387-5980
Website »

More information

Take an interactive musical adventure as Daniel Tiger and his friends explore the vibrant world of their much-loved Neighborhood of Make-Believe, sharing stories of friendship, helping others and...

Cost: $29.50 and up

Where:
Durham Performing Arts Center
123 Vivian St.
Durham, NC  27701
View map »


Website »

More information

Create a chainmaille necklace. Ages 12 and older.

Cost: $22.50 plus $8 materials fee

Where:
Durham Arts Council
120 Morris St
Durham , NC  27701
View map »


Sponsor: Durham Arts Council
Telephone: 919-560-2726
Website »

More information

Take an interactive musical adventure as Daniel Tiger and his friends explore the vibrant world of their much-loved Neighborhood of Make-Believe, sharing stories of friendship, helping others and...

Cost: $29.50 and up

Where:
Durham Performing Arts Center
123 Vivian St.
Durham, NC  27701
View map »


Website »

More information

Show More...
Show Less...
Edit Module

Magazine

Edit ModuleShow Tags
Edit ModuleShow Tags

Directories

Edit ModuleShow Tags Edit ModuleShow Tags

Annual Guides

Exceptional Child

Children with special needs face unique challenges. Find resources from A-Z in areas of advocacy, education, camps and therapies to support them as they grow.

GPS [Go. Play. See]

GPS is your guide to explore all the Triangle has to offer, from museum expansions to new parks and schools to youth sports and family fun. Plus, discover our 2016 Readers' Favorites.

Education Guide

The 2016-17 Education Guide offers 643 education resources in the Triangle, including area preschools, private schools, public school systems, charter schools, boarding schools and academic resources.