Many of the OC symptoms children experience are exactly the same as those that their adult counterparts face. Contamination and disease fears are very common, as are requirements for symmetry and order, counting, and responsibility concerns (fear of spreading disease or harming others with thoughts or actual deeds). However, there are other symptoms seen almost exclusively in children. These include:

• Extreme phobias related to school.

• Selective (sometimes called “elective”) mutism: that is, refusal to speak in certain situations.

• Excessive worry and preoccupation about being watched.

• Particular sensitivity to noise, odors, or other minutiae.

Children who have OCD are also known sometimes to experience extreme separation anxiety and to exhibit greater than normal fears about things like monsters and scary television programs; they may demonstrate behavior close to obsession when it comes to certain people, things, collections, and so on. Like their older counterparts, they may become “unglued” easily if their routines or precise ways of doing things are interrupted, or if they are prevented from exercising their avoidance behaviors.

Unlike adults with OCD, children who have the disorder often can't explain their reasons for doing the things they insist on doing and, depending on age, don't always possess the sophistication needed to hide their compulsive actions.

Rages in OC Children

It's been noted that children who have OCD experience “rages” more often than their older counterparts. This may happen in response to fear, especially when the child is prevented from performing his anxiety-relieving compulsion. Also, children who have OCD tend to suffer from a higher rate of mood disorders than the general population of children. (The same is also true for adults who have OCD.)

A Numbers Game

It's estimated that one out of every 100 to 200 children (or, 1 to 2 percent of children and adolescents) has OCD. As is the case with many other conditions, it's not always easy to tell. For one thing, many children, whether they have OCD or not, seem to experience obsessions: a bedtime ritual that must be performed exactly the same way each time, an insistence that two or more foods on the same plate must not touch, or a fascination with a hobby, interest, or collection, for instance. For another, some behaviors, such as a teenage girl's excessive preoccupation with grooming, diet, or a teen idol, might seem like (and, in fact, be) normal developmental stages. Further, many children today demonstrate much more anxiety than in previous generations. Children's worries over things like school shootings, war, and other issues in the news probably says more about our times than about childhood OCD.