First Signs of OCD
Younger children with OCD tend to show a fascination for details at a very early age. They have a strong need for order and repetition, and show severe upset reactions when interruptions and changes occur in their routines. They often demonstrate abnormally intense fears about germs, bugs, blood, fecal matter, genitals, separation, strangers, changes in routines, and the dark.
Of course, the fact that many of these fears are common and age appropriate for younger children can make it difficult for parents to detect a problem without the benefit of hindsight. Here are some examples of OCD symptoms in young children and preteens:
Even as an infant, Lisa had to have her covers, food, and good night rituals a certain way, or she would scream and cry.
At three, Jared built his Legos so they were just right, and then refused to take them apart. They had to stay exactly the same way for months at a time.
A four-year-old had to go around and check that every light switch and electronic appliance in the house was turned off at night before he'd go to bed.
At five, Bobby had a constant fear that there was “poop” in his pants. He would check his underwear at least eight times a day.
Eight-year-old Jamie feared that her underwear would fall down at school. She ended up wearing a bathing suit under her clothes to avoid that possibility.
Lisa, at ten, had to count everything around her, even if she was talking or while someone spoke to her. She counted cars, people on the street, words spoken to her or read on the page.
Justin, as a toddler, would do a puzzle over and over, fifteen or thirty times. If he did something wrong, he'd get angry and allow no one to help him.
A twelve-year-old won't use his pencils or crayons because if he does, they won't align evenly in the box.
These reports on the onset of their children's OCD symptoms come from parents. They reflect the most common childhood obsessions; namely, a fear of contamination and the need for order and certainty, along with the most frequently seen compulsive rituals and behaviors that often go along with these obsessions: washing, checking, avoiding, counting, and ordering.
Sometimes an ordering compulsion takes the form of a need for “perfect” symmetry. To many young people (and adults) with OCD, this takes the form of making things even. Many with OCD call this symptom “evening up” or “lining up.”
Here Paula T., a mom, describes the advent of her son's “evening up” symptoms at age eight in an account titled “Managing OCD for Life,” published on the OCD Chicago website.
For several years we didn't know Dan had OCD because he was symptomatic at school but not at home…. Dan retraced letters that looked uneven when he wrote, and if he touched something with his right hand, he had to touch it with his left hand, too. Dan also had to “even up” conversation by silently repeating backward everything he said and heard…. Dan is now thirteen, and dealing with his OCD is one of many things he does. Dan knows his OCD never really goes away, but with the training he received from his therapist, and refresher sessions as needed, he has the tools to manage his OCD for life.
My six-year-old son was climbing on my lap when his leg accidentally bumped the coffee table. He promptly got off my lap, went back to the table, and purposely bumped his other leg. Groan. I knew! He couldn't get into the kitchen, because he couldn't get both feet to touch the threshold at the same place and for the same amount of time. Back and forth over the threshold he would go. It was terrible to watch … I recognized that my eldest also had some of these symptoms and I recognized how much of this I had struggled with myself over the years.
From 10 to 50 percent of pediatric-onset OCD patients experience total or substantial remission of their OCD symptoms by late adolescence when they receive proper and effective treatment.
This second account, from Nancy G., posted on the OCD Chicago website, illustrates OCD as a family affair. Many parents describe young children who manifested an early symptom of OCD by speaking constantly, often repeating the same word(s) over and over. These mothers describe how this symptom developed at a very young age.
My daughter is six and an incessant talker. It can be awful when I'm stuck in the car with her; sometimes she'll have things I have to say back exactly the same. “We're going to the store” is one. Then I have to say, “Yes, we're going to the store,” right away, over and over or she'll have a meltdown. She even talks in her sleep.
My four-year-old daughter wants us to ask her the same questions all day long. She'll tell us to say, “What are you doing?” and then she'll answer, “Playing.” Then she'll want to repeat it until she's done with that activity (sometimes a half hour to an hour). This was cute when she started it at two, but now it's driving us crazy.
Incessant talking can be an early sign of OCD. But it can also be a passing phase, or a symptom of another disorder such as ADHD. Continued monitoring is your best first step, noting how long the behavior lasts and the co-occurrence of any other symptoms you may note. Then discuss your observations with your child's pediatrician.