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Symptoms of Childhood OCD
One percent of all children and teens have OCD (Obsessive Compulsive Disorder), which is usually diagnosed in children between the ages of seven and twelve. OCD consists of obsessions (intrusive thoughts) and compulsions (the need to go through specific rituals). Common obsessions that children with OCD have include dirt, germs, and bodily waste; perfect order and symmetry; religion and superstitions; and thoughts of violence or aggression. Common compulsions that children with OCD have include grooming rituals (e.g., compulsive hand washing), checking rituals (e.g., constantly making sure that she packed her lunch), cleaning rituals, hoarding, arranging in the "perfect" order, and repetitive rituals (e.g., going in and out of a doorway several times).
During childhood, obsessive compulsive disorders can severely impact daily routines and basic pleasures of life. A child with OCD may be constantly sleep-deprived and unable to stick to a schedule due to the rituals that "must be done" at specific times. Children also may feel ashamed and embarrassed of their obsessions or compulsions, which can lead to low self esteem. Their obsessive thoughts may also cause them to have difficulty concentrating in class.
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Causes of Childhood OCD
The causes of childhood obsessive compulsive disorders are not well understood. There is some evidence that OCD runs in families and has some genetic component, but there are probably environmental factors as well. What is clear is that OCD is never the child's fault, and a child cannot simply stop his obsessions and compulsions by "trying harder." Parents and teachers of children with OCD need to realize this, and act accordingly. For example, they need to recognize any small improvements through therapy as major accomplishments. They should refrain from criticizing the child and should remember that the child truly wants to overcome his OCD tendencies.
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Treatment for Childhood OCD
It is important to treat childhood obsessive compulsive disorders as soon as possible in order to avoid possible complications of the disorder. Therapy and medication are the two main options used to treat childhood OCD.
Cognitive-behavioral psychotherapy (CBT), the main therapeutic method of treating childhood OCD, involves slowly getting the child used to encountering the trigger of her obsessions or compulsions, but not giving into them. In other words, the therapist may have the child play in the sand without washing his hands. Doing this over and over again can dull the urge that the child may feel to repetitively wash his hands. Just talking about obsessions and compulsions has not been shown to help children control their OCD tendencies.
Instead of or in addition to therapy, children with OCD may take medications to control their disorder. The main medicines prescribed are different types of SSRIs (selective serotonin reuptake inhibitors). These medicines do not "cure" OCD; rather, they help the child control it only while on the medicine. Some studies have shown that therapies are more helpful than medicines to help childhood OCD.
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Understanding Obsessive Compulsive Disorders in Children
Has your child been diagnosed with OCD? Do you suspect your child may have OCD? Or does a parent of a child you know have OCD? These questions and more will be answered in this series of articles about children and OCD.