How can you tell if a child has OCD?

Signs of OCD in children

OCD is characterized by the presence of obsessions (i.e., recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted) and compulsions (i.e., repetitive behaviours or mental acts that your child feels they have to do in response to their obsessive thought or rules that OCD has created).

Each individual’s obsessions and compulsions can vary and so OCD can look very different from person to person, but some common behaviours amongst children with OCD are listed below.

• frequent and excessive worries about germs and other contaminants

• frequent and excessive worries that their actions or inaction could cause harm to themself or others (e.g., if I step on a crack, our dog will get sick OR if I don’t turn the lock 3 times someone will break in)

• repeatedly and excessively cleaning items or themselves

• repeatedly checking things over and over again (e.g., checking to ensure the doors are locked)

• refusal to touch certain items due to concerns that they may be dirty or contaminated

• repeatedly engaging in a behaviour until it feels “just right” (e.g., retying shoe laces over and over again until it feels right OR reorganizing items over and over again until they’re lined up correctly)

It’s also important to note that young children may not be able to explain their obsessive/intrusive thoughts or articulate why they are engaging in the behaviours you’re observing.

Does OCD need to be diagnosed?

Generally, we consider a diagnosis of OCD when there are obsessions and/or compulsions that are time-consuming (e.g., take up more than 1 hour each day) and are causing significant distress or impairment in important areas of life like school or social functioning. For example, some kids will avoid potential contaminants to the point that they’re not spending time with family; further, when their OCD tells them that they have touched something that’s contaminated they may spend excessive time washing their hands or showering. Ultimately, whether you pursue a diagnosis is up to you, but it can be a helpful step in learning to externalize these obsessive thoughts and begin treatment.

Who can diagnose OCD in Canada?

Each province and territory may have different regulations, but generally physicians (e.g., family doctors, paediatricians, psychiatrists), psychologists, and nurse practitioners can diagnose OCD and other mental health conditions in Canada. Some family doctors may feel less comfortable diagnosing OCD in children and may recommend that you meet with someone who specializes in mental health, like a psychologist or psychiatrist instead.

How can I get my child assessed for OCD?

You can get your child assessed for OCD through their family doctor/pediatrician, a private assessment with a psychologist, or an assessment through your local child and youth mental health program. If you’re located in Ontario, Canada, you can contact us at the Ontario-Wide Psychology Clinic for a private mental health assessment with one of our child psychologists. Our assessments usually begin with a clinical interview and then we may follow-up with additional questionnaires or gather collateral depending on your child’s needs. You can learn more about our assessment process and fees here.

Can a child have OCD and ADHD?

Individuals with OCD often have other occurring mental health or behaviour concerns. According to the DSM-5-TR, some children can present with a triad of OCD, ADHD, and tic disorder. Many individuals with OCD also meet criteria for an anxiety disorder (e.g., social anxiety disorder, panic disorder, generalized anxiety disorder, etc).