Does my Child have OCD?

Understanding Obsessive Compulsive Disorder in Children

OCD is one of those conditions that is both frequently misunderstood and frequently missed. It is not about being tidy or a little bit particular. It is a serious anxiety related condition that can take over a child’s life and, without the right support, a family’s life too.

If you are worried about your child, trust that instinct. And read on.

What OCD actually is

Obsessive Compulsive Disorder involves two things that feed each other in a cycle that can be very hard to break alone.

Obsessions are unwanted, intrusive thoughts, images, or urges that arrive uninvited and cause significant anxiety. A child with OCD does not choose these thoughts. They cannot simply stop them by trying harder. Common obsessions include fear of contamination, intense worry about something terrible happening to a loved one, intrusive violent or sexual images that horrify the child, and a need for things to feel exactly right or symmetrical.

Compulsions are the behaviours a child feels compelled to carry out in response to the obsession, to reduce the anxiety or prevent the feared thing from happening. Repetitive handwashing, checking locks or lights, counting, repeating words or actions a specific number of times, asking the same reassurance question over and over. The compulsion brings temporary relief. But the relief does not last, and the cycle begins again.

It is important to say clearly: children with OCD are not being naughty or wilful. Most are painfully aware that their behaviours do not make logical sense and feel powerless to stop them. That awareness makes it even harder to bear.

How common is it

OCD can affect people of all ages, backgrounds, and genders. It commonly starts in childhood and it is estimated that one to two percent of young people experience OCD, around 130,000 children in the UK alone. It often begins earlier than parents realise, and younger children in particular may not have the language to explain what is happening to them.

What causes OCD

The exact cause is not fully understood. Current research points to a combination of genetic factors, differences in how certain brain circuits function, and environmental triggers such as significant illness, trauma, or major life stress. It can run in families. It is also more common in children with other anxiety disorders or neurodevelopmental conditions.

An older explanation involving a simple serotonin imbalance is now understood to be an oversimplification. The neuroscience is more complex than that, and it is worth being cautious about any explanation that makes it sound straightforward.

The family angle

This is something I feel strongly about and that is often overlooked. When a child has OCD, families naturally want to help. Parents find themselves getting drawn into rituals, answering reassurance questions, adjusting routines to avoid triggers. This is completely understandable. It comes from love and from a desire to reduce a child’s suffering.

But over time, this accommodation of OCD tends to maintain and strengthen it rather than help. The child’s world shrinks. The OCD grows. And parents can find themselves exhausted, confused, and uncertain how to respond without making things worse.

Understanding this dynamic is an important part of the work. Supporting parents to respond differently, with warmth and without anger, is often as important as working with the child directly.

When to seek help

Not all repetitive behaviours or worries are OCD. But it is worth seeking support if the behaviours are causing significant distress, have been present for six months or more, are interfering with daily life at home or school, or if your child seems to be losing ground to the rituals rather than gaining any relief from them.

Your GP is the first point of contact. For further information and support:

OCD UK is an excellent resource for families.
OCD Action offers support and guidance.
Royal College of Psychiatry has clear information for parents.

Interested in working with me?

I work with younger children with OCD using a combination of play therapy, the World technique, and family work, always holding the whole system in mind. Supporting parents to understand what is driving the OCD and how to respond to it is central to the work. I also work with schools, helping staff understand what OCD looks like in the classroom and how to support a child without inadvertently reinforcing the compulsions.

If you would like to find out more, please do get in touch via my contact page.

Free resources

Understanding Your Child’s Guard Dog Brain explains what is happening in your child’s nervous system when big feelings take over.

Holding in the Storm is about staying steady as a parent in the hard moments.

When Darkness Comes includes specific support for sleep difficulties and anxiety at night.

All free to download.