Many people try to control their anxiety about daily events with mild ritualistic behaviors such as wearing a lucky shirt to a big test. It's normal for children to do the same, especially from ages 2 to 8. Some children experience compulsions and obsessions severe enough for a diagnosis of obsessive-compulsive disorder, a type of anxiety disorder.
If you've ever heard the children's rhyme "step on a crack, break your mother's back," you're familiar with the concept of magical thinking. Stepping on a crack in the sidewalk can't possibly harm anyone, but some children will go out of their way to avoid it because of this rhyme. Magical thinking between the ages of 2 to 8 is a normal and beneficial developmental phase even if it involves mildly ritualistic behavior, according to the OCD Resource Center of Florida. About 1 percent of all children go on to develop a problem with OCD, a type of anxiety disorder characterized by obsessions and compulsions.
Obsessions are persistent upsetting thoughts. A child suffering from obsessions might worry constantly that germs will make her sick or that she'll accidentally start a fire or that her parents will die. Compulsions are ritualistic behaviors intended to control the obsessions. For instance, the child might believe that if she washes her hands in a ritualistic way she won't get sick, or that her parents won't die if she counts to a thousand every time she thinks about it. Kids with relatively mild OCD symptoms often try to cover them up because they feel embarrassed by them. You can't see your child counting to a thousand in her head or washing her hands in a very specific way behind closed doors, so you might not realize there's a problem.
If your child seems highly anxious, unusually guilty about minor infractions or overly worried about cleanliness, look out for signs of ritual behaviors. You might notice your child touching objects in his environment in a certain order every time he passes by them, taking much longer than necessary to do homework or a chore or rearranging items so they look perfectly neat. If your child starts spending a lot of time in the bathroom and coming out with flushed hands or chapped skin, he could be washing his hands repeatedly to control an obsession with germs. Children with germ obsessions sometimes neglect their grooming to avoid contamination from touching something they perceive as unclean. Mild OCD rituals can take many forms and parents often don't notice them until they start to interfere with the child's daily life.
If you are concerned that your child might have OCD, take her to a child psychologist or counselor for an assessment. A psychologist will only make a diagnosis if the child displays certain symptoms, including persistent and upsetting thoughts about unrealistic worries and repeated behaviors intended to relieve the anxiety. Mild ritualistic behaviors aren't enough for a diagnosis of OCD if they don't interfere with your child's ability to live a normal, healthy life. For example, insisting on wearing a lucky shirt to a softball game is probably not a sign of OCD, but refusing to leave the house without performing a certain set of behaviors first might be.
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