Did you ever watch your child getting ready for bed and wonder, Is this all normal?
Maybe it’s the one more drink ritual, or your child needing to be tucked in “just so” that has you wondering. How about that bedtime story you need to read every single night, twice through, with voices?
Or if bedtime is uneventful in your house, can you recall parts of your own childhood bedtime routine? Did you ask your dad to cut an apple into tiny chunks as a snack each night? Did you go to the bathroom three times in a row every single night? As your mom pulled the covers up to your chin—no lower and no higher than precisely the tip of your chin—did you request a medley of songs to be sung in exactly the same order without skipping a single note?
Are those signs of OCD or just normal kid behavior? Did we all have OCD growing up and then find ourselves miraculously cured with age?
Mealtime can raise just as many questions.
Two identical pieces of chicken: one is utterly rejected and can’t be within six feet of your son’s plate, while the other is devoured to the last bite. Each piece looks and tastes identical—prepared in the same pan with the same ingredients—but some of our little guys and girls have supersonic sensors that can scan that chicken for irregularities. Are those OCD-sensors, or normal-kid sensors?
If you spotted these behaviors in an adult, you’d be dialing your friendly neighborhood therapist. That adult would benefit from counseling and perhaps a diagnosis. But is it as clear-cut in a kid?
We know that only one to three percent of children are diagnosed with OCD, yet a great deal more display similar bedtime and food ritual behaviors. Are they undiagnosed, or just kids being kids?
What Is OCD?
Let’s summarize what OCD or obsessive-compulsive disorder really is.
An obsession is an unwanted or intrusive thought or image. This obsession creates a tremendous discomfort and thus a compulsion, or ritual, is performed to neutralize the obsession.
The OCD sufferer acts out the compulsion, which appears to temporarily “tame” the obsession. In reality, the obsession is strengthened and returns with a vengeance. The person with OCD is tricked into a vicious, painful cycle of obsessions and compulsions that intensifies as time goes on.
The first clue in identifying OCD is that almost always the purpose of the compulsion is to alleviate the discomfort of anxiety generated by the obsession. This distinction is not always easy to make but is crucial when getting an accurate diagnosis.
Normal childhood development, however, is quite different. Kids thrive on routine and consistency and have a natural need for security. These three ingredients of routine, consistency, and needing security often result in some of the common childhood repetitive rituals we’ve become all too familiar with.
Security for Healthy Children
When a child needs one more drink, one more trip to the bathroom, one more time through that favorite story, or one more rendition of his favorite medley of songs, he’s most likely not trying to alleviate discomfort and anxiety—he’s just relaxing into the familiarity of routine. You’re helping him flourish by creating consistency, night after night. Your song and your story—even an apple cut into tiny pieces for one last bedtime snack—offer security to a healthy child in his formative stages.
The mealtime panic over that inferior piece of chicken is probably not flowing from an unwanted, intrusive thought or image, as the OCD-sufferer would be facing. Instead, that moment of chicken-panic can simply remind you that some kids are much more attentive to detail than adults are—your daughter may have spotted a bigger-than-expected clump of spices on the piece you offered her. That’s all. If she didn’t repeat the behavior when you gave her the other piece, she probably doesn’t have obsessive behavior that needs professional supervision and diagnosis. Try serving her a big scoop of rice instead, and instead of fretting about the chicken simply relax and have fun around the table. Every family benefits from a moment of warmth and laughter!
So next time your child refuses any other blanket than his old threadbare blanket that looks like Swiss cheese, trust that it’s probably just that need for security—instead of leaping to an assumption he’s got OCD, think back fondly to your own special blankie. You had one, didn’t you? And then you can hum the little medley to your child that your mom sang to you. It might offer you both a moment of comfort, just as it did when you were little.
Routine vs Rituals
Here are some key differences when assessing if your child’s behaviors are “normal” or in need of professional diagnosis:
- OCD manifests in the context of anxiety and distress. Normal childhood rituals are more comfort- and security-based
- OCD usually continues to spiral and isn’t “satisfied” with one consistent ritual. Be concerned if you notice that your child’s routines seem to grow or change in intensity.
- Normal childhood development can include repetitive behaviors, but take a closer look if those behaviors become more repetitious or if they are excessive in repetition
- Childhood development is broken down in stages, as the child ages and new stages are reached most of those concerning behaviors decrease. Keep watch If your child’s behaviors are not diminishing as he or she ages.