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Does My Kid Have OCD or is this Normal Childhood Behavior?

Daniel Ifrah LCSW

Have you ever watched your child get ready for bed and ponder if this is 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 may need to read every single night? Better yet, how about if you need to reread that same story 3 times in a row?  Ok so maybe bedtime is pretty uneventful in your house. Many of us can recall at least some parts of our childhood bedtime routine.  (I will most definitely not be sharing mine). Did we all have OCD growing up and then we were miraculously cured (or not) with age?   (I would love to add some humor here somehow).

Ok, so maybe bedtime is non-eventful in your home. But you definitely can’t escape the mealtime logic. Two identical pieces of chicken, one is utterly rejected and can’t be within 6 feet of your son’s plate while the other is devoured to the last drop. They look and taste identical, but our little guys have supersonic sensors that can scan that chicken for all kinds of foreign irregularities. If these behaviors were spotted on an adult, we would certainly be dialing our friendly neighborhood therapist. We know that only 1-3 percent of children are diagnosed with OCD yet a great deal more display similar bedtime and food ritual-like behaviors.

Let’s quickly summarize what OCD or obsessive-compulsive disorder really is.  An obsession is an unwanted or intrusive thought or image. This obsession creates tremendous discomfort and thus a compulsion or ritual is performed to neutralize the obsession. The OCD sufferer does the compulsion which temporarily appears to ‘tame’ the obsession when in reality, the obsession is strengthened and returns with a vengeance. The OCD sufferer 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. Another ingredient here is a child’s natural need for security. These 3 ingredients of routine, consistency, and needing security often result in some of the common childhood repetitive ’rituals that we have become all too familiar with.  So next time your child refuses any other blanket than his old threadbare blanket that looks like Swiss cheese, remember, it’s more than likely nothing but a nostalgic reminder of your old blanket when you were a kid.

Routine vs Rituals

Here are some key differences when assessing if your child’s behaviors are ‘normal’

  1. OCD is always within the context of anxiety and distress. Normal childhood rituals are more comfort and security based

  2. 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.

  3. Normal childhood development can include repetitive behaviors but keep a closer look if those behaviors become more repetitious or if they are excessive in repetition

  4. Childhood development is broken down into 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 s/he ages.

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