Signs of OCD in Children and Teens
Jazmin Anderson
| 3 min read
Jazmin Anderson is a 2026 Corporate Communications i...
Key Takeaways
- Children with OCD experience unwanted obsessions that cause anxiety and may perform compulsive actions, such as repeated handwashing, checking or counting, to ease distress.
- OCD is not simply about being neat or organized. Compulsions can be time-consuming, disruptive and even physically harmful, while some mental rituals, such as seeking reassurance or repetitive thinking, may be harder to recognize.
- Mental health professionals can diagnose OCD and distinguish it from other conditions. Cognitive behavioral therapy is the recommended first-line treatment for children, and medication may also be used to reduce symptom severity.
OCD affects up to 3% of people worldwide, according to Harvard Health. The disorder can start presenting itself in children at around 10 years old. During childhood, it is more common for boys to start presenting symptoms than for girls.
Here's a look at how OCD affects children, along with common signs of the disorder and treatment options.
What is OCD?
Those with obsessive-compulsive disorder (OCD) are troubled by intrusive thoughts, called obsessions, which are related to fears and can come with intense feelings of anxiety, fear or dread. In order to deal with the thoughts and accompanying emotions, those with OCD carry out repetitive thoughts or behaviors, which are called compulsions, according to Harvard Health. Compulsive rituals can interfere with your child’s daily life and development if they become frequent or intense.
Some common signs and symptoms of OCD in children, according to the Centers for Disease Control and Prevention (CDC), include:
- Unwanted thoughts, impulses or images that occur repeatedly, causing anxiety or distress
- To think about or say something repeatedly, such as counting or repeating words silently or out loud.
- To do something over and over, like handwashing, placing things in a specific order or checking the same things repeatedly.
- To do something over and over based on certain rules that must be followed exactly to make an obsession go away.
Children feel the need to engage in compulsive behaviors because they think doing so can prevent bad things from happening or soothe their intense feelings. However, there’s usually no actual danger.
The behaviors triggered by obsessions can be extreme, according to Harvard Health and the CDC, such as washing hands multiple times per hour. They are time-consuming and can cause physical injury, such as chapped hands from frequent hand-washing. Thought-based compulsions such as problem-solving, reassurance or avoidance may be harder to spot, and the child may not understand what they are experiencing isn’t normal.
Contrary to the popular understanding, those with OCD aren’t always neat or organized. Frequently, people with OCD are overly focused on one thing that must be done repeatedly, rather than on being organized. A child’s obsessions and compulsions can also change over time.
Rituals and obsessive thoughts normally occur with focus and purpose, depending on a child’s age during their growth and developmental process, according to the Boston Children’s Hospital. Preschool children frequently build routines around mealtimes, bath and bedtime to stay regulated. School-aged children tend to have social rituals built around games and sports, while older children, including teens, may develop hobbies or collect specific items. These are all normal parts of a child’s development and can be tools to socialize or manage stress and anxiety.
Diagnosis and treatment of childhood OCD
If you suspect your child might have OCD, the first step is to contact your child’s primary care provider about an evaluation. An evaluation by a mental health professional can determine whether your child’s distress is based on past trauma, OCD or another anxiety disorder
After diagnosis, treatment options can include cognitive-behavioral therapy (CBT) or medication. CBT teaches therapeutic skills to children and parents to target OCD symptoms on a step-by-step basis, according to Johns Hopkins Medicine. CBT is the more recommended treatment approach for pediatric OCD, as it has demonstrated considerable therapeutic benefit in randomized clinical trials.
Your child might also may be prescribed selective serotonin reuptake inhibitors (SSRIs) along with CBT to help reduce the severity of OCD.
OCD typically lasts for a lifetime, and there is not a cure. With proper treatment, children and teens can learn to manage the disorder and live with minimal symptoms.
Photo credit: Getty Images
