Does my 8-year-old have OCD?
April 29, 2010 5:48 AM   Subscribe

Seeking advice and insights on how to deal with/react to my 8-year-old son's recent obsessive-compulsive-like behavior.

My son has started some mild ritualistic behaviors: not stepping on cracks when walking and if he does, backtracking and going forward again so he doesn't; repeatedly asking if me if he will be harmed by aliens/storms/tornadoes; repeatedly asking if he will turn into a girl if he stands or steps a certain way; watching the same television show over and over for hours; repeatedly asking me to pinkie swear things won't happen if he thinks they will and then repeatedly asking me if just by saying it it will happen; repeatedly writing, erasing and rewriting certain letters or numbers on his homework.

So far, I have just been calmly answering "no" to every inquiry and making no big deal out of any of the other behavior. But some days the questions happen dozens and dozens of times.

He is otherwise healthy, eats well, plays well, participates in baseball without incident, does fine in school. I asked his teacher yesterday if she noticed anything and she said she did notice he didn't finish a morning math assignment in the allotted 25 minutes and the consequence was not going out for recess. When he discovered this, he finished the assignment in a couple of minutes. She looked at the paper and noticed some of the numbers were erased and rewritten numerous times even though they were the correct answers. She did not say this is impacting his learning yet.

I have an appointment next week with his pediatrician to get some advice.

Pertinent information: I am a single dad who has him most of the time. His mom is involved in his life but has decided to move recently from a few-minute drive from me to a 20-minute drive. We were divorced when he was three. I have asked him about the behavior and he says he just feels like he needs to do it. He can't explain why.

I would like to know if anyone else has a child who has experienced this? Should I keep on calmly answering his questions? Do I need to probe his feelings? Is this normal/just a phase?
posted by playmobil to Health & Fitness (13 answers total) 1 user marked this as a favorite
Yes, but I may be the wrong person to respond, because my 11 year old son began exhibiting similar behaviors (I'm a single parent, too) around the same age, and after several incredibly hairy months (including a pediatrician telling em he was being manipulative and pushing limits, looking for attention, etc.), he was diagnosed with OCD and put on an SSRI which has completely changed his life (with the addition of Cognitive Behavioral Therapy).

But before he was diagnosed, I had scary misdiagnoses, scary medicine trials, a suicide attempt, and ultimately he was hospitalized so he could become stable.

If you feel it's worrisome in your gut, PLEASE get it looked at.
posted by dzaz at 5:56 AM on April 29, 2010

I would like to know if anyone else has a child who has experienced this? Should I keep on calmly answering his questions? Do I need to probe his feelings? Is this normal/just a phase?

I was a kid like this; I would go so far as to try to be "perfect" in every behavior I did and would get upset when I broke that by using an incorrect word in a sentence, or something in my room was imperfectly placed.

As an adult, I have mild anxiety and some control issues, but otherwise I've grown out of a lot of the superstitious weird behavior I had as a kid. My parents did a really great job of providing rational, informed arguments when I had issues with anxiety and it really helped me deal with them. Perhaps you can become an expert on storms and aliens! Good luck!
posted by Hiker at 5:59 AM on April 29, 2010

I think it helps to teach him about anxiety and call it that for now. Tell him that lots of kids, especially around his age group, feel anxiety about lots of different things and that most kids grow out of it in just a few years but that even some grownups have anxiety issues, and there are relaxation techniques that you can learn and other things to try that can help.

If eventually he is diagnosed with a disorder, help him to learn about it. Demystifying it I think helps.
posted by maloon at 6:14 AM on April 29, 2010

I did some of these things as a kid -- the sidewalk cracks in particular, and wanting to be sure I stepped over them with each leg the same number of times. To the point I'd want to walk an extra distance and turn around if I'd stepped over too many cracks with my left leg so the right would be even too! At his age I was also pretty scared of thunderstorms, being kidnapped, and similar things (although I didn't mention my anxiety because my mom would have pooh-poohed it, so I just kept it to myself and worried about it constantly).

The watching the same thing on TV (or reading the same book) endlessly is common periodically throughout childhood and adolescence, particularly when the brain is consolidating learning, I've read. I personally spent one summer watching "Fried Green Tomatoes" every single day.

I do think superstitions and fears are pretty common at this age, and a lot of these sound like he's starting to take more notice of/interest in the wider world, but isn't yet quite sure how it WORKS or how much it can impact him or how much power he has in dealing with it. I think it's definitely a good idea to talk to the pediatrician, and to listen to your child and respond to his fears. But I do think the chances are good it is just a phase. (For your anecdata, I outgrew all of it, except I still make my husband go check on bumps in the night, and sometimes it's hard to resist playing hopscotch on a really nice terrazzo pattern in the floor!)
posted by Eyebrows McGee at 6:27 AM on April 29, 2010

You might get something out of David Sedaris' Plague of Tics in his book Naked.
posted by phrontist at 6:33 AM on April 29, 2010

You may find the book Up and Down the Worry Hill helpful. I came across it when I was looking for information and resources for my somewhat-anxious son a couple of years ago. It's aimed at kids with OCD, to be read with parents.

The tricky thing with so many kid behaviors is that it's hard to know whether it's part of a normal phase or something more. Kids with, say, anxiety disorders don't necessarily do anything other kids don't ever do--they just do it more, or to the extent that it interferes with their enjoyment of life and participation in activities they want to be doing. In my son's case, we found a consultation with a therapist useful because his expertise helped us evaluate where our son was completely within the realm of normal and where there were things we might need to be actively helping him with (FWIW, though, the therapist's evaluation pretty much confirmed what we had observed and thought about our son's behavior and thinking, so that's one anecdote in favor of, "if you think there's something wrong, there probably is, and if you think he's OK but just a tiny bit quirky, you may very well be right about that, too).
posted by not that girl at 6:37 AM on April 29, 2010

I was VERY much like this as a child, and I still have OCD now. I wish someone had noticed when I was a kid, and I'm happy that you pay such close attention to your son.

Throughout my childhood, I was intermittently treated for depression and anxiety and somehow, none of my treatment providers diagnosed me as being OCD. It was a major problem that evolved into dermatillomania as a teenager. I was 18 before I was diagnosed, and it was actually my family doctor who figured it out.

Before my diagnosis, it did not help me for my parents to dismiss or try to soothe my fears and anxieties. It definitely didn't help when members of my family started calling me out on my rituals, commanding me to "just stop". ("If you keep picking at your skin, you'll have scars for life" -- well, thanks. I don't know how to stop, and it's going to make me hideous. Thanks for the added anxiety.)

What I'm trying to say, is, it can't hurt to have your kid evaluated. If he does have OCD, you can help prevent a lot of unhappiness. Good luck.
posted by Coatlicue at 6:42 AM on April 29, 2010

You can request a psychological evaluation from your school district and they have to provide it. This may be especially important if he has a need that might impact his education. Put your concerns in writing and request to have a full psychological assessment completed. Walk it into the office and keep a copy. They have 15 days to get you an assessment plan. If it turns out that there is an issue there, like OCD, you can jump right into the IEP process to get your child the supports he may need if it starts to impact his education. I'd do this today since once the summer break hits, things will slow way down.

Take the results of the district testing to your pediatrician. Only the MD can make the formal "diagnosis" and having that information will help them to do so. You can also go from there to access your insurance for any additional mental health supports your son may need.

Good luck with everything, all the best to you and your son.
posted by Palmcorder Yajna at 8:38 AM on April 29, 2010

In the UK it's very rare for children to be taken to get checked out by specialists, unless something's very clearly wrong. Here is stuff I did as a child:

- would shout 'a mini!' every time I saw a Mini car, except when it was a picture, when I had to whisper it under my breath.
- for a period of about two years, repeatedly ask people what they thought of certain names, and make lists of names
- as a teenager, constantly looking for and picking at split ends

None of this was picked up on as potentially a problem, which suggests two things - either we aren't as vigilant/medicalising here or during the 80s, or they were just seen as kid stuff that would be grown out of eventually. However, if I'd started behaving in the anxious ways you describe, that would have definitely been seen as something to get checked out.
posted by mippy at 9:29 AM on April 29, 2010

The assessment/testing provided by schools is generally only academic and learning-disability focused, so if you decide to do it, you may need to specifically request emotional and behavioral assessment as well. Plus, if a kid has an IEP, it will help A LOT to have the input of a therapist who is already working with him and can advocate for the school to pony up for more resources, which a lot of schools won't just go ahead and do, because it's expensive for them. But kids who need them deserve to have them, and sometimes families need to be strategic about the whole process.

I think the first step should be to see a mental health professional (the pediatrician can give you a referral). You can't diagnose him, and neither can folks on the internet, no matter how much it sounds like he may have OCD. A mental health professional (does not need to be a psychiatrist, by the way--a psychologist, counselor, or therapist, whatever is available in your area) is able to diagnose and treat whatever issues may be present. Honestly, I would not say right off the bat that this is definitely OCD, even though the behavior seems like it; there are other things that can cause a presentation with obsessive thoughts and compulsive behaviors. A MH professional can help you figure this all out, and help your little guy manage it.

As far as what you can do--keep treating his questions calmly. You obviously know that he doesn't need to be told that his questions or actions are unnecessary or weird or stupid. Be present, give him lots of hugs, talk with him a bunch (whether it's talking about his "worry" or not), let him know you are right there with him. Treat him like you always have, and be the caring dad you are. Even if he does have some difficulties, it doesn't mean anything is wrong with him, or that he can't live a happy life. It sounds like he is in an ideal situation, because you are so ready to help him and not stigmatize him or make (what sounds like) his anxiety worse. Know that you're doing a great job.
posted by so_gracefully at 9:46 AM on April 29, 2010

Hi! Former OCD kid here, now the polar opposite.

I developed OCD symptoms when my dad left our family for good. I was around 7 when he stopped visiting entirely, and I thought that if I did certain rituals, he'd come back. I was subconsciously convinced that if I could just beep the correct signals out into the universe, my dad would come back. Your current parenting situation makes me think that your son is trying to cope with his mom's increased absence by engaging in compulsive behavior. Those weird little rituals help him feel more in control of a world where he doesn't get to choose when he can see his parents. Again, a 20-minute drive isn't that big of a deal to you, but your son might feel it far more keenly.

My mom tried to talk to me about it, but I was only dimly aware of how my hang-ups were bundled up in an over-arching anxiety over dad's disappearance. I grew out of the OCD behavior when I got used to the new family structure, but if my mom or other caregivers scoffed at my rituals or forced me (like, held me down when I tried to flip on the lights for the third time) out of them, I freaked out and regressed.

By calmly and patiently answering his disaster-related questions, you're letting him know that you respect his fears but that you don't think they'll become a reality. It might be useful to attend a family counselor with your ex-wife so both parents are on board with treatment and developments.
posted by zoomorphic at 9:56 AM on April 29, 2010 [1 favorite]

Agreed that we tend to pathologize behaviors more nowadays. However, I had many similar symptoms when I was a kid (and I still do, just different ones), and the anxiety, stress, and powerlessness ended up manifesting as severe migraines. No one ever figured it out.

I think you should acknowledge to your son that he appears to be having anxiety, and ask him if he wants to talk to a psychologist about it. Be encouraging, suggest that it might help, don't mention the cost. The big clue for me was when you said "he just feels like he needs to do it."
posted by Knowyournuts at 10:02 AM on April 29, 2010

As someone who also had issues like that as a kid that have become less of an issue (but still there, the "just feel the need to do it") please get him checked out. Don't panic, but get some sort of professional assessment.
posted by Brian Puccio at 6:28 AM on February 7, 2011

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