Research Report: Preschool Aged Children and OCD

Researchers at Brown University in Rhode Island are reporting that children as young as four can meet criteria for obsessive compulsive disorder (OCD). This condition, associated with anxiety, has been studied in older children and adolescents, but this new study was the largest ever study of OCD in preschool age.

“OCD, if left untreated, can significantly disrupt a child’s growth and development and can worsen as the child gets older,” said Abbe Garcia, PhD, director of the Bradley Hasbro Children’s Research Center (BHCRC) Pediatric Anxiety Research Clinic at Brown, and chief author of the new study. “[E]arly diagnosis and intervention are critical to reducing the severity of symptoms and improving quality of life.”

People are said to suffer from obsessive compulsive disorder when they have repeated, intrusive thoughts which bring fear or anxiety, and they feel compelled to carry out repeated actions in order to manage that anxiety or to avoid imagined harm. Children with OCD can have tremendous difficulty socially, in school, and even at home, as their eccentric behaviors may frustrate well-meaning family members.

The Brown study included 58 children, boys and girls, aged four to eight. Ten had been treated with medication and 13 had received psychotherapy. About two in five was also diagnosed with attention deficit hyperactivity disorder (ADHD) or generalized anxiety disorder (GAD).

Fear of contamination and violent themes involving harm to themselves or their families were common obsessive thoughts in the study. Most children had several obsessions and compulsions, including washing, “checking” (doors, people, objects, etc.), and repeating (words or actions). OCD is treatable, and non-medical interventions have shown some success. Medications can be helpful in more severe cases. Helping children healthily manage stress is key.

© Copyright 2008 by Daniel Brezenoff, Licensed Clinical Social Worker. All Rights Reserved. Permission to publish granted to

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  • Madeleine

    October 31st, 2008 at 2:57 AM

    There was a time when my daughter was around 4 that she began exhibiting some very mild symptoms of this, with things like she could not get to sleep at night until all of the books on her bookshelf were lined up in the “correct” pattern. This went on for a while, but then just as mysteriously as it appeared it vanished. I say that and it will probably come back tonight! :-) I guess in retrospect this was just a way for her to feel safe and comfy in her own room at night but I think about how problematic just that small innocent episode became for the house and then I wonder just how disruptive it must be when a child exhibits symptoms much more serious than this that do not go away. It makes me feel fortunate that our situation did not manifest itself as full blown OCD because I see how easily that could take over not only the life of the child but the entire house.

  • Jerry Brooks

    November 4th, 2008 at 10:03 AM

    Madeleine, I feel happy for you. One of my neighbor kids has a severe case of ocd. His parents are a sad lot… it has been many months since I have even seen them smiling.

  • michelle

    November 4th, 2008 at 10:15 AM

    I have a very good friend, who’s son was diagnosed with Autism. He has some of the characteristics of OCD, such as repeating words and actions, checking his room for misplaced items and such. He is such a special child and very intelligent at the same time. I know this is probably his way of coping and is a habit that cannot be helped. Sometimes I see him looking around as if he is searching for something or someone. His mother has said at one time that he is a very active child and fidgety which makes me believe he has ADHD.

  • Oregonmom

    November 4th, 2008 at 11:07 PM

    Jerry and Michelle, those are sad stories.

    Life must be difficult for the parents of these children. Knowing I can’t even sleep at night when my children are ill, it must be very hard for those parents. I pray to god and hope that those children get better soon.

  • Austin

    November 5th, 2008 at 3:55 AM

    I think in autistic children this may be called stimming, or doing things which give them a degree of comfort?

  • Jane

    November 5th, 2008 at 8:05 PM

    This is very useful information. thanks

  • Starla

    November 6th, 2008 at 3:55 AM

    OCD can devastate a family. I am glad to hear that many are now trying to do interventions at an earlier age so they can perhaps prevent the future disruptions that this can bring. I knew a family where one sibling exhibited this behavior and it tore them to pieces. They had no idea where to turn for help or what to do to help the son.

  • Noelle

    November 9th, 2008 at 6:04 AM

    Madeleine its good to hear that your daughter is out of it, but after reading the post and other comments, it sounds so terrible and sad. Can anyone guide on how to identify OCD ? I have a 6 year old son who compulsively washes his hands after everything he does and has a habit of talking to himself. But till now I have just attributed it to a part of his growing up but can it turn out to be something else ?

  • Sandy U

    November 9th, 2008 at 6:56 AM

    Are children with OCD ever mainstreamed into a regular classroom setting? How would their behavior be explained to the other children in the class? I would love to hear from an educator knowledgeable about this.

  • Leslie

    November 9th, 2008 at 11:15 AM

    Most definately children should be mainstreamed in regular education classrooms. These children can have an accommodation plan or Individual education plan if needed to help assist in the classroom.

  • gamecockfan

    November 20th, 2008 at 5:26 AM

    Sad, so sad. You look at children and should see all of the wonder and joy that life can bring but in today’s world that is not always the case. The instances of things like this manifesting themselves in young children has become all too common and it seems that none of us know why. There have to be some external contributing factors to go along with this. Are parents making their kids this way? Do they feel societal pressures at such an early age? This was never talked about twenty or thirty years ago and now it seems that everyone knows a child or a family experiencing some sort of disorder. What in the heck is going on?

  • John T

    December 22nd, 2008 at 2:24 PM

    OCD can be so devastating to youngsters. Even they are wise enough to know that something is going on that is not quite right but they are in no way capable of seeking help for this. I think there are still many who abhor the fact that their child will be labeled as having something wrong with him or her if they seek treatment for it so they try to ignore the situation. This will only make things worse in the end. You have to speak up and become knowledgeable about this so that you can get your child the help he or she deserves.

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