OCD, Children and Teenagers
Recognising early signs of obsessive compulsive disorder
Obsessive compulsive disorder (OCD) can emerge during childhood or adolescence. In some cases, early difficulties may go unnoticed, particularly if a child or young person finds it hard to describe what they are experiencing.
Children and teenagers may not have the language or confidence to explain intrusive thoughts, worries, or distress, and changes in behaviour can be an early indicator that something is not quite right. This might include routines becoming more rigid, tasks taking much longer than expected, or increased distress around particular fears or rules.
Concerns about peer reactions, stigma, or bullying can also make it harder for young people to speak openly, meaning difficulties may be hidden or minimised even when the distress feels significant.
While The OCD Treatment Centre primarily works with adults, we are able to assess and work with children and teenagers in some circumstances. Suitability is considered carefully on a case-by-case basis, and where specialist child or adolescent services would be more appropriate, we aim to discuss this openly and support families with appropriate signposting.
Developmental differences in OCD
Children often have less insight into obsessive thoughts than adults, and their ability to describe internal experiences is still developing. This can make it harder for parents and carers to recognise what is happening and can also complicate the assessment process.
Some children experience intrusive thoughts focused on harm coming to parents or loved ones, accompanied by a strong sense of responsibility for preventing this harm. Others may develop rigid rules or rituals aimed at reducing distress or preventing feared outcomes. These are examples of how OCD can present in childhood, but experiences vary widely.
Adolescents and young adults may present differently, with increased awareness of their thoughts and, in some cases, greater distress about their content. Understanding these developmental differences is an important part of assessment and formulation.
Parental Involvement
When working with children and teenagers, involving parents or carers is often an important part of the therapeutic process. This can help ensure that responses at home support treatment rather than unintentionally maintaining difficulties. The level and nature of parental involvement is considered carefully during assessment and depends on the young person’s age, needs, and circumstances.
PANDAS and OCD
Some research has explored a possible association between the sudden onset of OCD symptoms in children and certain infections, commonly referred to as PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections).
This remains an area of ongoing research and debate. While some children may experience a rapid change in symptoms following illness, OCD most commonly develops gradually and is influenced by multiple biological, psychological, and environmental factors. Any concerns about medical causes should be discussed with appropriate healthcare professionals as part of a wider assessment process.
Impact on school life
OCD can affect children differently across settings. Some children may suppress symptoms during the school day, which can be exhausting and impact concentration and learning.
Possible indicators in a school context may include:
Withdrawal from peers or changes in friendships
Reduced confidence or increased self-criticism
Reports of bullying related to visible routines or behaviours
Difficulty concentrating, completing work, or participating in class
These signs are not specific to OCD but may indicate that a child is struggling and would benefit from further support or assessment.
Our approach to working with children and teenagers
The OCD Treatment Centre primarily works with adults and is not a dedicated child or adolescent service. However, in some circumstances, we are able to assess and work with children and teenagers where this is considered appropriate.
Any work with younger people is carefully assessed on a case-by-case basis, taking into account age, developmental needs, family context, and whether specialist child or adolescent services would be more suitable. Where another service is likely to be a better fit, we aim to discuss this openly and provide appropriate signposting.