How to Help a Child With OCD at Home: Advice From an Expert

Understanding OCD in Children

Obsessive-compulsive disorder (OCD) impacts between 1-3% of children.¹ Symptoms of OCD in children typically follow the same OCD cycle, but the content of obsessions and compulsions may differ in children compared to adults. There are two ages that children tend to experience onset of these symptoms: between 8-12 years old and late adolescence.²

In most cases, OCD develops gradually over time. However, in some rare cases, there may be a rapid onset of symptoms due to a condition known as Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS).² This condition is more common in children between ages 3-12 and thus far, has shown to rarely occur in adolescence.³

OCD is characterized by:

• Obsessions: Obsessions are recurring, unwanted and intrusive thoughts that typically cause a high amount of distress, fear, or anxiety.
• Compulsions: Compulsions are repetitive behaviors that someone with OCD feels compelled to perform, often in response to an obsession. These behaviors can take multiple forms, such as mental compulsions or observable behaviors.

Recognizing the Signs of OCD in Children

Signs and symptoms of OCD in children include the cyclical presence of both obsessions and repetitive compulsions. A child with OCD may present with obsessions in the form of expressing an excess amount of worry about something bad happening, appearing preoccupied with needing to remember minor details, being overly attentive to order and symmetry, or expressing much concern over dirt and germs.⁴

Compulsions in children may be similar to adults with OCD, such as hoarding specific objects, repetitive checking, or excess handwashing. However, there are some differences that affect children more so, such as reassurance seeking. Although seeking reassurance does present in adults, it tends to be more prevalent in children, as a parent is typically readily available to provide this reassurance. It may also be a difficult compulsion to break if a parent struggles with not providing assurance, which can be hard at times.

Identifying OCD Triggers for Children

Triggers for OCD tend to vary in children, just as they do in adults. An OCD trigger typically initiates an obsession, leading to the urge to engage in a compulsion. Some of these triggers are specific to the type of OCD that the child is experiencing. Other examples may include times of increased stress, sleep disturbances, big life changes, or even breaks in routine such as a vacation or holiday.

The Impact of OCD on a Child’s Life

The compulsive behaviors that are prevalent in OCD are generally time-consuming and disruptive to a child’s daily life. Kids may be distracted from learning at school due to their focus being instead on the worry that comes with obsessions or having to engage in repetitive compulsions. Performing repeated compulsions may also interfere with playing at home or cause difficulties with socializing with peers.

How to Help a Child With OCD at Home

Helping support a child with OCD at home may feel overwhelming if you’re not sure where to start. OCD behaviors can be time-consuming, distracting and oftentimes they take awhile to break out of. Creating a supportive home environment can go a long way in helping your child manage their symptoms.

Here are 10 ways to help a child with OCD at home:

1. Educate Yourself About OCD

If this is your first time encountering OCD, it can be helpful to start with learning about this condition. Educating yourself on the symptoms of OCD, the cycle of OCD that occurs with the condition, and the treatments that are typically used can be helpful topics to start with. By learning what your child is experiencing, it can help you further support them.

Here are some tips for how to educate yourself about OCD:

• Read about OCD in children through reputable online OCD resources
• Seek out books on OCD from a parent perspective or listen to OCD podcasts
• Find books about OCD from a child perspective as well, to use as a resource to talk about OCD with your child
• Seek information from your child’s pediatrician or mental health professional

2. Maintain a Predictable Schedule

Sticking to an established routine is beneficial for children overall, but particularly for kids who have anxiety or OCD. The reliability of a consistent routine allows kids to have a sense of predictability and stability. This can reduce anxiety as they learn they can rely on the consistency of a set routine at home. Added stressors and anxiety may exacerbate OCD symptoms, so helping to decrease anxiety where you can is important.

Here are some tips for how to maintain a predictable schedule:

• Maintain regular mealtimes
• Have a consistent morning routine and bedtime routine
• Communicate openly and in advance if there will be significant deviations in established routines

3. Create an Environment Conducive to Open Communication

Talking about their worries and compulsions may feel overwhelming for a child. Depending on their age, a child may also not have the language they need yet to fully express the depths of what they are experiencing. Creating an environment that encourages open communication can help support a child in their journey of recovering from OCD. If your child feels they can confide in you, they are more likely to voice their emotions or seek help from you when they need it.

Here are some tips for how to create an environment conducive to open communication:

• Establish daily check-ins to talk about feelings and challenges
• If you notice they seem to be struggling, openly check-in with them about this
• Introduce language and age-appropriate education about different emotions, if needed, if your child appears to have a hard time expressing their thoughts and feelings

4. Practice Patience & Understanding

From the outside looking in, the need to repeatedly perform certain behaviors may not make sense to you. For your child, however, they feel an intense drive to engage in these compulsions that is difficult to break out of. Reducing OCD symptoms is a gradual process that occurs over time, as your child starts to decrease these compulsions.

Patience and understanding are of the utmost importance in supporting your child through OCD. There are times it may be hard to maintain this patience, such as when you are in a rush to get somewhere but your child has to finish a compulsion first or if their grades are falling because of OCD. However, being able to demonstrate empathy and understanding with your child can go a long way in supporting them.

Here are some tips for how to practice patience and understanding:

• Try to avoid showing anger when OCD behaviors are time-consuming
• Take a break to yourself (if possible) to regulate emotions when you are beginning to feel frustrated
• Learn more from your child about how they feel when they are driven to perform these behaviors, which can help see their point of view

5. Develop a Response Plan for OCD Behaviors

At times, it may be difficult to know how to respond to your child’s OCD behaviors. This can be particularly true if these behaviors are disruptive or interfering with necessary tasks and schedules. Creating a response plan in advance of how you plan to handle these behaviors can go a long way in helping decrease stress for both yourself and your child.

Here are some tips for how to develop a response plan for OCD behaviors:

• Create a step-by-step plan for handling intense OCD moments
• Ensure other individuals are aware of this plan so they know how to respond in these moments
• Identify how to handle when OCD behaviors occur during transitional times, such as bedtime, going to school, or leaving for other plans

6. Reinforce Positive Behaviors

For anyone with OCD, resisting the urge to act on a compulsion can feel highly distressing. For a child who does not yet have the language to explain how this feels for them, it may feel even more overwhelming. When your child is able to resist the urge to act on a compulsion, reinforcing this behavior in a positive way is vital for their continued success in fighting these urges. Particularly early in the process of treating OCD, positive reinforcement is a must.

Here are some tips for how to reinforce positive behaviors:

• Use a reward system for periods without OCD rituals
• Ask for your child’s input on this reward system so they are working towards things they have specified they would like
• Provide verbal acknowledgement, encouragement, or praise when they are able to not engage in OCD behaviors

7. Gradually Introduce Responsibility

OCD can manifest for a variety of reasons and one of these reasons may be as an attempt to feel more in control. By slowly introducing other ways to take on responsibility, this can help provide a sense of feeling in control for your child. Accomplishing these tasks may also help boost your child’s confidence as well. Start by choosing a small, simple task and modeling how it is done. After this first task is learned, build up over time to other tasks.

Here are some tips for how to gradually introduce responsibility:

• Assign age-appropriate chores to help build sense of responsibility
• Identify if there are any tasks your child prefers to do or takes more interest in
• Slowly build up over time from a simple task to more in-depth, as is appropriate dependent on age

8. Utilize Gentle Exposure Techniques

One of the most common and well researched therapies is known as exposure and response prevention (ERP) for OCD, which involves gradual exposure techniques. Under the guidance of a therapist, part of this treatment is to gently expose the child to something that provokes their feared obsession. Implementing this at home is a vital part of treatment in helping a child recover from OCD.

Here are some tips for how to utilize gentle exposure techniques:

• Take note of any specific triggers you notice at home tend to increase your child’s anxiety
• Slowly introduce the child to feared objects or scenarios in a safe setting; this is typically done while working under the guidance of a trained professional
• Encourage open communication throughout this gentle exposure to check in on how your child is feeling

9. Limit Reassurance Seeking

For children with OCD, a common compulsion can be reassurance-seeking. This may be hard to recognize at first, as many kids seek reassurance from their parents. In children with OCD this behavior is often in excess compared to what may be normally expected or compared to a child who does not have OCD.

As a parent, it can be difficult to not assure your child; you want to help calm their worries! Reassurance has a time and place of course. However, when it is excessive, for kids with OCD it leads to reinforcing the OCD cycle and can turn into a compulsion.

Here are some tips for how to limit reassurance seeking:

• Redirect to self-soothing techniques instead of providing immediate reassurance
• Implement “reassurance coupons” to reduce frequency
• Establish reassurance-free time periods

10. Encourage Healthy Coping Skills

Presenting alternative ways to cope with anxiety aside from engaging in compulsive behaviors can be helpful as well, however, it is important to monitor that the new skill does not become a compulsion itself. Learning new coping skills geared towards kids may be particularly helpful as your child is more able to reduce compulsions and the drive to perform them has started to decrease.

Here are some tips for how to encourage healthy coping skills:

• Teach deep breathing – it can be helpful to model this skill as you teach it
• Teach some mindfulness exercises for kids
• When you see your child using a healthy coping skill, acknowledge and encourage this behavior
• If you are working with a mental health professional who is teaching your child specific skills to implement, prompt your child to use these at home when needed

Talking About OCD With Your Child

For anyone with OCD, it can be hard to talk about their symptoms. Depending on a child’s age, it can be even more difficult if they don’t quite have the language yet to communicate how they feel. Creating a home environment that supports open communication, asking questions to understand them as best you can, and encouraging them when they do express themselves can all go a long way in talking to your child about their OCD.

Collaborating With Professionals to Help a Child With OCD at Home

When your child is presenting with symptoms of OCD, particularly if it has started to become disruptive to their functioning at school or home, it is vital to seek the help of a mental health professional. A trained provider can help provide treatment tailored to your child’s symptoms and needs. While treating OCD, parental involvement is highly important in helping a child cope through these distressing symptoms.

Integrating Therapy With Home Life

Treating OCD often involves implementing specific tools at home. These can be learning new ways to cope or intervening with specific behaviors. For OCD in particular, ERP typically involves assigned “homework” assignments in the form of specific exposures to complete with your child. The trained professional you work with can help walk you through what is expected during an exposure and how as a parent you can support them during this.

Helping your child integrate therapy at home is an important part of the process in treating OCD. Without this, therapy may not be as effective if the work done in a therapy session is not translating to this work continuing to be supported at home. To help with this, completing assigned homework with your child, reminding them of coping skills taught in session, and continuing to collaborate with your mental health provider are all key steps to take.

How to Help a Child With OCD at School

OCD can present a multitude of challenges for a child in a school setting. Repeated compulsions may be disruptive in the classroom, which can lead to disciplinary difficulties a child may face. It may also be a distraction to the child’s learning, both because of the distress an obsession can cause and from feeling the urge to perform a compulsion. In these cases, it is important to be your child’s advocate at school.

Working With Schools & Teachers

An initial step to take in working with the school and your child’s teachers is talking with them about what your child is experiencing. Providing education to them on the symptoms your child is going through and helping them recognize that your child often cannot help these behaviors can aid in providing explanation and receiving assistance. Identify and collaborate with your child’s educators to see what your child’s needs are and how they can be accommodated in the classroom environment.

Tailoring Educational Resources

Particularly if symptoms are high in severity, seeking accommodations for your child may be necessary. This is typically done after your child undergoes an assessment. After an assessment, collaborate with the school to see what their process is for seeking accommodations. Examples of these may be extra time on tests or assignments, changing location that tests are taken, or allowance for frequent breaks.⁵

Self-Care for Parents & Siblings of a Child With OCD

Supporting a loved one with OCD can take a significant toll on family members. Parents may devote extra time to the child with OCD or need to exert added patience with them at times. Siblings may be unsure how to respond to this individual’s OCD behaviors and the emotions surrounding them. Particularly with younger kids, there may be a lot of confusion as to why their sibling with OCD even does these behaviors. Overall, families may feel the added stress of supporting a child with OCD in different ways.

Finding Support Networks

Having support can go a long way in helping a family system through being affected by OCD. Leaning on trusted friends and other family members can be a good start, if available. Other resources include group therapy or support groups for other parents of children who have OCD. Talking with other families that are supporting a child with OCD can help in discussing shared experiences as well as learning additional coping strategies. Family therapy may be additionally helpful as well.

Ensuring Personal Well-being

Self-care and having time to focus on personal well-being can help go a long way in supporting the mental health of all family members. Identify what works best for your family in setting aside time for each person to be able to focus on their own mental health. Examples include carving out time for each parent to have alone time when possible, scheduling individual time for other children in the house (who may feel added attention is on the child impacted by OCD), or attending individual therapy for any affected family members.

When to Seek Professional Support

Seeking professional support is an important step in helping a child with OCD. Although many of the above tips can be applied at home, having the guidance of a trained mental health professional is valuable. This is particularly true in instances where OCD symptoms have started to affect the child’s functioning at home or school. Searching through an online therapist directory for a mental health professional who specializes in working with children with OCD is a useful place to start. You may also consider NOCD, an app for individuals ages 5 and up with OCD, offering live therapy sessions.