Diagnosing Obsessive–Compulsive Disorder in Children

NYU Langone doctors use several diagnostic methods to determine if your child has obsessive–compulsive disorder, or OCD. This mental health condition causes a person to have intrusive, unwanted thoughts, called obsessions. The person then feels driven to perform compulsions, or repetitive actions, rituals, or routines, to relieve the anxiety associated with those thoughts.

It’s common for adults and children to experience intrusive or random thoughts every now and then. For example, a person may worry that the front door was unlocked when leaving the house, and then check the lock once or twice to make sure it is secure. More often than not, this thought passes quickly, and the person can move on.

But for a child or adolescent with OCD, unwanted and repetitive thoughts, images, or impulses become “stuck” in the mind. This process is often associated with a fear that something bad may happen or that he or she may do something bad, leading to feelings of anxiety, shame, or disgust. Perfectionism and fear of losing control or being contaminated are other hallmarks of OCD in children.

In an attempt to neutralize these feelings, children with OCD engage in compulsions. Common compulsions include excessive washing, checking, or arranging things. Obsessive thoughts and compulsive behaviors significantly interfere with the daily lives of children and adolescents with OCD, potentially causing distress and embarrassment.

OCD can develop at any age, but it’s most likely to occur between 8 and 12 years old, in late adolescence, or in early adulthood.

Children and adolescents with OCD often realize that their obsessions are excessive and illogical, yet they can’t avoid these thoughts and the associated compulsive behavior. Many children and teens with OCD go to great lengths to hide their compulsions from friends and family.

Comprehensive Evaluation

To diagnose OCD in children and adolescents, clinicians from the Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone, meet with you and your child to perform a comprehensive evaluation.

A psychologist or psychiatrist conducts interviews with you and your child—both individually and together. The doctor may ask about the symptoms your child is experiencing and about any other conditions he or she may have, such as a mood disorder, a behavioral disorder, or attention deficit hyperactivity disorder.

You may also be asked to complete questionnaires that can give NYU Langone psychologists and psychiatrists details about your child’s obsessions, compulsions, and rituals, as well as possible causes. These questionnaires can provide specialists with information about how obsessions, compulsions, and rituals affect his or her daily life. They can also indicate whether the child’s symptoms are excessive compared to his or her peers.

Our clinicians speak with your child’s teachers, caregivers, and doctors, if appropriate. This can provide more details about your child’s behavior in other settings.

Assessments are conducted at the Child Study Center and typically last about two to three hours. They are given during one or two sessions.

After evaluating the information, our psychologists and psychiatrists plan a feedback session to discuss the diagnosis and the treatment options. Our specialists aim to help you understand your child’s behavior and the difficulties it may cause. They then provide you and your child with the most appropriate treatment plan.