Your child feels compelled to repeat certain behaviours like counting steps, washing their hands, and placing certain items in a particular way.
You may not fully understand why they behave that way and you dismiss it as neatness.
As we mark Mental Health Awareness Month, Affinity Health CEO Murray Hewlett warns that very often, obsessive-compulsive disorder (OCD), especially in children, is misunderstood.
“Many people assume it is simply about being neat, organised, or particular about how things are done. In reality, OCD is a mental health condition that causes unwanted thoughts, fears, or worries that keep coming back,” says Hewlett.
“These thoughts can create intense anxiety and often lead children to repeat certain behaviours or routines in an attempt to feel better. For some children, OCD can have a significant impact on everyday life. It may affect their ability to focus at school, spend time with friends, sleep well, or manage daily activities.
“Even when they realise their fears may not be logical, they can still feel powerless to stop the thoughts or behaviours. Children living with OCD are often carrying a heavy emotional burden that others cannot see. The signs are sometimes mistaken for bad behaviour or attention-seeking, when in reality the child may be struggling with overwhelming anxiety.”
Research, says Hewlett, shows that OCD can develop during childhood or adolescence and affects millions of children worldwide.
He says medical studies show that symptoms often begin between the ages of seven and 12 but some children may show signs earlier.
“The condition can look very different from one child to another. Some children become obsessed with germs or contamination, while others develop fears around safety, illness, mistakes, religion, or something bad happening to loved ones.
“In an attempt to manage the anxiety these fears create, some children develop routines or behaviours that they feel compelled to repeat. These may include washing their hands over and over again, checking things repeatedly, such as schoolwork, doors, or personal belongings, counting objects, steps, or words, repeating certain words or phrases quietly to themselves, needing items to be arranged in a particular way, and constantly asking parents, teachers, or caregivers for reassurance that everything is okay,” says Hewlett.
“These behaviours are not simply habits or preferences. For children with OCD, they can feel necessary to ease overwhelming anxiety, even if only for a short time... the impact of OCD in the classroom is not always obvious. A child may appear distracted, slow to complete their work, or overly worried about making mistakes, when they are actually dealing with intrusive thoughts and anxiety.
“Signs at school may include, struggling to concentrate during lessons, taking much longer than expected to complete tasks, falling behind despite putting in a lot of effort, frequently seeking reassurance from teachers, avoiding group activities or certain parts of the school day, and becoming distressed when routines change.
“OCD can also affect friendships. Some children feel embarrassed about their thoughts or behaviours and work hard to keep them hidden. Others may pull away from friends because they worry about being judged or misunderstood.”
OCD rarely affects only the child, says Hewlett, adding that it often has an impact on the entire family. “Parents may notice that everyday routines start taking longer than usual. Getting ready for school, leaving the house, or going to bed can become stressful if a child feels they need to repeatedly check their belongings or complete certain rituals before moving on.
“Many children with OCD keep their struggles to themselves. Some feel embarrassed by their thoughts, while others worry that nobody will understand what they are going through.
“The good news is that OCD can be treated, and early intervention can make a significant difference. The sooner a child receives support, the sooner they can learn healthy ways to manage their fears and anxieties. Treatment often includes cognitive behavioural therapy (CBT), particularly a specialised approach known as exposure and response prevention (ERP). This helps children gradually face situations that trigger anxiety while learning not to rely on compulsive behaviours for relief.”
He says in some cases, medication may also form part of a treatment plan.
Hewlett says that with the “right support, many children experience significant improvements in their confidence, emotional wellbeing, school performance, and quality of life”.
Parents should consider seeking advice if their child’s fears, worries, or repetitive behaviours persist, says Hewlett.
“Despite growing awareness around mental health, OCD remains widely misunderstood. Some parents worry that seeking help will result in their child being labelled, while others hope the symptoms will eventually disappear on their own.
“However, OCD is a recognised mental health condition, not a sign of poor parenting, bad behaviour, or a phase that children simply outgrow. With the right treatment and support, many children learn to manage their symptoms successfully and go on to thrive at school, at home, and in their relationships.”
