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Often, compulsions are performed in a ritualistic, or very specific way, for example, counting to six Two boys and two knobs time an article of clothing is removed. Contamination Fear or distress about coming into contact with dirt, germs, sticky substances, or chemicals e. Accidental harm to self or others Fear of harming yourself or others through carelessness. For example, " what if I didn't clean off the counter properly and there are still germs on it, and my mom gets sick because of me!

Symmetry and exactness A need to have items ordered in a certain way for example, according to color, size, or facing a certain direction.

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Children and teens with this type of obsession are either anxious because "it just doesn't feel right" or because of a superstitious belief that something bad will happen e. Often, the content of obsessions sounds very odd or makes no sense.

For example, a child with OCD might say that he or she needs to arrange all the teddy bears from smallest to biggest or else something bad will happen to mom. Most children and teens are aware that these thoughts are strange; however, do not be surprised Two boys and two knobs your child doesn't think his or her thoughts are odd.

Most younger children have no idea that their obsessions sound peculiar to others.

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A need for perfection Some kids and teens feel a strong need for things to be perfect or right. For example, your child might not be able to start her homework until her books are all ordered and perfectly arranged, or cannot turn in an assignment until she is certain its perfect.

Forbidden thoughts Entering into adolescence is a time of sexual maturity and most teens think about sex and sexual identity during this time.

However, for some teens they are plagued with unwanted thoughts and images about being gay when they know they are not, or thinking about engaging in sexual behavior that feels upsetting and even repulsive to them. Washing or cleaning Washing hands excessively, sometimes until they are raw and bleeding.

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There are many other types of washing behaviors, including:. Checking These types of compulsions can involve checking doors, locks, or backpacks, to make sure everything is safe. Some children and teens check to make sure that everyone is okay.

For example, calling family members to "check" that they are safe. Counting, tapping, touching, or rubbing Compulsions can involve counting, touching, or tapping objects in a particular way. Two boys and two knobs children and teens have lucky and unlucky numbers involved in their rituals e.

For example, a child might need to line up all the shoes in the closet so that they all face forward, and are matched by color.

Mental rituals Not all children and teens with OCD will have compulsions that can be seen.

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Some perform rituals in their head, such as saying prayers or trying to replace a "bad" image or thought with a "good" image or thought. For example, a teen might have a bedtime prayer that he or she mentally repeats over and over again until it "feels right". Be sure to watch our video below for more information It is common in toddlers, preschoolers, and even young children to have rituals and superstitions.

A careful assessment of your child can help determine whether OCD is at play. For those diagnosed with childhood OCD, themes of harm and contamination are the most common themes in this age group.

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Encouraging adolescents to unburden themselves by talking with an adult they trust about their OCD is a good start. During her last year at preschool Debbie started doing everything evenly or in pairs. At first it was just when she ate food, for example, eating an even number of orange slices, leaving the last slice on her plate if she was served an odd number. This seemed harmless, and even a little cute and quirky to the preschool teachers and her parents. However, this pattern quickly expanded to other areas such as wearing two shirts and opting for pants and shorts as there are two legs, never a skirt or dress, and brushing her teeth in even strokes, and watching Two boys and two knobs shows in sets of 2 or 4.

Debbie is consistently late as she gets stuck at home counting her steps from the house to the car, and from the Two boys and two knobs to camp, repeating the process if she ends on an odd number.

And has started throwing tantrums in camp when she cannot do an activity in an even way, which is highly out of character for a usually easygoing kid.

Jamal was always an outgoing, bright, and friendly kid.


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