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Forum Name: Psychiatric Topics

Question: Is 4 years old to early to diagnose OCD?


 mommy2boys - Thu Dec 21, 2006 2:23 pm

My 4 year old is a perfectionist and needs to have certain things done in certain ways. We homeschool, and if he doesn't write a letter or cut on the line exactly right, he flips out, and starts crying saying it's horrible, it's not perfect, he hates it, etc. I try to tell him, he just needs practice, it doesn't have to be perfect, things like that, encouraging without dismissing his feelings, but I don't know what to do?!
He also has certain things that he needs to be i n a certain way. For example at bedtime, his blanket has to be exactly square with his bed, if the boxes on a grocery shelf are mixed up or not all facing the same way, he will stop and fix them, he's even starting crying because I told him it was ok for them to be that way, and he wouldn't stop til I let him fix them. He's almost 5 and I'm hesistant to have him labelled with any kind of disorder (ADD, ADHD, OCD, whatever) but I'd like to know if this is something that could progress into a much more pronounced issue or if he's just being a picky kid?

Thanks for you time.
 Dr. Chan Lowe - Thu Dec 21, 2006 4:28 pm

User avatar OCD can appear in childhood. It's estimated that around 1-2% of children. OCD can be difficult to diagnosis in children, however, because children may feel embarrassed about their symptoms and "hide" them to the best of their abilities. The typical age that children are diagnosed is around age 10.

4 years old would be young, but this does not make it not possible. The symptoms you describe can be some beginning signs of OCD. Certainly there are other possibilities, but I would suggest discussing these symptoms with your child's doctor. If a developmental/behavioral pediatrician is available in your area, he/she would be an excellent resource for aiding in the diagnosis of your child's condition. You may need a referral from your primary doctor to get in to the specialist.

Some children like order. Children his age have become aware of patterns, etc. and very much dislike things to be in random arrangement. This does not necessarily lead to OCD. More concerning sympoms of OCD would be repetitive type behaviors. For example, repeating phrases a specific number of times, or repeatedly washing their hands more than "normal". Along with these rituals, come the obsessions, such as an intense fear of getting sick or contacting germs. These may be manifest as constantly asking of people are OK or sick. Often, the obsessions may lead to more rituals such as washing the hands to get the germs off.

Hope this helps.

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