DAYTON, Ohio — Amidst a playful group of preteens eating at a Boston-area food court, one youngster seemed different. Wearing a light blue T-shirt like the other kids from a local summer camp, she sat by herself looking rather sad and uncomfortable. Counselors would occasionally approach her and say a few words but she seemed non-responsive.
After finishing lunch, she began a rather unusual ritual. She put each of her fingers from her left hand into her mouth, briefly touching her lips to each knuckle on every finger except the ring finger. After a momentary rest, she would repeat the exact same sequence, with a look of relief when she was done. I was close enough to notice the red marks on each of her knuckles, suggesting this was a chronic habit.
While I realize that psychologists can't make a diagnosis by briefly observing a stranger for a few moments, this youngster appeared to have many of the symptoms of an unusual and confusing problem called obsessive-compulsive disorder (OCD). This anxiety disorder affects about 1 percent of the school-age population. These youngsters develop elaborate and time-consuming rituals that are perplexing to both parents and professionals. These kids relieve their anxiety by engaging in repetitive behaviors that make no sense.
One youngster I treated with this disorder took about an hour to get ready for school every morning. She felt she had to engage in an elaborate series of behaviors that involved touching each of her stuffed animals and positioning them in a certain way. Once completed, she repeated this ritual three times before she felt comfortable getting on the school bus.
After observing this youngster throughout my lunch, I wondered if I should say something to one of the counselors. However, I wasn't sure how advice from a stranger who was observing a young child might be received. I finished eating and took the subway to the airport, but here's what I wanted to say about OCD.
— Many parents wonder if their kids will grow out of various problems. Most of the time they do, but kids with OCD generally get worse without treatment. It's important to get professional help before these rituals become deep-seated habits that are difficult to alter.
— Kids with OCD have lots of other types of problems, particularly in their relationships with peers. Since some of their behaviors are rather strange, children can be ostracized by peers and even adults. This is another reason why treatment is so important.
— These are not bad kids who can control their ritualistic behaviors. They really can't help themselves, and rewards and punishments are generally ineffective.
— Treatment, typically involving behavioral therapy and sometimes medication, is extremely effective.
Treatment of OCD can have a tremendous positive impact on the child and the family. Please seek professional help if you think your child might have this disorder.
Gregory Ramey, Ph.D., is a child psychologist and vice president for outpatient services at The Children's Medical Center of Dayton, Ohio. For more of his columns, visit www.childrensdayton.org/ramey. Send comments to Ramey at rameyg(at)childrensdayton.org. This article appeared in the Dayton Daily News.