Ask An Expert / OCD: Obsessive-Compulsive Disorders

If a boy of 6 years old doesn’t want to touch the floor when he walks, could it be OCD?

Signs a child might be using a ritual to manage fears

Clark Goldstein, PhD

If a boy of 6 years old doesn't want to touch the floor when he walks, could it be OCD? Which therapy could be the best help?

Yes, this could be a symptom of obsessive-compulsive disorder. To answer your question more clearly, I’d need to know why he doesn’t want to touch it. Does he think something bad will happen if he does? Does he have any other behaviors that seem to focus on being overly concerned with touching or not touching things? Does he have any highly repetitive behaviors that don’t seem to make sense? Does he complain of getting thoughts stuck in his head that bother him?

To determine if it might be a symptom of OCD, it would be good to consult a cognitive behavioral therapist. Treatment for OCD focuses on helping kids recognize when the disorder is trying to bully them, and exposing them, in a safe setting, to fears that trigger their compulsions (such as washing, counting, or avoiding touching things) without engaging in them. For instance, touching the floor when OCD “tells” the child not to touch the floor helps the child break the cycle of avoidance and giving into rituals. Eventually their obsessions lose their power.

For some children, antidepressant medications, such as SSRIs, can be an important part of treatment, to reduce anxiety enough to allow the child to benefit from behavioral therapy. If your psychologist thinks your child would benefit from a medical consultation, he or she can refer you to a child psychiatrist.

Since cognitive behavioral therapy (CBT) is not a speciality in which one receives a licensing credential, it’s critical to seek out a clinician with training, experience, and success in treating anxiety disorders, and OCD in particular. If you don’t know of good CBT clinicians in your area, the ABCT website may be a good place to start. Know that, if it is OCD, there is good treatment out there!