A clinician will make a diagnosis if your child has obsessions, compulsions, or both. Obsessions are unwanted thoughts, images or urges that cause marked anxiety and an effort on the child’s part to suppress or neutralize them by thoughts or actions. Compulsions are repetitive, rule-based efforts to alleviate the anxiety that are not connected in a realistic way with what they are designed to neutralize. The behavior must interfere significantly with a child’s normal activities. In addition to the basic diagnosis, a professional can also determine the severity of the case and track the effectiveness of treatment using a widely accepted rating scale called Y-BOCS, or the Yale-Brown Obsessive Compulsive Scale.