Child and Adolescent OCD

OCD in Children and Adolescents

Obsessive-Compulsive Disorder is not just an adult condition — it affects children and teenagers too, often with profound consequences on their daily lives, school performance, and family relationships. OCD typically begins in childhood or adolescence, with many adults tracing their symptoms back to their earliest years. An estimated 1 in 100 children has OCD, meaning classrooms across New York and New Jersey have students quietly struggling with this condition every day.

Recognizing OCD in Young People

Children with OCD often struggle to understand or explain their fears. They may appear distracted, oppositional, or anxious — and their compulsive behaviors are frequently mistaken for stubbornness, quirks, or anxiety disorders. Early identification and specialized treatment are critical to preventing OCD from disrupting a child's development and becoming entrenched through adolescence.

~ How OCD Shows Up Differently in Children

Adult OCD typically involves clear insight — the person knows their fears are irrational, even if they can't stop. Children often have less insight and may be fully convinced their fears are real. A child with contamination OCD may genuinely believe they will die if they touch a doorknob. A child with harm OCD may be too frightened to hold a pencil near a classmate.

Children also rely more heavily on parents for reassurance, which can pull the whole family into the OCD cycle. When parents repeatedly reassure, accommodate, or modify household routines to reduce a child's distress, it unintentionally signals that the feared outcome was worth avoiding — strengthening the OCD rather than weakening it.

~ Effective Treatment for Young People

The gold standard treatment for childhood and adolescent OCD is Exposure and Response Prevention (ERP) therapy, delivered by a specialist trained in OCD. ERP teaches young people to gradually face their fears without performing compulsions — rewiring the brain's threat response over time. ERP for children is adapted to be developmentally appropriate, creative, and engaging — often using games, stories, and metaphors to help younger patients understand and participate in treatment.

At The Center for OCD, Dr. Henry Srednicki specializes in treating children and adolescents with OCD. With compassion, patience, and evidence-based methods, Dr. Srednicki helps young patients and their families break free from OCD's grip — restoring confidence, friendships, and academic success.

~ What to Expect in Treatment

Treatment for a child or teen with OCD includes both individual sessions and active parent involvement:

• Assessment: Understanding the child's specific OCD symptoms, triggers, and how the family has responded


• Psychoeducation: Teaching the child and parents about OCD in age-appropriate language — "bossing back OCD" and understanding the anxiety cycle


• ERP hierarchy: Building a personalized "fear ladder" with the child's input — from least to most scary


• Active ERP: Gradual exposures with Dr. Srednicki's guidance, plus homework tasks between sessions


• Parent coaching: Teaching parents how to stop accommodating OCD while staying warm and supportive


• School coordination: Liaising with teachers or counselors if OCD is affecting school performance

~ Frequently Asked Questions

At what age can a child start ERP therapy?
ERP can be adapted for children as young as 5–6 years old, with significant parental involvement. For younger children, much of the work is done through parent coaching. By age 8–10 most children can participate meaningfully in individual ERP sessions.

How do I know if my child has OCD or just normal childhood anxiety?
Normal childhood fears and worries are common and generally don't cause significant impairment. OCD is characterized by repetitive rituals or avoidance that takes up significant time, causes distress, and interferes with daily life. If you're unsure, a consultation with Dr. Srednicki can provide clarity.

Is telehealth available for children?
Yes. Telehealth sessions are available across 42+ states through PSYPACT authorization and work well for many children and teens. In-person sessions are also available at our Upper Montclair, NJ and New York City offices.