Expert: James Windell - 3/8/2005

Question
My almost three year old son has recently been displaying some behavior that is concerning me. He obsesses about strange things, such as a chair not being pushed up to the table or a pillow not being straight on the couch. He will scream and throw a tantrum if I don't let him fix these sort of things. And I can tell that he is truly distressed about them. He wants everything to be perfect all the time and if it's not he panics. He also obsesses about his clothes constantly. If they're the least bit twisted or wrinkled he will flop around like a fish out of water crying "my clothes". Yesterday we went to the zoo, a place I thought he would have a great time, but he could barely enjoy himself because he kept whining about his jacket sticking up a little bit in the front. He also obsesses about things he think should go together. For instance tonight we were playing in his room and I gave him a pretend kiss with one his toys and he said "give me a hug". So I have him a hug with the toy and then another kiss. He again said "give me a hug" and this went on and on until I put the toy in his toy box. He started crying and was searching for the toy because I had given him a kiss with it but not the hug that he asked for. I wasn't trying to torment him I just wanted to see what he would do because I am worried about this behavior. He has also become extremely bossy and tells me what to do all the time. He's not rude about it unless I don't do what he says. When he's rude, I just tell him that he doesn't tell mommy what to do and then he's usually ok about it. I am so afraid that I am doing something or not doing something to promote this behavior. Could my son have obsessive compulsive disorder? I do wash my hands constantly for fear of germs, but it does not affect my life to the point of never leaving the house or anything that extreme. My father used to check under his vehicle constantly for fear that he was dragging a body and my grandmother cleans to the point of ridiculousness. Could these be signs that OCD runs in my family? Also there is a lot of stress in my household. My husband and I have had financial problems for several years now due to a bad business decision. We try not to fight or show signs of the stress around our child, but unfortunately he picks up on it. I am a stay at home mom so my son and I are together 24/7. I also had a very stressful pregnancy. I was infertile for years until finally having a successful surgery to fix the problem. But I worried constantly about losing my baby because of all the female problems that I had. My son has his three year check up in a little over two months, but I'm very worried and was wondering if you could give me some insight into what might be going on with him. Thanks.

Answer
Hello Stacy,
Obsessive compulsive behaviors are sometimes seen in toddlers, but over all the disorder is relatively rare with only 1 to 2 percent of the population experiencing a true OCD. More often, it does not occur in children until about 9 or 10 years of age.
On the other hand, toddlers must learn routines and organization in order to master the world and their environment. Also, toddlers exhibit many behaviors that are transient. They change so rapidly that what was a problem one week is completely forgotten the next.
I would suggest not over reacting to your child's behaviors -- at least not yet. If these obsessive compulsive behaviors (and OCD probably is genetic) continue for a long time (a year, say) and they become debilitating (that is, they interfere with development or functioning at a particular age or stage), then you might seek out a good, experienced child psychologist.
I hope this helps.
Best,
James Windell