Diagnosing childhood OCD

Careful diagnosis and case conceptualization are central to effective treatment planning. However, diagnosis can be complicated when working with children and families. In addition to knowledge about diagnostic criteria, diagnosis relies heavily on clinicians’ ability to identify, conceptualize, and differentiate a range of symptoms in order to generate a successful treatment plan. There are a number of important considerations when diagnosing and differentiating obsessive-compulsive disorder (OCD) in children and youth. This chapter will discuss four key areas and skills that are central to a developmentally sensitive assessment of OCD. This chapter will (1) outline how to apply the diagnostic criteria for OCD to youth, including how to differentiate age-normative and pathological rituals; (2) review common OCD symptom presentations in youth; (3) provide clinical guidance on how to conceptualize and differentiate OCD symptoms from symptoms of anxiety and other psychopathology, particularly in the context of overlapping symptoms; and (4) highlight complicating factors to consider when assessing and diagnosing OCD in children and adolescents.