OCD in 4 year old

[Londoner202222]

My little boy is showing signs of OCD and wondering if any one has any children with similar problems/or other ideas of what is going on. He is a happy little boy who loves to be at home (hates going to nursery and gets v stressed leaving me but enjoys it when he’s there). He’s recently been diagnosed with possible asthma after numerous hospital admissions for chest infection and viral wheeze and is now on medication. He is otherwise a very active, busy, happy little boy!

He has started since about 2 months ago having small repetitive routines of wanting to park outside nursery in a certain spot and wanting to walk on the path a certain way. I didn’t think much of it and thought it was his anxiety going to nursery. This has now escalated with him not wanting me to touch him in public, if he does he has to rub his foot. He can’t let me get him in his car seat so he gets in and out over and over again. He doesn’t walk on cracks on the path. He takes a v long time at getting dressed as he has to do it in a certain way. He gets stressed in certain situations where he has to do something over and over again, it’s horrible to see and even harder to get to the bottom of it as he’s so little. When I’ve tried to ask him why he has to do these things and says just because. He’s my whole world and just hate the thought of him being stressed and anxious. Its getting really tricky going out in public and it’s giving me a lot of anxiety let alone him bless him. My husband thinks he will outgrow it but I just want any advice. Thank you for reading.

What medications is he on?
My little boy has asthma and has some strange mental symptoms when his blood oxygen is just below normal (e.g. might ask to go swimming twenty or thirty times in a row without listening to the answer). Having a pulse oximeter at home has been very useful.

Aaah bless him. Don't a lot of little kids grow out of this behaviour though? Is he hair pulling at all? I have OCD and the hair pulling was the first sign.

My son is now 6 and a half and has displayed what I describe as 'OCD traits' for a long time. He has a brain injury from when he was a newborn and although he's largely fine, he definitely has some interesting traits in terms of emotions and behaviour.

I first notice obsessive behaviours at age two.

I don't particularly have any advice but my son copes well at school. I'm hoping as he gets older we will be able to talk even more openly with him about some of his behaviours.

I would see a GP and ask for a referral.

What you have described sounds well beyond 'normal' to me. It sounds like it is massively impacting day to day life.

I wonder whether relaxing stuff like baby massage or toddler yoga may help?

@Londoner202222 Just out of interest OP - did this come on quite suddenly?
Has he had any form of Strep infection within the last few months?

We had a similar situation with or DS. Have a look at PANS/PANDAS and see if it sounds like a possibility.

I would read 'Breaking Free of Childhood Anxiety and OCD' by Leibowitz.

I'd nip it in the bud now before it really gets out of hand.

Teach your child that it's okay to have worries and to feel anxious.

Try not to protect them from worries.

Teach them that they can handle things by themselves, that they're capable and praise the wins, no matter how small.

From experience, it sounds like nursery is a trigger. I would judge if the anxiety reduces after a week or so off nursery.

When my son was that age, he was the same. It was only a few years later that he was able to verbalise why he didn't want to go to nursery.

How do you know that he's fine in nursery? If that's coming from the adults then your son may be holding in his anxiety at nursery and then acting out these behaviours to cope.

Also point out that you can see he's very worried/anxious and then point out when he has calmed down. Something like "I can see that your worries have calmed down a bit now. Worries come and they're scary but they ALWAYS calm down and get less scary'.

Don't avoid the worries.

Definitely discuss with a GP. If he is on montelukast (singulair) that is a bit notorious for causing these sorts of issues.

Thank you everyone for messaging. He is on montelukast, I have read it can cause ocd in teens but doesn’t mention little ones. He’s only been on it for 3 weeks I would definitely say his ocd symptoms have got worse since taking them but that could be a coincidence as he started being more anxious/ocd symptoms 6 weeks before so I’m dubious to say it’s solely the medication. We’ve also taken a break from nursery for the past two weeks to stay away from all of the bugs with him being poorly, that has eased his anxiety with nursery but not with all of the new things going on. I’ve noticed he gets worse when tired or anxious. We are seeing his specialist in 2 weeks and will definitely raise this with him. I agree I want to nip it in the bud now, we have OCD in the family also and can see certain traits but he just seems so little bless him. He’s only just turned 4 so can’t quite put into words how he is feeling/why he’s doing what he’s doing, I am also very aware of not making too much a of big issue with him as this I worry will make the issue worse,

I have just read up about pandas and ocd, he had to go to hospital a couple of times in the time frame for chest infection/viral wheeze. They tested for Covid and flu which were negative but not strep, they gave him antibiotics and steroids. I will definitely mention this to the dr also thank you.

Ignore it, do what he asks and make him feel comfortable.

My eldest had some ticks and stuttered for a year when he was small … it passed. He gets some social anxiety now and I can tell because he paces or taps his leg, but other than that he’s fine.

I would talk to the doctor about the montelukast as soon as possible, there are alternatives. The consultant was happy to change my son to a different treatment because it seemed to be affecting his dreams. The concern with small children is that there are other mental symptoms they can’t tell you about.