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Is preschooler's odd behavior a sign of OCD?

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Dear Dr. Laura,

My 3 and a half year old son has begun demonstrating some strange speech behavior. It started with "blowing". I should start by saying that he has lately become obsessive about not stepping on cracks (in sidewalks, on tile floors) and has consistently avoided doing this for about 3 months now.

About 1-2 months ago, he would "blow" when he stepped on a crack, saying this protected him from the "lasers" (the cracks). Then the blowing became a speech habit. He'll be speaking, will blow out twice, then continue his sentence. He now does this with tongue clicking too. He'll be in the middle of a sentence, will click his tongue a couple of times, then continue. He is otherwise in good health.

Should I be concerned?


It's almost certainly no big deal. Your son is anxious about the sidewalk crack lasers. He feels physical anxiety. He releases his anxiety by blowing. This is so effective that later when he is speaking and something makes him anxious -- what he is saying, a stray thought, worry about something -- he blows to release tension then also. This is so effective he begins to use tongue clicking as well.

Is this normal? No, most kids don't do it. We all get anxious many times a day, and we usually tolerate it without such physical expression. But is it an indication of anything serious? Much too young to tell, and much too mild a behavior. If your son was exhibiting compulsive, constant blowing and clicking that made other kids think he was weird and got in the way of social relationships, I would intervene. And if he begins any other odd behavior that gets in the way of normal functioning, I would intervene.

SO what can you do to keep this from getting worse? First, reduce any pressure on your son. He obviously is an anxious little guy, so your goal for now is to keep him unstressed as much as possible.

Second, give him another physical way to release his tension. Buy him a squeezy ball that he can keep in his pocket. Tell him the ball has protective powers and will help keep him safe. Tell him that when he gets anxious, he can put all of his worries in the squeezy ball, where they will all shrink and vanish.

What if his behavior worsens? You should probably speak with a therapist who is experienced with Obsessive Compulsive Disorder for an evaluation.

The bad news is that what you are describing MAY be an early indicator of OCD, which requires professional intervention. The good news is that his odd behavior will probably go away without any intervention, and even if it worsens, most kids who receive cognitive behavioral therapy for OCD in childhood do outgrow their symptoms, or at least learn to manage them, by the teen years.

Here's how OCD works. We all get anxious many times a day. Generally, we learn to tolerate our anxiety, and we do something to make ourselves feel better. For instance, if we're worried about the cracks being dangerous lasers, we're careful not to step on them. After awhile, we relax about the cracks and move on with our lives.

However, some kids find the anxiety intolerable and they develop a physical reaction to manage their anxiety. They get "addicted" to this way of managing their anxiety.

Cognitive behavioral therapy (CBT) is the most effective treatment for OCD behaviors. The child is slowly exposed to objects that cause anxiety and is helped to tolerate the anxiety without resorting to the compulsive behavior. Learning to manage their anxiety gives them an essential tool they can use in daily life, which reduces the number of times they feel anxious, as well as the need to blow or click.

But I want to stress that I am NOT diagnosing OCD. It is much too early for that, and even if your son has that tendency, it is probable that he can learn to manage his anxiety, with your help.

--Dr. Laura

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