At The Children's Naturopath, we see children whose obsessive thoughts, compulsive behaviours and anxiety have become increasingly difficult for families to manage.
Drawing on 28 years of clinical experience, our approach pays particular attention to when OCD symptoms first appeared, whether they developed gradually or suddenly, and whether an illness or infection occurred around the same time.
OCD is diagnosed and treated by a doctor, paediatrician or mental health professional, and effective treatments exist. What we look at is nutrition and physical health alongside that care, never in place of it. If your child's symptoms are escalating, speak with their doctor.
One pattern we investigate is a child who was previously managing everyday life comfortably but develops intense anxiety, obsessive thoughts or compulsive behaviours over a very short period.
Parents may describe a sudden change in their child's personality or behaviour, sometimes occurring within days.
For example, a child may suddenly become frightened of contamination, refuse certain foods, develop repetitive rituals or experience extreme separation anxiety.
When symptoms appear abruptly, we pay particular attention to the child's recent illness history.
PANS and PANDAS are conditions associated with the sudden onset of obsessive-compulsive symptoms or significant food restriction.
PANDAS is associated with streptococcal infections, while PANS may occur following other suspected infectious or inflammatory triggers.
In some children, the onset of OCD symptoms may be accompanied by:
Sudden separation anxiety or intense fears.
Refusal to eat or significant changes in food intake.
Emotional outbursts, aggression or irritability.
Sleep disturbances.
New tics or repetitive movements.
Changes in concentration, behaviour or school participation.
Understanding the timing and combination of these symptoms can help distinguish a sudden-onset presentation from OCD that has developed more gradually.
One question we regularly ask parents is: "Was your child unwell in the weeks before these behaviours began?"
We are interested in whether the child experienced a respiratory infection, sore throat, fever or other illness before the onset of symptoms.
We also explore whether the child's behaviour changes during subsequent illnesses, or whether symptoms become more noticeable when they are physically unwell.
An infection does not automatically explain OCD symptoms, but the timing can provide important information about the child's overall clinical history.
Children experiencing OCD may also develop increasingly restricted eating habits, particularly when fears surrounding contamination, food safety or swallowing become part of their symptoms.
In clinic, we consider whether these changes are affecting the child's nutritional intake. Iron, zinc, magnesium and other essential nutrients are important for normal brain and nervous system function.
We pay particular attention to children whose food intake has changed significantly, whose appetite has declined or whose diet has become increasingly limited — while recognising the challenges that obsessive thoughts and anxiety can create around food.
When supporting children with OCD, we want to understand more than the behaviours themselves.
We explore the child's symptom history, recent illnesses, sleep, nutritional intake and any changes in emotional or physical wellbeing. A symptom diary can be particularly useful for recording when behaviours intensify, whether they fluctuate with illnesses and how they affect everyday life.
By looking at these patterns, we can provide personalised nutritional and general health support that takes the child's broader wellbeing into account, alongside their existing treatment.
Royal Children's Hospital Melbourne — Kids Health Info: Obsessive Compulsive Disorder
Childhood OCD, its effects on daily functioning, and where families can get help.
National Institute of Mental Health — PANS and PANDAS: Questions and Answers
Sudden-onset OCD symptoms, associated behavioural changes and possible infectious triggers. NIMH notes that no laboratory test confirms either condition.
The paper that defined the PANS criteria, in Pediatrics & Therapeutics.