Mothers are rarely silly; they more-often-than-not know when something isn’t quite right. I learned long ago to trust mother-instincts. I am unable, of course, to make a diagnosis on the basis of a letter alone. But I can tell you that what you describe is consistent with OCD. Many pediatricians who are excellent general doctors are not trained to recognize psychiatric problems in young children. The onset of OCD usually tends to happen later, so he may have ruled it out due to her age. However, it is not unheard of for a child as young as four-years-old (or even younger) to have symptoms.
According to National Center for Biotechnology Information, “Obsessive-compulsive disorder (OCD) is a very distressing disorder for both patient and caregiver. Usual onset of the disorder is in late second or early third decade of life. It is diagnosed in children but rarely before 5 years. However, symptoms can appear in first decade sometimes as early as 2 years.”
“Estimated prevalence of OCD in very young children (5-7 years of age) is 0.01% which is much lower than in general pediatric patients (0.5-4.0%). Pre-pubertal onset is more common in boys than girls, in the ratio of 2-3:1.”
Some of my adult patients have told me that they can’t remember ever not having the compulsions of OCD.
Please take your child to a child psychiatrist for an evaluation. Because she is only 4 and may not respond well to questions, the psychiatrist will be relying on you to provide detailed information about what your daughter does and under what circumstances. Take careful notes over a week or two so you can give specific examples of what happens and how often. Please do some reading to educate yourself more about OCD so you can ask good questions during the visit. As with most things, early diagnosis and early intervention is very helpful.
I wish you well.
This article has been updated from the original version, which was originally published here on April 16, 2007.