What is it? 

Obsessive-Compulsive Disorder (OCD) is a chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviours (compulsions) that they feel the urge to repeat over and over.

What are the symptoms of OCD?

Children with OCD ­have obsessions which are unwanted thoughts that make them worry and become very anxious. To control these anxious thoughts, they develop rules for themselves which can also be described as compulsions. Children can have obsessions, compulsions or both. 

Common obsessions may involve:

• Excessive worrying about germs or dirt 
• Extreme fears about bad things happening like getting sick or dying
• Extreme fears about doing something wrong
• Excessive attention to detail
• Disturbing and unwanted thoughts about violence or self-harm

Common compulsions may involve:

• Excessive checking and rechecking (e.g. checking to make sure that their snack is in their lunchbox) 
• Excessive washing and/or cleaning
• Hoarding
• Repeating actions like counting and recounting a lot
• Preoccupation with organization, symmetry, or accuracy
• Mental compulsions (e.g. excessive reviewing)
• Repeating sounds or words said by oneself or by others
• Excessive reassurance seeking

When is it time to seek professional help? 

OCD usually begins in children before the age of 10. It may be time to seek professional help when obsessions and compulsions become more intense and frequent, affecting the day-to-day functioning of the child.

What can be done? 

There are two main treatments that can help manage and reduce the symptoms of children with OCD. These treatments may also be used with other therapies or medications when concurrent neurodevelopmental challenges contribute to OCD. 

Exposure and Response Prevention (ERP)

ERP is a type of Cognitive Behavioural Therapy (CBT). It helps children with OCD gradually face their fears and worries without turning to their usual compulsive behaviours. The first step in ERP is to help children try to understand OCD using metaphors, age-appropriate resources and play therapy.  

Serotonin Reuptake Inhibitors (SRIs)

SRIs are a type of medication that helps to reduce the severity of OCD symptoms by altering the balance of chemicals in the child’s brain. It is recommended that SRIs be used along with ERP when a child has severe symptoms.

What makes some children more vulnerable to OCD? 

Genetic factors: family history of mental health challenges and brain-based disorders especially if the child has a first-degree relationship with a family member with OCD (e.g. parent, child or sibling). The risk is higher if the first-degree relative developed OCD as a child or teen.

Environmental factors such as adverse childhood experiences or toxic stress during childhood

Brain structure and functioning: Both genetic and environmental risk factors can alter brain chemistry and development. Scientists believe that the brains of children with bipolar disorder grow and develop differently than those of other children.

Where can I access support?

Talk to the child’s family doctor or pediatrician to help identify if the child’s behaviour is normal for their developmental stage.  

Talk to the child’s guardianship worker and share your behavioural observations. Explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

Get an assessment through your local Child and Youth Mental Health team. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC. 

You can also contact a private psychologist or counsellor through the BC Association of Clinical Counsellors or the BC Psychological Association. You can use website filters to search for a counsellor in your community that specializes in certain mental health challenges.

What is it?

 Fetal Alcohol Spectrum Disorder (FASD) is used as a diagnostic term to describe the significant impacts that can occur to individuals prenatally exposed to alcohol. FASD’s effects may include physical, mental, behavioural, and/or learning disabilities with lifelong implications. 

Learn about FASD in this video:

What are the symptoms of FASD?

FASD is a lifelong condition but the symptoms may change as the child gets older.

Newborns with FASD may:

• have low birth weights and small heads. They may not grow or gain weight as well as other children
• have slight differences in their faces, such as small eyes, and a thin or flat upper lip
•  be fussy and find it difficult to settle
• have problems sleeping

Babies exposed to large amounts of alcohol before birth may go through withdrawal. Withdrawal often starts before babies leave the hospital.

Symptoms of withdrawal include:

• extreme fussiness,
•  tremors or shaking,
• feeding problems, and diarrhea
• problems with their heart rate, breathing or digestion

Toddlers with FASD may be: 

•  hyperactive,
• unable to follow simple instructions,
• too cheerful and friendly, even to strangers, and
• delayed in their development

What can be done? 

Children with FASD can benefit from:

• early intervention services
• mental health support
• educational supports
• speech and language therapy
• occupational therapy
• physical therapy 
• parent/caregiver training

Medication

There is no medication for the treatment of FASD itself. However, some medications can help with the related challenges that accompany FASD, such as ADHD, depression, and anxiety.

What makes some children more vulnerable to FASD? 

FASD is not inherited. To prevent FASD, a woman should avoid drinking alcohol if she is pregnant or might be pregnant. This is because a woman could get pregnant and not know for up to 4 to 6 weeks. There is no safe amount of alcohol during pregnancy or when trying to get pregnant.

Where can I access support?

Talk to the child’s doctor about getting an assessment. If FASD is suspected, they may refer the child to the Complex Developmental Behavioural Conditions (CDBC) network in your Health Region. They may also refer you to a pediatrician or psychiatrist to rule out other possible medical causes for the difficulties and behaviours that concern you.

Talk to the child’s guardianship worker and share your behavioural observations. Explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

Get support from an FASD key worker. In BC, there is a free Key Worker and Parent Support Program that provides emotional and practical support for families of children with FASD, even before an assessment. They also refer families to resources like training and support groups. There are FASD key workers located in each Health Region across BC. You can find an FASD key worker or support in your community here.

What is it?

Emotional regulation or self-regulation is the ability to control “big feelings” or emotions, when they have them, including the way they experience and express them. Some children are born with self-regulation challenges. However, young children under the age of 6 are little people with big feelings and sometimes, angry outbursts can be the only way they know how to express their feelings.

What are the common signs of emotional dysregulation disorder in children?

• Angry outbursts without a justified reason 
• Excessive crying, often more intense and lasting longer than what is situationally appropriate Physical aggression toward others
• Self-harming thoughts and behaviours

When is it time to seek professional help? 

Infants can show signs of emotional dysregulation, and some then grow up to have behavioural and emotional problems. It may be time to seek professional help when the child is showing signs of extreme fluctuations of mood and emotions and their inability to regulate their emotional state is beginning to affect their family, peers, school performance, and long-term mental health.

What can be done? 

• Build emotional literacy by encouraging children to accurately identify and name feelings. 
• Play therapy involves the use of toys and games to help the child recognize, identify, and express feelings. 
•  Provide psycho-education and teach a child how to identify unique body signals and how to connect them with their feelings. 
• Teach self-regulation and coping skills using positive language and mindfulness strategies.
• Cognitive behavioural therapy (CBT) can help a child recognize unhealthy behaviours and learn how to change them.

What makes some children more vulnerable to emotional dysregulation? 

• Family history of mental health challenges and brain-based disorders 
• Trauma, adverse childhood experiences and toxic stress

Where can I access support?

Talk to the child’s family doctor or pediatrician to help identify if the child’s behaviour is normal for their developmental stage. 

Talk to the child’s guardianship worker to explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

Get an assessment through your local Child and Youth Mental Health team. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC. 

You can also contact a private psychologist or counsellor through the BC Association of Clinical Counsellors or the BC Psychological Association. You can use website filters to search for a counsellor in your community that specializes in certain mental health challenges.

What is it?

Eating disorders are problems with the way a child eats that affect them physically and mentally. Eating disorders in young children can create a lot of stress for families.

What types of eating disorders are common in children?

Anorexia Nervosa (AN) 

Anorexia is a form of self-starvation. People with anorexia nervosa have an intense fear of gaining weight and a distorted body image. 

Common signs of anorexia in children include:

•  low body weight
• fear of gaining weight, even as he or she is losing weight
• having a distorted view of their body weight, size, or shape
• refusing to stay at the minimum normal body weight for their age
• denying that they feel hungry
• being socially withdrawn, grouchy, moody, or depressed

Bulimia Nervosa (BN) 

Children with bulimia overeat or binge uncontrollably. This overeating may be followed by purging (self-induced vomiting. 

Bulimia has two types:

Purging: A child with this type overeats habitually and then forces themselves to throw up. Older children may also misuse laxatives and diuretics, enemas as a form of purging. 

Non-purging: Instead of purging after overeating, a child with this type uses other unhealthy ways to control weight such as exercising too much.

Common signs of bulimia in children include: 

• usually, a low body weight but sees themselves as weighing too much
• habitual binge eating, often in secret
• self-induced vomiting, often in secret
• excessive exercise 
• anxiety
• depression 
• obsession with food, weight, and body shape 

Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidant/restrictive food intake disorder is both a sensory and eating disorder. Children with ARFID lack interest in food or refuse to eat food due to fears of aversive experiences such as choking and vomiting. 

ARFID is different from developmentally appropriate behaviours such as “picky eating” or “fussy eating” among children. Some children have extreme sensitivity to the colour, smell, texture, taste, or temperature of certain foods. 

ARFID is not due to lack of access to food, cultural practice, anorexia, bulimia, or a concurrent medical condition. Doctors will not diagnose ARFID if a child’s symptoms can be explained by cultural practice or lack of access to food or if a child’s weight loss can be explained by a physical condition or other mental health or neurodevelopmental disorder.

Common signs of ARFID in children include: 

• low interest in food or refusal to eat due to a fear of choking or vomiting
• reluctance to eat meals with others
• delayed growth 
• weight loss or failure to gain weight 

Binge-eating Disorder (BED) 

Binge-eating disorder involves eating very large amounts of food with no purging. 

Common signs of binge-eating disorder: 

• eating large amounts of food rapidly despite not feeling hungry, often and in secret 
•  lack of control during binging episodes
• rapid weight gain
• obesity
•  immobility
• social isolation
• diabetes
• dental issues
•  breathing difficulties

Night-eating Syndrome (NES)

Night-eating syndrome is an eating disorder in which children eat large amounts of food after the evening meal, often waking up during the night to eat. It is different from binge eating disorder because children with binge eating disorder usually do not have to wake up to overeat during the night. 

Eating Disorder Not Elsewhere Classified (EDNEC)

EDNEC is a form of dysregulated eating that does not fit the diagnostic criteria of anorexia, bulimia or binge-eating disorder. An example of EDNEC is orthorexia, an eating disorder characterized by an unhealthy obsession with healthy eating.  

Pica

Pica is a compulsive eating disorder in which a child habitually eats non-food or non-nutritional substances such as hair, soap, paper, plastic, or flaking paint.

When is it time to seek professional help? 

Early intervention is key to treating eating disorders in young children. Research shows that children as young as three years old become aware of different body types and social attitudes toward weight. Setting the course for a lifelong healthy relationship with food starts during the early years of childhood. Talk to the child’s family doctor so they can help detect the early onset of an eating disorder and prevent it from continuing.

What can be done? 

Psychotherapy

Psychotherapy refers to a wide range of techniques and methods used to help children who are experiencing difficulties with their emotions or behaviour. There is good evidence for the effectiveness of psychotherapy as a treatment for depression in young children. Some common types of psychotherapy include: 

• Cognitive behavioural therapy (CBT)
•  Dialectical behavioural therapy (DBT)
•  Interpersonal therapy (IPT) 
• Mindfulness-based cognitive therapy (MBCT)
• Family-based therapy

Children with eating disorders can benefit from nutritional counselling with a registered dietitian or nutritionist where they can work on improving food-related behaviours through an individualized program. 

Medication

Medications such as antidepressants, antipsychotics, or mood stabilizers may be prescribed for eating disorders and other concurrent disorders such as anxiety or depression. 

What makes some children more vulnerable to eating disorders? 

• Biological factors such as genes and brain chemistry: Scientists have found that hormones or brain messengers like serotonin and dopamine contribute to eating disorders. Studies of families have also found that having a first-degree relative (e.g. parent or sibling) with an eating disorder increases a person’s risk of developing an eating disorder. 
• Psychological factors such as temperament and coping strategies
• Environmental factors such as anxious parenting, adverse childhood experiences, cultural ideals, weight stigma and exposure to media promoting an ideal body image 
• Being bullied about weight

Where can I access support?

Talk to the child’s family doctor or pediatrician to help identify if the child’s behaviour is normal for their developmental stage. 

Talk to the child’s guardianship worker to explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services. 

BC Children’s Kelty Mental Health Resource Centre connects people with eating disorders to resources and supports all around the province. You can use their wayfinding tool to help you locate supports available in your community. Programs for young children under the age of 6 who are exhibiting symptoms of an eating disorder may be limited but they can direct you to resources.

What is it?

Behavioural disorders may be diagnosed when children exhibit challenging and disruptive behaviours that are uncommon for their age at the time, persist over time, or are severe.

What types of behavioural disorders are common in children?

Oppositional Defiant Disorder

Oppositional Defiant Disorder (ODD) typically starts before 8 years of age, but no later than by about 12 years of age. Children with ODD are more likely to act oppositional or defiant around people they know well, such as family members, caregivers or teachers.  

Some of the typical behaviours of a child with ODD may include:

• Easily angered, annoyed or irritated
• Frequent temper tantrums
• Argues frequently with adults
• Refuses to obey rules
• Seems to deliberately try to annoy or aggravate others
• Low self-esteem
• Low frustration threshold
• Seeks to blame others for any misfortunes or misdeeds

Conduct Disorder

Children with conduct disorder have a difficult time following rules and behaving in socially acceptable ways. Their behaviour can be hostile and sometimes physically violent.

 Some of the typical behaviours of a child with conduct disorder may include:

• Frequent refusal to obey parents, caregivers or other authority figures
• Physical aggression (e.g. cruelty toward animals or bullying) 
• Lack of empathy for others and trouble expressing remorse
• Eagerness to start physical fights
• Frequent lying or manipulation
• Blaming others for bad behaviour

Intermittent Explosive Disorder

Intermittent explosive disorder (IED) is a mental health disorder in which children exhibit short episodes of intense, uncontrollable anger or aggression. 

Some of the typical behaviours of a child with IED may include: 

• Frequent outbursts 
• Inability to resist impulses or anger
• Intense explosions that can cause physical harm to people or animals, or damage to objects

 Low tolerance for frustrating situations, resulting in large and aggressive outbursts

What can be done? 

Behavioural disorders are complicated and may include many different factors working in combination. For example, a child who exhibits conduct disorder may also have ADHD, anxiety and depression.  

Diagnosis methods may include:

• Diagnosis by a specialist, which may include a paediatrician, psychologist or child psychiatrist
• In-depth interviews with the parents, caregivers, child and teachers
• Behaviour checklists or standardized questionnaires

Treatment for behavioural disorders is usually multifaceted and depends on the particular disorder and factors contributing to it, but may include:

• Parental/caregiver education: teaching the caring adults in the child’s life how to communicate with and manage their behaviour
• Family-based therapy: the entire family is helped to improve communication and problem-solving skills
• Cognitive behavioural therapy (CBT): the child is taught to recognize unhealthy thoughts and behaviours and learn how to change them
• Social training: the child is taught important social skills (e.g. playing cooperatively with other children)
• Anger management: the child is taught how to recognize the signs of their growing frustration and given a range of coping skills designed to defuse their anger and aggressive behaviour. Relaxation techniques and stress management skills are also taught.
• Medication

What makes some children more vulnerable to behavioural disorders? 

• Family history of mental health challenges and brain-based disorders 
• Fetal exposure to substance abuse
• Adverse childhood experiences and toxic stress

Where can I access support?

Talk to the child’s family doctor or pediatrician to help identify if the child’s behaviour is normal for their developmental stage. 

Talk to the child’s guardianship worker to explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services. 

Get an assessment through your local Child and Youth Mental Health team. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC. 

You can also contact a private psychologist or counsellor through the BC Association of Clinical Counsellors or the BC Psychological Association. You can use website filters to search for a counsellor in your community that specializes in certain mental health challenges.