Help with 9 year old son showing increasing signs of possible OCD

[ch22]

Hi,  my 9 year old son has been showing increasing signs of compulsive behaviour. He has always had some anxiety, particularly when going into both nursery and school and received support from school through Thrive to help him overcome this when he was in YR1 . He was also quite shy and struggled to form new friendships, although he has always had at least one close friend. This has improved and he has a bigger social circle but he does tend to stick with one friend.

When he was younger he would often fill his pockets, with scrunched up paper or small toys or stones he'd found this then seemed to ease off for a while. However over the past 6 months or so he has begun collecting leaves, stones and random things he's found on the floor. He has also begun taking loo rolls from the bathroom and hiding them under his bed, rips off small pieces of loo roll and places them around the house,  collects wrappers/ bottles/ cans from food he has eaten/ drunk and wants to keep them in his room - he becomes distressed if we tell him no. Recently he has also been going through our bins, both indoor and outdoor to retrieve rubbish. Again if we tell him no he screams and shouts and gets, what was uncharacteristically, angry and will sometimes lash out. 

When we leave to go out when we say good bye to him he asks for '2 lots of 4 kisses' and on the final kiss wants you to make a mwah noise. This will be repeated over and over ( I'm not able to tell if there is a specific number of times) and can often take up to 5 minutes to say goodbye. If we try different ways to stop this he becomes very upset. When we drop him to school this also happens but he will also ask the same questions 'am I school dinners?', 'am I at after school club'  and 'who's picking me up?' repeatedly. This morning he asked my husband these questions 14 times. 

I have spoken to my son to see if anything is worrying him on a number of occassions and he always says no and says he doesn't know why he does these things. I said to him would he like us to find him some help to stop and he said 'can someone help me to stop?' so I do think he does realise it is a problem and wants to stop.

We have tried different ways of dealing with the situation including not giving the number of kisses he asks for in the playground - however he gets very upset and will often run after me out of the school grounds, not highlighting/ questioning the behaviours with him, trying to help by giving him somewhere to keep certain pieces of rubbish rather than indoors (I'm worried this is probably not helping and reinforcing this is something he should do) and giving him some time to see if this is a faze he is going through and whether it will resolve on its own.

However my feeling is that the behaviours are now getting worse and are having more of an impact on his (and our) day to day life and wonder if intervening now will help to stop things getting worse for him.

I'm wondering what would be the best first steps to take? I have spoken to school about some of his behaviour at home but they don't seem to have any concerns about his behaviour in school although the situation at home has got worse since I last spoke with them.

Please could someone advise what the best first steps would be? Is it worth going back to school first to see if they have any support they can put in place or should I go straight to our GP? I'm not sure if the behavior is 'bad' enough to result in a referral to CAMHS and I'm also aware that if is is the waiting time is approx 18months. Should we look to find a private therapist and if so what type of therapy/ist should we be looking for?

Any help would be greatly appreciated - thank you.

[howard]

I'd suggest going straight to your GP and talk to them about an assessment and referral. I like the sound of your son, he sounds interesting, although going through bins would be too much for me. I wonder if he displays these behaviours at school? Or is it just at home.

I think while you have to be kind, understanding and supportive of your son(and it sounds like you very much are), you have to be aware that he is the child and many children if given the chance would like some power over their parents. I wonder if some children either knowingly or subconsciously use their OCD to get their own way too much.

As you say he gets upset. So a slow reduction in allowing him to run through his obsessions and compulsions would probably help. Help him when he gets stressed out, to find a way to calm down. 

High anxiety often causes symptoms to get worse, and although he didn't say he was anxious and doesn't understand why he does these compulsions, it might help to talk to him and try to explain more. Sometimes if a child understands more, then they feel able to take back control. He may realise that something is making him anxious and it's playing out through his compulsions.

Good Luck.