Your Child's Unusual Behaviors: A Guide for Parents

The child's condition is unusual?

Hello Doctor, my daughter is in second grade this year, but she seems to be exhibiting several issues since the beginning of the school year.

1.
She has no sense of time or responsibility; no matter how rushed the situation is, she remains slow and indifferent, even when facing consequences from teachers or parents.
However, she is very concerned about her image.
2.
During meals, whether at home or outside, she constantly picks out what she perceives as problematic black spots from her food and throws them on the floor, and the quantity is considerable.
Teaching her has been ineffective.
She repeatedly asks whether the food is safe to eat, showing excessive concern, which has caused a lot of distress for the adults around her.
3.
Once, when a battery leaked onto a toy, I told her not to touch it, and I cleaned the toy.
However, due to her contact with many things, she became overly worried about her clothes, hands, face, food, and the table being contaminated.
She kept washing her hands and repeatedly mentioned the battery leak for an entire week.
I later noticed that she is also very concerned about hand soap and toothpaste, constantly washing her hands and worrying about contaminating other items.
No matter how I explain or reassure her, it seems ineffective.
I am unsure how to help her in this situation.

jiāt, 40~49 year old female. Ask Date: 2016/01/18

Dr. Liang Sunyuan reply Psychiatry

Hello, based on your description, she seems to exhibit some symptoms of obsessive-compulsive disorder (OCD), needing to engage in various ritualistic behaviors to alleviate her internal anxiety.
Even though her worries are clearly irrational, she is unable to control or be persuaded otherwise.
The treatment for OCD can begin by listing all the things she fears and worries about, then ranking them according to the level of fear, starting with the least feared items to gradually overcome them, building up successful coping experiences.
However, children with OCD often struggle significantly with their symptoms, making it difficult to change.
It is advisable to seek evaluation and treatment from a child psychiatrist.
Best wishes to you.

Reply Date: 2016/01/18

More Info

Understanding your child's unusual behaviors can be challenging, especially when they manifest in ways that seem concerning or disruptive. Based on the behaviors you've described, it appears that your daughter may be experiencing anxiety-related issues, which can often present as obsessive-compulsive tendencies or a heightened sensitivity to cleanliness and order. Here’s a breakdown of the behaviors you've mentioned and some strategies to help you navigate this situation.

1. Lack of Time Awareness and Responsibility
Your daughter's slow response to time constraints, even when faced with consequences, may indicate a developmental delay in understanding the concept of time or a lack of motivation to change her behavior. Children at this age often struggle with time management, but if this behavior is persistent and affects her daily life, it might be worth exploring further.
Strategies:
- Visual Timers: Use visual aids like timers or clocks to help her understand how much time she has left for tasks. This can make the concept of time more tangible.

- Routine Establishment: Create a structured daily routine that includes specific times for activities. Consistency can help her develop a better sense of time.

- Positive Reinforcement: Reward her for being on time or completing tasks promptly. This can motivate her to take responsibility.

2. Food Obsession and Cleanliness
The behavior of picking out "black spots" from food and expressing concern about what she can eat suggests a heightened sensitivity to food safety or cleanliness. This could be a manifestation of anxiety, where she feels the need to control her environment to feel safe.

Strategies:
- Education: Teach her about food safety in a fun and engaging way. Understanding why certain foods are safe or unsafe can help alleviate her fears.

- Mindfulness Techniques: Introduce simple mindfulness exercises that can help her manage anxiety. Breathing exercises or focusing on the present moment can be beneficial.

- Gradual Exposure: If she's overly concerned about certain foods, gradually introduce them in a safe and controlled manner, allowing her to explore them without pressure.

3. Excessive Hand Washing and Fear of Contamination
Her repeated washing and concern about contamination, especially after the incident with the battery, could indicate obsessive-compulsive tendencies. This behavior can be distressing for both the child and the parents, as it often leads to significant disruptions in daily life.

Strategies:
- Limit Washing: Set specific times for hand washing (e.g., before meals and after using the bathroom) and gently remind her of these limits.
- Discuss Fears Openly: Encourage her to express her fears about contamination. Sometimes, simply talking about these fears can reduce their power.

- Seek Professional Help: If her behaviors are significantly impacting her daily life or causing distress, it may be beneficial to consult a child psychologist or counselor. They can provide tailored strategies and support.

Conclusion
It's essential to approach these behaviors with empathy and understanding. Children often express anxiety or discomfort through various behaviors, and addressing these concerns early can help prevent them from escalating. Engaging with professionals who specialize in child psychology can provide additional support and resources tailored to your daughter's needs.
Remember, your child’s behaviors are not uncommon, and with the right strategies and support, you can help her navigate these challenges effectively. Encourage open communication, and reassure her that it’s okay to have fears and concerns, but there are ways to manage them.

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