Symptoms Choose any First line
contamination fears with washing checking ordering or redoing things until they feel just right unwanted intrusive thoughts with mental rituals repeated reassurance seeking
Reviewed Choose any
Obsessions, compulsions, time spent, distress, insight, avoidance, and family accommodation reviewedDefault
Assessment Choose one
Obsessions and compulsions taking significant time, causing distress, and interfering with daily life, consistent with obsessive-compulsive disorderDefault Mild obsessive-compulsive symptoms without significant impairment Sudden onset of obsessive-compulsive symptoms with other neuropsychiatric changes, concerning for PANS Repetitive behaviors better explained by tics than by OCD Repetitive worries and behaviors better explained by another anxiety disorder than by OCD Repetitive behaviors and routines better explained by autism than by OCD
Co-occurring concerns present Choose any
depression other anxiety tics ADHD symptoms restrictive eating
Co-occurring concerns absent Choose any
depressionDefault other anxietyDefault ticsDefault ADHDDefault restrictive eatingDefault
Suicide and self-harm screen Choose one
Denies suicidal ideation, self-harm, and thoughts of harming others Passive thoughts of wishing to be dead, without plan or intent Suicidal ideation with plan or intent; sent for same-day emergency evaluation
Therapy Choose any
Referred for cognitive behavioral therapy with exposure and response preventionDefault
Family accommodation Choose any
Discussed reducing family accommodation of rituals and reassurance, step by step and with supportDefault
Medication plan Choose one
Medication deferred after shared decision making given mild to moderate symptoms; therapy firstDefault Started an SSRI given moderate to severe symptoms, after discussing benefits, side effects, and the boxed warning Medication not needed at this time
Bipolar history Choose any
No personal or family history of bipolar disorder
Strep testing Choose any
Recent strep infection reviewed; strep testing sent given sudden onset
Psychiatry Choose any
Referred to child psychiatry
School Choose any
Discussed school supports, including a 504 plan
Follow-up Choose one
in 2 weeks in 1 monthDefault in 3 months as needed
Follow-up reason Choose any Joins the line above
the response and side effects progress in therapy
Counseling paragraph Choose one Paragraph
Obsessive-compulsive symptoms are common, treatable, and not the child's fault. Therapy with exposure and response prevention, in person or by video, teaches the child to face fears in small steps without doing the ritual, and families help most by gradually stepping back from joining rituals or giving repeated reassurance. Recommended supportive care with an emphasis on regular sleep, daily physical activity, and calm, consistent responses to rituals. Return precautions given including rituals taking more of the day, trouble eating or drinking, refusing school, low mood or safety concerns, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.Default Obsessive-compulsive symptoms are common, treatable, and not the child's fault. Therapy with exposure and response prevention works best alongside the medicine, which takes several weeks for full effect; early side effects such as stomach upset or restlessness are usually mild. Take it every day and do not stop it suddenly. Recommended supportive care with an emphasis on regular sleep, daily physical activity, and calm, consistent responses to rituals. Return precautions given including rituals taking more of the day, trouble eating or drinking, refusing school, new agitation or restlessness, low mood or safety concerns, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions. Mild repeated thoughts or habits are common and do not always need treatment; they are worth watching if they start to take more time or cause distress. Recommended supportive care with an emphasis on regular sleep, daily physical activity, and not joining or reinforcing rituals. Return precautions given including rituals taking more of the day, distress, refusing school, low mood, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions. A sudden start of obsessive-compulsive symptoms with other changes can follow an infection, so testing and a specialist visit come first; therapy and steady routines still help in the meantime. Recommended supportive care with an emphasis on regular sleep, regular meals, and calm, consistent responses to rituals. Return precautions given including trouble eating or drinking, new movements or tics, rituals taking more of the day, refusing school, low mood or safety concerns, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions. These repeated behaviors fit another condition better than obsessive-compulsive disorder, and treatment will focus on that condition. Recommended supportive care with an emphasis on regular sleep and daily physical activity. Return precautions given including rituals taking more of the day, distress, refusing school, low mood or safety concerns, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
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Obsessive-compulsive symptoms
• Obsessions, compulsions, time spent, distress, insight, avoidance, and family accommodation reviewed
• Obsessions and compulsions taking significant time, causing distress, and interfering with daily life, consistent with obsessive-compulsive disorder
• No concerns for depression, other anxiety, tics, ADHD, or restrictive eating
• Referred for cognitive behavioral therapy with exposure and response prevention
• Discussed reducing family accommodation of rituals and reassurance, step by step and with support
• Medication deferred after shared decision making given mild to moderate symptoms; therapy first
• Follow up in 1 month
Obsessive-compulsive symptoms are common, treatable, and not the child's fault. Therapy with exposure and response prevention, in person or by video, teaches the child to face fears in small steps without doing the ritual, and families help most by gradually stepping back from joining rituals or giving repeated reassurance. Recommended supportive care with an emphasis on regular sleep, daily physical activity, and calm, consistent responses to rituals. Return precautions given including rituals taking more of the day, trouble eating or drinking, refusing school, low mood or safety concerns, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.