Treatment of Obsessive Compulsive Disorder in Young Children: An Intervention Model and Case Series

Abstract

This article presents an intervention model for young children with obsessive-compulsive disorder (OCD). The intervention, designed to reduce compulsive behavior and improve parenting practices, was tested using a multiple baseline design with 7 children (M = 6 years old; 57% female) in which participants were randomly assigned to 1, 2, or 3 weeks of baseline (i.e., no treatment). All children were diagnosed with OCD using a semi-structured diagnostic interview. Baseline and weekly ratings of obsessive-compulsive (OC) symptoms and family accommodation were obtained. In addition, at pre- and post-treatment and 1-month follow-up, independent evaluators and/or parents completed measures assessing the severity and impact of OC symptoms and child and family functioning. Findings revealed that participants had a 33–66% reduction in OC symptoms (as measured by the Children's Yale-Brown Obsessive Compulsive Scale; CYBOCS) at posttreatment and 6 of the 7 children were rated as treatment responders on the Clinical Global Impression-Improvement (CGI-I) Scale. At the 1-month follow-up, participants had a 17–82% reduction in OC symptoms. Treatment was also effective in reducing parental accommodation of child OC behaviors. Overall treatment satisfaction was high and parents found most core treatment ingredients (e.g., psychoeducation, exposure and ritual prevention, contingency management) very helpful. Implications for further developing and testing psychosocial treatments for young children are discussed.

KEYWORDS:

• children
• contingency management
• exposure and ritual prevention
• obsessive-compulsive disorder
• preschool aged

Acknowledgments

This study was funded by an OC Foundation grant awarded to Dr. Golda S. Ginsburg. The authors wish to thank Dr. Martin Franklin for providing clinical supervision and Drs. Mark Riddle, Marco Grados, and Martin Franklin for their consultation.

Notes

Note. CYBOCS = Children's Yale Brown Obsessive Compulsive Scale; CGI-I = Clinical Global Impressions Scale-Improvement; Pre = pre-treatment assessment; Post = post-treatment assessment; f1 = one-month follow-up assessment.

Note. BASC = Behavior Assessment System for Children Adaptability Subscale; FAD-GF = Family Assessment Device–General Functioning Subscale; COIS-BRP = Child Obsessive Compulsive Impact Scale-Brief Revised Parent Version; Pre = pre-treatment assessment; Post = post-treatment assessment; f1 = one-month follow-up assessment.

Additional information

Notes on contributors

Kimberly D. Becker

Kimberly D. Becker, PhD, is now at the Johns Hopkins Bloomberg School of Public Health, Department of Mental Health.