Ask Dr. Meg: Does my daughter have OCD or a sensory disorder?

Hi Dr. Meeker,

I am hoping you can give me some direction with my 10-year-old daughter, Lily. When she was 5 years old, she was exhibiting sensory integration issues to the point that we almost couldn’t leave the house. I wanted to take her to an occupational therapist but at the time we couldn’t afford this, so I turned to some self-help books and felt with time, the issues were getting better. Things have been fine the last 4 years until recently, she has become obsessed with her weight and appearance. She is trying to spend hours in from of the mirror and looking down at her stomach and thighs so frequently it almost looks like she has a tic. She is very repetitive with brushing her hair, ironing her clothes, checking her pants, etc. It seems a little OCD, and she exhibited repetitive behavior like this 5 years ago but in other ways. It makes me wonder if this obsessive concern about her weight is linked more to her sensory problems instead of an eating disorder. I’m not sure if I should take her to an eating disorder therapist, or an occupational therapist. I thought that she would grow out of her sensory integration issues but have since read an article saying this is not something someone ‘outgrows’. I want to get her help but have no idea where to start. Any suggestions and insight would be so greatly appreciated!!

Thank you for your time!

– Concerned Mother

Dear Concerned Mother,

I think that your evaluation of your daughter is correct, but I think that several things may be going on. If she really has repetitive behaviors, this points more toward obsessive-compulsive disorder and this can be treated. An occupational therapist is not the one to treat her. I would start with her pediatrician and tell him/her what you have told me. She will need some cognitive behavioral therapy by a good therapist and if she feels really out of control, she may need a little medication.

Second, until you help her get the OCD under control, it’s hard to tell if she really has an eating disorder. When kids have OCD, they can obsess over anything. They may not care about what they are obsessing about but that is the one thing they have latched onto. I have seen kids obsess about reading a chapter 10-15 times before bedtime, but they really don’t like reading. I have had kids repeatedly change their clothes or wash their faces but they really don’t care about how they look. OCD rears its head in many ways.

So, make an appointment with your pediatrician first. He/she will help you tease these issues apart and refer you to the right person to treat her. Taking her to an eating disorder specialist or occupational therapist may well be a waste of your time.