Children with Obsessive Compulsive Disorder (OCD) tend to adhere to rules, details, procedures, and schedules to the extreme. Deviation of rules, procedures, and schedules are difficult for a child with OCD to handle, causing the child to act out or become withdrawn. This need to follow routine and schedules to the extreme causes great anxiety for most of these children. A young child might worry throughout the day about a change coming up or be distracted because a room is arranged differently than it had been.  If routines or schedules are changed, they may cry, plead, get angry or aggressive, or become depressed.

Some children with OCD cannot tolerate messiness or not following rules in other children. This causes socializing issues for the child. Therapy consists of helping the child be aware of their obsessive compulsive behaviors and teaching them relaxation and coping skills.