Care and Feeding

I’m Starting to Wonder if My Daughter Has OCD

Small hands tying sneakers.
Photo illustration by Slate. Photo by Getty Images Plus.

Care and Feeding is Slate’s parenting advice column. Have a question for Care and Feeding? Submit it here or post it in the Slate Parenting Facebook group.

Dear Care and Feeding,

My daughter just turned 7, and she is very neat and tidy for a little kid. When she was younger, we had her tested for autism because she had so many different routines and other things that needed to stay “just so,” but other than that she showed no signs of autism. Her toys have to be in a certain alternating order, one pillow has to be fluffed three times, and she always ties her shoelaces three times before leaving the house. At school, she would tap the classroom door five times before leaving (at home, she closes and opens her computer three times before ending). She has no other problems at school—she’s doing great socially, has lots of friends, and is very empathetic and intuitive, and is ahead in reading but struggles a little in math. I’m starting to wonder if she has OCD. My sister has it, and she also has to do certain things a certain number of times and would arrange things in patterns. Can OCD show up in younger kids, or are these just little quirks?

—Too Many Routines in RI

Dear TMRiRI,

Obsessive-compulsive disorder can certainly show up in children as young as 7, and your daughter’s symptoms do seem to point in this direction. I say this with a certain amount of conviction because I have personal experience of the sort that (unfortunately) turns one into an expert. Because of this hard-won expertise, I would urge you to have your daughter evaluated by a psychiatrist who not only specializes in treating children but for whom pharmaceutical intervention is not their first line of defense. There are numerous, effective ways to treat children who are displaying symptoms of OCD that do not involve medication—and although you may need to do a lot of Googling and make a great many phone calls, it will be worth it. What you want is a child psychiatrist who will do a thorough evaluation (it may take multiple visits) and who has multiple arrows in their treatment quiver. Will you let me know what happens? I’ll be thinking of you.

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Dear Care and Feeding,

After a decade together, my husband and I (35M, 33F) have decided to try for a baby. Coming from an abusive family background, I was reluctant for a long time. It took a lot of therapy, discussion, and negotiations to get to a point where it seems both realistic and welcome, but here we are. We live abroad and given the way this pandemic is going, there is a good chance we will be doing this all on our own. My question is this: Where do we even start? How do we prepare for the realities of coming home from the hospital with a tiny baby when neither of us has any experience looking after a newborn? I am extremely anxious about the possibility of having to look after a baby with no support from someone who knows what they are doing. And then, of course, there is the actual parenting! The only thing I am certain of is that I want to be a loving parent who does not emotionally abuse or neglect their baby. But there are so many parenting styles and books out there, I don’t even know where to begin! I am definitely on the overpreparing side of things, but in this case I feel like my anxieties are justified. How do I get it right? Please help!

—Let’s Do This, but How?

Dear LDTbH,

As someone who prepared for the birth of her baby as if she were studying for the Big Test, I understand. I read every book, and I read some of them twice. I made promises to myself, some of which I kept (and some of which I should not have kept). Some of this overpreparation helped, I guess—I knew what to do for diaper rash, I had a list of things to try if the baby wouldn’t stop crying, I knew how to swaddle her—and some of it was a waste of time and energy and sometimes money … and some of it, to be honest, messed me up and messed my daughter up (principally, my determination to be the Perfect Mother). About the latter I have written pretty extensively in a book-length memoir, so I’ll skip right over that here and cut to the chase—which is that you don’t need to get it right. That’s not really the point of the undertaking.

Preparing to be the most important person in someone’s life is an extension of being a person. Can you be kind and generous? Compassionate and empathetic? Patient? Can you take things in and figure out when it’s time to do something/say something and when it’s time to just be chill and simply there? Are you capable of love? Can you put someone else’s needs ahead of your own (and also recognize when those needs are genuinely theirs and not yours in disguise)? These are the kinds of things you can’t learn from books, parenting styles, blogs, or websites. If your answers to these questions, and others along these lines, are hell, no or Jesus, I haven’t the faintest idea, I’d gently propose you continue talk to a therapist, who’ll help you move toward yes. But it sounds like you’ve had a lot of therapy, and I’m betting that you’ve already waited until you can answer at least a tentative, nervous yes to all of the above.

I’ve said this before too, but it bears repeating: There are a lot of good ways to raise children. Just like there a lot of good ways to live your life, be in a marriage, get through a day, bake a loaf of bread. There’s no one-size-fits-all answer once you get beyond the fundamental truths you already hold to be self-evident. Are you going to breastfeed or bottle-feed or some combination of both? Will you co-sleep? Will you sleep-train? All of these (and everything in between each of these) are viable, good options. There are a million(ish) little—and big—decisions to make, and those of us who are by nature anxious people have the crazy idea that we can make them in advance and stick to them. (And some stressed out parents then berate themselves when they don’t or can’t stick to these arbitrary decisions they’ve made ahead of time.) Familiarize yourself with what’s likely to come up and the different ways different parents have responded when they have … and then play it by ear. Trust your instincts (I promise you: You have them). Many of the decisions you make will be rooted in your own temperament, and your understanding of what’s going to work for you. Many of them will be rooted in your personal philosophy, what you want to teach your child early on, the kind of adult you hope they will eventually become (because of course that’s what we’re really doing: We’re raising future adults). Much of this will be all mixed up together. Do not allow yourself to be swept up into the “there’s only one way to do this right” bullshit that you will begin to hear about from the instant that people know you are pregnant.

For practical day-do-day advice and calm-down counsel, I will recommend the most recent editions of the books that helped me the most—Penelope Leach’s Your Baby and Child and T. Berry Brazelton’s Touchpoints, as well as a book that came out when my daughter was 4 years old (and, thank goodness, is still available as an e-book) that I found myself wishing I’d been able to read before she was born, Nina Barrett’s I Wish Somebody Had Told Me. But there are a lot of much more recent books that younger parents swear by, like Daniel Siegel’s Whole-Brain Child. And I’m kind of in love with the new book, Weird Parenting Wins, by Hillary Frank. Read a few pages of a bunch of different books online and then choose a few to read while you’re pregnant, sure—just to get the lay of the land. But try not to overwhelm yourself by trying to read everything out there that covers every possible point of view—for example, by doing a deep dive into both the Sears approach to sleep and the diametrically opposed method of Richard Ferber. When the times comes—as it surely will—that you are struggling with getting your baby to sleep, or keeping your baby asleep, you can consult the “expert” whose advice aligns with your own overall parenting style … which I assure you that you will discover as you go along.

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Dear Care and Feeding,

I am struggling with how to deal with various family members as my daughter’s fourth birthday approaches, particularly in light of coronavirus. My husband and I separated this spring; I moved out after struggling for nearly two years with the decision and spending too much time debating whether his behavior was technically emotionally abuse or not. In addition to our daughter, who now spends about the same amount of time with each of us, my husband has a 20-year-old son who lives across the country from us. He lived with us from age 10 through high school graduation, after which he moved back in with his mom. I was always supportive of having him live with us, though our relationship was rocky and became increasingly distant as he got older. I wouldn’t call it warm now either, but we do stay in touch by text. My ex-husband and stepson—and ostensibly my daughter—came up with a plan a few months ago for my stepson to come visit for her birthday. This requires a plane trip, since he lives on the opposite coast. My ex and stepson presented the idea, saying that the decision was mine, and although my initial response was negative, I did some research and was persuaded by some MIT studies about air circulation on planes, as well as my stepson’s assertion that he had likely already had coronavirus and his promises to take precautions during the flight. My ex also told me that I should set any rules that I wanted followed for safety, and that he and my stepson would follow them. While I hated that I was given all responsibility without any real engagement from them, I came up with what I thought were some reasonable precautions, including not socializing with anyone else while my stepson is here.

Well, it’s now seeming like neither my ex nor my stepson is interested in limiting contacts during his visit, and I’m struggling with how to respond and conduct myself while he’s here to minimize risks for everyone, including myself and my daughter, without causing deep family rifts—or whether I should try to cancel the whole visit. My ex and I are handling this pandemic very differently. I am working at home (and privileged to be able to) and have limited all socializing to a handful of people, wearing masks and staying outdoors, even with my own parents; my ex has frequent gatherings with friends without masks or distance, sharing food.

On top of those day-to-day problems, it now comes out that my stepson has two friends tagging along for his trip who are staying in an Airbnb directly across the street from my ex. So now there are at least two more people in our birthday week bubble whom I don’t know and don’t want to have contact with, and I’m extremely anxious about how many more people my stepson and ex are going to want to be in contact with. (I’m also sad that my stepson supposedly wanted to come to celebrate his little sister’s birthday, and then turned it into a way to hang out with friends.) I have tried asking both my ex and stepson directly about their plans and reminding them about the rules they asked me to set up for the visit, and have gotten absolutely no reply. My nuclear option is that since I purchased the ticket for my stepson, and the airline has very flexible rescheduling policies right now, I could cancel the ticket and reschedule the visit for six months from now. And this is tempting, though I don’t see any great outcomes from pulling that trigger. But what else can I do to try to get through to them and try to get them to limit their contacts while he’s here? And how do I manage to keep the focus on my daughter, whose birthday it is, without getting so wrapped up in my own anger and uncertainty and fear?

I know I can only control my own actions, so I’m already contemplating minimizing the time I spend with them, or remaining masked whenever I do, which is painful, as I had hoped this visit could be a way to strengthen our relationships, rather than cause further rifts. I don’t know that I could go so far as to refuse to allow my daughter to see her brother, or insist she wear a mask the whole time she’s with him. But it also doesn’t feel right to ignore health and safety risks and my own desire to feel safe (regardless of actual risks, which seem to be up for debate in today’s America). How do I survive this visit and celebrate my daughter safely?

—It’s Her Birthday and I’ll Cry if I Want To

Dear IHBaICiIWT,

The more I thought about your letter, the less straightforward the problem seemed to be. I’ll cut to the chase, though: If I were you, I would cancel the trip. But then if I were you, I wouldn’t have agreed to it in the first place.

You already knew that your ex wasn’t following safe guidelines (which are only “up for debate” by those who decline to accept the recommendations of public health and safety experts) and yet you took him at his word when he told you to “set any rules that [you] wanted followed for safety, and that he and [your] stepson would follow them.” Now that it turns out that this promise was just a way to persuade you to say yes—to humor you, as it were, because your ex doesn’t believe this virus represents a true risk—it isn’t unreasonable to say, “This isn’t going the way you assured me it would.” Will this create a “further rift” in the family? Well, it will make your ex unhappy, for sure, and your stepson will be disappointed/angry that his vacation has been canceled. But these are both grown men, and they will have to handle their dissatisfaction—that’s not your job. (And they’ve made their own beds; it’s about time your stepson learned—and way past time your ex learned—to lie in it.)

But you’re not without responsibility for this confusing situation, either. Not only do I think it was naïve of you to agree to this plan, given what you know of your ex’s unwillingness to take responsible precautions, but your own intentions and plans seem to me contradictory. Of course you should wear a mask when you interact with them (why do you see this as punitive?). Of course your daughter should (ditto). Despite the refusal of many people to behave responsibly during a pandemic that continues to rage on, we do have clear guidelines about safety when interacting with those who are not part of our households. Follow them. And if (when) your ex tells you that you are overreacting/being hysterical, calmly direct him to the Center for Disease Control and Prevention’s guidelines, apologize politely for changing your mind given the expanding circle of contacts and your concern for your (and his) daughter’s health as well as your own, and tell him and your stepson how much you look forward to celebrating your daughter’s fifth birthday, post-pandemic (let us hope), with the whole family.

Dear Care and Feeding,

I’m pregnant with my first child, and my husband and I have narrowed our selection of names down to a handful that we love, with a plan to wait until we meet the baby before choosing one of them. The issue is my parents, with whom I am very close. They’ve asked to review our list of names so they can veto any that they might have “bad associations with.” I told them I’d consider it, because I love them, but I also said I didn’t want to feel I needed their permission to name the child I’m carrying around in my body! All my friends think their request is ridiculous, but my parents stand by their belief that it is quite reasonable, as close as we are. Who is being more ridiculous, me or them?

—By Any Other Name

Dear BAON,

Them.

—Michelle

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My fiancé moved in with my parents and me last year. He has a 2-year-old son whom I’ve taken on as my own and plan on adopting. We have chosen to limit certain things when it comes to our 2-year-old. We don’t want him watching much TV, playing with a cellphone or a tablet, or eating much sugar during the day. But my parents don’t abide by these rules. What should we do?