Jenna Ewing, B.A. and Gregory S. Chasson, Ph.D.

Department of Psychology, Towson University

Let’s be honest—not everything children do makes perfect sense to parents.  Think of your own child’s morning, evening, or bedtime routines and rituals.  What does your child have to do, no matter what, and in a certain way or order?  For example, does your child get dressed a certain way or request a particular bedtime story over and over again?  Whether or not these routines, compulsions, or habits make sense to parents or seem just plain silly, children experience this period of repetitive behavior and play as part of their normal development.

Repetitive phenomena, such as rituals and rigid routines, are normal in young children. Children may also need things to be exact or “just right,” or want to do things “my way.”   These behaviors are most frequent between the ages of two and four years old.  As part of healthy development, toddlers recognize the routines and habits of those around them.  They then expect these routines and for things to be done a certain way1.  Engaging in repetitive behavior may be a toddler’s way of trying to establish predictability and order in a world where they have little to no control or understanding of the world around them,1 which can be anxiety provoking. Toddlers may find transitions to be confusing and difficult, preferring activities such as bathing, bedtimes, or mealtimes to be done their way2.  Parents may find this repetitive behavior to be particularly frustrating, time consuming, and confusing.

By the time a toddler has reached the age of three or four years old, they tend to outgrow their rigid behavior to some degree, but many still have significant rituals and ceremonies3.  Related to these repetitive behaviors are normal and age-appropriate anxieties, such as fears of having nightmares or being in the dark.  These fears may make a child want to engage in repetitive behavior, such as having a bedtime story read to them over and over so that they can postpone sleep4.

Repetitive play is especially common in three- to five-year-olds; at this age, young children might line up trains or stuffed animals5.  They may especially need things to be done “just right” before they can proceed to the next activity6.  However, by the time the child reaches eight or nine years old, parents can usually expect bedtime rituals and other, related ceremonies to mostly subside7.

It is important for parents to recognize the difference between normal repetitive behaviors and abnormal repetitive behaviors.  There are some cases in which repetitive behaviors, needs for exactness, and demands to do things “my way” can go awry.  Repetitive behaviors, compulsions, and rigid routines may become abnormal if they are associated with a significant amount of distress or anxiety in the child (beyond age-appropriate levels) or other family members, or if the behaviors are associated with life impairment(s) (e.g., school issues). A parent may want to pay particular attention to when the repetitive behavior is interrupted, as a child’s response to this interruption may inform the parent about the level of the child’s distress.

Parents who are concerned about the level of distress or life impairment associated with their child’s repetitive behavior should seek consultation from a child-trained mental health expert, particularly ones that provide gold-standard behavioral interventions for anxiety.  These professionals will be able to make an accurate assessment of the child and whether the behaviors seem like part of a healthy, developmental phase or appear to be abnormal in nature.

For additional information on abnormal repetitive behaviors, as well as helpful resources, visit The International OCD Foundation website.

References

1. Gesell, A., Ames, L. B., & Ilg, F. L. (1974). Infant and Child in the Culture Today. New York: Harper and Row.

2. Leonard, H. L., Goldberger, E. L., Rapoport, J. L., Cheslow, D., & Swedo, S. E. (1990).  Childhood rituals: Normal development or obsessive-compulsive symptoms? Journal of American Academy of Child and Adolescent Psychiatry, 29(1), 17-23.

3. Nagera, H. (1980). The four-six year stage. In: The Course of Life, Vol. I, Infancy and Early Childhood, ed. S. Greenspan and G. Pollock. Washington, DC: DHHS Publication.

4. Garber, S. W., Garber, M. D., & Spizman, R. F. (1993). Monsters under the bed and other childhood fears. New York: Villard.

5. Evans, D. W., Leckman, J. F., J. A. C., Reznick, S., Henshaw, D., King, R. A., & Pauls, D. (1997).  Ritual, habit, and perfectionism: The prevalence and development of compulsive-like behavior in normal young children.  Child Development, 68(1), 58-68.

6. Garrison, W., & Earls, F. (1982). Attachment to a special object at age three years: Behavior and temperament characteristics. Child Psychiatry and Human Development, 12, 131-141.

7. Van Amerongen, S. T. (1980). Latency and prepubertal children. In: Basic Handbook of Child Psychiatry, Vol. III, ed., J. Noshpitz. New York: Basic Books.

Gregory S. Chasson, Ph.D

Gregory S. Chasson, Ph.D

Website

Dr. Chasson is a Harvard-trained, tenure-track Assistant Professor in the Department of Psychology at Towson University in Baltimore, MD, where he spearheads the Site for OCD & Autism Research. He is also a licensed psychologist and clinical director of CBT Solutions of Baltimore, which provides cognitive-behavior therapy to adolescents and adults with obsessive-compulsive disorder, high-functioning autism spectrum disorders.