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It depends on your child's reasons for doing these rituals, says Alan Greene, a pediatrician and author of six parenting books, including Raising Baby Green.
Your child may have rituals for the same reason that he likes to eat homemade pizza every Friday or watch cartoons every Saturday morning — he likes regular things that he can count on.
Many children get a sense of security and pleasure from idiosyncratic routines, like lining up their action figures in a certain order or tapping their toothbrush in a special rhythm after brushing.
"Rituals can be a wonderful, quirky part of childhood. They go with kids' delightful imaginations as they're figuring out how to live in and control their world," Greene explains.
According to Greene, if your child enjoys his rituals, if they aren't taking up too much time or interfering with his life, and if he doesn't experience anxiety when he can't do them, then there's no need to worry.
On the other hand, some children who perform rituals have a condition called obsessive compulsive disorder, or OCD. The primary difference between normal rituals and OCD is that a child with OCD does not enjoy the rituals. Instead, he feels that he has to do them in order to prevent something bad from happening — and he experiences intense anxiety if he can't do them. The rituals are often strongest during stressful times, like before school.
Common OCD rituals, which are called "compulsions," include hand-washing, counting, and touching things in a certain way or a certain number of times. Compulsions take up a lot more time than "fun rituals" — usually an hour per day or more — and they can interfere with a child's school and social life. For example, a child with OCD may have trouble participating in games at recess because he "has to" repeatedly count the cracks in the asphalt.
If you're concerned that your child has signs of OCD, arrange for him to be evaluated by a mental health professional. "It's better to go ahead and get it checked, rather than taking a 'wait and see' approach," says Greene. The good news is that if your child has OCD, it can often be resolved with effective treatment — and the earlier you catch it, the better.