Diagnostics: OCD, Anxiety, ADHD, and Phobias in Kids and Teens

Available with English captions and subtitles in Spanish.

A conversation with Lisa W. Coyne, PhD, and Jeff Szymanski, PhD, on best practices when it comes to recognizing and diagnosing OCD, anxiety, ADHD, and phobia.

Accurately Diagnosing Kids and Teens

One of the most important topics when it comes to addressing common mental health challenges in kids and teens is diagnostics. Without getting to the right diagnosis, treatment is impossible.

Watch now to learn more about:

  • How clinicians accurately diagnose mental health conditions
  • Why it is important to involve others in a child’s assessment
  • Which conditions commonly occur with anxiety disorders

Clinicians use evidence-based measures to identify the presence or absence of disorders. They also look for the presence of co-occurring disorders (conditions that appear alongside each other), and they keep in mind that it is possible to mistake one mental health condition for another.

As part of the diagnostic process, clinicians in the U.S. consult the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which defines and outlines criteria for mental health conditions.

In assessing anxiety in children and adolescents, clinicians use tools such as the Anxiety Related Interview Schedule for Children or the Diagnostic Interview for Anxiety, Mood, and OCD and Related Neuropsychiatric Disorders (DIAMOND).

When assessing for mental health conditions, clinicians tease out the symptoms that are being reported by a patient by showing curiosity. Szymanski points out that once a clinician establishes a good relationship with a patient, they can explore what might be keeping the young person from living fully.

“From those questions about what life you want to have, we start to get clues about what the obstacles are. And that tells us what questions to follow up on,” he says.

Coyne recommends that clinicians conduct assessments by talking to other key figures in the child’s life. She states: “Do talk to parents, whether paired with the child or without, and do make an effort to get some information from teachers.”

She adds, “Get data about how these symptoms are impairing the child—get a sense of when this all started, how this looked, and if it has been around for a long time.”

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Audience Questions

  • What are some of the major challenges in getting a diagnosis correct?
  • Given that anxiety disorders and OCD have so many subtypes, how does the diagnosis process work?
  • Typically, who is doing the first diagnostic assessments for children or teens with anxiety or OCD symptoms?
  • What is the DSM and how is it used in the diagnostic process?
  • What should we know about autism and how it co-occurs with anxiety and OCD?
  • What should we know about pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS)?
  • What should we know about the relationship between eating disorders and anxiety and OCD? Which should be addressed first?
  • How common is it for anxiety disorders and OCD to co-occur with other mental health challenges in children and teens?
  • How is ADHD diagnosed in comparison to anxiety and OCD?
  • Is a tool like the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) something that a clinician might use to continue to evaluate progress?
  • How can one differentiate personality quirks from OCD symptoms?
  • Should clinicians ask about trauma histories for potential anxiety or OCD diagnoses?
  • What should we know about intrusive thoughts? And when do they become problematic?
  • How do you differentiate between OCD behaviors and tics?
  • Are there cultural considerations that should be taken into account when diagnosing these disorders?
  • Can you speak to the diagnostic differences between OCD, bipolar disorder, and psychotic disorders?
  • How can substance misuse complicate diagnostics?
  • How can genetics play a role in anxiety and OCD?
  • Are there anxiety and OCD assessment tools for non-clinicians to use with children and teens?

The information discussed is intended to be educational and should not be used as a substitute for guidance provided by your health care provider. Please consult with your treatment team before making any changes to your care plan.

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About Dr. Coyne

Lisa W. Coyne, PhD, is a senior clinical consultant at McLean Hospital and an assistant professor of psychology in the Department of Psychiatry, part-time, at Harvard Medical School.

Dr. Coyne is a licensed clinical psychologist, an internationally recognized acceptance and commitment therapy (ACT) trainer, and the author of numerous books for parents, children, and teens.

About Dr. Szymanski

Jeff Szymanski, PhD, a clinical psychologist, is the founder of Getting to the Next Level Consulting. Dr. Szymanski is a lecturer on psychology in the Department of Psychiatry, part-time, at Harvard Medical School, where he supervises pre-doctoral psychology interns through McLean’s internship program. He is the author of “The Perfectionist’s Handbook,” has appeared in over 150 media stories, and has presented at a multitude of conferences as well as domestic and international trainings.

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