This chapter covers the growing literature on the phenomenology, assessment, and recent advances in treatment of obsessive-compulsive problems in very young children, and concludes with a discussion of future directions and areas in need of focused empirical attention. Obsessive-compulsive (OC) symptoms in early childhood tend to onset gradually. Comprehensive assessment of OC disorder (OCD) in young children must include evaluation of functional impairment associated with the OCD symptoms. Family-based cognitive behavioral therapy (CBT) consists of four main components: psychoeducation, parent tools largely focused on behavior management training, child tools consisting of behavioral components (i.e., exposure with response prevention, or EX/RP) and cognitive strategies to externalize OCD, and family process components. Recent work evaluating the potential of videoconferencing methods for remotely delivering family-based CBT may offer transformative solutions.
