ST. PETERSBURG — One child feared that stepping on a crack would harm his mother, just like the old nursery rhyme warned.
Another child wouldn't touch anything that had fallen on the floor.
For these children, and thousands like them, what at first may sound like a silly aversion can evolve into an all-consuming phobia. But obsessive-compulsive disorder is difficult to treat, particularly in children. It's hard to find talk therapy geared to children. And many parents are reluctant to try drug treatment, fearful of the side effects or the stigma of the antidepressants used to control OCD.
Now, University of South Florida researchers are offering an unlikely alternative.
With $1.1 million from the National Institutes of Health, the university is studying a treatment for childhood OCD that uses an antibiotic traditionally prescribed for tuberculosis. The medication, D-cycloserine or DCS, appears to enhance the brain's ability to extinguish the fears that feed into OCD.
Lead researcher Eric Storch, a USF psychologist, already has seen promising results in a small, pilot trial of the antibiotic in children with OCD.
Now, with the NIH grant, he is leading a study that will eventually include 150 children between the ages of 7 and 17. Half of them will receive the antibiotic, a pill taken before each of seven therapy sessions. The others will receive a placebo.
All of the children will get a form of talk therapy known as cognitive behavioral therapy designed to address and combat the fears at the root of their OCD.
"The beauty is they are getting the gold standard of care," said Storch, noting that more than 80 percent of children with OCD will see some improvement with therapy alone, although about half will still struggle with OCD symptoms. The drug may improve results.
"It's kind of like running a marathon with a 10-pound ankle weight," he said of childhood OCD, estimated to affect 1 to 4 percent of youth. "It's very hard to do all of the things that a child would want to do, or would be expected to do, such as school or homework."
That's the case for 8-year-old Ben Watson of New Tampa, one of the first children enrolled in the study.
Ben's symptoms began about three years ago after he learned about germs in school. His mother, Emily Watson, recalls that her son came home with lots of questions about germs. He started requiring hand sanitizer when they were out shopping if he would trip and touch the floor.
Soon, washing his hands was an extensive ritual, lasting as long as it took him to count to 100. Ben's germ fear made it difficult for him to pet animals at the zoo. Recently, he became hysterical about touching a bird at SeaWorld.
"It's so different with all OCDs. It's not always flipping the light switch 50 times," Emily Watson said of a common phobia. "There's no rhyme or reason to it."
Under the trial design, she doesn't know if Ben is receiving the tuberculosis medication or the placebo, but the therapy results are promising.
Ben was encouraged to take a lollipop from the floor and lick it, reinforcing that he had nothing to fear. Now therapists are helping Ben to address other concerning behaviors, such as his tendency to erase and rewrite certain letters when doing school work. Complicating matters further for Ben is that he also has attention-deficit hyperactivity disorder (ADHD) and Tourette's syndrome, which sometimes occur in kids with OCD.
"It is making a difference," his mother said. "He is at the point now where he'll drop something on the floor, he'll stick it in his mouth and he's so proud of himself because it doesn't bother him anymore."
She said the family likes knowing that their participation could help other children with OCD. And while they have a long drive to the research office in St. Petersburg, it helps that Ben is receiving the therapy at no charge, as is customary with clinical trials.
So far, the study has enrolled a half-dozen children, including a family that comes from Georgia each week. Researchers plan to see each child for 10 sessions of therapy.
And the hope, Storch said, is that by successfully treating OCD early in life, children will grow up to live as adults without the burden of the disorder.
"A child's brain is developing at this early standpoint," he said. "If we can address things and teach them, then the brain can almost reprogram itself."
Letitia Stein can be reached at firstname.lastname@example.org or (727) 893-8330. For more health news, visit www.tampabay.com/health.