My DD9, who always had trouble sleeping and has some anxiety issues, was exhibiting some more extreme OCD behaviors last year. I talked to her about it, and she explained that when she does something like touching the ground with one hand (to pick something up for example), she feels the need to touch the ground with the other hand. She described it as a symmetry thing. So if I touched her right cheek, she would reach up and touch her left cheek. I tried not to make a big deal about it (I remember having some quirks like that as a kid, so I told her that), but asked her if she was able to keep herself from doing the follow-up action, and she started trying to do so. I noticed the behavior coming and going since then. We did talk with a counselor to see if she needed to see someone, but she said to just keep an eye on it for a while. She knew that we were working on fixing her school issues, so I wonder if she knew that it may be related.

Now that DD9 is in a new school for HG+ and does not have behavior issues, I have not noticed it in months. It's funny because I had actually forgotten about it until I read your post. So I agree that OCD behaviors can be directly tied to issues that go along with their giftedness. It makes me so sad to think about all the kids who don't get help for the root cause of their issues because giftedness is not considered a special need.