Social / Emotional · Obsessive Compulsive Disorder

What is it?

OCD is a type of anxiety disorder. With OCD, obsessions and worries preoccupy thoughts. Someone with OCD feels strong urges to do certain things repeatedly — called rituals or compulsions — in order to eradicate thoughts and return their world to normal. Children use rituals to alleviate anxiety.

What causes it?

It is currently believed that OCD is linked to blocked serotonin levels in the brain. This sends out false danger messages which the brain cannot filter out causing the person to feel unrealistic fear. OCD can run in families.

Incidence

Approximately 1 in 200 students have a diagnosis of OCD yet others will display tendencies.

Medical Considerations

Adolescents with OCD commonly have obsessions including germs, neatness, numbers and fear of harm. Compulsions include hand washing, cleaning, double-checking, ordering or arranging objects. Possible signs of OCD can include:

• raw, chapped hands from constant washing
• holes erased through test papers and homework
• a persistent fear of illness
• OCD is common in students with Tourette Syndrome and Asperger’s Syndrome.

Treatment should be sought if the rituals take up more than an hour each day, causes distress and interferes with daily activities.

Characteristics

The anxiety or worry is so strong that a child feels like he or she must perform the task or dwell on the thought to the point where it interferes with everyday life. Repetition is "required" by the student to neutralize the uncomfortable feeling. While this may work in the short term, the rituals may actually worsen the severity of the OCD long-term.

OCD can become an ordeal for the child and their families and can be very time-consuming. OCD can create feelings of shame, embarrassment and low self-esteem. Students might have difficulties with attention or concentration because of the intrusive thoughts. OCD is common in students with Tourette Syndrome, Asperger’s Syndrome, ADHD and depression.

Support

Obsessive-compulsive behavior is not something that a child can stop by trying harder. OCD is a disorder and is not something kids can control or have caused themselves.

Further Information

It is important to support a student undergoing treatment by being patient and recognising that the OCD is the problem and NOT the child.

Lesson Preparation & Materials

• Give the child a choice of projects.

Teaching Strategies

• Break homework into chunks to help students with perfectionist tendencies to avoid feeling overwhelmed.
• Access Books on tape so that students can get meaning without obsessing over every word.
• If rewriting/erasing is really problematic for a child, assignments can be typed instead of handwritten.
• Avoid reading out aloud as students who feel they need to read perfectly may have to go back and reread sentences or whole paragraphs over and over to make sure they've got them right.

Feedback & Assessment

• If the student is taking medication during the school day, discuss with the parents possible side effects.
• Do not assume a student's difficulties or frustrations in school are due entirely to OCD. If the student still has academic difficulty or is reluctant to attend school, consider an assessment for other learning issues.
• Adjust the homework load to prevent the child from becoming overwhelmed. Academic stressors, along with other stresses, aggravate symptoms. Suggest that the student change the sequence of homework problems (for example, if fears related to odd-numbers, start with even-numbered problems ) Allow the child to tape record homework if the child cannot touch writing materials.
• Students with OCD do better, be less overwhelmed, more in control of their thoughts and of their reactions under separate supervision. Extend time for tests and papers if perfectionist writing traits are a problem.
• Provide extra time for transitions and for completing assignments. Starting school work and finishing work in the appropriate time frame may be difficult. Waive or extend time limits and make a quiet location available for test-taking, if needed.
• Keep in mind that persistent, repetitive thoughts may interfere with the student's ability to concentrate, which may affect many school activities, from following directions and completing assignments to paying attention in class.

Classroom Management

• If the school is noisy you might have them sit in the front, where they're less able to hear the noise.
• Negotiate reasonable expectations for transitions. When a child with OCD refuses to follow directions it anxiety rather than intentional oppositionality.
• If the student insists on certain OCD rituals at school, work with him or her to identify less intrusive rituals (e.g., tapping one desk rather than tapping every desk).
• Be aware of triggering events. Fatigue is a huge piece of OCD, and it can be exacerbated by medication. Therefore, if a child is drowsy in class, it may not be because they're being oppositional or disrespectful, but may be overwhelmed with fatigue.
• Plan an escape route: Develop plan between child and teacher without interrupting the class.
• Accommodate late arrival due to symptoms at home.
• Plan for transitions between grade levels and different schools. Find out about the student's strengths, interests and needs, symptoms and successful strategies.
• Watch for signs of social isolation or withdrawal. Work with other school staff to identify difficult or stressful situations for the student. Collaboratively develop strategies to reduce the student's stress. Enlisting the student in this task will foster the student's ability to solve problems.
• Learn as much as you can about how OCD may affect learning and social and emotional well-being. Reading, asking questions and talking to qualified professionals will build your understanding and help you make decisions to support the student's success at school.
• Anticipate school avoidance if there are unresolved social and/or academic problems.
• Check in on arrival to see if the child can succeed in certain classes that day.
• With permission, it may help to explain in non-judgmental terms what and OCD is and feels like.
• A buddy is like a peer coach who sits next to the child and prompts him to keep up with note-taking and staying on task. This is great for fostering friendship.
• Assist with peer interactions in order to alleviate concerns for both the child and peers.
• Irritability and frustration are two things that students with OCD feel daily. Prepare students for transitions.

Peers & SLSOs

• Seat student away from peers if ritualised behaviours may be distracting or embarrassing.
• The student's unusual behaviours may be distressing to peers. Misunderstandings may lead to clashes between peers. Help peers respond to unusual behaviours.

Have I...

• Considered alternative marking scales which are non-numerical?

• Discussed successful strategies with the Learning Support Team?

• Included suggested time limits for sections of activities?

• Developed subtle signals between student and teacher?

• Arranged for special provisions in assessment tasks – separate supervision?