Post: 7 Informational Teachers Packet OCD

As I was putting this packet together I began thinking what would be best for my teachers and others to learn more about childhood OCD. I wanted to incorporate as much information as I could to better help educators define, notice, and deal with childhood OCD.

As I was doing some research I came across this amazing web-site http://www.ocdeducationstation.org/. It is web site developed for educators and parents to give information about OCD. I got most of my information that I put into this packet from this site and learned a few things from it as I was making the packet. It makes me feel good to know that childhood OCD is becoming more noticeable not just with researchers but with doctors and educators.

Below is the packet (I could not upload it since it is a word document), but I will email you all the word document as well if you would like to print it off and use it (it is 11 pages long).

Dear Teachers,

Please take a few minutes and read through this information about OCD. This packet will:

1. Explain what OCD is and why it is important to know the difference between OCD and ADD.

2. Helpful tips to identify and deal with OCD.

3. Resources to help you further.

If you have any questions please let me know. There will also be a post survey about this information, so please take your time and read through it, you could really make a difference with this information.

Shannon Schulz

What is OCD?

OCD= Obsessive Compulsive Disorder

OCD is categorized within the mental health group as an anxiety disorder. People with OCD express and have compulsive thoughts, worries, or fears that result in exhaustive rituals that help keep these thoughts under control.

Who Gets OCD and Why?

Who-

One person in forty suffers from CCD. Symptoms can appear anytime in ones life span, but most commonly show up in childhood. The first symptoms that come about in childhood is repetitive touching, tapping, or counting behaviors, or have obsessions with dirt or being dirty. OCD is not biased; it affects people in every society, religion, race, and gender.

Why-

First and foremost, although there has been many theories and research that has taken place, the reason of OCD is still not clear. It was once thought that OCD came into play because of bad parenting and or toilet training, but that is not the case. The most recent research and evidence say that OCD is inherited. OCD has also been linked in children to different environmental factors such as experiencing death, illness, and or divorce at an early age.

So with that said, with the current research and evidence OCD is a result to genetics and environmental aspects.

What OCD Looks Like:

Like explained before OCD is a complex condition with a variety of symptoms and types. A person with OCD has obsessive thoughts that are followed up with compulsive actions. In other words, OCD begins with irrational thoughts or doubts that can be soothed by certain rituals such as hand washing, checking, and hoarding. Below is a list of rituals expressed by people with OCD.

• The first symptoms that come about in childhood is repetitive touching, tapping, or counting behaviors, or have obsessions with dirt or being dirty.
• These first symptoms are symptoms of many disorders, such as ADD and or autism.

· Compulsive hand washing - this ritual is brought on by thoughts of being dirty or worrying about germs.

·        Child will ask to wash hands through out the day or express anxiety if he or she cannot wash hands.

·        May shut down from all activities or “act out” if he or she cannot correct this compulsion with hand washing.

· compulsive ordering and symmetry obsessions- this ritual is brought on by thoughts of things not "feeling right."

·        This is where many children are diagnosed with autism. The need for order, structure, repeating things over and over, organizing.

·        May shut down from all activities or “act out” if he or she cannot correct this compulsion.

· Hoarding- this ritual is brought on by thoughts of "what if" what if I need it, or it has sentimental value to it, which leads to what if get rid of the object I will have to get rid of the memory.

·        Although seen more in adults, children also have this symptom as well. Refusing to throw stuff away. Keeping things close at hand, checking for items, messy desks or bags (not to be confused with the “unorganized child.”

All the information below was found on this very helpful website:   http://www.ocdeducationstation.org/recognizing-ocd-at-school/what-does-ocd-look-like-at-school/

 

 

Common Symptoms of OCD at School

Obsessions

Compulsions

Fears of germs or contamination

Repeatedly washing hands, using anti-bacterial wipes or hand-sanitizer “Protecting” what is perceived as “clean” space -- personal desk or locker, other personal property Avoiding touching “dirty” surfaces that others may have touched, including any common-area objects such as doorknobs or desks, shared supplies, lab equipment, computer keyboards, paints, paste, soap, cafeteria trays, etc. Avoiding contact play or sports -- either because of a fear of catching a disease or fear of contaminating another student Avoiding the use of school washrooms Seeking reassurance that they (students with OCD) or others are not “sick” or “dirty” Refusing to share items or supplies with others Refusing to eat in the cafeteria Avoiding certain products or surfaces because they may contain “poison” (substances used in chemistry, lab tables)

 

Obsessions		Compulsions
Fears that harm, illness, or death, will befall oneself or others; fear of causing harm to oneself or others, including violent or aggressive obsessions (fear of killing or injuring oneself or another person; molesting a child**) **Note: Individuals with OCD who have violent/aggressive thoughts neither have a history of violence nor act upon these urges or ideas.		“Checking” behavior such as making sure doors and/or windows are locked Checking light switches or turning them on and off repeatedly Reading a paragraph over and over again to prevent harm from coming to a loved one, pet, etc. Asking the teacher for reassurance that the student (with OCD) is “safe” Avoiding leaving a “safe” zone (such as a classroom); avoiding going into certain "unsafe" zones (for example, for lunch or recess areas) Avoiding open spaces, such as a gymnasium Unreasonable avoidance of peers, teachers, for fear of causing them harm
Obsessions	Compulsions
Fears/feelings/urges related to numbers, e.g., "good" numbers, "bad" numbers, "magical" numbers	“Counting” behavior such as counting, touching or saying words a certain number of times (believing there is a magical significance to certain numbers and, for example, using those numbers to “magically” keep harm from coming to another); counting the number of steps between locations, and having to start over if interrupted Touching objects a certain number of times; not being able to move on unless this touching has been accomplished Reading words or pages a certain number of times, causing delays in completing assignments Going back and forth through doorways a certain number of times before it’s OK to enter the room Avoiding using certain numbers that are "unlucky" or "not safe;" only using numbers that are "safe" or "lucky." When avoiding certain numbers, math problems may be answered improperly, pages may not be read if the information is on an unlucky page number, certain page numbers may be avoided or pages may be numbered out of sequence to avoid an unlucky number. In general, assignments may be incomplete.
Fears/feelings/urges related to discarding something (e.g., fears that something bad will happen or feelings of incompleteness if something is thrown away); fears of contamination that prevent an individual from touching an item; need to buy items in multiples of a particular number (OCD-based hoarding)	Saving useless items -- scraps of paper, candy wrappers, bottle caps, broken items; being unable to part with things that are not needed any more Holding on to items for fear that they might be needed sometime in the future, such as books, toys, food, school papers; wanting multiples of the same item (e.g., buys in multiples of 3 because it's his magic number) Holding on to what is “my” book, pencil, desk, chair, etc. and getting overly upset if another student uses, borrows or touches their possessions Accumulating items or objects in a particular area (e.g., locker) because they are contaminated
Excessive fear of violating religious or moral rules (scrupulosity)	Apologizing or confessing that something was (or is thought to have been) wrong, such as breaking rules, including religious, classroom or school rules Constantly seeking reassurance that a task has been completed right or perfectly; seeking affirmation that a mistake was not made Saying prayers a certain number of times; excessive praying to atone for being “bad;” repeatedly confessing perceived “sins” or bad behavior Repetitive praying, confessing to neutralize or “undo” bad thoughts, intrusive sexual thoughts, or visions of acting badly including cursing or blaspheming in school or church Avoiding answering questions for fear of telling a lie
Fears/feelings/urges related to symmetry or order	Constantly “evening up” items or groups of items, such as books on a shelf or items on a desk; aligning edges to be “just right” or “even” Rearranging items to be in a certain order, for example, by color or alphabetical order Avoiding a particular room with square tiles (e.g., bathroom); seeing the tiles would necessitate tracing each of the edges with the eyes
Fears/feelings/urges/images related to sexual content	Seeking reassurance that one is not gay or lesbian, despite being heterosexual Excessive praying to atone for having inappropriate sexual thoughts or images Avoiding magazines, books, DVDs, etc., for fear of seeing something sexually-related
Excessive doubting/dread of uncertainty	Constantly rechecking to see if everything that should be in a backpack or book bag is actually there Asking to leave the classroom to recheck a locker or its contents Avoiding a school locker to prevent checking the lock over and over again
Fears/feelings/urges related to having something "just right," "just so" or "perfect"	Getting up and sitting down repeatedly at a desk, until the "just right" feeling has been achieved Repeatedly revising the way letters, words, numbers, or one's name is written to make them look "just right;" getting "stuck" writing the same letter or word over and over again Repeatedly filling in circles on answer sheets; getting "stuck" on one or two questions because too much time is spent carefully filling in the circles, erasing, refilling until it looks 'just right" or "perfect" Erasing words and rewriting over and over -- sometimes until holes are rubbed in the paper Extreme slowness with activities or school work -- making sure that everything looks "just right" or is done "just right," possibly in a certain order or pattern Repeating various actions over and over for no apparent reason Avoiding a hallway in which one must walk repeatedly until it feels "just right"

 

The Role of School Personnel - Help for Students Who Have OCD

Identifying OCD at School

The first step in helping a student with OCD is to recognize the presence of potential OCD symptoms. School personnel can’t expect that parents will necessarily alert them to their child's problems. In fact, research has indicated that parents may not be the first to realize that their child is experiencing difficulties with OCD. Also, it is very unlikely that the students themselves will volunteer to discuss their problems with school personnel. Because of the shame individuals with OCD usually experience, they frequently keep their symptoms hidden, or secretive. In fact, one researcher dubbed OCD the "Secretive Syndrome." Unfortunately, even when a student has been diagnosed with OCD by a clinician, parents and the student sometimes choose not to share this information -- or others have recommended that they not share this information -- with teachers and other educational staff. It is, in many cases, an alert teacher, school psychologist, school nurse, social worker, counselor, paraprofessional, administrator or other staff member who recognizes that a child is having difficulties.

A number of different scenarios may characterize the status of a student with OCD symptoms:

• The student has been diagnosed with the disorder, and the family has already obtained professional treatment to help their child learn skills to overcome the obsessions and compulsions. Moreover, the family has discussed this issue with teachers and other pertinent school staff members. This is the best scenario possible because the student has a treatment plan in place, and school personnel and the family have forged a working relationship to help the student manage the OCD.
• The student has been diagnosed with OCD and is receiving professional help. However, the family has opted not to share information about OCD with school personnel. It may be difficult to understand why parents would choose such an option. There are a number of reasons, however, why they may have reached this decision. First, parents sometimes fear that, if they reveal their child's OCD, he or she may be labeled or stigmatized. And although much progress has been made, misconceptions and stigma surrounding mental illness still abound. Of note is that, in some cases, it is the student who prefers that school personnel not be told for fear that he or she will be singled out or receive special treatment from the teacher. Second, some parents have concerns that, if school personnel learn about the child's illness, they will immediately try to persuade the family to put the child on medication -- a decision many parents are hesitant to make. Third, parents sometimes fear that the information they provide school personnel will not remain confidential and privacy will be breached. Finally, many parents have been counseled by clinicians, either directly, or indirectly via various articles, publications, etc., that there is no real need to inform school personnel about their child's OCD if it isn't interfering with school performance and symptoms aren't present at school.
• The student and his or her family are struggling with confusing symptoms and do not understand what is happening as OCD progresses.
• The student is hiding symptoms of OCD either at home or at school. This means either parents or school personnel do not see the child or teen struggling with the anxiety or discomfort associated with OCD, and may not see any compulsive behavior. Academic performance may be affected -- but it will be harder to uncover the fact that the student has OCD because the teacher and the parents are dealing with two different sets of observations about the student’s behavior. It is important to note that, whenever parents inform school personnel about difficulties with OCD at home, it is critical that educators take parents at their word.
• The student is hiding OCD symptoms both at home and at school.
• The student is experiencing a sudden onset of OCD symptoms, switching from “normal” behavior to being overwhelmed with obsessions and compulsions almost overnight. A sudden onset of OCD symptoms has usually been reported in conjunction with a certain type of strep infection which may trigger OCD in those children who have a genetic predisposition to the disorder. This type of OCD, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Strep, or PANDAS, affects only a very small percentage of children. Researchers continue to conduct studies to learn more about this topic. Due to the sudden appearance of symptoms with PANDAS, the student is most likely to get help quickly because both parents and school personnel will see such a dramatic change in an otherwise “normal” student.

In all of these situations, school personnel need to know what behavior may signify OCD in order to formulate a plan to help the student. When educators are knowledgeable about OCD, they are in an excellent position to recognize symptoms early and set a course of action to help. Without knowledge about OCD symptoms, educators are ill-equipped to manage the student or, in some cases, the classroom, when OCD is present.

When School Intervention is Needed - Helping a Student Who May Have OCD

Identifying a Problem Exists

The first step in obtaining necessary interventions is identifying that there is a problem. Teachers and other school personnel, especially those who have been practicing for some time, are typically very familiar with behavior that falls within the range of normal child development. As a result, they're good at picking up on students who are struggling academically, socially, behaviorally, or emotionally. And even though it's not always easy to know what is causing the problem, warning bells go off when education professionals observe that:

• A student who has previously been doing well in school and has appeared to be acting “normally” in interpersonal situations begins to have difficulties.
• A student who is of normal intelligence begins to struggle unduly with assignments that ordinarily would have been easy to understand and complete -- ones that are completed readily by his or her peers.
• A student is overly tired and is repeatedly late for school or has not completed homework.
• A student whose school attendance has been good begins to avoid school.
• A student begins to seem distracted or disinterested in class and continues this behavior even when it is brought to his or her attention by the teacher.
• A student begins having trouble concentrating in class, is not paying attention to the teacher or class presentations, cannot concentrate on an in-class assignment or test, or is too tired to stay awake in class.
• A student begins asking to go to the bathroom frequently.
• A student begins asking over and over for reassurance that he or she understands the work, that homework is correct, that performance on a test was good, etc.
• A student begins asking the teacher to repeat a question or comment over and over again.

These are just some of the ways a student may exhibit chronic symptoms that are suggestive of an underlying problem. Identifying changes in student behavior that raise concern gives teachers and other school personnel a framework within which to begin helping the student. If it appears that a student is exhibiting behaviors that are consistent with symptoms of OCD, an intervention may be in order. School personnel would need to assess the nature of the student’s problem and develop a plan to help the student manage symptoms at school.

Reviewing the symptoms of OCD in children and adolescents is a good beginning if educators suspect a student is developing problems academically, socially, behaviorally or emotionally.

 

 

Gathering Information and Developing the Case for School Intervention

A teacher may be the person who observes difficulties that could be symptomatic of OCD. When this occurs, it’s important for the teacher to document the problems to build a case for helping the student. It’s likely that classmates or other staff members also have noticed unusual behavior and, when this is brought to the attention of the teacher, it should be noted in writing as well.

Documentation should be detailed as to the type of behavior observed. It's also important to be objective about observations. For example, it is much better to write, "The student is walking around his desk," rather than "The student is disrupting the classroom." It is also important to record what the student is doing rather than what he or she is not doing (e.g., "The student is erasing and re-erasing the words on his paper," rather than "The student isn't completing his worksheet").

Specifics regarding the time and situation or setting in which the behavior occurred, and any event/s that occurred directly before the behavior (antecedents) or after the behavior (consequences) should also be recorded. This information may be helpful in determining potential patterns related to triggers for a behavior (e.g., every time the teacher asks a student to sit on the floor, he cries) or what follows it (e.g., each time the student cries, the teacher verbally reprimands him for not sitting on the floor). In addition, any social impact the behavior has on peers, others in the room, or the classroom climate should be recorded (e.g., peers laugh when teacher repeats her directive). Finally, any adaptations or interventions that have been tried with the student should also be documented.

Specificity regarding student observations cannot be overemphasized. For example, documenting that a student's math homework assignments have been missing for the last 5 days and that the student has stated each day that his or her homework wasn't "good enough to turn in" (which could be an indication of needing to have something done "just right") are concrete observations that can be shared with parents. Merely stating that the student "isn't getting his work done" doesn't help parents understand the bigger picture -- the student's concern over homework being "good enough to turn in" -- which may indicate that a problem is developing.

When the teacher has observed behavior that is consistent with symptoms of OCD, it will be important to gather additional information. One of the first strategies may be to contact parents. Parents or other family members may provide important information such as their perspectives of the student’s behavior and changes in the student’s life that might be affecting school functioning.

The Importance of Effective Communication with Parents

When a student is observed to have symptoms that point to OCD, early intervention is essential. Ignoring problems can give OCD more time to take a stronghold, making a child’s or adolescent’s struggle with the disorder all the more difficult.

Enlisting the help of parents is key. But how school personnel approach parents and discuss their concerns is critical to gaining parental support and action. Communication with parents requires preparation and careful dialogue.

 

Planning Ahead for Various Scenarios

When school personnel speak with a student’s parents, it’s likely that they will encounter one of the following scenarios:

• The parents are already aware of their child’s difficulties and have taken steps to address them by having the student evaluated by a mental health professional. The best scenario is that OCD has already been diagnosed, and the student is undergoing treatment (e.g., Cognitive Behavior Therapy) to learn to manage obsessions and compulsions.
• The parents have observed some behavior at home that is consistent with the observations of school personnel. The parents may also provide additional information about other behaviors of concern at home. Although they are worried about these difficulties, no action has been taken. They are open, however, to discussing the problem and formulating a plan to help their child. They may or may not be highly stressed because of the child’s difficulties, depending on the severity of the symptoms.
• The parents have observed some behavior at home that is unusual, but they had no idea their child was having difficulties in school obvious enough to cause school personnel to become concerned. They, too, are worried about these difficulties and may be open to discussion and suggestions offered by school personnel.
• The parents are accommodating the child’s behavior at home in some way. They may be participating in OCD rituals (such as doing excessive amounts of laundry for a child who has contamination fears), for example, or allowing avoidance behaviors (e.g., they allow a child to use paper plates for meals, because the family's usual dinnerware is "contaminated"). The situation at home likely is very stressful, and the parents may or may not be open to listening to information provided by school personnel.
• The parents have not observed any behavior at home that might suggest a problem, or are ignoring symptoms. They are defensive about their child and may even resent “interference” by school personnel.

When school personnel are prepared for any of these situations, communication with parents will be enhanced. This is essential, because the way in which educators express their concerns can make the difference between whether a child receives needed help or is left to struggle -- with no relief -- with a potentially debilitating mental disorder.

As described in the Intervention section of this web site, learning about OCD is the first step toward understanding the disorder and recognizing OCD symptoms. If a teacher suspects OCD may be causing or contributing to a student's learning, social, behavioral or emotional difficulties, it is essential that school personnel observe the student and document specific examples of behavior that point to OCD. Providing details about the child's behavior will go a long way to facilitate communication with parents.

 

Dialogue with Parents

A face-to-face meeting with parents is an excellent way to discuss the student's specific difficulties. A phone conversation may be more convenient, but by talking with parents in person -- especially the first time the student's problems are brought up -- school personnel are in a better position to express their concern and empathy during the discussion.

The purpose of a conference with the parents is to establish a two-way information exchange. Several general guidelines for talking with parents regarding potential OCD symptoms may be helpful. First, it is extremely important to begin a conversation by sharing positive feedback with parents about the student's behavior and providing examples of other strengths exhibited by the child. Parents need to hear "what's right" with their child. Moreover, starting a conversation in this manner may result in the parents' being more receptive to information about the child's difficulties.

Second, it is important to provide parents details about a student's behavior. As noted above, a discussion of specific examples of student behavior and objective information are much more meaningful to parents than subjective impressions. Stating that a child completes an average of one out of four assignments is far preferable to saying that the child is lazy.

Third, parents frequently experience great emotional pain and frustration as they grapple with their child's difficulties. Therefore, it is important to approach parents with an attitude of caring and concern. Blaming parents for a child's symptoms is unwarranted and inappropriate. It is also extremely important to listen carefully and empathically to parents as they describe what may be very sensitive concerns. Whatever school personnel can do to reassure parents that everyone is working to help the student (and not criticize or blame) will likely lead to more productive conversations and greater cooperation.

Fourth, it is vital that school personnel avoid using educational jargon and acronyms that may confuse parents (e.g., IDEA, IEP, OHI). This language should be used only if it has previously been explained to parents.

Fifth, communication should reflect respect not only for parents and their child but also for their culture. Parents may feel very uncomfortable discussing certain issues because of cultural or social beliefs.

Finally, it is always important that school personnel be familiar with local and state regulatory constraints and privacy laws governing communication among parents, school personnel, and the student.

 

 

Ongoing Communication with Students, Parents and Mental Health Providers

When a student is being treated for OCD, behavioral improvements usually are not immediate but can occur within a few weeks. If the student is being treated by a cognitive behavior therapist, he or she will be seeing the therapist at regular intervals, and will be assigned “homework,” consisting of Exposure and Response Prevention (ERP) exercises to do at home between therapy visits. If the student's obsessions and compulsions are triggered by events, people, places, or other situations in the school environment, the therapist may need to conduct some of the ERP exercises at school. Some experts even suggest that, under the careful supervision of a therapist, school personnel may be able to carry out certain ERP tasks in the classroom (it is inappropriate for a teacher, however well-intentioned, to take the lead in implementing ERP with a student; unsuitable interventions could actually worsen a student's OCD symptoms).

During treatment, the student will be working hard to overcome his or her obsessive fears, doubts and worries, but until these disturbing thoughts, impulses, and images are conquered, they will be present and can still interfere with classroom work, attention during class and homework assignments. Establishing rapport with the student and letting him or her know that you are a “listening ear” and are always willing to provide support will be especially important. It's important to remember, however, that some students will be uncomfortable sharing their OCD symptoms and experiences. Therefore, communication with the student may be limited. However, teachers and other school personnel should have open and frequent communication with parents to discuss the progress of the student and identify particularly troublesome activities or situations.

It's important to note that the success of interventions for children and adolescents with OCD depends upon effective communication among all parties involved in treatment: school professionals, parents, the student, outside professionals, and any other individuals who are participating. Effective communication helps with the creation of realistic and meaningful interventions for the student with OCD. Moreover, good communication among all treatment partners throughout the student's intervention is vital to determining the effectiveness of the treatment program and making any necessary adjustments.

Individuals taking part in the treatment plan must develop a practical system for communicating with one another. Although information may be exchanged in person, via telephone, or email, newer technologies such as texting have greatly improved the ease of communication. Communication can occur as frequently as necessary: biweekly, weekly, or even on a daily basis. A parent-teacher log, in which parents and teachers share written information/feedback about a student, for example, can be used each school day.

Families are typically very eager to learn about any progress the student has made as a result of treatment (e.g., Cognitive Behavior Therapy and/or medication, school-based interventions). What appears to be an inconsequential gain to the outside observer may, in fact, be monumental to the child and his or her family: a student who has been unable to touch the classroom door knob without first covering his or her hand with the end of a shirt sleeve or paper towel, for example, is now able to touch the door knob without a covering. In these instances, it is important for school personnel to communicate this information to therapists, as appropriate, and parents. Considering the stress parents frequently experience because of the negative impact of OCD on the family, some good feedback can give parents a much-needed "boost." But it's also essential that school staff members communicate directly with students, commending them for their hard work and successes. School personnel should always praise effort, too -- even in the absence of success. Positive feedback can have a dramatic effect on a student's self-esteem.

 

Enlisting Help from Other School Personnel

It may also be beneficial for teachers to discuss their concerns with the school psychologist, social worker, counselor, school nurse, or other pertinent school professionals. Today's schools frequently have an array of professionals with expertise in many areas, and they can be effective allies in evaluating a student's behavior. It may be very helpful for the teacher to share his or her observations and concerns with one or more of these staff members, who may then conduct additional observations of the student in class or in social settings (such as the cafeteria, between classes, in sports activities or other activities) to validate the teacher's observations. These professionals may also ask parents, other school staff who work with the student, or the student to complete questionnaires, checklists, rating scales, etc., to gather additional information. When school personnel agree that a student is having difficulties, and the observations are documented and consolidated, it will make explaining the observations to the student’s parents more effective.

School personnel who interact with the student can also help by identifying a student’s strengths. Focusing on positives, such as the student’s abilities in certain areas (creativity, language skills, artistic ability, gymnastics, etc.) helps to reinforce that the child has capabilities and value -- and that the OCD-related problem is just a part of the whole student, not the focal point. Emphasizing a student's strengths can not only help a student with self-esteem issues related to OCD but can also help parents keep a more positive perspective.

 

Evaluation

The best thing for a student who is having continuing difficulties that may be related to OCD is to have an outside evaluation by a physician or mental health therapist. Because of differences in state laws and school liability issues, however, teachers should never make a direct, formal school recommendation to parents to get a medical evaluation for their child.

It may be helpful for school personnel to suggest to parents that they have seen other students (taking care never to reveal the names of other children, for confidentiality purposes) who have exhibited symptoms similar to those exhibited by their child. If parents ask for the school’s ideas for mental health providers, school personnel may provide names and contact information of therapists in the area. It is extremely important that staff provide information about therapists who have experience treating children with OCD. Not all mental health professionals are familiar with how to diagnose and treat OCD in children and adolescents appropriately. OCD Chicago can refer parents to therapists who have experience working with children who have OCD. Parents can also find a list of therapists on the International OCD Foundation web site at www.ocfoundation.org or at the web site for the Anxiety Disorders Association of America at www.adaa.org.

School personnel may also suggest that the parents consult their child's doctor and discuss the school staff's observations. These observations may be put in writing and shared with the health professional who, in turn, could direct the parents to various services, as appropriate

Next Steps in Helping the Student Who Has OCD

Once a student is diagnosed with OCD, educators and other school personnel know what they are dealing with and can begin to formulate plans to help the student function in school. In cases in which there is no formal diagnosis of OCD but the student is experiencing chronic, serious, school-related difficulties, however, school personnel will still need to take action. A common way to begin the process of helping the student is to bring the problem to the attention of the school’s pre-referral or intervention assistance team. (If the school does not have an intervention assistance team, the general education teacher may enlist the help of the special education teacher or other school personnel to review the situation.)

Response to intervention (RTI), which has been widely used for students’ academic concerns, is increasingly being used for students who exhibit emotional and behavioral difficulties. With a three-tier RTI model, the time currently spent evaluating students with OCD to determine whether they qualify for special education and related services (as required by the Individuals with Disabilities Act of 2004 -- the law governing special education services in the United States) might be used more effectively to implement evaluation procedures to identify successful services and interventions for these students.

In an RTI program for students with OCD or who may potentially have OCD, a possible first-tier level of services might include universal screening for emotional and behavioral disorders as well as prevention techniques such as (1) teaching all students strategies for coping with anxiety and (2) creating a positive and calm classroom environment. At the second tier, students with OCD whose symptoms interfere with learning and/or behavior could be brought to the attention of a school psychologist. The psychologist might conduct further assessment and collaborate with families and professionals outside the school to implement various interventions (e.g., cognitive behavioral therapy, medication). Although clinicians would play the major role in implementing these interventions, school personnel play a critical role in supporting and monitoring the effects of these interventions. For students with substantial needs, third-tier services may include individualized, resource-intensive, and comprehensive interventions. An evaluation might also be conducted to determine whether the student qualifies for special education services.

 

Managing OCD in the Classroom

In any classroom, the teacher is the central figure who leads the class in learning, enlightens with insight, maintains order, promotes good behavior and rewards good work. The teacher also sets the mood of the classroom.

When a teacher has a positive attitude, the students are also likely to be positive. Conversely, a teacher's negative attitude can have an adverse impact on the class. A teacher's approach is all the more important for students with OCD. When a teacher supports and encourages these students, and tolerates no ridicule or discrimination from other students, it can make a huge difference in terms of how the student with OCD progresses.

One of the most important things teachers must remember when faced with the challenge of managing OCD in the classroom is that children and adolescents are very impressionable. Peer pressure to fit in and to be part of a group of friends can be extremely hard for the student who has OCD.

There are a number of ways teachers can provide support. With some basic planning, a teacher can make accommodations that help the student academically, socially, behaviorally and emotionally. The following sections, beginning with Healthful Support Strategies, will provide ideas and strategies for teachers and other school personnel to work more successfully with and improve the school functioning of the student who has what may be a very distressing disorder.

Roadblocks

There are a number of school-related challenges that children with OCD face, but some of these difficulties occur outside the classroom and are not easily monitored by school personnel. Completing homework, for example, can pose serious problems for students with OCD and their families. But teachers and other school staff can still be effective in helping the student meet and overcome these challenges.

Other potential roadblocks include ‘high stakes” issues such as taking tests, doing independent study assignments and completing long-term projects.

With understanding and planning, a student can improve his or her approach to common challenges related to:

• Studying effectively, including studying for tests
• Completing homework assignments
• Avoiding school
• Managing study and sleep time
• Test-taking at school
• Fears about homework or school in general

Understanding the Law as It Relates to Students with OCD

School personnel are likely to be familiar with the federal laws that protect a child’s right to a free appropriate public education in the least restrictive environment:

• Section 504 of the Rehabilitation Act of 1973 (Section 504)
  
  and
• The Individuals with Disabilities Education Improvement Act of 2004 (IDEA).

But when a student has OCD, it’s not always clear how to ensure that the student receives the best education. What’s important is that school personnel, the parents, the therapist (when the student is receiving treatment) and the student, as appropriate, are all working together to make sure that the student gets the best education possible. Everyone should be on the same side -- the student’s side.

The information in several sections of the OCD Education Station web site provides background on OCD, the effect of OCD on learning, social, behavioral and emotional development, how to recognize OCD (or possible OCD) and how to communicate effectively with parents. Additionally, best practices in intervention (including accommodations and support strategies) are presented to give school personnel practical suggestions that can help them manage OCD in the school setting.

The ideas and specific tactics outlined help many educators, administrators and school staff effectively work with students who have OCD, and today countless students currently benefit from their use. But school personnel, parents, or both may want or need to develop a more structured approach to managing a student who has OCD to maximize his or her academic, social, behavioral and emotional development. That’s when considering the laws pertaining to a student's civil rights, the provision of special education and related services, and the safeguarding of privacy is a good course of action.

 

 

Making the Best Choices for the Student Who Has OCD

School personnel can play a critical role in helping a student with OCD get the education he or she needs in the least complicated manner. Schools do not have a uniform approach to working with students who have OCD. The way a student with OCD is treated -- and the education he or she receives -- depends on school personnel’s knowledge about OCD and experience in working with students who have the disorder. It can also depend on school personnel’s willingness to find a way to help and, of course, individual school and school district policies.

Some students with OCD need easy-to-implement accommodations (such as many of those detailed on this web site) that can be put in place without additional cost or extra time for existing personnel. Individual schools differ on their approaches to making even simple accommodations but, in certain cases, students with OCD may receive simple accommodations and supports without going through the more formal processes associated with Section 504 and IDEA. It is important to note, however, that many parents prefer having even simple accommodations documented in writing under Section 504, rather than an informal verbal agreement with a teacher or other school staff member. Circumstances change; the teacher with whom a verbal agreement about accommodations was made, for example, may leave the school. A plan developed under Section 504 (504 plan) documents, in writing, decisions that have been made regarding a student's services.

Having a 504 plan in place can also be important because accommodations and supports may be needed during periods of heightened OCD symptoms (when symptoms wax) but not at other times (when symptoms wane). Equally important, if a student is seeking eligibility for accommodations for college entrance exams, during the college years, or later in life, the presence of a history of prior formal recognition of the disability is important documentation of the disability and need for accommodations. By contrast, informal accommodations are less useful as documentation later on. Moreover, Section 504 plans may contain important procedures for managing learning, behavior or medical problems that sometimes occur when a student has OCD. For example, procedures for managing a student who has an OCD-related outburst or dispensing emergency medications may be documented in a 504 plan.

The essential purpose of Section 504 is to "level the playing field" for children and adolescents with disabilities. In other words, Section 504 ensures that reasonable accommodations and supports be provided to students with disabilities so they can access educational opportunities and learn in a manner similar to their peers. Importantly, support strategies may be needed only temporarily, and should be discontinued as the student recovers from OCD and is able to overcome his or her obsessions and compulsions.

In many cases, Section 504 is the appropriate vehicle for providing students necessary accommodations and supports. In other cases, special education and related services under IDEA will be necessary for students with OCD who have more serious needs. The most important objective is to meet the individual needs of the student and provide the best opportunity for academic, social, behavioral and emotional success. The information below outlines some of the differences between Section 504 and IDEA.

 

 

Tools and Resources for School Personnel

In addition to the information contained on the OCD Education Station web site there are other resources we recommend for additional good information. We have reviewed the books and web sites we feature to make your information search easier.

OCD Guides Provide Information You Can Use

Our OCD Guides were developed to provide comprehensive, practical information about living with OCD. They include information about symptoms, facts (and myths) about OCD, related disorders and treatment options.

The guides provide current, accurate information in a detailed and readable booklet format. Thousands of people have received the guides and their feedback is that the information is not only helpful, but empowering.

• How to Help Your Child - A Parent’s Guide to OCD
• Got OCD? A Guide for Teens
• Overcoming OCD: A Guide for College Students
• Relief from OCD: A Guide for People with Obsessive Compulsive Disorder
• School Personnel: A Critical Link in the Identification, Assessment, and Treatment of OCD in Children

 

Selected Web Sites for School Personnel

The web sites listed in this section are ones we’ve found to be helpful for school personnel seeking additional information about OCD. Included are web sites that focus on OCD or related anxiety disorders, general mental health topics, laws that pertain to OCD and OCD in college students. Some sites address ways to manage OCD in the classroom.

After you have visited these web sites, we encourage you to come back to the OCD Education Station web site to find recommended books about these topics.

(We provide these links as a convenience, but OCD Chicago does not endorse any publication or other web site.)

OCD at School

Teen Mental Health

Visit this site

Council of Parent Attorneys and Advocates

Parents who are looking to find a special education advocate for a child with disabilities may look up referrals in the COPAA member directory.
Visit this site

Students with OCD - A Handbook for School Personnel

Visit this site

National Association of School Psychologists

Collection of reproducible handouts for parents from their online book store, including handouts on OCD and anxiety disorders. Select “Helping Children at Home and School III”
Visit this site

School Psychiatry Program & Madi Resource Center, Massachusetts General Hospital

What OCD looks like in children and adolescents; Interventions at School
Visit this site

WorryWiseKids.Org

The Children's Center for OCD and Anxiety provides this web site and a free e-newsletter for parents and school teachers of children with excessive fears and anxieties.
Visit this site

SchoolBehavior.com

Contains information to help educators learn about a number of neurological disorders that may impair a student's functioning and occasionally create chaos in the classroom
Visit this site

Wrightslaw

Special education law, education law, and advocacy for children with disabilities.
Visit this site

IEP4U

Lists over 4000 goals and objectives (IEP-ITP) each with changeable benchmarks.
Visit this site

Social Competence and the Child with Learning Disabilities

Help a child develop social skills through a social autopsy.
Visit this site

Center for Effective Collaboration and Practice

IDEA rights and requirements; IEP introduction to functional behavioral assessment and behavior intervention plans
Visit this site

KidSource’s Overview of ADA, IDEA, and Section 504

Provides an overview of three different laws that require govern services for students with disabilities in the U.S.
Visit this site

Americans with Disabilities Act (ADA)

Visit this site

Family Medical Leave Act (FMLA)

Visit this site

Social Security Benefits

Visit this site

Medicaid and Medicare

Visit this site

Section 504 of the Rehabilitation Act of 1973

Visit this site

Parents & Children

OCDChicago.org

Up-to-date information on OCD for individuals, parents, friends and family, college students, school personnel, clergy and the media.
Visit this site

WorryWiseKids.Org

The Children's Center for OCD and Anxiety provides this web site and a free e-newsletter for parents and school teachers of children with excessive fears and anxieties.
Visit this site

International OCD Foundation

OCD in the Classroom kit for presentation to school personnel; also The Touching Tree: A Story of a Child With OCD – award-winning video about a young boy facing his OCD and getting treatment for it. For information, email info@ocfoundation.org.
Visit this site

OCD in Kids

Keys to helping children with OCD; homework and school recommendations
Visit this site

Kids Health

Great, kid-friendly explanation of OCD.
Visit this site

American Academy of Child and Adolescent Psychiatry: Facts for Families

Visit this site

Awareness Foundation for OCD

“In the Shoes of Christopher” – video tape about a middle school bully and a boy with OCD.
Visit this site

Columbia University's TeenScreen Program

Builds community-based partnerships to raise awareness of the problem of youth depression and suicide risk, promote mental health screening, and implement screening programs.
Visit this site

Yahoo Health Groups: The OCD and Parenting List

Very active online support group for parents of children with OCD. Advised by Dan Geller, M.D., Gail B. Adams, Ed.D., and Tamar Chansky, Ph.D.
Visit this site

Answers for Special Kids (A.S.K.)

Support and education for families of children with special needs or learning differences in the Chicago North Shore area
Visit this site

Resources:

Dufrene, B., & Hyman, B. (2008). Coping with ocd. Oakland: New Harbinger

            Publications, Inc

http://www.ocdeducationstation.org/