Obsessive-Compulsive Disorder What Every Teacher Needs to Worry About

1. Obsessive-Compulsive DisorderWhat Every Teacher Needs to Worry About Kristina Planinsek

2. Objectives Participants in this seminar will be able to: • Think differently about students with OCD. • Identify the symptoms of OCD and how they can affect your students’ learning. • Analyze ideas you can implement in your own classroom. Copyright 2007 K. McCallen-Planinsek

3. What is Obsessive-Compulsive Disorder? Classified in the DSM-IV-TR as an anxiety disorder. Characterized by recurrent, time-consuming obsessive or compulsive behaviors that cause distress and/or impairment. Obsessions may be repetitive intrusive images, thoughts, or impulses. According to the DSM-IV-TR (2000), compulsive behaviors, such as hand-washing or cleaning rituals, are often an attempt to displace the obsessive thoughts. (Surgeon General’s Report, 1999)

4. Glossary • OCD – Obsessive Compulsive Disorder • DSM-IV-TR – The guide used to diagnose mental disorders in the United States. • Obsessions – recurrent, persistent, irrational thoughts, impulses, or images that cause marked anxiety or distress Copyright 2007 K. McCallen-Planinsek

5. Glossary • Recurrent – occurs for more than an hour a day every day • Compulsions – repetitive acts or behaviors (rituals or routines) that are uncontrollable • FBA – Functional Behavioral Assessment – observations of student completed by a professional to analyze the benefits of certain behaviors for a student in order to create a behavior plan Copyright 2007 K. McCallen-Planinsek

6. Prevalence Estimates of prevalence range from 0.2 to 0.8 percent in children, and up to 2% of adolescents (Flament et al., 1998). Affects children and adults. It is usually detected in childhood, the teen years, or early adulthood. Children as young as 5 or 6 can show full-blown OCD. Affects males and females equally. Between 30% and 50 % of adults with OCD reported that their symptoms started during or before mid-adolescence (Watkins, 2003).

7. Obsessions (irrational thoughts) worrying about germs concerned about intruders need for everything to be neat & orderly afraid they will do something that will hurt or offend someone they care about Compulsions (rituals and routines) repeating words, phrase, & songs being a “pack-rat” cleaning; themselves & their personal/living space checking & rechecking; that their locker is locked, the curling iron is unplugged, that their crayons are in the box What Does OCD Look Like? Copyright 2007 K. McCallen-Planinsek

8. Biological Factors Often times OCD appears to run in families. Cause of OCD is unknown. Regularly appears with another disorder such as eating disorders, depression, or other anxiety disorders. A group of patients have seen a connection with streptococcal infections and an increase in the severity of symptoms (Evans, et. al, 2007).

9. OCD & School Peer pressure to fit in and be like everyone else is troublesome when you cannot stop yourself from completing certain rituals. Students with OCD often look at their symptoms as fantasy or magical…if they don’t do things a certain way something bad will happen to someone they care about.

10. OCD & Family OCD often runs in families, but no direct cause is known. Stress can exacerbate symptoms, so unstable home life can increase problems. Ignoring symptoms does not help. Support and reassurance from parents makes OCD more manageable for their children.

11. How OCD Affects School Performance Affects schoolwork Perfectionism Fear of germs on paper Distracts fellow classmates Inadvertently breaks rules without meaning to Distractions can affect own and others’ ability to learn

12. Legal Safeguards in Pennsylvania Students with OCD would qualify under PA Chapter 15 for a Section 504 plan District must provide necessary supports for a child to participate in and benefit from the educational program at school. The child must have equal access to all extracurricular school programs and activities such as clubs, assemblies, lunch, and field trips. (Pennsylvania Education Law Center, 2006)

13. What Teachers Can Do Keep routines as predictable as possible. Establish rules and consequences and keep them consistent Encourage tolerance and understanding of peers who are different

14. What Else Teachers Can Do Involve movement into your teaching…exercise can help to calm symptoms Encourage older students to journal…this can help them to identify triggers for symptoms Ask for an FBA, Functional Behavior Assessment, to be completed on a student who is diagnosed with or you suspect might have OCD. If triggers are identified, you may be able to help eliminate them.

15. What Teachers Should Avoid Avoid negative responses to symptoms. Avoiding rewards such as chocolate Caffeine can cause symptoms to flare up. Avoid abrupt changes to schedules and routines.

16. How Do I, as a Teacher, Help a Parent Understand OCD? See Brochure Handout

17. Where You Can Get More Help http://www.ocfoundation.org/ Founded by a group of individuals with OCD in 1986, the mission of the Obsessive Compulsive Foundation is to educate the public and professional communities about OCD and related disorders; to provide assistance to individuals with OCD and related disorders, their family and friends; and to support research into the causes and effective treatments of OCD and related disorders.

18. Where You Can Get More Help Blink, Blink, Clop, Clop: Why Do We Do Things We Can't Stop? by Moritz and Jablonsky, ChildsWork, ChildsPlay (1998) This illustrated book explains OCD to elementary-aged children. It uses the metaphor of farm animals who are tormented by "O.C. Flea." It can be a useful story early on in the child's therapy. This book is probably best read with or to a child. Some of the concepts and vocabulary are more advanced and should be explained.

19. Case Study See Handout to read Josie’s Story

20. References • American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, fourth edition (text revision). Washington, DC: Author. • Evans, D.L., Ed. et al. (2007). Treating and Preventing Adolescent Mental Health Disorders; What we know and what we don’t know. Retrieved October 14, 2007 from the World Wide Web: http://amhitreatingpreventing.oup.com/anbrg/public/index.html • Flament, M. F., Whitaker, A., Rapoport, J. L., Davies, M., Berg, C. Z., Kalikow, K., Sceery, W., & Shaffer, D. (1988). Obsessive compulsive disorder in adolescence: An epidemiological study. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 764–771. • The National Institute of Mental Health. (2007). Anxiety disorders. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES • National Institutes of Health. Retrieved September 8, 2007 from the World Wide Web: http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml • Obsessive-Compulsive Foundation. (2006-2007). Retrieved September 16, 2007 from the World Wide Web: http://www.ocfoundation.org • U.S. Department of Health and Human Services. (1999). Mental Health: A Report of the Surgeon General—Executive Summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health. Retrieved September 8, 2007 from the World Wide Web:http://mentalhealth.samhsa.gov/features/surgeongeneralreport/chapter3/sec6.asp • Watkins, Carol E., and Brynes, G. (2003). Anxiety disorders in children and adults. Retrieved October 14, 2007 from the World Wide Web: http://www.ncpamd.com/anxiety.htm Copyright 2007 K. McCallen-Planinsek

21. Contact Information If you wish to duplicate this material, please contact the author, Kristina Planinsek, at kplaninsek@wiu.k12.pa.us 314 Pittsburgh St. New Derry, PA 15671 Copyright 2007 K. McCallen-Planinsek