Obsessive Compulsive Disorder

Transcription

1 Obsessive Compulsive Disorder A neurobiological condition. Anxiety Disorder: characterized by unwanted thoughts, ideas or worries that are called obsessions. Obsessions cause child to perform repetitive actions (compulsions). Numerous studies have determined that OCD runs in families. If a first tier relative (parents, siblings) have OCD, your childs risk of developing the disorder increases 12%. 80% of children and adolescents who have OCD also have one or more anxiety disorders (most common, ADHD and social phobia). 1

2 OCD and children Affects one in every 100 young people in the US. This can mean about 3-5 students with OCD in an average sized elementary school and about 20 teenagers in a large high school. Age of onset and gender of OCD Some children can show OCD symptoms as young as 3 or 4 years of age. Prevalent in boys around age 7. Girls are more likely to develop symptoms in adolescence. Of the estimated five to six million adults in the US with OCD, nearly half identify the onset of symptoms in childhood. 2

3 Difference between an obsession and a compulsion Obsession: irrational, intrusive and involuntary thought or image that a child is unable to make go away. Compulsion: repetitive or ritualistic behavior that results from that thought or image. The child performs the compulsive behavior to (unsuccessfully) attempt to get rid of the obsessive thought. OCD and the brain Brain Lock: Low levels of serotonin cause thoughts to keep flowing. Rituals reinforce that brain pathway associated with OCD. 3

4 What makes a behavior OCD? Time consuming (takes up more than an hour a day). Interferes with daily functioning. High anxiety level surrounding childs repetitive behaviors. There are attempts to minimize the inappropriate thoughts, impulses, or images and they are recognized as coming from within the persons own mind. Common OCD symptoms relating to obsessions or compulsions Contamination: Washing and cleaning Harm or danger: Checking/fear of causing harm to self or others Doubting: being unsure if youve completed common tasks Hoarding: fear of throwing out useless objects or the need to buy objects Religiosity: praying a lot, doubting faith Body fixations: Grooming Need for symmetry: arranging in order, lining up Need for perfection: Seeking reassurance Counting: counting to a certain number, even or odd repetitions, needing to perform something at a certain time 4

5 School issues Other children encouraging a childs ritualistic behavior. Compulsions = lost learning and socializing opportunities. Stress: high levels time and energy given to OCD Sleep deprivation Depression/Shame Agitation Need to keep busy Anxiety School issues continued Neuropsychological differences: children with OCD may have stronger verbal skills, weaker nonverbal skills, difficulty writing, and reduced processing speed/efficiency and expressive written language skills. Behavioral Difficulties: hyperactivity, impulsivity, and inattentiveness. Social difficulties: bullied, fear of contamination, no time left for social agendas, embarrassed. 5

6 Treatment Cognitive Behavioral Therapy: goal is to change clients belief system so that unproductive behaviors will be dropped (reframing). For patients with OCD also pair with Exposure Response Prevention techniques (ERP). Prozak, Paxil and Zoloft increase the amount of serotonin in the brain and is FDA approved for use by children. Suggestions for helping at school Have a safe person student can access. Allow for a code word exchange between student and teacher. Discuss any planned changes. Allow more time to complete homework and in-class assignments/shorten assignments or set a work limit. Accommodate late arrivals. Give the student a choice of projects. Allow the student to change sequence of numbering. Focus on childs strengths (self esteem). Keep the classroom a safe environment. 6

7 Suggestions for helping at school (continued) Early Dismissal Give the student their own materials. Allow the student to be first to hand out materials. Change testing format and keep it untimed. Break down long term assignments into small chunks with due dates. As child works on OCD issues, use FBA and incentive systems. Michelle ABC News Primetime. OCD Kids: Michelle 7

8 References Chansky, Tamar E. Freeing Your Child from Obsessive-Compulsive Disorder New York. Crown Publishers. Martin, Steven The Everything Parents Guide to Children with OCD. Canada. F+W Publications, Inc. OCD Education Station: A Resource for School Personnel. OCD Chicago. OCD Kids: Michelle. ABC News Primetime. Aired August 4,