obsessive- compulsive disorder what every teacher needs to worry about kristina planinsek

Obsessive-Obsessive-Compulsive Compulsive

DisorderDisorder What Every Teacher What Every Teacher

Needs to Worry AboutNeeds to Worry About

Kristina PlaninsekKristina Planinsek

Copyright 2007 K. McCallen-PlaninsekCopyright 2007 K. McCallen-Planinsek

ObjectivesObjectivesParticipants in this seminar will be able Participants in this seminar will be able

to:to:

Think differently about students with Think differently about students with OCD.OCD.

Identify the symptoms of OCD and Identify the symptoms of OCD and how they can affect your students’ how they can affect your students’ learning. learning.

Analyze ideas you can implement in Analyze ideas you can implement in your own classroom.your own classroom.

What is What is Obsessive-Obsessive-Compulsive Compulsive Disorder?Disorder?

Classified in the DSM-IV-TR as an anxiety disorder.Classified in the DSM-IV-TR as an anxiety disorder.

Characterized by recurrent, time-consuming Characterized by recurrent, time-consuming obsessive or compulsive behaviors that cause obsessive or compulsive behaviors that cause distress and/or impairment. distress and/or impairment.

Obsessions may be repetitive intrusive images, Obsessions may be repetitive intrusive images, thoughts, or impulses. thoughts, or impulses.

According to the DSM-IV-TR (2000), compulsive According to the DSM-IV-TR (2000), compulsive behaviors, such as hand-washing or cleaning rituals, behaviors, such as hand-washing or cleaning rituals, are often an attempt to displace the obsessive are often an attempt to displace the obsessive thoughts.thoughts.

(Surgeon General’s Report, 1999)(Surgeon General’s Report, 1999)

Copyright 2007 K. McCallen-PlaninsekCopyright 2007 K. McCallen-Planinsek

GlossaryGlossaryOCDOCD – Obsessive Compulsive Disorder – Obsessive Compulsive Disorder

DSM-IV-TRDSM-IV-TR – The guide used to – The guide used to diagnose mental disorders in the diagnose mental disorders in the United States.United States.

ObsessionsObsessions – recurrent, persistent, – recurrent, persistent, irrational thoughts, impulses, or irrational thoughts, impulses, or images that cause marked anxiety or images that cause marked anxiety or distressdistress

Copyright 2007 K. McCallen-PlaninsekCopyright 2007 K. McCallen-Planinsek

GlossaryGlossaryRecurrentRecurrent – occurs for more than an – occurs for more than an hour a day every dayhour a day every day

CompulsionsCompulsions – repetitive acts or – repetitive acts or behaviors (rituals or routines) that are behaviors (rituals or routines) that are uncontrollableuncontrollable

FBAFBA – Functional Behavioral – Functional Behavioral Assessment – observations of student Assessment – observations of student completed by a professional to analyze completed by a professional to analyze the benefits of certain behaviors for a the benefits of certain behaviors for a student in order to create a behavior student in order to create a behavior planplan

PrevalencePrevalence Estimates of prevalence range from 0.2 to 0.8 Estimates of prevalence range from 0.2 to 0.8

percent in children, and up to 2% of adolescentspercent in children, and up to 2% of adolescents (Flament et al., 1998)(Flament et al., 1998)..

Affects children and adults. It is usually detected Affects children and adults. It is usually detected in childhood, the teen years, or early adulthood. in childhood, the teen years, or early adulthood. Children as young as 5 or 6 can show full-blown Children as young as 5 or 6 can show full-blown OCD. OCD.

Affects males and females equally.Affects males and females equally.

Between 30% and 50 % of adults with OCD Between 30% and 50 % of adults with OCD reported that their symptoms started during or reported that their symptoms started during or before mid-adolescence before mid-adolescence (Watkins, 2003)(Watkins, 2003). .

Copyright 2007 K. McCallen-PlaninsekCopyright 2007 K. McCallen-Planinsek

What What Does Does OCD OCD Look Look Like?Like? ObsessionsObsessions

(irrational thoughts)(irrational thoughts)

worrying about germsworrying about germs

concerned about concerned about intrudersintruders

need for everything to need for everything to be neat & orderlybe neat & orderly

afraid they will do afraid they will do something that will something that will hurt or offend someone hurt or offend someone they care aboutthey care about

Compulsions Compulsions (rituals and routines)(rituals and routines)

repeating words, repeating words, phrase, & songsphrase, & songs

being a “pack-rat”being a “pack-rat”

cleaning; themselves cleaning; themselves & their personal/living & their personal/living spacespace

checking & checking & rechecking; that their rechecking; that their locker is locked, the locker is locked, the curling iron is curling iron is unplugged, that their unplugged, that their crayons are in the boxcrayons are in the box

Biological Biological FactorsFactors

Often times OCD appears to run in families. Often times OCD appears to run in families.

Cause of OCD is unknown. Cause of OCD is unknown.

Regularly appears with another disorder Regularly appears with another disorder such as eating disorders, depression, or such as eating disorders, depression, or other anxiety disorders.other anxiety disorders.

A group of patients have seen a connection A group of patients have seen a connection with streptococcal infections and an with streptococcal infections and an increase in the severity of symptoms increase in the severity of symptoms (Evans, (Evans, et. al, 2007)et. al, 2007)..

OCD & OCD & SchoolSchool

Peer pressure to fit in and be like Peer pressure to fit in and be like everyone else is troublesome when everyone else is troublesome when you cannot stop yourself from you cannot stop yourself from completing certain rituals.completing certain rituals.

Students with OCD often look at their Students with OCD often look at their symptoms as fantasy or magical…if symptoms as fantasy or magical…if they don’t do things a certain way they don’t do things a certain way something bad will happen to something bad will happen to someone they care about.someone they care about.

OCD & FamilyOCD & FamilyOCD often runs in families, but no OCD often runs in families, but no

direct cause is known.direct cause is known.

Stress can exacerbate symptoms, Stress can exacerbate symptoms, so unstable home life can increase so unstable home life can increase problems.problems.

Ignoring symptoms does not help. Ignoring symptoms does not help. Support and reassurance from Support and reassurance from parents makes OCD more parents makes OCD more manageable for their children.manageable for their children.

How OCD How OCD Affects School Affects School PerformancePerformance

Affects schoolworkAffects schoolwork PerfectionismPerfectionism Fear of germs on paperFear of germs on paper

Distracts fellow classmatesDistracts fellow classmates Inadvertently breaks rules without Inadvertently breaks rules without

meaning tomeaning to Distractions can affect own and Distractions can affect own and

others’ ability to learnothers’ ability to learn

Legal Legal Safeguards in Safeguards in PennsylvaniaPennsylvaniaStudents with OCD would qualify under Students with OCD would qualify under

PA Chapter 15 for a Section 504 planPA 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, (Pennsylvania Education Law Center, 2006)2006)

What What Teachers Can Teachers Can

DoDoKeep routines as predictable as Keep routines as predictable as

possible.possible.

Establish rules and consequences Establish rules and consequences and keep them consistentand keep them consistent

Encourage tolerance and Encourage tolerance and understanding of peers who are understanding of peers who are differentdifferent

What Else What Else Teachers Can Teachers Can

DoDoInvolve movement into your teaching…Involve movement into your teaching…

exercise can help to calm symptomsexercise can help to calm symptoms

Encourage older students to journal…this Encourage older students to journal…this can help them to identify triggers for can help them to identify triggers for symptomssymptoms

Ask for an FBA, Functional Behavior Ask for an FBA, Functional Behavior Assessment, to be completed on a Assessment, to be completed on a student who is diagnosed with or you student who is diagnosed with or you suspect might have OCD. If triggers are suspect might have OCD. If triggers are identified, you may be able to help identified, you may be able to help eliminate them.eliminate them.

What Teachers What Teachers Should AvoidShould Avoid

Avoid negative responses to Avoid negative responses to symptoms.symptoms.

Avoiding rewards such as Avoiding rewards such as chocolatechocolate

Caffeine can cause symptoms to Caffeine can cause symptoms to flare up.flare up.

Avoid abrupt changes to Avoid abrupt changes to schedules and routines.schedules and routines.

How Do I, as How Do I, as a Teacher, a Teacher,

Help a Help a Parent Parent

Understand Understand OCD?OCD?

See Brochure HandoutSee Brochure Handout

Where You Can Where You Can Get More HelpGet More Help

http://www.ocfoundation.org/http://www.ocfoundation.org/

Founded by a group of individuals with OCD Founded by a group of individuals with OCD in 1986, the mission of the Obsessive in 1986, the mission of the Obsessive Compulsive Foundation is to educate the Compulsive Foundation is to educate the public and professional communities about public and professional communities about OCD and related disorders; to provide OCD and related disorders; to provide assistance to individuals with OCD and assistance to individuals with OCD and related disorders, their family and friends; related disorders, their family and friends; and to support research into the causes and and to support research into the causes and effective treatments of OCD and related effective treatments of OCD and related disorders.disorders.

Where You Can Where You Can Get More HelpGet More Help

Blink, Blink, Clop, Clop: Why Blink, Blink, Clop, Clop: Why Do We Do Things We Can't Do We Do Things We Can't Stop?Stop? by Moritz and Jablonsky, ChildsWork, ChildsPlay by Moritz and Jablonsky, ChildsWork, ChildsPlay

(1998)(1998)

This illustrated book explains OCD to This illustrated book explains OCD to elementary-aged children. It uses the elementary-aged children. It uses the metaphor of farm animals who are metaphor of farm animals who are tormented by "O.C. Flea." It can be a tormented by "O.C. Flea." It can be a useful story early on in the child's useful story early on in the child's therapy. This book is probably best read therapy. This book is probably best read with or to a child. Some of the concepts with or to a child. Some of the concepts and vocabulary are more advanced and and vocabulary are more advanced and should be explained.should be explained.

Case StudyCase StudySee HandoutSee Handout

to read Josie’s Storyto read Josie’s Story

Copyright 2007 K. McCallen-PlaninsekCopyright 2007 K. McCallen-Planinsek

ReferencesReferencesAmerican Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, fourth edition (text revision). Washington, DC: Author.Disorders, fourth edition (text revision). Washington, DC: Author.

Evans, D.L., Ed. et al. (2007). TEvans, D.L., Ed. et al. (2007). Treating and Preventing Adolescent Mental Health reating and Preventing Adolescent Mental Health Disorders; What we know and what we don’t know.Disorders; What we know and what we don’t know. Retrieved October 14, 2007 Retrieved October 14, 2007 from the World Wide Web: from the World Wide Web:

http://amhitreatingpreventing.oup.com/anbrg/public/index.htmlhttp://amhitreatingpreventing.oup.com/anbrg/public/index.html

Flament, M. F., Whitaker, A., Rapoport, J. L., Davies, M., Berg, C. Z., Kalikow, K., Sceery, W., & 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 Shaffer, D. (1988). Obsessive compulsive disorder in adolescence: An

epidemiological study. epidemiological study. Journal of the American Academy of Child and Adolescent Journal of the American Academy of Child and Adolescent Psychiatry, 27Psychiatry, 27, 764–771., 764–771.

The National Institute of Mental Health. (2007). The National Institute of Mental Health. (2007). Anxiety disordersAnxiety disorders. U.S.. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES • National Institutes of Health. DEPARTMENT OF HEALTH AND HUMAN SERVICES • National Institutes of Health.

Retrieved September 8, 2007 from the World Wide Web: Retrieved September 8, 2007 from the World Wide Web:

http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtmlhttp://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

Obsessive-Compulsive Foundation. (2006-2007). Retrieved September 16, 2007 from the Obsessive-Compulsive Foundation. (2006-2007). Retrieved September 16, 2007 from the World World

Wide Web: Wide Web: http://www.ocfoundation.orghttp://www.ocfoundation.org

U.S. Department of Health and Human Services. (1999). U.S. Department of Health and Human Services. (1999). Mental Health: A Report of the Mental Health: A Report of the SurgeonSurgeon

General—Executive SummaryGeneral—Executive Summary. Rockville, MD: U.S. Department of Health and . Rockville, MD: U.S. Department of Health and Human Human Services, Substance Abuse and Mental Health Services Administration, Center for Services, Substance Abuse and Mental Health Services Administration, Center for Mental Mental Health Services, National Institutes of Health, National Institute of Mental Health. Health Services, National Institutes of Health, National Institute of Mental Health.

Retrieved September 8, 2007 from the World Wide Retrieved September 8, 2007 from the World Wide Web:Web:http://mentalhealth.samhsa.gov/features/surgeongeneralreport/chapter3/sec6.asphttp://mentalhealth.samhsa.gov/features/surgeongeneralreport/chapter3/sec6.asp

Watkins, Carol E.Watkins, Carol E., and Brynes, G. (2003). Anxiety disorders in children and adults. Retrieved, and Brynes, G. (2003). Anxiety disorders in children and adults. Retrieved October 14, 2007 from the World Wide Web: October 14, 2007 from the World Wide Web: http://www.ncpamd.com/anxiety.htmhttp://www.ncpamd.com/anxiety.htm

Copyright 2007 K. McCallen-PlaninsekCopyright 2007 K. McCallen-Planinsek

Contact Contact InformationInformationIf you wish to duplicate this material,If you wish to duplicate this material,

please contact the author, please contact the author,

Kristina Planinsek, Kristina Planinsek, atat

kplaninsek@wiu.k12.pa.uskplaninsek@wiu.k12.pa.us

314 Pittsburgh St.314 Pittsburgh St.

New Derry, PA 15671New Derry, PA 15671