OCD in children is a mental health condition that is related to anxiety, and presents in persistent, distressing and unwanted thoughts, urges (obsessions) or images. They will display repetitive behaviours or mental acts to try to reduce the anxiety, which are often beyond their control.
OCD can be very disruptive on the child’s home and school lives. Treatment typically involves cognitive behavioural therapy (CBT) and medication to help develop managing strategies.
What obsessions and compulsions are association with OCD?
- Obsessions are unwelcome, intrusive thoughts, worries, images, or urges that a child with OCD cannot get rid of. Examples include fears of germs, contamination, getting sick, or causing harm to someone; thoughts of something bad happening if things are not done “just right”; or unwanted violent or sexual images. Some children become obsessed with symmetry or lining things up perfectly. In schools, children with OCD are often pre-occupied with others coughing or sneezing or touching items they consider as dirty, and this is the most common obsession with children
- Compulsions are repetitive behaviours or mental acts that a child feels they “have to” perform to cope with their obsessions or reduce anxiety. Examples include repeatedly washing hands, checking locks, ordering objects, counting, or mentally repeating phrases or words until they “feel right”
Children with OCD often experience high levels of anxiety and distress and may be unable to stop themselves from performing rituals and actions that may seem excessive or illogical to others.
Common behaviours in pupils with OCD
- Frequent requests to go to the toilet – often to wash hands. Children will sometimes do this to get respite from germs in the classroom
- Constantly seeking reassurance, or checking doors, windows or lockers
- Getting stuck on tasks. A child with OCD may need to complete a task in full before moving on to something else
- Retracing steps. A bad thought can lead to a child retracing their steps to fix the problem. For example, a child who had a bad thought going down the stairs on the way to a class might need to go that way again to have a good thought
- Obsessive erasing of text. This happens when the child want their letters to look perfect, or have used a word that disturbs them and they can’t stand seeing the word written on the paper
Supporting a pupil with OCD in the classroom
- Use discretion on seating arrangements. It might be easier to sit the child away from doors if noise disturbs them. However, if they have observable symptoms and don’t want others to see them rocking or fidgeting, the back of the room might be more suitable
- Skip reading aloud. The child who seeks perfection may feel they need to go back and re-read whole sentences or paragraphs to ensure they are correct, making it a challenging task for the OCD students
- Provide laptops for writing. If the erasing and rewriting is a problem consider allowing the child to use a laptop
- Extended time for assessments and exams. The need for getting it exactly right may require additional time in exams
- Private exam rooms. Children with OCD tend to perform better when they are less overwhelmed, more in control, and away from the distraction of others
- Break down tasks and homework to avoid overwhelm and anxiety and can lead to mistakes
- Be aware of their triggers. For some children it might be tiredness, or side effects of medication. Work out a system of the child letting you know when symptoms are coming on so they can leave the classroom or go to a safe space in the class
- Give advance notice of changes to timetables or activities, which can feel very disruptive to a pupil with OCD
- Peer support and buddying can help to foster friendships as well as supporting the child in the lesson with note-taking or staying on task.
*For more information go to Young Minds and NHS.
