A Teacher’s Guide to Helping Kids With OCD
What you can do to help a child who’s struggling
Senior Director, Anxiety & Mood Disorders Center; Director, Intensive Pediatric Obsessive-Compulsive Spectrum Disorders Program
Child Mind Institute
If a child in your classroom is struggling with OCD, he may be distracted, frustrated in completing his work, and even disruptive to other students. (To identify the symptoms and behaviors of OCD, see A Teacher's Guide to OCD in the Classroom.) Here are some things we can do to help him, and the class as a whole, focus on learning:
Extended time for tests and papers. If writing is a problem for a child who needs to find the perfect way to say something, he's going to need more time to finish those essay questions or papers.
Laptops for writing: If writing and rewriting/erasing is really problematic for a child, consider letting her use a laptop for taking notes, and having all assignments be typed instead of handwritten.
A buddy system: A buddy is like a peer coach who sits next to the child and prompts him to keep up with note-taking and staying on task. It can be great for the buddy, to foster a sense of confidence and pride, to be able to help someone in need, and great for fostering friendship.
Private testing rooms: Research is quite clear that kids with OCD and OC spectrum disorders do better, are less overwhelmed, and are more in control of their thoughts and of their reactions if they're in a quiet place away from the other kids.
Skip reading out loud: Kids who feel they need to read perfectly may have to go back and reread sentences or whole paragraphs over and over to make sure they've got them right. So reading becomes a very laborious task, and reading in front of the class can become a nightmare. So if we know reading is a problem for children, we can spare them.
Books on tape: If kids get so hung up reading that it takes forever, listening to the books can be a solution.
Break homework into chunks: If looking at a whole page of math makes kids feel overwhelmed and anxious—think of the potential for mistakes—the problems can be broken up over four pages. It helps kids stay focused on doing the problems instead of worrying.
Plan an escape route: Try working out a communication system so that if the student feels symptoms coming on, she can signal to you and leave the classroom, or go to a protected place in the classroom, without interrupting the class. It can prevent an embarrassing and disruptive blowup of symptoms in the classroom, and the other kids picking on or bullying her about it.
Be aware of triggering events. It's very important for teachers to know what kind of things might trigger the symptoms. Fatigue is a huge piece of OCD, and it can be exacerbated by medication. So it's important to know that if a child is drowsy in class, and maybe he's putting his head down, it's not because he's being oppositional or disrespectful, but overwhelmed with fatigue.
Advance notice: Irritability and frustration are two of the longer-lasting things that kids with OCD are feeling on a daily basis. Changes in schedule can be very disruptive for a child with OCD, so it can be helpful for teachers to give advance notice of things. Kids who know what to expect are less likely to be thrown by the change.
Seating arrangement: If the school has noisy hallways, you might not want to have a child with OCD sit by the door. You might have them sit in the front, where they're less able to hear the noise, and stay more focused on their work. On the other hand, a child who has very observable symptoms, and doesn't want other kids to see them fidgeting with their hands, or rocking, or getting up a lot, might be better off closer to the door, toward the back of the room.
Peer understanding program. Finally, children oftentimes are teased and bullied because of the symptoms of their OCD. Kids feel very uncomfortable about their rituals, knowing that they're being watched. During a peer understanding program we have a presentation in the classroom that explains (with the child participating) what OCD is. The child might say, "Listen, I have OCD. It's an anxiety disorder. It makes me think that my hands are dirty and I have to wash my hands a lot, so if you see me getting up and going to the sink to wash my hands, that's why."
Psychologists can role-play with the teacher and child ahead of time, to anticipate questions his classmates might ask, and how to answer them. This is a good way to educate the whole class about what's going on. It can be a very effective if a child is going to be in the same school for a number of years, and can inspire a surprising amount of support from other children.
Updated: August 18, 2014