Obsessive-Compulsive Disorder. Obsessive-compulsive disorder, also known as OCD, is an anxiety

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1 Kyle Sustich 07U:100 - Therrien Disability Paper Obsessive-Compulsive Disorder Nature of the Disability Obsessive-compulsive disorder, also known as OCD, is an anxiety disorder which, traps people in endless cycles of repetitive thoughts and behaviors (WebMD, 2009). Anxiety disorders can not only affect a person s mental, but also their physical behavior (Hallahan, 267). Specifically, people with OCD tend to be excessively nervous and have to perform rituals or compulsions to help themselves deal with the anxiety. The two symptoms of OCD are obsessions and compulsions, which can be different for every person (WebMD, 2009). Some examples of obsessions are, but are certainly not limited to, a fear of germs, fear of thinking bad thoughts, and the one most likely to be brought up when talking about OCD, a need for cleanliness or order (King, 2008). To deal with these obsessions, persons with OCD may have to perform rituals or compulsions that to an observer may seem irrational or crazy, but to the person performing the ritual, are a necessity. A few examples of rituals would be refusal to make physical contact with another person, constantly cleaning or rearranging one s room, or even checking to make sure a door is locked multiple times (King, 2008). Most of the people afflicted with this disease know that their own rituals are irrational and maybe even useless, but without treatment or help, they must perform them on a daily basis to function at all.

2 Causes There is some disagreement in the scientific field on the cause of OCD. One side of researchers and scientists believe that the disease is caused by environmental factors, or it comes as on offset of learned behavior (WebMD, 2009). Studies show that environmental stressors can lead to the onset of the disease or a worsening of the disease by those people who already have it. In other words, traumatic life experiences or unexpected changes in a person s life can flip a switch in someone s brain and leave them susceptible to the mental disease. While these environmental stressors may leave a person more susceptible to the disease, growing research has began to show that the disease is actually caused by chemical imbalance in the neurons of the brain. Recent studies have concluded that OCD can develop in a person whom has a low level of a certain neurotransmitter, called serotonin, in their brain (King, 2008). This neuron is responsible for transmitting signals from the brain to the body and helps regulate body functions, specifically judgment and planning (WebMD, 2009). This imbalance is the most likely cause of the impulses and compulsions that persons diagnosed with OCD have to deal with on a daily basis. Although some studies believe that the disease is caused by either environmental factors or biological factors, most suggest that it could be a combination of the two. Certain studies even suggest that a repeated onset and non-treatment of the strep infection could leave a person vulnerable to developing the disease (King, 2008).

3 Prevalence in Children OCD is a disease that affects 1 million children in our country, and 3.3 million Americans total (WebMD, 2009). Persons afflicted with the disease usually show the first signs around the age of puberty. The disease affects about 1 in every 200 children, although it usually isn t diagnosed until adulthood (King). Overall the disease doesn t seem to be more prevalent in either sex or any race, but according to the Obsessive Compulsive Foundation, the first signs tend to show up in adolescent boys before girls. According to the U.S. Congress Office of Technology Assessment, although the average age of diagnosis is about 20 years of age, approximately one half of those afflicted with the disease show the first symptoms in their adolescent years (around years of age). Studies have also shown that persons with a history of family members having OCD are at a higher risk of developing the disease than persons with no family history of the disease (King, 2008). Misconceptions One misconception about OCD that many people have about people with the disease is that people with OCD are crazy or weak-minded (OCDSymptoms, 2000). Although people with OCD may seem different or crazy because of their rituals, there is nothing they can do about it, and most can live normal lives. No person with OCD takes pleasure in performing his or her rituals and would certainly like nothing more than to not have the necessity to perform them.

4 Another misconception about the disease is that a poor upbringing or bad parenting can cause OCD. As stated before, OCD is most likely caused by a chemical imbalance in the brain and therefore has nothing to do with the way a person was raised or the socioeconomic status they were brought up in. Bad parenting cannot cause a child to develop OCD (OCDSymptoms, 2000). The overwhelming misconception that many people seem to hold about the disease is that once someone is diagnosed with OCD, they are stuck performing their rituals forever and there is nothing they can do about it. This is most certainly not true. There are many types of treatments for people with the disease. The most common treatments for OCD are antidepressant medications called selective serotonin reuptake inhibitors, or SSRI s, which work to correct the chemical imbalance in the brain (WebMD, 2009). The physical treatment most predominately used in children is exposure therapy, in which the child is gradually exposed to the cause that triggers obsessive or compulsive thoughts and is taught new coping skills that do not include obsessive-compulsive behavior (King, 2008). It is important to provide a source of treatment, especially for young children diagnosed with the disease, as early as possible to help them function better in the future. Issues in Identification in Children There are a few big problems with trying to identify OCD in an individual, especially in young children. First off, because the exact cause of OCD is not yet certain and the symptoms are different for mostly every person, there is no laboratory test to determine if someone has the disease (King, 2008). The only

5 way to tell if someone has the disease is for a parent to request an assessment by a trained physician. It is especially hard to diagnose children with the disease at a young age because during their adolescent years the disease can come and go, or not even show up at all until adulthood (King, 2008). Since the disease is hard to diagnose, most parents don t even ask for an assessment unless they see their child having trouble functioning in their daily life. Sometimes the disease is easier to identify because the child will develop related symptoms in connection with OCD, such as eczema on the hands because of excessive hand-washing (King, 2008). However, at a young age most children with the disease don t even know that there is anything wrong with them. So, unless physical symptoms appear, or extreme rituals keep occurring, a lot of children with OCD go undiagnosed until they become an adult (King, 2008). Issues in Instruction Children diagnosed with OCD often have trouble performing well in school. Their rituals and need for perfection often can cause them to struggle with their work and often get in the way of creating social bonds with their classmates (Packer, 2004). Teachers will often need to give them more time to complete their work or sometimes provide a private space for the student so that they can complete their work without distractions or the added tension of being around other students. As a teacher of a student with OCD, it is important to find out about it and talk with the student as soon as possible.

6 According to Dr. Hymen of the OCD Resource center of Florida, it is important to, differentiate between the child and the OCD. He also recommends giving the OCD a name, such as Mr. Worry or The Count. By separating the child from the disease, the child wont feel as if there is a problem with him or her, the OCD is the problem. Children handle OCD much better when they understand it is not their fault, and that they are not alone (Hymen, 1999). It is important for the teacher to be a support for the student and help the student in whatever way possible to succeed. If that means having one-on-one meetings every week to discuss how the student is doing, or giving them a permanent hall pass so that they can leave the room without disruption whenever they feel flustered, then so be it (Hymen, 1999). It is the teacher s job to make sure the student feels comfortable and receives a meaningful learning experience, and no disease should get in the way.

7 Works Cited Hallahan, Kauffman, Etc. (2009) Exceptional Children. Boston, Ma. Pearson Publishing (pg ) Hymen, B. (1999). Guidelines for Families with Children who have OCD. Retrieved March 1, 2009, from OCD Resource Center of Florida King, S. (2008). Obsessive Compulsive Disorder & Children. Retrieved February 28, 2009, from Your Total Health OCDSymptoms (2000). Common OCD Misconceptions. Retrieved March 1, 2009, from OCDSymptoms.co.uk Packer, L. (2004). Tips for Accommodating Students with Obsessive-Compulsive Disorder. Retrieved March 1,2009, from Tourettesyndrome.net

8 U.S. Congress Office of Technology Assessment. (1994) Mental Disorders and Genetics: Bridging the Gap Between Research and Society. Washington DC. U.S. Government Printing Office. (pg. 20) WebMD. (2009). Mental Health: Obsessive-Compulsive Disorder. Retrieved March 1, 2009, from WebMD.com