Oh, man. There goes the bell for the end of 4th period. I hate this bell. It means I have to go to my locker and unload all my stuff from the first four periods and pick up everything else I need through the end of the day. I only go to my locker once a day and have to cram everything I need in my backpack, because my stupid lock combination has the number “6” in it. Six is a terrible number – it’s associated with the dev… well, you know what I mean. And it’s right up there with “9” – which is 6, flipped around. I get stuck on the 6 every single time I do my lock combination and have to say a bunch of good numbers, like “2” or “8,” to feel better. And all of this takes up a lot of the passing period. On top of this, there’s this really weird kid who walks down the hall every day at this time. No way do I want to bump into him, because if I do, I’m afraid I’ll get contaminated and become like him. Now THAT just can’t happen. So I have to hide out around the corner until he passes by. There goes some more time.
I’m late to 5th period so much that my teacher says she’s going to drop me a grade if I’m tardy one more time. And that would be a disaster. Fifth period is math class, and I spend half the math period mentally saying good numbers because 6’s and 9’s are everywhere. So I never get my work done. In fact, my grade in math right now is a D. The teacher thinks I’m lazy or dumb, but I’m not. In fact, a test I took a while back showed I have a really high IQ. Problem is the bad numbers come up a lot in my other classes, too. It feels like the teachers are always yelling at me for not paying attention. I wonder how much work they’d get done if they had all this stuff going on in their heads. Some of them even told my parents they think I have AD/HD. But it’s almost impossible to concentrate when there’s a war between numbers going on in my head. Sometimes I hate school…
The student in this vignette has obsessive-compulsive disorder, or OCD. OCD is an anxiety disorder characterized by the presence of obsessions and/or compulsions. The vast majority of individuals with OCD have both obsessions and compulsions. Rarely, however, a person may experience only one or the other. Obsessions and compulsions are time-consuming, cause marked distress, and/or interfere with a person’s usual routine, occupational or academic functioning, social activities, or relationships with others. Although figures vary, it is estimated that the prevalence of OCD in children and adolescents is approximately 1-2%.
Obsessions are recurrent and persistent ideas, thoughts, impulses, or images that intrude into a person’s thinking. Commonly-reported obsessions include worries about contamination; fears of harm, illness, or death; intrusive thoughts about harming oneself or others (even though there is no intent to do so); excessive religious fears; a compelling need for symmetry or order; and obsessive doubt.
Compulsions, also known as rituals, consist of repetitive, purposeful behaviors or mental acts that individuals perform to relieve, prevent, or undo the anxiety or discomfort created by the obsessions. In some cases, rituals are carried out to prevent some dreaded event or situation from happening. For example, a young boy may place multiple sticky notes inside his father’s car, each containing a message imploring his dad to drive carefully, to prevent him from being killed in an automobile accident. Common compulsions include overt behaviors such as excessive washing, cleaning, checking, repeating, reassurance seeking, confessing, and counting, as well as covert mental rituals, such as mental praying, counting, or repeating words silently.
As seen in the opening vignette, OCD can have a particularly devastating impact on students in school. Thousands of children and adolescents with OCD struggle, on a daily basis, in classrooms all over the world. Held hostage by OCD, they cannot perform tasks they have the ability to do. Unable to complete assignments, these students frequently receive poor and even failing grades. Moreover, their social competence is often compromised because of the intrusion of OCD.
The good news is that school personnel can play an integral role in providing school-based interventions for children and adolescents with OCD. One factor crucial to the success of these interventions is effective collaboration between parents and school professionals. A home-school partnership characterized by an open exchange of information and effective communication can go a long way to facilitate the creation of realistic and meaningful interventions to support students with this potentially debilitating disorder.