OCD and the Special Needs Student

Obsessive-Compulsive Disorder (OCD), according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), is an anxiety disorder characterized by intrusive thoughts that trigger nervousness, anxiety, dread, or worry. These thoughts are typically followed by repetitive behaviors meant to reduce the anxiety, or by a combination of obsessive and compulsive behaviors intended to alleviate the distress. OCD can severely disrupt a person’s life, leading to chaos and turmoil in their mind, compelling them to carry out repetitive behaviors without regard to their physical well-being.

For special needs students, this can be particularly challenging from an educator’s perspective. There are treatment options available, such as counseling and medication, but applying these treatments in a special education setting is often complex. Unlike adults, who typically seek relief voluntarily, students—due to their age and disabilities—may not fully understand what is happening. When attempts are made to help the child, these can sometimes backfire, leading to defiance, depression, and increased anxiety. Educators may find themselves teaching a student who does not fully comprehend their disability or resist treatment, making education feel cumbersome and inefficient. As a result, the needs of other students in the classroom may be neglected. This is where parents can be a valuable resource. By sharing their insights into the child’s behavior at home, parents can help educators craft a more effective plan for the classroom.

Understanding the Symptoms
The first challenge is understanding the symptoms of OCD. The DSM-IV provides the following descriptions:

Obsessions are characterized by the following:

• The person experiences recurrent, persistent thoughts, impulses, or images that are intrusive and inappropriate, causing significant anxiety or distress.
• These thoughts, impulses, or images are not simply excessive worries about real-life problems.
• The person attempts to ignore or suppress these thoughts, impulses, or images, or neutralize them with another thought or action.
• The person recognizes that these obsessional thoughts are a product of their own mind (not imposed from outside, as in thought insertion).

Compulsions are characterized by the following:

• The person engages in repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, silently repeating words) that they feel driven to perform in response to an obsession or according to rigid rules.
• These behaviors or mental acts are intended to prevent a dreaded event or situation, but they are either not realistically connected to what they are meant to neutralize or are excessively performed.

When OCD is present alongside other disabilities, such as mental retardation, speech or language impairments, hearing impairments, visual impairments, serious emotional disturbance, or physical impairments, the educator’s responsibility increases significantly. Each diagnosis requires specific knowledge, and integrating these disabilities into a working educational model for the student can be challenging. Consultation with parents, doctors, or counselors is essential in creating and implementing an effective Individualized Education Plan (IEP). Flexibility, kindness, patience, and creativity are key factors in developing successful teaching strategies for a special needs student with OCD.

OCD affects individuals differently in terms of severity and the occurrence of obsessions and compulsions. It is critical for both the educator and the parent to recognize the specific obsessions and compulsions that the student exhibits, allowing for lessons tailored to their unique needs.

Strategies for Teaching Students with OCD

Here are some teaching strategies that can help educators effectively support students with OCD, drawn from various sources:

1. Be flexible with due dates and the completion of schoolwork. Students with severe checking rituals may struggle to finish their assignments on time.
2. Respect the physical boundaries of students who have a fear of germs. Many students with OCD become highly agitated when touched.
3. Shorten assignments that require extensive handwriting, such as writing exercises.
4. If students are working on long-term projects, like research papers, allow them to submit components of the project separately.
5. Provide students with notes or outlines summarizing daily lessons. This will help students with OCD, who often struggle to organize materials.
6. Use alternative testing methods, such as multiple-choice questions or including a word bank for fill-in-the-blank questions.
7. Recognize the need for students to perform certain ritual actions, such as hand-washing or counting.
8. Keep an eye out for less noticeable OCD behaviors, such as silently counting or staring without blinking.
9. If you observe a student seemingly daydreaming or talking to themselves, take a closer look before reprimanding them.
10. Always remember that the child cannot control their actions and requires support from the educator.
11. Do not try to handle the situation alone. Collaborate with outside agencies and professionals who have more direct knowledge of the treatment process and the child’s needs.

While these strategies are helpful, they are not exhaustive. There are many educational websites and resources available to offer more information and guidance. Conducting keyword searches or using specialized literature can help educators better understand how to support students with OCD.

Helping a child with OCD can be difficult and frustrating. However, parents play a crucial role in supporting educators by providing insight into the child’s behavior at home. By sharing what works and what doesn’t, parents can help educators develop more effective strategies. Varying assignments and offering specific instructional direction can be beneficial, but educators must always keep in mind the nature of the disorder. Teaching special needs students with OCD requires understanding, flexibility, and creativity. The student will always benefit from an informed educator who applies their knowledge in a way that caters to the individual needs of the student.