Troubles in School
It's impossible to know exactly how your child's OCD symptoms will affect his behavior, performance and overall experience in school. However, it's likely that school will present at least some challenges. For example, classrooms can generate numerous distractions for children who have counting compulsions.
Shared bathrooms may give rise to terrible anxiety on the part of a child who suffers from contamination fears. A young person who has perfection obsessions may hand in tests and papers late, because he's still not “finished” with them, or because he may feel driven by impossible standards.
OCD can produce seemingly bizarre symptoms such as fear of school lunches or even of other children. (Please keep in mind that, to your child, these worries are as real as any you might experience, yourself.) Your child may suffer from debilitating social phobias or find ambient noises intolerable. (On the plus side, observant elementary school teachers have been known to pick up on early signs of OCD in children in their classrooms, leading to sensitive consultations with parents, and early diagnosis and treatment.)
On the other hand, your child may be subject to touching compulsions, perhaps finding it impossible to refrain from touching or even kissing other students (obviously, a more common problem in younger children). How you and your child's school choose to handle these behaviors will depend to a large degree on attitudes, knowledge, creativity, and other factors.
It would probably be wise to discuss your child's situation with his teacher (or other administrators, if appropriate). Sometimes, simple modifications can go a long way toward helping your child to feel less anxious and to perform well at school.
Your child may find that other children pick on him because of his OC behaviors. If this happens, please make sure to talk with his teacher or school administrators. It should be clear to them, and to the children creating the problem, that bullying is not acceptable and will not be allowed. Most schools, in fact, now have zero-tolerance policies about bullying.
Creative solutions for bathroom fears might include allowing the child the use of a faculty facility. Or, if noise is a problem, permitting tests to be taken in an area away from the classroom. Lunch and beverages from home might take care of food phobias, at least to a degree. If your child is displaying inappropriate or aggressive behavior toward other students, of course, you will need to work on getting that under control. Parent support groups and organizations may be able to offer helpful ideas for situations like these.
If your child has washing compulsions but is limited in the number of times she may get up to leave the classroom, hand sanitizer might do the trick. (Do see that she also has topical moisturizer to take to school, though, especially if dry skin becomes a problem.) The teacher might need to repeatedly let a child with perfection compulsions know that he is not expected to turn in absolutely mistake-free work each time. Or she might allow him to type assignments on a computer, even though the other children turn in reports written by hand.
Children sometimes outgrow obsessions (about 20 to 25 percent do; another 49 percent or so will see enormous symptom reduction over time). A child or anyone else who truly has OCD is not faking symptoms for sympathy or attention. Her worries or obsessions are, most likely, a kind of torture. She deserves support and treatment.
You get the idea: A little imaginative problem solving, with a hand from your child's “team,” while you work on getting help for his OCD symptoms, can make school a more productive and less anxious place for him.
How to Talk to Your Kids about OCD
OCD — yours or your child's — can be talked about truthfully in a matter-of-fact way. You might want to choose words along the lines of: “OCD is a disorder of the brain that can make people have upsetting thoughts or fears about unlikely things. Having OCD doesn't mean you are crazy. It may mean that you feel nervous more often than other people do, or that you do things that might look strange. With some work, it can be managed so that you can do your work and live your life without too much bother.” Emphasize that you love and care about your child, and will do whatever you can to help and be supportive.
Most children's attention spans are on the short side. You probably won't need to say more than this, but do make yourself available to answer any questions your child might have. You don't have to know all of the answers right away.
It's okay to say you will try to find out, and to follow up by doing so. Other people, such as your child's therapist, may be able to answer questions that you can't — and, in so doing, educate you and your child both. There are also many excellent books and online resources about childhood OCD.
Talking to the Teacher (or Principal)
You will undoubtedly want to discuss your child's situation with his teacher and perhaps one or two administrators, as well. Most schools today are well aware of many of the challenges faced by modern children. While OCD is relatively rare, it is certainly not unheard of. Aside from this,
Although you may be on the lookout for side effects when your child begins a course of medication, do not forget later on that medication may be the cause of heretofore unexplained physical symptoms or behaviors. Discuss any concerns, whenever they crop up, with your child's doctor.
How equipped and aware your child's school is should determine what you'll discuss. Assuming the teacher and principal don't know much at all about OCD, here are some things you might want to keep in mind for your discussion:
Foremost, you will want them to understand that your child's seemingly strange behavior is caused by an overabundance of worry or doubt, or sensitivity to things like noise or light. (Those particular sensitivities are more often seen in younger children.) It is not indicative of a behavior problem, or caused by a lack of discipline. Your child doesn't want to be a prisoner of ritual or anxiety, but is.
Perhaps you can identify the most troublesome aspect of classroom life for your child and his teacher and work on a solution together. For example, if your child is particularly sensitive to sound and can't concentrate during tests because of ambient noises, a test-taking spot in the library or conference room might be arranged for him.
If your child has perfection compulsions, it may be wise to let the teacher know. While effort should, of course, be rewarded, it might be better for the teacher to let your child know that her work is not expected to be perfect. One wise first-grade teacher lets all the kids know early on that mistakes are absolutely necessary — and publicly revels in her own! — as they become teachable moments from which everyone can learn.
Communication will probably serve all sides well. Be sure your child's teacher lets you know, from time to time, how things are going, and of any problems that might arise. Similarly, if you're working with a therapist on cognitive behavior techniques, you will probably want to enlist the teacher's help as well; it will be useful to be as specific as possible, so the teacher can be “on the same page” as you and your child's therapist.
OCD may, and probably will, cause your child distress. But it is not life threatening, just unpleasant and a little unusual. Along with your child's therapist and school “team,” you can help your child to see OCD as a manageable nuisance or a simple, perhaps even truly special, difference.
The public school system, by the way, is obligated by law to provide what is called “free and appropriate education” to all of its students. In other words, a public school or teacher may not lawfully discriminate against your, or any, child because she has OCD. Or for any other reason.
In some cases, OCD may qualify a child for special education services (which may be a good idea if your child's symptoms are getting in the way of his getting an education). This usually requires an evaluation by committee, and its decision can be appealed, if you wish. The school may need to provide reasonable special accommodation, although it also can make a case for refusing to do so (and will, just as often as not, because of budget restrictions). More information about working with school systems is available in books and online. (Additional resources are listed in Appendix A.)