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Hayley van Zwanenberg provides a useful guide to supporting children with OCD at home and at school

Children often find expressing their emotions difficult, so it can be challenging for a parent, carer or teacher to recognise when a child is suffering from a mental health problem such as obsessive compulsive disorder  (OCD).

Early intervention can help to prevent the condition from becoming anything more serious that could impact a child’s quality of life later on. Therefore it is important to be able to recognise signs of OCD so that a child with the condition can get the support and care they need.

What is OCD?

OCD is an anxiety disorder made up of two parts – obsessions and compulsions. Obsessions can occur in the form of thoughts, images or urges. These come into a person’s mind when they do not want them and can be extremely upsetting. Compulsions are the actions a person carries out to manage or get rid of their obsessions, while helping to reduce the anxiety associated with them.

OCD symptoms can differ between children and adults. Children are likely to have different concerns to adults. They can also experience solely compulsions or just obsessions. If a child doesn’t have obsessions and compulsions in equal parts, this isn’t a reason to overlook the symptoms.

OCD symptoms at school

If you are the teacher of a child you think may have OCD, here are the symptoms to look out for:

  • frequently getting up from their assigned chair to carry out repetitive behaviour
  • avoiding equipment and not interacting with children in the playground
  • worrying about writing neatly or keeping their desk organised, to the point of anxiety
  • constantly requesting to go to the bathroom
  • asking repetitive questions and regularly seeking reassurance
  • being unable to shift between subjects easily
  • retracing or counting steps
  • being frequently disengaged and not listening in class.

OCD symptoms in the home

At home, there are also signs to look out for that could indicate a child has OCD:

  • doesn’t want to play with other children or unfamiliar toys
  • frightened at the thought of catching germs
  • collecting or hoarding objects in high volumes
  • washing their hands and possessions repeatedly
  • constantly worrying that a mistake could have a disastrous impact, such as the house burning down or a parent dying
  • repetitive or ritualistic movements with irrational justifications
  • repeatedly tapping objects and making sure objects are in the right place
  • preoccupation with death, religion and abstract concepts such as good and evil
  • obsession with special numbers
  • asking for words to be repeated from the television that they believe they have missed
  • asking for certain phrases to be repeated over and over.

OCD symptoms in a child may not be consistent and may increase and decrease over time. It is important to note that this is the natural course of the illness and isn’t a sign of recovery, so it is still crucial to take steps in order to get the child the care that they need.

What to do if you think a child has OCD?

Children can sometimes struggle to explain how they feel. As a parent, teacher or carer, you are in the best position to act as a confidante. These tips can help you to get a child to open up and talk about their emotions.

Teachers:

  • introduce self-soothe boxes into the classroom; allow children to decorate the boxes and place items in them that help to relax them. They can go to these boxes when they start to feel upset
  • use PHSE lessons or group time to talk about mental health; encourage children to talk about when they were last anxious or worried, and what they did to overcome these feelings; this can
  • help them to learn coping strategies for any future situations
  • have time for relaxation; have a keyword or phrase for a relaxation exercise that you use at some point in the day. When you say the word, everyone should stop and practice the skill.

Parents:

  • listen to why a child is upset or anxious; acknowledge that you understand their feelings before you distract them with something more positive
  • take time out to talk; many children don’t understand the depths of their emotions. When you see a child feeling a certain way, point out the emotion, name it, and explain why they may be feeling it
  • set boundaries and be flexible with routines; it is important for a child to learn that everything will be fine if the same routine isn’t followed all the time.

How to get the right support for the child

OCD symptoms can be a worrying experience for a child. The earlier you can treat a child for their condition, the greater the impact the support is likely to have.

If you think a child that you teach or care for is expressing worrying signs, these steps can help you ensure they get the support they need.

How a teacher can help:

  • arrange a meeting with the child’s parents. This may be a difficult meeting, so ask the headteacher or a senior colleague to accompany you for support
  • talk the parents through the signs you have identified and encourage them to talk to a medical professional
  • assure parents that you will continue to do all you can to support their child; show them some of the strategies you have in place – or want to implement – to help their child cope with OCD.

How a parent can support

  • talk to your GP; they can arrange a referral to your local child and adolescent mental health service. Here, you and your child can discuss their symptoms with a health professional, who can
  • advise on the next steps
  • alternatively, you can talk to a private practice; here, they will be able to provide practical guidance or help arrange an appointment
  • speak to your GP or health professional about your own feelings; this can help to make sure you get the information and support that you need.

Further information


Dr Hayley van Zwanenberg is a consultant child and adolescent psychiatrist at Priory Group, which offers specialist treatment for people suffering from obsessive compulsive disorder:

www.priorygroup.com


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