Disorder in Children - Symptoms and Treatment
"1,2,3,4,5. Now the door is locked"
~Jack Nickelson playing a person with Obsessive-Compulsive
Disorder in the film, "As Good As It Gets"
I. What is Obsessive-Compulsive
We have all, as children, wished upon a star
or skipped over cracks in a sidewalk. A person suffering with
Obsessive-Compulsive Disorder will do and think these kinds
of things to the point where these thoughts and rituals rule
their lives. They feel helpless and at the mercy of these
persistent thoughts and rituals.
Obsessive-Compulsive Disorder (OCD) is characterized
by thoughts (obsessions) and/or actions (compulsions) that
affect the ability of the sufferer to cope successfully in
society. OCD has a significant impact on its sufferers' ability
to go to school, work and socialize without stress.
It is estimated that one in 200 children or
adolescents in the United States has varying degrees of Obsessive-Compulsive
Disorder (OCD). Research shows that OCD tends to run in families,
but it does not necessarily follow that a child will develop
OCD even though another member of their family has the disorder.
II. What are the symptoms of OCD?
For children, rituals are a very important
part of life. Children like to be tucked into bed around the
same time every night, after a bedtime story, after brushing
their teeth, etc. Children like to be able to depend on the
consistency of everyday living. It is only when the patterns
become ritualistic: for instance, the brushing of teeth many
times over, the over concern with worries, that do these thoughts
and rituals become problematic.
Obsessions: Obsessions are thoughts that occur
over and over again. The person feels out of control with
their thoughts. Some common obsession symptoms are: losing
control of urges, over concern with contamination and germs,
imagining harming others or self or worry about harm coming
to others or self.
Compulsions: Compulsions are the acting out
of obsessive thoughts. They bring a small bit of relief to
the obsessions. For instance, a child who is afraid of an
intruder breaking in to harm his or her family may compulsively
keep checking the doors at night to make sure they are locked
securely. They will check the doors over and over again, fearful
that they've missed something. Some common compulsive symptoms
are: washing, checking, counting, arranging things, hoarding,
touching, and repeating.
III. How is OCD Diagnosed?
A teacher or guidance counselor may suspect
a child may have OCD may refer the parents to a psychiatrist
who will review the behavior with the child and the family.
Family physicians, mental health centers can make referrals
to mental health professionals who may provide treatment.
There are doctors and specialists who specialize in the treatment
Diagnosticians use a series of checklists
in order to help them diagnose OCD. These are measurement
scales. Among the different measurement scales are the Yale-Brown
Obsessive-Compulsive Scale: this is a 1- item scale that measure
how severe the symptoms are in OCD patients. The Patient Self-Rating
Scale is a seven item scale that compares the patient's current
status with that before treatment. The National of Institute's
of Mental Health's Global Scale measure and rates obsessive
and compulsive symptoms against how well the patient functions.
IV. How is OCD Treated?
Medications have been shown to be very effective
in treating OCD. The SSRI group of medications are now used
to control the symptoms of OCD. These medications are not
curatives but do help the patient reduce the symptoms by 50-80%
or more. Some of these medications include Prozac, Luvox and
Psychotherapy combined with medication and
cognitive-behavioral therapy has been shown to be the most
effective way of treating OCD.
V. I suspect my child
has OCD. What do I do now?
Professionals to Seek Out
- See your physician or pediatrician
- Consult with your clergy to assist in spiritual
- Consult with an educational consultant
to help you
find the right program for your child.
- Consult with a therapist or counselor.
- Consult with an Educational Advocate to
you with your current school situation
- Consult with an Educational Consultant
to find the
right program for your child.
out more about Educational Consultants
- Inpatient: hospitalization
Outpatient facilities have therapeutic staff on-hand to
offer therapy and support to patients on a part-time basis.
Emotional Growth schools are highly structured environments
that stress academics and teach coping skills through the
use of conflict resolution. Children learn they can make choices
and learn to accept responsibility through the use of modeling
behavior and outdoor therapy. The length of stay is between
9 and 18 months, at which time they either return to the mainstream
or attend a boarding school, if possible. Parents are involved
with the school staff and the children throughout the child's
attendance at the school.
out more about Outdoor Therapy
Residential Boarding School
These schools are usually fully accredited schools with emotional
growth programs. They stress holistic education: growth of
the person through holding children responsible for their
actions. There is no rehabilitation or physicians on staff.
A Therapeutic Wilderness program does not necessarily have
academics; their goal can be to introduce the children to
a different role. These programs use Outdoor Therapy to help
build low self-esteem. They make obtainable goals for them
to reach. The programs vary but they are about 6 to 8 weeks
long. It is a very structured program with a goal of teaching
the children coping skills and raising their self-esteem.
Children go from this program to mainstream back into their
public school or attend a small structured boarding school.
more about Therapeutic Wilderness Programs
d. Residential Treatment School
A Residential Treatment Program or School provides a full
professional staff that includes therapists, psychologists,
and psychiatrists. They also have a small academic program.
Many of the children in the program have been recommended
there by mental health agencies that make the placements.
It is a highly structured environment whose emphasis is on
treatment and learning coping skills and independent living.
Chemical dependence education and rehabilitation is also provided.
Outdoor therapy is sometimes used to facilitate building social
skills and self-esteem. Recovery programs are also available.
Residential Treatment schools are secure schools.
more about Residential Treatment Schools
program is right for my child?