For most of my career, I have been working with children and youth with Obsessive-Compulsive Disorder (OCD). OCD is more common in students than many realize, affecting approximately 2% of the population. This neuropsychiatric illness often begins in childhood and has significant consequences in students' lives, affecting not only their academic but also family and social functioning. As parents and educators, understanding OCD and implementing effective support strategies is essential to helping these students thrive.
Both my PhD and post-doctoral research focused on better understanding how youth with OCD function at school. I spent over 8 years conducting standardized testing and collecting survey data on hundreds of kids with OCD, their siblings, and those without such a diagnosis (called "healthy controls"). This work was extensively supported by the Provincial OCD Program at the BC Children's Hospital and would not have been possible without the outstanding guidance of Dr. Evelyn Stewart. The findings from these studies, along with prior research, highlight several factors that are crucial for understanding and supporting OCD in schools.
The Impact of OCD on School Life
Students with OCD face unique challenges that can affect their academic performance and behaviour in the classroom. School avoidance, refusal, and lower academic achievement are common (Geller et al., 1998), so it's important for educators to recognize and address these problems quickly. Academic difficulties are often most noticeable in high school, though some improvement might be seen in college (Pérez-Vigil et al., 2018). These students may also struggle with math (Negreiros et al., 2018) and have difficulties with executive functions (Negreiros et al., 2019; Snyder et al., 2015) and social interactions (Storch et al., 2006).
Executive function is a set of skills that help our brains get things done, and it's been widely studied in kids with OCD. Many studies show that children with OCD have more trouble with planning, working memory, cognitive flexibility (switching between tasks or thoughts), and inhibitory control (suppressing inappropriate behaviours or responses) compared to their peers. My dissertation research found that both students with OCD and their siblings struggle with planning (Negreiros et al., 2019).
Schools and families might consider providing extra support to help these kids achieve their goals. This could include using organizational tools (like planners and automatic reminders), supportive strategies (like breaking tasks into smaller steps and setting priorities), and skill-building exercises (like time management techniques such as the Pomodoro method).
Recognizing OCD in the Classroom
OCD can manifest in ways that might be misunderstood as daydreaming, misbehaviour, or lack of interest. Students might seem distracted, engage in repetitive behaviours, or appear excessively concerned about cleanliness, order, "bad thoughts," or doing their work in a "just right" way, taking much more time than needed to complete activities or show their true potential. Understanding these behaviours as symptoms of OCD, rather than simple defiance, inattention, or boredom, is the first step in providing effective support.
Building a Supportive Environment
Creating a supportive environment for students with OCD starts with knowledge and awareness. Educators should familiarize themselves with OCD symptoms and their impact on students' lives. The following resources can be helpful to start the knowledge-building process:
Anxiety Canada: https://www.anxietycanada.com/
OCD Education Station: http://www.ocdeducationstation.org/
OCD in Schools from IOCDF: https://anxietyintheclassroom.org/
OCD at School from ADAA: https://www.adaa.org/understanding- anxiety/obsessive-compulsive-disorder/ocd-at-school/hidden-symptoms
OCD in Schools Handout that I created for schools: https://www.anxietycanada.com/downloadables/identifying-and-supporting-students-with-ocd-in-schools/
For books, here are some suggestions:
Students with OCD: A Handbook for School Personnel (by Adams)
Teaching Kids with Mental Health and Learning Disorders in the Regular Classroom: How to Recognize, Understand and Help Challenged (and Challenging) Students Succeed (by Cooley)
Teaching the Tiger: A Handbook for Individuals Involved in the Education of Students with Attention Deficit Disorders, Tourette Syndrome or Obsessive-Compulsive Disorder (by Dornbush & Pruitt)
Effective Communication and Collaboration
Open communication and collaboration between home and school are vital. In fact, one of the studies I led showed that when families disclosed their child’s OCD diagnosis to the school, such disclosure had positive outcomes for their child (Negreiros et al., 2022). Thus, the collaboration between educators, families, and mental health professionals is likely to foster a more understanding and supportive classroom atmosphere.
To achieve this, establish a communication system that ensures everyone under the student's care is on the same page regarding their needs and progress. In addition, collaborating with mental health professionals specialized in pediatric OCD to develop individual educational plans (IEPs) can improve the student’s ability to manage their symptoms at school.
Practical Classroom Strategies
Implementing practical strategies in the classroom can greatly assist students with OCD. Consider using a prearranged signal system that allows students to discreetly indicate when they need help managing their symptoms or need a break. Designating a safe person and a safe place for students to go when they are struggling can provide immediate relief and support. Additionally, providing temporary accommodations, such as extra time for assignments or a quiet space for tests, can help students manage their workload without feeling overwhelmed. If you want to learn more about why accommodations for students with OCD (and anxiety) should be temporary, check out this Podcast, where I provide the rationale for it.
Celebrating Progress
Finally, it’s important to celebrate the successes and progress of students with OCD. Recognizing and acknowledging their efforts in managing their symptoms can boost their confidence and motivate them to keep striving. Creating a positive and supportive school environment not only helps students with OCD but also enriches the entire classroom community.
Last Words
Supporting students with OCD requires a comprehensive approach that includes understanding the disorder, fostering open communication, and implementing tailored strategies. By working together, educators, parents, and mental health clinicians can create a nurturing environment that helps students with OCD thrive both academically and socially. Let's embrace the opportunity to make a meaningful difference in these students' lives, ensuring they feel supported and understood every step of the way.
About the author: Dr. Juliana Negreiros is a registered psychologist and the founder of Beacon Psychology Clinic. She has dedicated most of her career to supporting young people with OCD and anxiety.
