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Does my child need an IEP for OCD?

IEP's, or Individual Education Plans, are plans put in place by schools for children with disabilities to ensure that they are in the best position to succeed educationally, socially, and emotionally. IEP's are commonly used for children with psychological differences including autism spectrum disorder, ADHD, dyslexia, and more. As a psychologist who frequently works with children and adolescents, I have helped may families and schools create and maintain IEP's built to help children succeed. However, I always hesitate in creating an IEP for children with OCD.

Children and adolescents with OCD are besieged by intrusive thoughts, or unwanted, unpleasant, often inappropriate thoughts that cause anxiety or discomfort. As a result, they perform compulsions, or actions/thoughts to neutralize the initial thought. This pattern can grow until it takes over a child's life. Treatment for OCD is called Exposure and Response Prevention (ERP), and focuses on helping the child or adolescent challenge their unwanted thoughts instead of placate them. For instance, if a child is afraid of germs and is not using the restroom at school, good ERP will give the child a rational to challenge their OCD and then help them to face their fear by purposefully contaminating themselves, showing their OCD that they are in control and can get "contaminated" used the school restroom, and move on with their day.

When a child or adolescent is struggling with their OCD their school performance will likely suffer. The first instinct of many parents, teachers, and school counselors is to put accommodations in place for a child with OCD. This is always done with the best intention, but there is a problem with giving OCD accommodations either at school or at home: accommodations feed OCD. If a child with OCD is allowed to say, stand by their desk instead of sit because sitting triggers their OCD, they may gain some functioning and focus for a short time, but OCD will always ask for more. Without a pressure against the OCD, like the need to sit in a chair at school, or use a restroom, OCD will often become more severe leaving the child or family in a worse position then where they started.

As an OCD provider I prefer to constantly and consistently challenge OCD at home and at school. This would mean taking all opportunities to perform ERP when faced with intrusive thoughts or feelings which is at-odds with an IEP.. However, this is not always possible. I have helped children and adolescents get IEP's for OCD. Sometimes they are struggling so significantly that it is necessary to have them continue in school. However, I always make a plan for them to have accommodations at school for a set time, work on OCD symptoms that directly impact school functioning, and reclaim their lives. If your child is struggling with OCD and has or is trying to get an IEP, please find an OCD specialty therapist or contact me and make sure you have a plan to help your child succeed in school and with their OCD.

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