Author: Natasha Boskic

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2.10 Children with Communication Disorders: Fluency Disorders

Fluency Disorders

Children with fluency disorders have difficulty with the flow of their speech. They often struggle to get their words out. The most common type of fluency disorder is stuttering. In stuttering, children usually:

  • Repeat the first syllable of a word (for example, “ ba ba ba ba baby”);
  • Repeat the first word in a sentence (for example, ” I I I I need help”);
  • Stop in the middle of a sentence and say nothing (for example, “I want ——some juice”).

Children who stutter do not stutter all the time. Stuttering appears to happen in certain situations. The child’s stuttering may get worse if he or she is placed in a stressful situation (speaking in front of the entire class is an example of a stressful situation). Many young children stutter at one point or another in their lives. Some overcome it on their own without the help of a speech and language pathologist. But according to the Stuttering Foundation of America, if a child stutters for more than three to six months or if the stuttering is severe, an appointment with a speech and language pathologist should be made as soon as possible.

The causes of stuttering are not clear. Genetics could play a role in stuttering because it appears to be mostly a boys’ disorder (the boy/girl ratio is 4/1) and it seems to run in families. Also, children who are under extreme amounts of stress and are asked to do a lot more than they can handle could also stutter. However, according to the Stuttering Foundation of America, there is no indication that children who stutter suffer from serious psychological and/or mental health disorders.

Children who stutter are not placed on an Individual Education Plan (IEP) in school. However, the teacher could help them by (adapted from the Stuttering Foundation of America (Fig. 1)):

working with kids

Figure 1. Working with kids
  • Being patient and giving them all the time that they need when talking;
  • Not telling them to “slow down” or “relax;”
  • Never finishing their sentences for them;
  • Only asking them questions for which they know the answers (at least in the beginning);
  • Allowing them to give answers by using short, simple sentences;
  • Expecting the same amount of work from them. Children who stutter should be allowed to use shorter sentences. At the same time, they should be expected to submit the same assignments or work as everyone else;
  • Allowing them to read along with someone else during oral reading assignments. This reduces the anxiety level and therefore the degree of stuttering.

Most children who stutter are happy, and they turn into happy, healthy, and well-adjusted adults. They lead full lives and are active and contributing members of society.

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2.10 Children with Communication Disorders: Language Disorders

Language Disorders

Language disorders fall into three categories. Information on each is discussed below.

Receptive Language Difficulties

Children with receptive language difficulties have trouble understanding what others may be trying to tell them. They often:

  • Have trouble following directions, even simple ones;
  • May appear to not to be paying attention to what is happening around them;
  • May appear to be defiant (for example, they may appear not to follow the rules);
  • May not like books or being read to;
  • May avoid language-based activities (such as storytelling or show and tell);
  • May not understand jokes;
  • May be literal in their thinking and may not understand figurative speech (for example, “it’s raining cats and dogs”).

Many children with receptive language difficulties also have expressive language difficulties (please see below). That is because one needs to understand language in order to learn and develop it.

Children with receptive language difficulties do not usually have an Individual Education Plan (IEP) at school. However, the school teacher could help them by:

  • Using simple language when giving them instructions;
  • Breaking down what they have to do into small steps;
  • Repeating a direction or instruction several times;
  • Making sure the child is familiar with any language used in a test;
  • Encouraging (but not forcing) the child to read and speak;
  • Using signs and gestures in combination with oral language when communicating with the child (Fig. 1).

communication

Figure 1. Communicating with children

Some children with receptive language difficulties may have anxiety in social situations. In cases of serious anxiety, regular session with the school counselor may be needed.

To learn more about receptive language difficulties, please visit the zero to six section of this course.

Expressive Language Difficulties

Children with expressive language difficulties have trouble letting others know what they want. They may:

  • Take a long time to say a sentence;
  • Use only very simple language;
  • Make a lot of grammatical mistakes (for their age);
  • Have a smaller vocabulary than their peers;
  • Struggle when it comes to naming objects;
  • Use the wrong format when asking questions (for example: “why you not want?”) or using negations (for example: “me no want”);
  • May repeat the same thing over and over again;
  • May have difficulty retelling basic parts of a story;
  • May struggle when someone asks them to talk about their experiences in detail.

Some children who struggle with expressive language also struggle with receptive language. Most of these children do not usually have Individual Education Plans (IEPs) at school. The classroom teacher can still help them by:

  • Giving them all the time they need, when they are trying to communicate something to someone;
  • Giving them the week’s vocabulary list in advance so they can study it at home;
  • Encouraging them to speak with others;
  • Encouraging them to read.

Some children with expressive language difficulties may have anxiety in social situations. In cases of serious anxiety, regular session with the school counselor may be needed.

To learn more about expressive language difficulties, please visit the zero to six section of this course.

Apraxia

Apraxia is an umbrella term that covers a set of disorders that have to do with the motor aspect of language. Children with apraxia understand language well, but their brain seems unable to make their mouths move in order to produce the words necessary for speech. These children may:

  • Take a long time to produce a word. They know exactly what word they want to say, they just cannot say it (that is because the brain has trouble telling the muscles of the mouth what to do);
  • Use very simple sentences;
  • Say words out of context (that is, a child may want to say one word, but another word, closely related to it, may come out of his or her mouth);
  • May have difficulty with fine motor skills;
  • May struggle with reading and writing;
  • May appear uncoordinated or clumsy.

In the classroom, the regular educator can help children with developmental apraxia of speech by offering them the same type of support that they would offer children with expressive or receptive language difficulties.

To learn more about apraxia, please visit the zero to six part of this course.

Children with expressive and/or receptive language difficulties and those with apraxia need the help of the speech and language pathologist (SLP). The SLP will help them with all aspects of language and could also help them improve their reading skills. Children with apraxia could also benefit from Occupational therapy (OT) services.

Most children with such disorders grow to lead full and healthy lives. They participate in every aspect of life, just like everyone else.

a girl with a book

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2.10 Children with Communication Disorders: Articulation Disorders

Articulation Disorders

Children with articulation disorders have trouble saying certain letters and letter sounds. Although they have typical intelligence, their cognitive and academic development appears to be slightly behind that of their typically developing peers.

Children with articulation disorders usually make the following mistakes when talking:

  • Omissions: leaving out one or more sounds from a word,  for example,  saying “kool” instead of “school”;
  • Additions: adding a sound to a word, for example, saying “p-a-lease” for “please”;
  • Substitution: changing one sound for another, for example, saying “wabbit” for “rabbit” or “tlee” for “tree.”

To learn about the development of speech sounds in children in the English language,  visit this website. Children with articulation disorders usually receive speech therapy. In the classroom, teachers can help them by:

  • Being patient and giving them all the time they need when talking;
  • Not finishing their sentences for them;
  • Saying what the child said wrong the correct way, but without reprimand (for example,  if the child says “I went to kool yesterday,” the teacher could respond by saying “You went to school yesterday, wow.”);
  • Encouraging them to talk and read.

Most children with articulation difficulties grow up to be typical adults. Some overcome their difficulties and others do not.

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2.10 Children with Communication Disorders

Children with Communication Disorders (CD):

Children with CD struggle with language. They may struggle with one or more aspects of language (please see below). These children appear to be developing typically in every way except language. They usually have typical intelligence but may struggle with various aspects of development because of the difficulties that they experience with communication.

There are many types of communication disorders. The most common types are:

Having a communication disorder can have serious impact on development:

  • Cognitive skills: most children who have a CD have typical intelligence, but many have IQ scores (see full Glossary) that fall in the low average range. Also, because cognition and language are related, delays in language could impact the development of some cognitive skills, such learning about colors (Fig. 1), shapes and other concepts;
  • Academic skills: most of what children learn in school (for example, reading and writing) is language-based. Delays in language could have a negative impact on language development ;
  • Social/emotional: social skills are related to good language skills. Most of us communicate with others by using language, so  a language delay could have a negative impact on the child’s social skills. Children who have difficulties with their social skills may have low self-esteem and poor self-confidence, which affects their emotional skills.

colour wheel

Figure 1. Colour wheel

In the next sections, we will discuss the major types of CD.

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2.8. Children with Chronic Illness: Asthma

Asthma

To get general information about asthma in children, please visit the zero to six portion of this course.

Children who have asthma experience difficulty breathing. This is  caused by a constriction of the airways in the lungs (Fig. 1). Asthma attacks can last a few minutes or a few days. Some attacks are more acute or intense than others. An intense (or acute) asthma attack can look very frightening, especially to a child who may be watching a classmate during an asthma attack. Some of the signs of an asthma attack include (adapted from the BC Ministry of Education):

lungs

Figure 1. Lungs
  • Coughing and wheezing;
  • Feelings of tightness in the chest;
  • Looking pale and tired;
  • Sweating;
  • Difficulty walking and/or talking;
  • Difficulty breathing.

An asthma attack can be triggered by exposure to certain products or materials. It is very important that classrooms be free of these materials, if they do trigger asthma attacks in a child. They include:

  • Dust;
  • Art and craft supplies (which may need to stored outside the classroom, when not in use);
  • Strong odors;
  • Chalk dust;
  • Pollen in the spring and fall (Fig. 2).

pollen in the spring and fall

Figure 2. Pollen in spring and fall

Children who have asthma can be at a disadvantage in school because they tend to be absent more often than other children. They sometimes perform less well academically than their peers because some of them miss many school days each year. In order to make sure that children who have asthma still feel that they belong in the classroom, teachers can:

  • Make outlines of class lessons and mail or email them to the family;
  • Write a “get well soon” card, get all the students to sign it, and send it to the family;

Children who have asthma do not usually have Individual Education Plans (IEPs). The school nurse is usually involved in the child’s care, and knows how and when to intervene if the child has an asthma attack at school. The school nurse can also train other staff what to do in case the child suffers a major asthma attack.

Children who have asthma will need to be monitored and may need extra help. Here are a few suggestions:

  • Lines of communication should be kept open between the family and the school. Parents can update the school about any changes in their child’s condition;
  • An emergency plan should be put in place so caregivers  know what to do should the child suffer a major asthma attack;
  • The signs and symptoms of an asthma attack should be made known to those who work closely with the child;
  • Classmates and other students should be told about asthma and how it is treated. They should also be made aware of the signs and symptoms of an asthma attack. Knowing what to expect in case of an asthma attack may make it easier on the children to see one if it ever occurs in their presence.

Some children who have asthma may experience sadness because they may not be able to participate in certain types of sports or because they cannot be in certain places (for example, in the park in the spring and fall, when pollen is at its highest level). It is very important that the child’s mental health be monitored and that regular sessions with the school counselor be provided if and when they are needed.

Some children who have asthma will need medical treatment. To learn about some of the medical treatments that are available to children with asthma, please visit the birth to six section of this course.

Most children who have asthma grow up to become fully contributing members of society. They lead full and typical lives.

a boy with asthma

Figure 3. A boy with asthma
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2.8. Children with Chronic Illness: Cancer

Cancer

To get general information about childhood cancer, please visit the zero to six part of this course.

Children who have cancer form a very special group. These children grow up knowing that they may not reach adulthood. They are children who take a lot of medications, some of which have serious side effects. They are children who may go through chemo- or radio-therapy, which also have serious side effects. Because of that, many children with cancer miss a lot of school days. When they do attend school, they may have low energy and may not be able to participate in some classroom or playground activities. They may not be able to participate in physical education classes. Teachers need to be aware that certain arrangements may need to be made for these children. Such arrangements include:

  • Making outlines of class lessons and mail or email them to the family, when the child misses more than one or two days of school. Communication between the teacher and the parents is essential. Teachers need to know whether or not it is appropriate to send these lessons or outlines to the family. That is, if the child has had a particularly difficult chemo-therapy session, and is having a hard time recovering from it, sending the lesson to the family may not be appropriate, because the family and the child would be dealing with the medical aspect of the child’s disease. It is essential that teachers ask parents whether or not the lesson or lesson outline should be sent to them;
  • Writing a “get well soon” card, getting all the students to sign it, and sending it to the family (Fig. 1);
  • Periodically mentioning the child who is absent in order for his or her classmates not to forget about him or her, and also in order for the children who may be worried about their classmate to know how he or she is doing;
  • Talking about and discussing childhood cancer in the classroom. Teachers can even read a children’s book about cancer, to the entire classroom. One such book is “I Have Cancer”.

Get well soon letters

Figure 1. Get well soon!

Children who have cancer do not usually have Individual Education Plans (IEPs). They are usually monitored by the school nurse, who watches their development and behavior very closely. The school nurse could also help children with cancer with any medication they may have to take at school. In order to make sure that children who have cancer are safe at all times, it is recommended that teachers:

  • Communicate frequently, or as frequently as possible, with the child’s parents;
  • Have a plan ready, in case the child has to be rushed to the hospital;
  • Inform the child’s classmates that the child may appear very tired at times (this should be mentioned very sensitively. Children need to understand why their classmates may not always be able to participate in certain activities with them).

Some children who have cancer (Fig. 2) may experience sadness because they know that they have a very serious disease that may end their life. Others may be sad or frustrated because they may not be able to participate in certain types of activities.  It is very important that the child’s mental health be monitored, and that regular sessions with the school counselor be provided if and when they are needed. For children who experience serious levels of sadness and, perhaps, depression, regular sessions with a clinical psychologist may be recommended.

Figure 2. With cancer

To learn more about childhood cancer, please visit the birth to six section of this course.

Some children who have cancer get cured from it. They grow up to become fully contributing members of society. Others pass away in their teens or early adult years. It is important to keep that in mind when working with a child who has cancer.

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2.8. Children with Chronic Illness: HIV and AIDS

HIV/AIDS

To get general information about HIV and AIDS, please visit the zero to six part of this course.

Children with HIV/AIDS have a different experience with school and life than their peers. They live with the knowledge that they may die. Some of them may miss a lot of days of school. Others may perform less well than their peers in some or all academic areas. Most children with HIV/AIDS have typical intelligence, but they still perform less well academically than their peers, either because they miss too many days of school, or because their illness makes it harder for them to concentrate.

Because some children with HIV/AIDS miss a lot of days of school, there are things the school teacher can do  to make sure that these children still feel that they belong in the classroom. The following can also help the classmates of these children feel that their peer is part of the classroom, when he or she is not there physically:

  • Make outlines of class lessons and mail or email them to the family;
  • Write a “get well soon” card, get all the students to sign it, and send it to the family;
  • Periodically mention the child who is absent in order for his or her classmates not to forget about him.

Children with HIV/AIDS do not usually have Individual Education Plans (IEPs). They are usually monitored by the school nurse, who watches their development very closely. The school nurse could also help children with HIV/AIDS with any medication they may have to take at school. In order to make sure that children with HIV/AIDS are safe at all times, it is recommended that teachers:

  • Communicate frequently, or as frequently as possible, with the child’s parents;
  • Have a plan ready in case the child has to be rushed to the hospital;
  • Have a plan ready in case the child injures him or herself (especially if it is an open injury where blood is coming out of the child’s body);
  • Watch the child and report any change in his or her behavior to the school nurse or parents;
  • Inform the child’s classmates that the child may appear very tired at times (this should be mentioned very sensitively. Children need to understand why their classmates may not always be able to participate in certain activities with them).

Some children with HIV/AIDS may experience sadness because they may not be able to participate in certain types of sports. They may also experience sadness because they know that they have a serious disease that could kill them.  It is therefore very important that the child’s mental health be monitored, and that regular sessions with the school counselor be provided if and when they are needed. For children who experience serious levels of sadness, and perhaps depression, regular sessions with a clinical psychologist may be recommended.

Many children with HIV/AIDS grow up to become fully contributing members of society. Others pass away in their teens or early adulthood years. It is important to keep that in mind when working with a child who has HIV/AIDS.

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2.8. Children with Chronic Illness: Diabetes

Childrent with Chronic Illness: Diabetes

Children who are Chronically Ill

Parenting a child who is chronically ill can be very stressful for a family.  The family needs to deal with many medical appointments and financial costs are very high. The stress on family relationships may sometimes be too much. Each child and family is unique in how they deal with these stressors.

Children who Have Diabetes

Children with diabetes can be at a disadvantage in school, because they tend to be absent more often than other children. They sometimes perform less well academically than their peers because some of them miss many school days each year. Teachers can do the following to make sure that children with diabetes still feel that they belong in the classroom. The following can also help the classmates of children with diabetes feel that their peer is part of the classroom when he or she is not there physically:

  • Make outlines of class lessons and mail or email them to the family;
  • Write a “get well soon” card, get all the students to sign it, and send it to the family;
  • Periodically mention the child who is absent in order for his or her classmates not to forget about him or her.

Children with diabetes do not usually have Individual Education Plans (IEPs). The school nurse is usually involved in the child’s care and knows how and when to administer insulin (Fig. 1) (see ECI Glossary) (if needed) and what the signs of low or high blood sugar are.

Figure 1. Insulin

According to the BC Ministry of Education, children with diabetes are perfectly capable of fully participating in school activities and events. However, they:

  • May experience difficulty concentrating when their blood sugar level is either too high or too low;
  • May need to make frequent trips to the washroom;
  • May need to make frequent trips to the water fountain in order to get water;
  • May need to eat something before or after they engage in any physical activity.

Some children with diabetes will need to be monitored and extra help may be provided if the child needs it. Here are a few suggestions, adapted from the BC Ministry of Education:

  • Lines of communication should be kept open between the family and the school. Parents should update the school about any changes in their child’s condition;
  • An emergency plan should be put in place for what happens if the child suffers a medical setback;
  • Any change in the child’s behavior should be reported to the parents and perhaps to the school nurse;
  • The signs and symptoms of low and high blood sugar should be made known to those who work closely with the child;
  • Diabetes emergency kits should be made available;
  • “What to do in case of diabetes emergency” flyers should be posted throughout the school, while at the same time respecting the privacy of the child who has diabetes;
  • Classmates and other students should be made aware that they are not to share any of their food with the child who has diabetes, because he might be on a restricted diet.

Some children with diabetes may experience sadness because they may not be able to participate in certain types of sports or because they may be placed on a restricted diet. It is very important that the child’s mental health be monitored, and that regular session with the school counselor be provided, if and when they are needed.

To learn more about diabetes, please visit the birth to six section of this course.

Most children with diabetes grow up to become fully contributing members of society. They lead full and typical lives.

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2.9 Children with Mental Illness: Separation Anxiety Disorder

Separation Anxiety Disorder

Most school-aged children separate easily from their parents, especially when going to a familiar place like school. But for some children, separating from parents is very difficult. They worry when their parents are not around. The child is very worried about being separated from the parent, even when he or she is going to a familiar place, like school or grandma’s house. When the child’s worries become excessive and interfere in the child’s ability to lead a typical life, the child may get diagnosed with separation anxiety disorder.

Separation anxiety is quite common and typical in younger children. It becomes a problem in children who are over the age of 3 years. Many children find it difficult to separate from their parents but they still do well when the parent is not around. This is typical.

Other children worry excessively about being separated from their parents. When they separate from their parents, they usually engage in the following behaviors:

  • Temper tantrums (for example, having a tantrum for an hour);
  • Crying uncontrollably;
  • Clinging to the parent and refusing to let the parent go (for example, by clinging to the parent’s pants or leg (Fig. 1));
  • Getting distressed at the thought of being separated from the parent;
  • Worrying that if the parent leaves he or she may get hurt or die;
  • Refusing to leave the house;
  • Refusing to go to school;
  • Refusing to go to sleep for fear that the parent(s) is going to go away while the child sleeps;
  • Having a panic attack (see full Glossary);
  • Exhibiting the physical symptoms of anxiety;
  • Exhibiting the mental and emotional symptoms of anxiety;
  • May be insecurely attached to the parent.

a boy clinging to his mother

Figure 1. Clinging to his mother

Having separation anxiety disorder can seriously hurt a  child’s ability to have a happy childhood. That is because children who refuse to leave the house or separate from their parents may miss out on typical middle childhood activities:

  • Participating in after-school programs;
  • Engaging in leisure activities (such as taking a drawing or swimming class);
  • Engaging in sports activities (for example: soccer or basketball practice);
  • Hanging out with friends.

Children with separation anxiety disorder need help and support in the classroom. To help the child, the the classroom teacher can:

  • Make sure the child feels welcome in the classroom;
  • Allow the child to call the parent (how often a child is allowed to do so would be determined by the parent and teacher together, and would follow any recommendations the child’s psychotherapist may have (Fig. 2));
  • If the child has a cellular phone, allow him or her to text the parent (whether or not the child should be allowed to use a cellular phone and the frequency of text messaging should be determined by the parent and the teacher in consultation with the child’s therapist);
  • Allow the child to have a “security object.” This is something that belongs to the parent (like a watch or a necklace) and that may make the child feel safe. In younger children a common security object is a baby blanket;
  • Be patient with the child when he or she has anxiety symptoms (please see reference to physical and mental symptoms, above).

a girl on the phone

Figure 2. Phoning

Children who have separation anxiety disorder need psychotherapy. Children who receive good psychotherapy are able to overcome their separation anxiety and grow up to lead happy and healthy lives.

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2.9 Children with Mental Illness: Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD)

OCD is an anxiety-based disorder with two parts: obsession  and compulsion. Obsessions are unwelcome recurring thoughts and feelings that the child cannot get out of his or her head. This is the obsession. No matter how hard the child tries, he or she cannot get rid of these thoughts unless he or she performs a certain action, over and over again. This is the compulsion. For example, a girl keeps worrying that her father is going to get in a car accident while driving home from work. For some reason, the child feels that if she touches every wall in the house, the father will be safe. That is, the physical action of touching every wall in the house will save the father’s life and  get rid of the obsessive thought.

Most people with OCD understand that the obsessions and compulsions are not really related. For example, touching every wall in the house will not save the father’s life. But they do it anyway. Many adults with OCD say they fully understand their actions do not make any sense. But they still feel that they have to perform them. Ignoring the thoughts does not work. It leads to more anxiety, and this  leads to the compulsive behavior. OCD is a serious disorder. It  often hurts the child’s ability to lead a typical life. Imagine washing your hands 100 times or more before you leave the house. Imagine checking that you turned off the lights 100 times before you leave the house. Imagine not playing outside with your friends or classmates because you are afraid of getting germs.

The symptoms of OCD usually appear gradually but sometimes  they appear all of a sudden. OCD usually starts in the late teen to young adult years. However, more and more younger children (under ten years of age) are now being diagnosed with OCD.

There are many types (or themes, as they are called by psychiatrists) of obsessions and compulsions. Here are the most common types:

Obsessions:

  • Fear of germs and getting contaminated or dirty;
  • Fear related to safety: for example, fear of not turning off the oven, or not locking the door;
  • Fear of hurting someone (usually present in teenagers and adults).

Compulsions:

  • Washing one’s hands over and over;
  • Checking that the door is locked or the oven is off, 100 or 200 times;
  • Repeating certain actions over and over again: for example, touching every wall in the house, licking every flat surface in the house (even the dirty ones), walking on every tile in the bathroom or kitchen;
  • Keeping everything in a room orderly. That is, the child makes sure that every item in the room has a place and makes sure nothing gets moved from its place (Fig. 1);
  • Compulsions can also involve mental acts, such as praying, counting and repeating certain words over and over again.

Figure 1. Room in order

Children with OCD need a lot of help in the classroom. Many do not perform as well as they could in school and may have low-average IQ scores (see full Glossary). This  is because their OCD prevents them from focusing on their work. Instead of focusing on what the teacher is saying, the child focuses on the obsessions that are inside his or her head, and what actions they can perform to make these thoughts go away. To make the classroom experience as pleasant as possible for the child with OCD, the teacher can:

  • Make sure the child knows that he or she is safe and welcome in the classroom;
  • Let the child know that he or she will be allowed to act on certain compulsive behaviors if needed (this should be done in collaboration with the child’s therapist, please see below);
  • Let all children in the classroom know, as sensitively as possible, that this child may sometimes engage in certain behaviors, and that this is ok;
  • Give the child extra time for assignments, homework and tests if needed;
  • Plans ahead for outings and field trips and collaborate with the child’s therapist to make it possible for the child to participate in these activities.

OCD does not go away and its symptoms could get worse under stressful conditions. Although OCD cannot be cured, there is a lot that can be done to help the child deal with the obsessions and their accompanying compulsions. To learn more about OCD, please watch this short video, available from the Anxiety BC website.

Children with OCD need help that cannot be provided by a classroom teacher or school counselor. They need psychotherapy. How much  psycho-therapy the child needs will depend on his or her symptoms. For example, some children actually put sharp and dangerous objects in their mouths in order to stop the obsessive thoughts. If the child has dangerous symptoms like this therapy session will need to be frequent (possibly twice a week or more). If the child’s symptoms are not very severe, the child may get therapy sessions once a week or once every other week. The most common type of psycho-therapy is cognitive-behavioral therapy. The child is taught how to think differently and approach his or her compulsions from a more positive angle. At the same time, they are taught new ways to deal with unwelcome obsessive thoughts.

It is believed that one of the causes of OCD is an imbalance in certain neuro-transmitters (see full Glossary)  (in this case, serotonin) in the brain. This imbalance can sometimes be fixed with medication. If the child’s family chooses to place him or her on medication, here are a few things to consider:

  • What type of medication should my child take?
  • What dosage should my child get?
  • What are the side effects?
  • What are the risks?
  • Has this medication been tested on children my child’s age?

Although the obsessions and compulsions can be quite overwhelming, most people with OCD do lead happy and healthy lives. They (Fig. 2)  graduate from college, get jobs and have lots of friends and family who

Figure 2. A girl
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