Obsessive Compulsive Disorder

Overview

Obsessive Compulsive Disorder (OCD) is an anxiety based condition where recurrent and persistent thoughts, impulses, or images are experienced and where repetitive behaviours or mental acts (i.e. counting, repeating words silently) are performed. The thoughts or impulses are intrusive and inappropriate and cause anxiety and distress. They are not just excessive worries about real life problems. The compulsions are uncontrollable deliberate behaviours or thoughts that are done to rid the person of anxiety associated with conscious or unconscious thoughts.

Although people with OCD usually recognise their obsessions and compulsions, they mostly do not understand why they do it and are often embarrassed and try to hide the behaviours.

Therefore, OCD is not always recognisable. People with even obvious OCD behaviours will often try to cover these up with excuses. For example, people who are late to appointments due to time consuming behaviours may use excuses like, missed the bus or train, heavy traffic etc. Even when these excuses may be detrimental (i.e. are seen as poor excuses for being continually being late for work), the person would often rather people believe they are lazy, indecisive or undependable than have their secret known.

While OCD was once thought of as a rare condition, it is now known that it affects approximately one in forty people.

Examples of Obsessive Compulsive Disorder

Excessive checking and rechecking - e.g., going around the house to check that taps have been turned off or windows closed. This does not include standard checking. This can be done many times and the person may make a number of trips home a day to check again;
Excessive washing hands;
Excessive straightening and tidying;
Need to ritualise simple tasks, or undertaking tasks in certain orders e.g., having a shower, having a drink eating a biscuit before going to bed. While many people have night-time and other rituals, a person with OCD will not be able to settle unless the ritual is done exact enough. If the ritual is done out of order, or is interrupted, then they may need to start again until it is completed correctly;
Need to do certain tasks a particular number of times e.g., need to turn handle three times before opening the door, clap hands 4 times before having a drink, shaking the salt 2 times on a particular piece of food;
Picking skin or pulling hair;
Thinking the same thought or song over and over, counting etc.
There are limitless ways OCD manifests itself. However, the above are some of the more common examples.

The effects of the condition

The obsession or compulsion causes marked distress, are time consuming (take more than an hour a day), or significantly interfere with the persons normal routine, occupational or academic) functioning, or social activities and relationships. This can be mild (where no one else notices the behaviours, or the behaviours are seen as peculiarities of the person), through to being completely debilitating (where the person has extreme difficulty interacting with others or difficulty holding down jobs or completing study).

Appropriate Adjustments in the Tertiary Education Environment

As each student will have different needs, it is important to negotiate these needs on an individual basis. The following is a list of adjustments that may assist the student:

General

Make book and reading lists available prior to the commencement of lectures (preferably at least two weeks prior to the commencement of the semester);
Provide students with chapter outlines or study guides. These should also be available at least two weeks prior to the commencement of semester;
Where possible, provide any written work in electronic format - either in an accessible format on the web, or on disk. This allows the student to reproduce the material in alternative formats (i.e.. large print, alternative colour print and background, via screen readers).

Lecture / class room adjustments

Have print copies of overheads available for students prior to the commencement of lectures;
Repeat and rephrase important points;
Speak clearly and face the students whenever talking;
Always verbalise any points that are either written on the board or put up on overheads;
Use a microphone whenever the equipment is provided;
Tape lectures and place in the library for students to copy;
Have regular breaks in long lectures - this will assist to prevent 'information overload';
Avoid putting the student on the spot by targeting them for questions or reading aloud in class - unless the student has indicated their willingness to participate (i.e.. raised hand etc);
Be flexible in relation to what constitutes 'participation' in tutorials. High anxiety levels of the student may mean that they avoid participating in discussions;
Supply comprehensive lecture notes;
At the beginning of each lecture, outline the key points that will be raised in the lecture reintegrate these and at the conclusion of the lecture;
Try and make sure there is good lighting in the lecture theatre/class room. If possible adjust blinds to ensure their is no glare on the board or where overheads are being projected;
The student may need to leave class with little or no notice or turn up to class late. Allow this without drawing attention to the student;
The student may display some unusual behaviours. Again, allow this without drawing attention to the student. If the behaviours are disruptive, talk to the student privately and discuss the effects of the behaviour on class, there may be ways of accommodating these behaviours without them impacting on the class. (e.g. a student may tap their pen during class. Ask the student to bring along a piece of foam rubber so they can tap their pen on it, rather than the desk and therefore will cause less disturbance);
The key issue is to display acceptance and understanding and to work with the student to think of lateral and creative solutions to the problem.

Assignments

Be flexible with deadlines and extensions;
Provide clear feed back to the student both verbally and in writing;
Consider negotiation an individual learning program for the student. This can include:
- Flexible deadlines for assignments to take into account the effects of their disability and the requirements of other subjects;
- Alternative marking arrangements such as allowing the student to hand in a 'draft' for comment prior to submitting their final paper;
- Consider setting alternative assignments (of commensurate level) if the task set is something that triggers OCD behaviours.

Examinations

Allow extra time in formal exams, school based exams and class tests;
Allow the student to complete oral exams if requested;
Allow the student to use a PC;
The student may require natural or non-fluorescent lighting. They also may require their question and answer sheets to be on alternative coloured paper etc;
The student may require a reader and/or a scribe (amanuenses);
The student may need a private room;
Allow time for rest breaks;
Allow the student to take in food, drink and medication if required.

* Remember: Alternative Adjustments, is about providing the opportunity for equality, not the attainment of a particular outcome. A student with a disability is still required to present work that is of a recognised standard. Providing flexibility in the process of learning does not mean that the subject standards are lowered.

Obsessive Compulsive Disorder

Disability Support Services

Obsessive Compulsive Disorder

Overview

Examples of Obsessive Compulsive Disorder

The effects of the condition

Appropriate Adjustments in the Tertiary Education Environment

General

Lecture / class room adjustments

Assignments

Examinations

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