School and parent perspectives on symptomatology in pediatric obsessive-compulsive disorder (OCD)

Abstract

Obsessive-compulsive disorder (OCD)-affected youth face notable impairments in the school setting related to concentration, homework, certain subject material, and overall program completion. We aim to examine the relative perspectives of school personnel versus parents regarding the OCD-affected child's (a) executive function (EF) deficits via the teacher and parent behavior rating inventory of EF (BRIEF), (b) OCD-specific symptoms via the teacher report form (TRF) and child behavior checklist (CBCL), and (c) common childhood psychiatric disorder symptoms via the TRF and CBCL. Correlational analyses revealed significant concordance between respondent groups regarding EF deficits and common childhood psychiatric disorder symptoms (e.g. guilt, worries). Inter-rater agreement was less consistent regarding the presence of OCD-specific symptoms, with school personnel reporting lower rates overall. However, when considering OCD-specific and common childhood psychiatric disorder symptoms together, school personnel reported some youth above the OCD threshold despite parents reporting them below. Our findings highlight that having multiple informants who communicate their concerns with one another about students' impairing symptoms at school may help with earlier recognition of pediatric OCD and better long-term outcomes. Future research can explore optimal school-family communication strategies, specialized OCD training for school personnel, and direct disclosure of an OCD diagnosis by a family.